June 2022

Topics: 

• Guidance Updates
• Quarantine/Isolation
• COVID-19 Testing Requirements
• COVID-19 Rebound after Paxlovid
• DOH Question of the Week

Guidance Updates

Vaccine Update

Recently, CDC changed their definition of “up-to-date” to include all eligible vaccine shots. Individuals who are over 50 or immunocompromised and 4 months since their last booster would need a 2^nd booster to be considered up-to-date. This has implications for quarantine vs no quarantine if a resident is exposed to COVID, quarantine for new admissions, AGP guidance, and CMS required routine staff testing for SNFs. DOH definition of up-to-date is based off of the CDC, so this change is in effect.

WA DOH Recommendations for Healthcare Facilities

Quarantine/Isolation

Residents

Staff

COVID Testing Reporting Requirements 

If you are CLIA waived facility conducting antigen tests or point of care (POC) testing on your staff or residents you are required to report positive results because of Washington law:

• Washington Administrative Code WAC 246-101 requires laboratories to report COVID-19 results to public health within 24 hours of the test. This reporting requirement applies to all facilities using POC or rapid diagnostic tests for COVID-19.
• The Washington State Board of Health’s emergency rule, WAC 246-101-017 requires additional data elements that much be reported, including complete demographic data aligned with new federal requirements from the U.S. Department of Health & Human Services.
• As of April 20, 2022, WAC 246-101-017 was revised. In summary, POC sites, which are licensed to conduct waived tests under a certificate of waiver, are required to report only positive test results from molecular and antigen tests. Ask on Order Entry questions, such as symptoms or whether it was the patient’s first test, are no longer required to be reported.

Click here to learn more on antigen reporting requirements and how to report for facilities.

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.

COIVD-19 Rebound After Paxlovid Treatment

Provider Alert 5/25/22

• Be aware, Centers for Disease Control and Prevention (CDC) issued a health advisory about COVID-19 rebound after Paxlovid treatment. Continue to offer Paxlovid for early-stage treatment of mild to moderate COVID-19 in people at high risk of severe disease.
• Be aware, providers have reported COVID-19 rebound—recurring symptoms or a new positive test after a negative test—2–8 days after initial recovery. A brief return of symptoms may be part of SARS-CoV-2 infection in some people, regardless of treatment or vaccination status. Case reports suggest patients with COVID-19 rebound who were treated with Paxlovid have mild illness.
  • Do not offer retreatment. Evidence does not indicate additional treatment is needed.
  • Tell patients with COVID-19 rebound to isolate per CDC guidance and take additional precautions to prevent transmission.
  • Tell patients to stay up to date on COVID-19 vaccine and seek Evusheld therapy if immunocompromised.
  • Continue to prescribe Paxlovid to people who meet treatment criteria.

DOH Question of the Week 

Q:  WHAT IS A SIMPLE WAY I CAN EXPLAIN HOW THE MRNA COVID-19 VACCINE WORKS? 

A: When someone is interested in understanding how the COVID-19 vaccine works, it's important to use simple, clear language.  Keep it high-level (unless details are requested), incorporate graphics if possible, and be patient as you educate.  Here's an example...
Messenger RNA (mRNA) vaccines use genetic material created in a laboratory to teach our cells how to make a protein, or piece of protein, that will trigger an immune response inside our bodies.  Once the immune system is activated it will begin producing antibodies, which provide protection if we are exposed to the real virus. 
Medical professionals know the process that takes place inside our bodies is complicated, but by focusing on key steps, we can describe the mRNA vaccine in a way the most people can understand.  Consider ending your conversations by assuring patients of important facts.

The Facts:

• Messenger RNA vaccines are safe and effective.
• COVID-19 mRNA vaccines cannot give someone the virus that causes COVID-19 or any other viruses.
• mRNA vaccines do not use the live virus that causes COVID-19.
• They do not affect or interact with our DNA in any way.
• Our cells break down mRNA and get rid of it within a few days after vaccination.
• Pfizer-BioNTech and Moderna are mRNA vaccines and are the preferred COVID-19 vaccines in the United States.

Additional Information:
Understanding mRNA COVID-19 Vaccines | CDC
How mRNA COVID-19 Vaccines Work | CDC Infographic, English