Combating the Novel Coronavirus (COVID-19): Week of July 11

MHA Covid-19 update

Michigan’s COVID-19 case numbers and hospitalizations have increased since early July with the onset of omicron variant BA.5. Here are the latest key statistics:

  • 875 hospitalizations with confirmed or suspected COVID-19, a 20% increase since July 1.
  • 23 pediatric hospitalizations with confirmed or suspected COVID-19.
  • 67.6% of all residents have at least one dose of vaccine.
  • 29.2% of kids aged 5-11 have now initiated vaccination.
  • Roughly 2% of kids aged 6 months-5 years have initiated vaccination since approval was granted in mid-June.

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.

Governor Signs COVID-19 Liability Legislation

Gov. Gretchen Whitmer recently signed several COVID-19 liability-related bills:

  • House Bill 5244 (Public Act 138 of 2022) amends Public Act 238 of 2020, which prohibits an employer from taking certain actions against an employee who does not report to work under circumstances related to COVID-19, to specify that the Act would not apply to a claim or cause of action that accrued after July 1, 2022. In addition, the bill will repeal PA 238 of 2020 effective July 1, 2023. HB 5244 was sponsored by Rep. Andrew Fink (R-Hillsdale).
  • House Bill 6128 (Public Act 140 of 2022) amends Section 85 of the Michigan Occupational Safety and Health Act to specify that certain conditions establishing immunity for employers whose employees were exposed to COVID-19 would not apply to an exposure that occurred after July 1, 2022. In addition, the bill would repeal Section 85 and Section 85a, which defines COVID-19 under the Act, effective July 1, 2023. HB 6128 was sponsored by Rep. Yousef Rabhi (D-Ann Arbor).
  • House Bill 6215 (Public Act 139 of 2022) amends the COVID-19 Response and Reopening Liability Assurance Act to specify that the Act, which provides immunity to a person that acts in compliance with certain federal, state and local orders related to COVID-19, would not apply to a claim or cause of action that accrued after July 1, 2022. In addition, the bill would repeal the Act effective July 1, 2023. House Bill 6215 was sponsored by Rep. Graham Filler (R-DeWitt).

Novavax Vaccine Gets FDA Authorization

The Food and Drug Administration (FDA) granted emergency use authorization to Novavax’s COVID-19 vaccine July 13. The vaccine is a two-dose series administered three weeks apart and uses a different, older vaccine technology than is used in the messenger RNA vaccines and Johnson & Johnson shot.

Novavax’s vaccine is authorized for people ages 18 and older as a primary series. It may be appealing to those adults who were hesitant to receive another brand of vaccine due to the components or development process.

In a trial of more than 26,000 adults, two doses of the Novavax COVID-19 vaccine were more than 90 percent effective at preventing symptomatic disease. For adults 65 and older, effectiveness was more than 78 percent. There were no serious side effects or safety concerns.

The Centers for Disease Control and Prevention (CDC) will next decide whether it will endorse the vaccine. The CDC Advisory Committee on Immunization Practices will meet July 19, though an agenda is not yet available.

The Biden administration recently announced that it had purchased 3.2 million doses of the Novavax vaccine. If the vaccine is recommended by the CDC, it will be made available at no cost to states, jurisdictions, federal pharmacy partners and federally qualified health centers. The MHA will keep members apprised of vaccine availability and ordering processes at the appropriate time. Members with questions may contact Ruthanne Sudderth at the MHA.

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).

Combating the Novel Coronavirus (COVID-19): Week of June 20

MHA Covid-19 update

MHA Covid-19 updateAs of June 22, there were 714 adults and 27 children in Michigan with confirmed or suspected cases of COVID-19, with new cases averaging 1,780 per day the previous week. Over 100 hospitalized adults were being cared for in intensive care units. According to the state’s vaccine tracker, 67.4% of Michigan residents had received at least one dose of a COVID-19 vaccine as of June 22.

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.

Children Ages Six Months Through Five Years Eligible for COVID-19 Vaccine

The Michigan Department of Health and Human Services (MDHHS) announced June 21 that all Michiganders ages six months and up are now eligible for a COVID-19 vaccine. The pediatric vaccine, which received emergency use authorization for this age group from the Food and Drug Administration, was recommended by the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices June 18. The MHA released a media statement following the CDC recommendation, which makes 500,000 more Michigan children eligible for vaccination.

The MDHHS is recommending providers begin vaccinating children ages six months and older as soon as possible. The Moderna series is two doses given 28 days apart for ages six months through five years. For children six months of age through four years, the Pfizer series is three doses, with the first two given three weeks apart and the third dose administered at least eight weeks after the second dose. For ages five and older, the Pfizer series is two doses given 21 days apart.

In addition, the CDC has issued important updates to the Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States. The MDHHS has provided an outline of the updates. The updates are outlined in the attached communication from MDHHS.

Questions about COVID-19 vaccines should be directed to Ruthanne Sudderth at the MHA.

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).

Combating the Novel Coronavirus (COVID-19): Week of June 21

MHA Covid-19 update

The COVID-19 vaccines appear to be effective in protecting against serious illness from the more contagious delta variant of the virus. However, the variant continues to infect many in regions throughout the world, with news reports of renewed lockdowns in Australia and New Zeeland and increasing numbers of cases in U.S. states including Missouri, California, Florida and Texas, where fewer residents are vaccinated. Meanwhile, Michigan’s vaccine dashboard shows more than 61% of residents ages 16 and older have received at least one dose of a COVID-19 vaccine, with nearly 9 million doses administered.

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.

Emergency Orders Rescinded Effective June 22

Several emergency public health orders that have been in place for much of the last 15 months are rescinded as of 12:01 a.m. June 22. The orders rescinded and the dates on which they took effect are:

  1. Gatherings and Face Mask Order (June 1, 2021)
  2. Temporary Restrictions for Entry into Congregate Care and Juvenile Justice Facilities (Oct. 29, 2020)
  3. Mandatory Testing for Michigan Department of Health and Human Services’ Juvenile Justice Facility Staff (Sept. 18, 2020)
  4. Mandatory Testing for Michigan Department of Health and Human Services Hospitals and Centers Staff (Sept. 14, 2020)
  5. Exceptions to Temporary Restrictions on Entry into Congregate Care and Juvenile Justice Facilities (June 29, 2020)
  6. Exceptions to Temporary Restrictions on Entry into Certain Facilities (June 3, 2020)
  7. Safe Housing for Housing Unstable Individuals (May 12, 2020)
  8. Handling of Bodily Remains (May 4, 2020)
  9. Safe Housing for Michigan Homeless (April 28, 2020)

While the rescission of the facemask and hospital visitor restrictions would seemingly allow hospitals to stop screening visitors and make their own determinations about masking, the Michigan Occupational Safety and Health Administration (MIOSHA) announced new rules June 22 that essentially defer to the OSHA at the federal level. The OSHA rules currently in place still require healthcare facilities to screen visitors and require masks for employees. However, some exceptions are outlined by the OSHA for well-defined areas where employees are fully vaccinated; a flowchart on the OSHA website provides details. The OSHA also refers healthcare facilities to Centers for Disease Control and Prevention recommendations that continue to urge mask requirements for visitors. The MHA is reviewing the OSHA complete set of rules.

Because the MIOSHA adopted the OSHA rules by reference, the OSHA effective and compliance dates apply. The OSHA COVID-19 Emergency Temporary Standard (ETS) is effective June 21, 2021. The compliance date for the ETS is July 6, 2021, with a few exceptions. Compliance with paragraphs (i) Physical Barriers, (k) Ventilation, and (n) Training is required by July 21, 2021.

As an interim final rule, the new OSHA standard is open for comment. The MHA will submit comments on behalf of its members after a more thorough review of the rule, and members are encouraged to share content for the MHA comment letter with Laura Appel. The MHA will continue to advocate with the MIOSHA for consistency in state and federal rules for healthcare settings and keep members apprised of any developments on this issue. Members with questions may contact Adam Carlson at the MHA.

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 Michigan Department of Health and Human Services Community Health Emergency Coordination Center (CHECC).

Combating the Novel Coronavirus (COVID-19): Weeks of Nov. 23 and Nov. 30

MHA Covid-19 update

04COVID-19 patients continued to fill Michigan hospitals throughout the Thanksgiving holiday and into December, while drug companies Pfizer and Moderna applied for emergency authorization of their respective COVID-19 vaccines from the Food and Drug Administration (see related article). The MHA keeps members apprised of pandemic-related developments affecting hospitals through email updates and the MHA Coronavirus webpage. Important updates are outlined below.

Nursing Home Application Deadline Extended; CRC Bulletin Issued

The state announced Nov. 30 that it is extending the deadline from Dec. 1 to Dec. 15 for long-term care (LTC) facilities to become care and recovery centers (CRCs) and COVID relief (CR) facilities. The MHA has advocated for this extension to ensure LTCs do not transfer residents to hospitals without medical indication simply to avoid being out of compliance with new law requirements. While this is a positive step, the MHA will continue to advocate for more permanent solutions to transfer issues and the number of LTCs approved as CRCs and CR facilities.

The MDHHS also issued a bulletin for hospital-based CRCs. Bulletin Number MSA 20-78 supplements Bulletin Number MSA 20-73, which established operational requirements for nursing facilities to operate as CRCs during times of a public health emergency and provides a pathway for Michigan hospitals to establish hospital-based CRCs to support the safe care and isolation of COVID-19-positive individuals. Details about requirements for hospitals seeking designation as a CRC, how to apply and more are available in the bulletin.

Quarantine Duration Requirements Addressed

The MHA hosted its weekly call of hospital/health system chief medical officers Dec. 4, which was joined by representatives of the MDHHS. Among the topics discussed was quarantine requirements and the new guidance from the Centers for Disease Control and Prevention (CDC) advising the public that shorter quarantine periods of 7-10 days may be acceptable, depending on their access to testing and their symptoms or lack thereof.

According to Public Act 238 of 2020, healthcare workers who are exposed to COVID-19 but test negative and are not symptomatic are still able to report to work. Employees’ quarantine needs apply to how they spend time outside of work. There remains in state statute a 14-day quarantine provision for employees who test positive for COVID-19. The MHA is working with state officials and legislators to amend Public Act 238 of 2020 to bring quarantine times for employees who test positive in line with the CDC guidance. Additional information on the statute and administration rules is available from the Michigan Occupational Safety and Health Administration (MIOSHA), as discussed below.

Healthcare facilities and professionals may get questions from patients/community members on this change in quarantine guidance. The state announced its recommendation that the public continue to use the 14-day quarantine as a best practice, but if that is not feasible, the 10-day recommendation should be followed. The state did not endorse a seven-day quarantine with a negative test as a safe alternative.

MIOSHA Emergency Rules Clarified

The MHA hosted a call Dec. 1 with representatives from MIOSHA regarding its emergency rules that, among other items, emphasize the use of a remote workforce and proper use of personal protective equipment.

MIOSHA provided an overview of the rule set and answered questions, emphasizing the agency’s reliance on CDC guidelines in developing the rules and the availability of the free MI Symptoms app to assist employers. Questions or requests for the meeting materials should be directed to Adam Carlson at the MHA.

New Uses of Surge Capacity Beds May Require Certificate of Need Approval

Temporarily licensed surge capacity beds that have already been approved by the Bureau of Community and Health Systems (BCHS) may continue to be used if the following criteria are met:

  • An originally required emergency certificate of need (CON) approved by the MDHHS remains in effect.
  • The facility has maintained the BCHS-approved surge capacity so that it can be used within 48 hours if needed.
  • The facility has not notified the BCHS since the original approval that it has voluntarily surrendered the surge capacity.

If facilities with existing BCHS-approved surge capacity beds want to operate these beds in a different location, manner or use than originally requested, they must contact the MDHHS CON program, as applicable, and the Michigan Department of Licensing and Regulatory Affairs (LARA) State Licensing Section to determine whether new approval is required. Such requests must include a detailed narrative description of the proposed new use, space and floor plans of the area showing the new bed locations. If the proposed space deviates from current BCHS physical plant regulatory requirements, such as minimum square footage, hand sink locations or number of patients/residents to a room, the facility must include a narrative description of how those issues will be addressed to ensure patient/resident safety and care needs.

If the state has questions or concerns on a proposal as submitted, the Health Facilities Engineering Section engineer assigned to the facility will follow up as needed to address those concerns.

All applications not previously approved must apply to both the MDHHS and LARA as applicable and required. Both BCHS-HFD and Appendix E forms are required when applying. Members with questions may contact Paige Fults at the MHA.

BCBSM Provides Update on Coverage for COVID-19 Care and Testing

Blue Cross Blue Shield of Michigan (BCBSM) recently announced that it will continue to waive cost-sharing for its members diagnosed and treated for COVID-19 through March 31, 2021. This extension of a temporary benefit, originally set to expire Dec. 31, means members will not pay out-of-pocket costs — copays, deductibles or coinsurance — for the medical care and pharmacy costs associated with COVID-19. Members with feedback or questions are encouraged to contact Jason Jorkasky at the MHA.

Judge Denies Injunction for Bars, Restaurants Ordered Closed by MDHHS

A federal judge Dec. 2 denied a motion for preliminary injunction seeking to end the temporary MDHHS-ordered closure of bars and restaurants intended to prevent further spread of COVID-19. The MHA submitted an amicus or “friend of the court” brief in support of the temporary emergency measures enacted by the MDHHS. The MHA also issued a media statement supporting the order, which is effective from Nov. 18 through Dec. 8.

The ruling on Michigan Restaurant and Lodging Association v. Gordon was issued by Judge Paul Maloney of the U.S. District Court for the Western District of Michigan. It states that the motion was not granted to plaintiffs because it found the MDHHS’ reasoning for the order convincing and that groups tend to linger more in those settings than transitional environments like a food court or airport dining area.

Maloney further stated that, because the Michigan courts have not yet had an opportunity to evaluate the state issues and these challenges must be adjudicated before the federal claims can be considered, he scheduled a Dec. 17 certification hearing and will accept briefs from the parties to determine which legal questions to pass on to the state courts for further consideration. The MHA’s brief in support of the MDHHS provided medical evidence of the effectiveness of face covering and social distancing in curbing the spread of infection and reducing strain on the healthcare system. There are several other legal challenges in federal and state court against state and local public health orders requiring face coverings, social distancing measures and cooperation with contact tracing. Members with questions about the ruling may contact Amy Barkholz at the MHA.

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). Members with MHA-specific questions should contact the following MHA staff members: