Combating the Novel Coronavirus (COVID-19): Week of April 19

MHA Covid-19 update

Michigan continues to make good progress vaccinating our adult eligible population as Michigan exceeded over six million COVID-19 vaccine doses administered April 16, displaying significant progress in Michigan’s effort to achieve the goal of vaccinating at least 70% of Michigan adults. The MHA continues to keep members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

MDHHS Issues Multiple Vaccine-Related Alerts

The Michigan Department of Health and Human Services (MDHHS) issued multiple vaccine-related provider communications in the past week.

  • Vaccine Administration Error Guidance: The MDHHS sent providers several resources and reminders about how to proceed when questions arise about restarting the vaccine process if the second dose timeframe is missed and more. In short, providers should not “start the vaccine process over” with an additional first dose if the second dose timeframe is missed. Please reference guidance from the Centers for Disease Control and Prevention (CDC) for instructions on this and other administration error issues.
  • Bamlanivimab FDA EUA Revoked: The U.S. Food and Drug Administration (FDA) revoked April 16 the emergency use authorization (EUA) for bamlanivimab, when administered alone, to be used for the treatment of mild-to-moderate COVID-19 in adults and certain pediatric patients who are at high risk of disease progression or hospitalization. MDHHS stated that REGEN-COV as well as bamlanivimab and etesevimab (administered together) continue to be available under EUA.

Sites that are administering monoclonal antibodies can order bamlanivimab and etesevimab, etesevimab to pair with the current supply of bamlanivimab that the site has available, or REGEN-COV from the authorized distributer using the direct ordering process. The MDHHS continues to encourage all providers to consider offering antibody treatments to prevent severe COVID/COVID hospitalizations and is working on additional offerings to assist providers in this effort.

Additional Vaccine Updates

  • State leadership reported to the MHA a slight improvement in Michigan’s vaccination speed, but a desire to continue to lessen vaccine supply on hand to ensure resources from federal partners remain in place. As of April 23:
    • 2.7 million Michiganders, or 33% of the eligible population, have received complete schedules of COVID-19 vaccines either through two doses of an mRNA vaccine or one Johnson & Johnson dose.
    • 6.3 million doses have been administered in total.
    • 3.8 million people have initiated vaccination, or 47% of the eligible population.
    • 65% of people 65 and older are now fully vaccinated.
       
  • Hospitals and health systems are encouraged to consider working with local employers, local industries such as hospitality businesses, or local colleges/universities to offer specific clinics to employees or students of those organizations. Because some employers’ work or shift hours can be irregular, partnering with them to offer clinics at times when their employees are available could improve access for those individuals. The MHA will continue to pursue conversations with the trade groups representing such stakeholders to identify any opportunities for statewide or regional coordination.

There is also still a need for increased vaccine access for homebound individuals. As a reminder for any clinic offering, many local transit authorities around the state have offered free rides to vaccine clinics for individuals in need of transportation. If you’d like to arrange transportation to your clinics, please contact your local transit authority.

  • The state announced it is seeking vendors to execute mobile vaccinations. Awards will be based on the ability to provide services to one or more of the six site types and multiple awards may be issued. Contractors will also be responsible for rapid response to provide vaccinations (and potentially testing) at locations and community locations when COVID-19 outbreaks occur. Members that may be interested in this contract should review the full announcement for other details about expectations, and be aware that bids are due Wednesday, May 12 by 3 p.m. RFP No. 210000001690 is posted on the SIGMA Vendor Self-Service at Michigan.gov/SIGMAVSS.
    • On a related note, the state shared some entities in Michigan are using their Meals on Wheels operations via their Area Agency on Aging to deliver vaccinations out in the community and/or to homebound individuals. Members are encouraged to consider these partners if they haven’t already and have capacity to do so.
       
  • Pfizer continues to work on smaller quantity packages of their vaccine, to allow smaller provider settings to use their product without risk of waste or storage issues. Those smaller quantities are not yet available; we will keep members apprised of any updates.

Members with vaccine questions may contact Ruthanne Sudderth at the MHA.

Care and Recovery Centers Remain Available for Patients

Hospitals are reminded that the MDHHS has established Care and Recovery Centers (CRC) to care for confirmed COVID-19 positive patients discharging from a hospital requiring isolation until Transmission-Based Precautions are discontinued. Currently, the MDHHS has 14 designated nursing facilities with approximately 300 beds across the state serving as CRCs. Within each CRC exists a designated unit to properly isolate and care for confirmed COVID-19 positive individuals. Hospitals are encouraged to coordinate with CRCs as part of their discharge planning process of confirmed COVID-19 positive hospital patients. Patients admitted directly from the hospital do not need to meet MDHHS Nursing Facility Level of Care. Members with questions may contact Kelsey Ostergren.

mAb Webinar Recap and Recording

The MHA and MDHHS this morning hosted a webinar for health system and hospital leaders to learn more about the overall benefits of, and operational considerations for, increasing the administration of monoclonal antibody therapies for eligible COVID-19 patients.

 The webinar highlighted what resources, time, space and support is needed to administer mAb treatment and what the state has in place to assist. Earlier this week, the MDHHS issued an alert on the Michigan Health Alert Network to hospitals and health systems that included the following resources. The MDHHS has set a goal of at least 50% of people who are eligible to receive mAb therapy receive the treatment within 10 days of symptom onset.

  • A memo from MDHHS Chief Medical Executive Joneigh Khaldun, MD, encouraging hospitals and health systems to increase use of mAb treatment to prevent hospitalizations/death from COVID-19;
  • A summary of current recommendations;
  • FAQs for clinicians;
  • A summary of current evidence;
  • And considerations for hospitals.

A recording of the webinar can be found online. Members with questions may contact Laura Appel.

Additional information on the COVID-19 pandemic is available to members on the MHA Community Site and the MHA COVID-19 webpage. Questions on COVID-19 and infectious disease response strategies may be directed to the MDHHS Community Health Emergency Coordination Center (CHECC).