Notes from ME DHHS Medical Directors Call 1/4/2022Below are remarks and resources shared during the 1/4/22 Medical Director's call with the ME CDC and DHHS, as well as the Q&A's that were discussed on the call:
- From Carrie Rice on infection prevention resources:
- US CDC Strategies to Mitigate Staff Shortages: https://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-shortages.html
- ME CDC: Healthcare Acquired Infection (HAI) resources: https://www.maine.gov/dhhs/mecdc/infectious-disease/hai/resources.shtml
- From William.Montejo :
- Wanted to make everyone aware that CMS released QSO-22-07 last week (Omnibus COVID-19 Health Care Staff Vaccination interim final rule): https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/guidance-interim-final-rule-medicare-and-medicaid-programs-omnibus-covid-19-health-care-staff-0
- From Lynn.Hadyniak
- Note QSO 20-39 from Nov 2021 on facility visitation: https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf
- Also, there is a visitor FAQ that was added to the bottom of QSO-30-39 (https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf) that speaks to facilities using good judgment about visitation
Q: It was my understanding a person who tested positive for COVID could continue to test positive for up to 90 days. Is this still accurate?
A: Yes, on PCR testing (not rapid Ag testing)
Q: Would you recommend pooled testing for staff regardless of vaccination status?
A: Yes - even those who are vaccinated are susceptible, particularly to the omicron variant
Q: I have reviewed the HCW Exposure Guidance decision tree. If asymptomatic High Risk Exposure for HCW, it says to test immediately. Should this test be a PCR or is an antigen test OK?
A: Either an antigen test or Nucleic Acid Amplification Tests (NAAT) such as PCR can be used. Some people may be beyond the period of expected infectiousness but remain NAAT positive for an extended period. Antigen tests typically have a more rapid turnaround time but are often less sensitive than NAAT. Antigen testing is preferred for symptomatic HCP and for asymptomatic HCP who have recovered from SARS-CoV-2 infection in the prior 90 days.
Q: Is anyone using antigen testing on residents to release them from quarantine?
A: Testing should not be used to shorten quarantine
Q: Can we NOT do PCR confirmation of an antigen test?
A: PCR testing is not routinely needed to confirm a positive antigen test, particularly if the individual is symptomatic and/or is a known close contact of someone with acute COVID infection
Q: If a person has been positive in the past 90 days and is now symptomatic- do you recommend PCR and NOT antigen?
A: PCR testing is always preferred when available
Q: Would you treat an exposed (but test negative) roommate with COVID antivirals or monoclonals?
A: COVID antivirals (i.e. Paxlovid & molnupiravir) can only be used for symptomatic patients, and not for COVID post-exposure prophlyaxis (PEP). Some monoclonals can be used for PEP (REGEN-COV & bam-ete), but that is changing as use of those two monoclonals is not recommended for PEP or COVID treatment once we are at >80% omicron prevalence in the state.
Q: What labs, if any, should be checked prior to administration of oral antivirals?
A: Providers should consult the FDA EUA Provider Health Care Fact Sheets for specifics on use these new medications: Paxlovid Provider Fact Sheet and Molnupiravir Provider Fact Sheet
Q: Is there any guidance regarding getting a booster if you have had a possible exposure to COVID?
A: US CDC advises that all adults get a COVID booster as soon as possible; the only time not to get a booster is while an individual is acutely infected with COVID and in their isolation period (and that is primarily to protect others around them from being exposed).
Q: What pharmacies are carrying the COVID antivirals?
A: The state is distributing its very limited supplies of Paxlovid & molnupiravir at a subset of Walmart & Hannaford pharmacies. You can search Walmart website to find store nearest you that is carrying oral anti-virals: https://www.walmart.com/cp/2766660
Q: At this time are we able to follow Federal CDC guidance and have an employee who tests positive for COVID return to work after 7 days rather than 10 if we obtain a negative test and other symptoms have improved and no fever within 24 hours?
A: The new updated guidance for Healthcare workers can be followed, the tools referenced on the HAI website reflect these changes. Take a look here: https://www.maine.gov/dhhs/mecdc/infectious-disease/hai/resources.shtml
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