Combating the Novel Coronavirus (COVID-19): Week of May 10

MHA Covid-19 update

MHA COVID-19 UpdateAs the spring surge of COVID-19 cases continues to recede in Michigan, the state has surpassed the 55% mark in adults ages 16 and older receiving at least one dose of the vaccine to prevent the disease. In addition, the Michigan Department of Health and Human Services (MDHHS) has launched its “Vacc to Normal” tracker that reports both state and federal data on vaccination rates, providing markers for reopening the state’s economy.

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.

Press Conference Urges Youth Vaccinations

The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) voted late May 12 to recommend use of the Pfizer COVID-19 vaccine in children ages 12 to 15. The MDHHS and the Protect Michigan Commission, with assistance from the MHA, held a press conference May 13 promoting this expansion of eligibility and urging parents to get their kids vaccinated as quickly as possible.

Because research has shown that children are more likely to get vaccinated if their parents are vaccinated, the MHA encourages members to begin their outreach on the vaccine eligibility of this age group with adults already vaccinated by their hospitals/health systems.

Pfizer’s studies have proved its vaccine is safe and effective for 12- to 15-year-olds, for whom it is 100% effective in preventing COVID-19. In addition, the CDC announced that COVID-19 vaccines may now be given in conjunction with other vaccines. It was previously recommended that two weeks pass between getting a COVID-19 vaccine and any other inoculation. With this change, providers are encouraged to offer other recommended immunizations when administering COVID-19 vaccine to young teens to help offset the decreased rate of childhood vaccinations during the pandemic.

The MDHHS is also urging all primary care physicians (PCPs), especially pediatricians, to enroll as COVID-19 vaccine program participants to ensure all families with a PCP can access the vaccine. Hospitals that wish to transfer vaccine to any primary care office settings must verify the office setting is enrolled and has a redistribution agreement in place to ensure the vaccine supply is tracked appropriately.

The state’s Vacc to Normal economic reopening plan will not include the numbers of vaccinated 12- to 15-year-olds toward easing public health measures and gathering capacity limits, as the plan ties vaccination rates of adults 16 and older to those events. The newly eligible age group, which comprises approximately 498,000 kids in Michigan, will be included in the regular data tracking on the state’s vaccine dashboard. On May 10, Michigan reached the milestone of 55% of adults having at least initiated vaccination, which will allow office workers to return to their places of employment May 24.

Vaccine Now to Be Ordered via Michigan Care Improvement Registry

The MDHHS has announced a change in the way COVID-19 vaccines are allocated. Providers must now electronically request their desired doses through the Michigan Care Improvement Registry (MCIR), including both first and second doses. Orders will not be automatically approved; local health departments (LHDs) will review requests and approve allocations accordingly. Providers should ensure they are following LHD guidance prior to placing an order in MCIR.

Providers should plan operationally to order second doses within the MDHHS MCIR order timing recommendations to ensure they arrive before patients’ second dose appointments. The MDHHS has provided a tip sheet on how to place orders; a recording and slides from a May 11 webinar detailing the process; and additional ordering information and resources on its website. It will add other materials as they are created throughout the transition.

The state has also received an allocation of the Moderna vaccine in the new 14-dose (maximum 15-dose) vials. Both the 10- and 14-dose vials may be ordered via MCIR.

Comprehensive resources for COVID-19 vaccination efforts are available on the MDHHS COVID-19 Vaccine Provider Guidance webpage. Members with vaccine questions may contact Ruthanne Sudderth at the MHA.

CDC Updates Guidance, Michigan Lifts Mask Requirement for Fully Vaccinated Individuals

CDC Director Rochelle Walensky, MD, announced May 13 revised guidance allowing fully vaccinated individuals to participate in any indoor or outdoor activity without masks. Walensky cited several factors that influenced the decision, including published literature on the safety of the COVID-19 vaccine and its effectiveness on the original virus and its variants circulating in the United States; the low risk of transmission from vaccinated individuals; and universal access to vaccines. The recommendations specifically apply to individuals in nonhealthcare settings. The CDC stated that healthcare settings can continue infectious disease practices that require masks within their facilities.

The following day, Gov. Gretchen Whitmer announced the MDHHS would update its Gathering and Mask Order to align with the updated CDC guidance, effective May 15. Under the updated order, Michiganders who are outdoors will no longer need to wear a mask regardless of vaccination status. Residents who have not completed their vaccinations must continue to wear a mask or face covering indoors to protect themselves and others. After July 1, the broad indoor mask mandate will expire.

While the MDHHS order has been updated, the Michigan Occupational Safety and Health Administration (MIOSHA) emergency rules for workplace safety remain in effect. Among other things, the rules stipulate screening and tracking of visitors and employees, mask wearing and other social distancing measures. The MHA has been in contact with the MIOSHA and expects the emergency rules to be significantly revised in the coming days (see below).

Process to Approve MIOSHA Permanent COVID-19 Workplace Rules Continues

The MIOSHA continues to pursue permanent workplace COVID-19 rules, even though Michigan is making progress vaccinating eligible residents. Because the state recently reached the 55% vaccination benchmark in the governor’s MI Vacc to Normal plan, in-person work will no longer be prohibited where it is feasible for the employee to work remotely, beginning May 24. All other workplace regulations that govern the use of personal protective equipment, physical distancing, contact tracing and other pandemic-related modifications would be required under the rules.

The MHA submitted comments to the MIOSHA expressing disagreement with the proposed permanent COVID-19 rules as written, because they fail to address concerns on cementing rules into the administrative code that do not reflect the rapidly changing environment related to the pandemic. The MHA recommended the rules be updated to address, at a minimum, two main concerns:

  1. Any new standard should be promulgated in a manner that would allow future updates, based on current CDC guidance, to be made automatically.
  2. A sunset clause for the rules to expire after the MDHHS declaration of emergency has ended.

The MIOSHA will host a public hearing at 9 a.m. May 26.

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).