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April 2022


Hello and Welcome!

This is the first of many newsletters from the Whatcom County Health Department Communicable Disease Program! We know that your time is valuable, we will try to keep these newsletters quick and short while trying to hit the main points.

Topics:

  • Second Booster Dose Recommended for Certain Individuals
  • COVID Therapeutics 
  • Respirator Fit Testing
  • COVID Testing Plan
  • Gastroenteritis 

Second Booster Dose Recommended for Certain Individuals

The WA DOH updated its booster dose recommendations following guidance from the US FDA, CDC, and the Western States Scientific Safety Review Workgroup.

DOH’s updated booster dose recommendations are as follows:


  • Everyone 50 and older can receive a second booster dose four months after receiving their first booster dose.

  • Everyone 12 and older should receive a booster dose five months after completing their two-dose vaccine series of Pfizer or Moderna, or two months after receiving the single-shot Johnson & Johnson (J&J) vaccine.

  • Individuals 12 and older who are moderately or severely immunocompromised can receive a second booster dose four months after receiving their first booster dose.

  • Those 18 and older who received a primary vaccine and booster dose of the J&J vaccine four months ago can receive a second booster dose of an mRNA COVID-19 vaccine.

COVID Therapeutics 

side by side

Side-by-side overview

Click here for a side-by-side overview of Therapeutics Authorized or Approved for the Prevention of COVID-19 Infection or Treatment of Mild-Moderate COVID-19 

locate

Therapeutic Distribution Locator

Click here to search for COVID Therapeutics that are available locally. 
The therapeutics locator is intended for provider use. Patients should not contact locations directly unless instructed to do so by their healthcare provider.  

Evusheld

Evusheld (tixagevimab co-packaged with cilgavimab) is a monoclonal antibody treatment that is used for pre-exposure prophylaxis for the prevention of COVID-19 in adults and children (12 years and older) before infection with COVID-19. At present, those eligible to receive Evusheld include people:

  • Who have moderate to severe immune compromise due to a medical condition or have received immunosuppressive medicines or treatments and may not mount an adequate immune response to COVID-19 vaccination; OR
  • For whom vaccination with any available COVID-19 vaccine is not recommended due to a history of severe adverse reactions (such as severe allergic reaction) to a COVID-19 vaccine(s) or COVID-19 vaccine ingredient(s).

Individuals interested in this treatment should talk to their health care provider to determine if they are eligible for Evusheld. If they are, they can work with their providers to find a facility where they can receive the injection.  

Fact sheet. 
https://www.fda.gov/media/154702/download

Respirator Fit Testing

  • LNI Requirement – annual fit testing.  For tight-fitting respirators, L&I began enforcing the requirement of annual fit testing on January 1, 2022 (see DOSH Directive 11.80). This means, for example, if your employees were fit tested on 11/1/2020, they will need to be fit tested again before 11/1/2021. If they are not, your facility may be cited January 1, 2022 for not providing annual fit testing. For questions, email [email protected].

  • Respirator Rule, WAC 296-842: https://apps.leg.wa.gov/wac/default.aspx?cite=296-842

  • Train the Trainer fit testing with DOH - If you have signed up for fit testing in 2021 and have not yet gotten your fit testing done, please contact [email protected].

  • DOH will cover the cost of medical evaluations for a limited time (slated to end in June at this time). To enroll your employees in no-cost online respirator medical evaluations, please send the following information to [email protected]

  • For more info visit : Respiratory Protection Program for Long-Term Care Facilities | Washington State Department of Health.

COVID Testing

  • DOH/CMS Testing requirement - https://doh.wa.gov/sites/default/files/2022-02/420-334-TestingLongTermCareFacilities.pdf?uid=6247650977c1c

  • Testing supply funding for DOH is slanted to run out July 1st. WCHD receives their antigen supply from DOH. After July 1st facilities will need to manage their own supply sources.

  • If your plan is to test through WCHD or get supplies from WCHD this may no longer be a viable option. WCHD is not able to do onsite testing for LTCFs and will likely not able to continue to provide supplies due to federal funding slanted to run out by July 1st. 

Antigen Testing Supplies

If your organization is in need of COVID-19 antigen tests, please fill out this inquiry form and we’ll fulfill your request based on available supplies. Please note, this is for  facilities  within Whatcom County.

Gastroenteritis

Gastroenteritis (norovirus, "Stomach bug") outbreaks have been noted in the community. Here are some quick facts.

Incubation period: 12 to 48 hours (median approx. 33 hours)
Period of communicability: Varies but in general from onset of symptoms until 72 hours after symptom resolution (communicability can be prolonged in immunocompromised individuals)
Symptoms: Acute onset of nausea, vomiting, diarrhea, abdominal cramping, fatigue and low grade fever. (Acute diarrhea is defined as the abrupt onset of 3 or more loose stools per day and lasts no longer than 14 days)
Treatment: Supportive, watch for signs and symptoms of dehydration and treat dehydration appropriately
Lab testing: RT-PCR from stool. In the absence of clinical laboratory diagnostics or in the case of delay in obtaining laboratory results, use Kaplan’s clinical and epidemiologic criteria to identify a norovirus gastroenteritis outbreak.
Kaplan’s Criteria
      1. Vomiting in more than half of symptomatic cases and,
      2. Mean (or median) incubation period of 24 to 48 hours and,
      3. Mean (or median) duration of illness of 12 to 60 hours and,
      4. No bacterial pathogen isolated in stool culture
Not all of norovirus outbreaks meet these criteria, if the criteria are not met, it does not mean that outbreak was not caused by norovirus. Testing should be done to determine the cause of illness.
Immunity: Short term after infection, no vaccination available
Report to Public Health: Within one day of two or more similar illnesses resulting from a common exposure that is either suspected or laboratory-confirmed to be caused by norovirus.

Key points to remember during an outbreak:

  1. Rapid identification and isolation of suspected cases. Ill residents should be placed on enteric isolation precautions.

  2. Increased adherence to hand hygiene particularly the use of soap and water after contact with symptomatic patients

  3. Designate staff to care for ill residents and minimize staff movement between areas in the facility with illness and areas not affected by the outbreak. Consider setting up a separate break room for staff caring for ill residents.

  4. Enhanced environmental cleaning and disinfection using EPA approved disinfectants for norovirus.

  5. Cancel group activities and consider serving all meals to residents in their rooms if the outbreak is widespread.

  6. Only essential kitchen staff should be allowed in the kitchen area. If reasonable, kitchen staff should have a designated bathroom during norovirus outbreaks.

  7. Exclude ill staff until their symptoms have been resolved for at least 48 hours.

  8. Place signs around facility indicating that an outbreak is occurring. Limit visitation and exclude anyone with Noro-like illness from visiting the facility.

 

Check out the Norovirus Outbreak Control Checklist for Health and Long-Term Care Facilities from the Washington State Department of Health. 

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Contact Information

Whatcom County Health Department
1500 N State St., Ste 100
Bellingham, WA 98225

Email: [email protected]

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311 Grand Ave. Bellingham, WA 98225

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