COVID-19 Alaska Clinical Update: Wednesday, October 13, 2021

DHSS Clinical Update

COVID-19 Alaska Clinical Update
Wednesday, October 13, 2021

CDC recommends Pfizer-BioNTech booster vaccine for select populations at least 6 months after their initial 2 dose series

The CDC recommends that the following groups should receive a booster shot of Pfizer-BioNTech’s COVID-19 Vaccine at least 6 months after completing their Pfizer-BioNTech primary series (i.e., the first 2 vaccine doses):

  • people aged 65 years and older
  • residents aged 18 years and older in long-term care settings
  • people aged 50–64 years with underlying medical conditions

CDC also recommends that the following groups may receive a booster shot of Pfizer-BioNTech’s COVID-19 Vaccine at least 6 months after completing their Pfizer-BioNTech primary series, based on their individual benefits and risks:

  • people aged 18–49 years with underlying medical conditions
  • people aged 18–64 years at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting (e.g., health care, schools, correctional facilities, homeless shelters)

These recommendations only apply to people who previously received a Pfizer-BioNTech primary series (i.e., the first 2 doses of a COVID-19 vaccine).

Moderna and Johnson & Johnson apply for EUA for booster dose

On September 23, Moderna submitted an application to the FDA for authorization of a booster dose to be given at least six months after completion of the primary vaccine series. On October 5, Johnson & Johnson (J&J) announced that it had applied to the FDA for authorization of a booster dose of its single-shot COVID-19 vaccine. Both companies’ applications reiterate that while the primary vaccine series provides effective protection against severe/critical COVID-19, booster doses resulted in increased protection against symptomatic COVID-19, increased strength and breadth of immune responses against variants and increased protection against severe/critical COVID-19.

FDA committee meetings on October 14-15 to discuss Moderna and J&J boosters; meeting on October 26 to discuss Pfizer-BioNTech vaccine for children ages 5-11 years

On October 14, the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) will meet to discuss the use of booster doses of the Moderna COVID-19 Vaccine. On October 15, the committee will discuss the use of booster doses of the J&J COVID-19 Vaccine; they will also hear presentations and discuss the available data on the use of a booster of a different vaccine than the one used for the primary series of an authorized or approved COVID-19 vaccine (heterologous or “mix and match” booster).

On October 7, Pfizer-BioNTech submitted its application to the FDA to amend the EUA for its vaccines to allow the use of its COVID-19 vaccine in children 5 through 11 years of age. The FDA’s VRBPAC has a meeting scheduled on October 26 to discuss this application.

Alaska COVID-19 Update on Hospitalizations, Deaths, and Vaccine Breakthrough Infections through August 2021

The Alaska Division of Public Health Section of Epidemiology recently released an update on COVID-19 hospitalizations, deaths, and vaccine breakthrough infections for March 2020-August 2021. The report also includes statistics about multisystem inflammatory syndrome in children.

Pfizer-BioNTech real world vaccine efficacy against COVID infection declined from 88% to 47% after five months, efficacy against hospitalization remained high at 93% at six months

In this retrospective cohort study, researchers analyzed records from 3,436,957 individuals in the Kaiser Permanente system from December 2020-August 2021 to assess Pfizer-BioNTech vaccine effectiveness against SARS-CoV-2 infections and COVID-19-related hospital admissions for up to 6 months after full vaccination. For fully vaccinated individuals, effectiveness against SARS-CoV-2 infections was 73% (95% CI 72–74) and against COVID-19-related hospital admissions was 90% (95% CI 89–92). Effectiveness against infections declined from 88% (95% CI 86–89) during the first month after full vaccination to 47% (43–51) after 5 months. Vaccine effectiveness against hospital admissions for infections with the delta variant for all ages was high overall (93% [95% CI 84–96]) up to 6 months. Among sequenced infections, vaccine effectiveness against infections of the delta variant was high during the first month after full vaccination (93% [95% CI 85–97]) but declined to 53% [39–65] after 4 months. Effectiveness against other (non-delta) variants the first month after full vaccination was also high at 97% (95% CI 95–99) but waned to 67% (45–80) at 4–5 months. This analysis of both delta and non-delta variants over 5 months shows that decreasing vaccine effectiveness is likely to be primarily due to waning vaccine effectiveness rather than the delta variant escaping vaccine protection.

Potential for False Positive Results with Certain Lots of Ellume COVID-19 Home Tests Due to a Manufacturing Issue

The FDA is alerting test users, caregivers, health care personnel, and the public of the potential for false positive results with certain lots of the Ellume COVID-19 Home Test, due to a recently identified manufacturing issue. For these tests, a “false positive” is a test result that indicates that a person has the virus when they do not actually have it. Negative results do not appear to be affected by the manufacturing issue.  

For more information, check out the State of Alaska’s At-Home COVID-19 Testing Guidance.

Merck applies for Emergency Use Authorization for oral antiviral medication; claim that it reduces risk of COVID-19 hospitalization or death by 50%

On October 11, Merck and Ridgeback Biotherapeutics submitted an application with the FDA for Emergency Use Authorization (EUA) of molnupiravir, an investigation oral antiviral medication, for the treatment of mild-to-moderate COVID-19 in adults at high risk of severe disease. If authorized, this drug would be the first oral COVID-19 treatment. In a press release, the company announced its interim analysis of its Phase 3 trial in at risk, non-hospitalized adult patients with mild-to-moderate COVID-19. The study enrolled 775 patients; all patients had laboratory-confirmed mild-to-moderate COVID-19 with symptom onset within 5 days of study randomization. All patients were required to have at least one risk factor associated with poor disease outcome at study entry. At the interim analysis, molnupiravir reportedly reduced the risk of hospitalization or death by approximately 50%; 7.3% of patients who received molnupiravir were either hospitalized or died through Day 29 following randomization (28/385), compared with 14.1% of placebo-treated patients (53/377); p=0.0012. Through Day 29, no deaths were reported in patients who received molnupiravir, as compared to 8 deaths in patients who received placebo.

Two Indian generic drug manufacturers last week requested permission to end late-stage clinical trials of generic versions of molnupiravir, after the drug did not show “significant efficacy” among people with moderate COVID-19 disease. A Merck spokesperson noted that the Indian studies defined moderate disease differently than the FDA and included patients with more severe disease.

Pfizer and Roche, among other pharmaceutical companies, are actively developing oral antiviral medications targeted at preventing COVID infection, hospitalization, and death, however Merck is the first to apply for EUA.

*These results have not gone through peer review and were announced as a press release by the sponsoring pharmaceutical companies. The results might contain errors and report information that has not yet been accepted or endorsed in any way by the scientific or medical community.

Vaccine hesitancy changes over time

In this cohort study, surveys measured COVID-19 vaccine hesitancy at baseline (August-December 2020) and follow-up (March-April 2021). A total of 3,439 participants completed both surveys. Among persons hesitant to vaccinate at baseline, at follow-up, 32% reported receiving 1 or more vaccine doses, 37% reported being likely to be vaccinated, and 32% remained unlikely to be vaccinated. In contrast, among persons likely to be vaccinated at follow-up, 54% had received 1 or more vaccine doses, 39% remained likely to be vaccinated, and 7% reported being unlikely to be vaccinated. Baseline vaccine willingness was higher among persons with a bachelor’s or graduate degree than among persons with lower education (76% vs 65%), and at follow-up these differences were reflected in vaccination. This study found that COVID-19 vaccine hesitancy is not a stable trait precluding vaccination but, instead, is labile. Hesitancy decreased between late 2020 and early 2021, with nearly one-third (32%) of persons who were initially hesitant being vaccinated at follow-up and more than one-third (37%) transitioning from vaccine hesitant into vaccine willing. Early plans regarding vaccination frequently deviated from later action in vaccine seeking.

CDC Morbidity and Mortality Weekly Reports (MMWR)

Side effects and safety profile of 3rd dose booster vaccine for Pfizer-BioNTech appears similar to those seen after 2nd dose

In this MMWR, researchers used self-reported data from the CDC’s v-safe surveillance system for 12,591 registrants who completed a health check-in survey after receiving 3 doses of an mRNA vaccine to evaluate the reported side effects and safety profile of the third dose compared to the second vaccine dose. After the third dose, 79.4% and 74.1% reported local or systemic reactions, respectively, compared to 77.6% and 76.5% reported local or systemic reactions after the second dose, respectively. Reactions were most commonly reported the day after vaccination. This analysis shows that local reactions are slightly increased and systemic reactions are slightly decreased after dose 3 of an mRNA vaccine than after dose 2. No unexpected patterns of adverse reactions were identified; those reported were mild to moderate and transient.

Despite low vaccine hesitancy, persons with disabilities have more difficulties obtaining COVID vaccine than those without disabilities

In this MMWR, authors used data from the National Immunization Survey Adult COVID Module (NIS-ACM) to describe COVID-19 vaccination status and intent, as well as perceived vaccine access among adults by disability status. This cellular telephone survey collected data from May 30–June 26, 2021, and 5,361 (9.4%) self-reported having a disability. In age-adjusted analyses, adults with a disability were less likely than were those without a disability to report having received ≥1 dose of a COVID-19 vaccine (adjusted vaccination prevalence ratio (aPR) = 0.88; 95% CI = 0.84–0.93) but more likely to report they would definitely get vaccinated (aPR = 1.86; 95% CI = 1.43–2.42). Overall, adults with a disability were more likely than were those without a disability to report that it would be or was somewhat or very difficult to get vaccinated (aPR = 1.19) and this observation was more pronounced among the unvaccinated (aPR = 2.69). Among unvaccinated adults, those with a disability were more likely than were those without a disability to report having the following difficulties associated with getting the vaccine: getting an appointment online (aPR = 2.14), not knowing where to get vaccinated (aPR = 1.95), getting to vaccination sites (aPR = 3.43), and vaccination sites not being open at convenient times (aPR = 1.69).

High vaccine coverage and multiple prevention strategies were highly effective at preventing spread of COVID-19 at overnight camps

This study assessed the number of COVID-19 cases and potential secondary spread among 7,173 staff members and campers from 50 states, 13 countries, and U.S. military overseas bases at nine independently operated U.S. summer youth camps between June-August 2021. The camps implemented multiple prevention strategies including vaccination, testing, cohorting, masking, physical distancing, hand hygiene, and vaccinations for eligible persons aged ≥12 years. Vaccination coverage was 93%; approximately 30% of persons were aged <12 years and thus ineligible for COVID-19 vaccination. All staff members (1,955) and campers (5,218) received prearrival testing and screening tests during the camp session. Screening testing identified six confirmed COVID-19 cases (one in a staff member and five in campers). Three additional cases (in two staff members and one camper) were identified based on symptoms and were confirmed by testing. Campers from camps with confirmed cases were either sent home or isolated according to local health department guidance. No secondary transmission was detected during camp. Testing for SARS-CoV-2, isolation, and quarantine in a population with high vaccination coverage resulted in no known secondary transmission of SARS-CoV-2 identified during camp.

Low vaccination coverage and underutilization of masking and physical distancing associated with COVID outbreaks at Louisiana summer camps

In this report, the Louisiana Department of Health used camp reports and contact tracing data to identify 28 camp outbreaks statewide, which included a total of 321 COVID-19 cases among an estimated 2,988 campers and staff members during June-July 2021. 50% of the camps were overnight camps and 50% were day camps. The mean outbreak size was 11.5 cases (range = 2–59 cases); the mean outbreak size of day camps was 9.3 cases (range = 2–21 cases) and overnight camps was 13.6 cases (range = 2–59 cases). 274 cases (85.4%) occurred among campers, and 47 (14.6%) among staff members. Among all campers with COVID-19, two (0.7%) were fully vaccinated against COVID-19; 133 (48.5%) were age-eligible but not vaccinated, and 139 (50.7%) were not age-eligible for vaccination. All cases among staff members occurred in persons who had not received COVID-19 vaccine. The average camp outbreak size peaked at 15.3 cases during the week of July 18. Only one (3.6%) of 28 camps with outbreaks required indoor masking for staff members and campers with an outbreak size of eight cases among four staff members and four campers, and one camp (3.6%) mandated vaccination for all staff members and contractors with an outbreak size of 20 cases among campers. All camps reported some form of cohorting of campers, and seven (25.0%) reported unmasked interactions among cohorts of campers.

Symptoms of anxiety and depressive disorders peaked in December 2020-January 2021 but remain higher than rates in 2019, appear to be highly correlated with average number of daily COVID-19 cases

This study presents data from the US Census Bureau Household Pulse Survey (HPS) on trends in symptoms of anxiety and depressive disorders among adults aged ≥18 from August 2020-June 2021. HPS is a biweekly, online survey developed with assistance from CDC and other federal agencies to assess the social and economic impacts of the COVID-19 pandemic on U.S. households, beginning on April 23, 2020. The total sample size was 1,526,154 for all 19 bi-weekly survey waves, ranging from 58,729 (wave 18) to 110,019 (wave 14). Overall survey response rates ranged from 5.3% to 10.3% among the 19 waves examined. Frequency of experiencing anxiety and depressive symptoms was assessed using the four-item Patient Health Questionnaire (PHQ-4), which includes the two-item Generalized Anxiety Disorder (GAD-2) scale and the two-item PHQ-2, which assesses symptoms of depression. In most states, the average anxiety and depression severity scores increased from August–September 2020 to December 2020–January 2021. By May–June 2021, anxiety and depression severity scores were similar to or lower than those during August–September 2020. During August–December 2020 and January–June 2021, state-level trends in anxiety and depression severity scores were similar to national trends, with scores for most states peaking during December 9–21, 2020, or January 6–18, 2021. For the same periods that HPS was administered, an association was found between numbers of COVID-19 cases and the frequency of anxiety and depression symptoms. The average number of daily COVID-19 cases was highly positively correlated with anxiety (rho = 0.79) and depression (rho = 0.81) severity scores.

RECURRENT TOPICS

Providing COVID-19 vaccinations

In addition to the most recent CDC recommendation explained above, we still recommend that all healthcare providers outreach to their patients who are immunocompromised and are candidates for a third vaccine dose, whether they received Pfizer-BioNTech or Moderna.

All Alaskans and people who work or live in Alaska who are aged 12 years and older are eligible for vaccination against COVID-19.

If you are interested in providing the COVID-19 vaccine in your office or clinic, please visit the COVID-19 Vaccination Program Provider Enrollment page. If you have additional questions, please email Matthew Bobo at matthew.bobo@alaska.gov

Pregnancy

On September 29, the CDC released a health advisory strongly recommending COVID-19 vaccination either before or during pregnancy because the benefits of vaccination outweigh known or potential risks.

For the latest recommendations, check out the CDC webpage on COVID in Pregnant and Recently Pregnant People and recommendations from the American College of Obstetrics and Gynecology.

Monoclonal Antibodies

Monoclonal antibody treatment for COVID-19, REGEN-COV (casirivimab and imdevimab) and Eli Lilly’s bamlanivimab and etesevimab, have been approved to treat mild-moderate COVID-19 and for post-exposure prophylaxis of COVID-19 in individuals age 12 years and older who are at high risk for progression to severe COVID-19.

If you are interested in providing monoclonal antibody therapy for COVID-19 in your office or clinic, please refer to this guide from the U.S. DHSS, and then send an email to Coleman Cutchins (coleman.cutchins@alaska.gov) and CJ Kim (cj.kim@alaska.gov) for local assistance.

AstraZeneca applies for EUA for long-acting antibody combination for prophylaxis of symptomatic COVID-19

On October 5, AstraZeneca announced it had submitted an FDA application for EUA of its long-acting antibody combination for prophylaxis of symptomatic COVID-19. In August the company had announced results from a Phase III placebo-controlled randomized trial with 5,197 participants. They claimed the treatment had reduced the risk of developing symptomatic COVID-19 by 77% (95% confidence interval (CI): 46-90), compared to placebo. The trial accrued 25 cases of symptomatic COVID-19 at the primary analysis. There were no cases of severe COVID-19 or COVID-19-related deaths in those treated with AZD7442. In the placebo arm, there were three cases of severe COVID-19, which included two deaths. More than 75% of participants were reported to have co-morbidities, which include conditions that have been reported to cause a reduced immune response to vaccination. The medication utilizes half-life extension technology with claims to provide up to 12 months of protection from COVID-19, and is delivered by intramuscular injection. This medication has not yet been authorized or approved for use by the FDA.

*These results have not gone through peer review and were announced as a press release by the sponsoring pharmaceutical companies. The results might contain errors and report information that has not yet been accepted or endorsed in any way by the scientific or medical community.
For the latest recommendations, check out the CDC webpage on Monoclonal Antibodies for High-Risk COVID-19 patients and COVID-19 Monoclonal Antibody Resources for Healthcare Providers.

Ivermectin

On August 26, the CDC issued a Health Advisory about the increase in ivermectin prescriptions and an associated rise in the number of calls to poison centers reporting overdoses or adverse effects.
According to the Merck, the drug company that manufactures ivermectin, there is:

  • No scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies;
  • No meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19 disease, and;
  • A concerning lack of safety data in the majority of studies.

A Cochrane Review published July 28 concluded, the “reliable evidence does not support the use of ivermectin for treatment or prevention of COVID‐19.” In addition, the FDA has recently created a webpage further explaining why you should not use ivermectin to treat or prevent COVID-19 and the potential harms of taking a veterinary formulation of this mediation. Infectious Disease Society of America (IDSA) guidelines DO NOT recommend ivermectin.

Post-acute Sequelae of COVID-19 (PASC)

WHO releases Clinical Case Definition of PASC

On October 6, the WHO released a clinical case definition of post COVID-19 condition.
“Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARSCoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others [full list of symptoms available in linked document] and generally have an impact on everyday functioning. Symptoms may be new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time. A separate definition may be applicable for children.

Notes: There is no minimal number of symptoms required for the diagnosis; though symptoms involving different organs systems and clusters have been described.”

For the latest recommendations, check out the CDC webpage on Post-COVID-19 Syndrome and Evaluating and Caring for Patients with Post-COVID conditions

Myocarditis

Pfizer-BioNTech mRNA COVID vaccination associated with increased incidence of myocarditis in young male recipients in Israel

In this retrospective review, researchers used medical records from the Israeli Ministry of Health to review presumptive cases of myocarditis for the 6 months from December 2020 through May 2021, during which 5,125,635 people received two doses of the Pfizer-BioNTech mRNA COVID vaccine. During this time, 283 cases of myocarditis were reported and confirmed. These cases included 142 among vaccinated persons within 21 days after the first dose and 30 days after the second dose, 40 among vaccinated persons not in proximity to vaccination, and 101 among unvaccinated persons. Among the unvaccinated persons, 29 cases of myocarditis were diagnosed in those with confirmed Covid-19 and 72 in those without a confirmed diagnosis. Of the 142 cases among vaccinated persons, one person with fulminant myocarditis died; 129 of the cases were generally mild with resolution of myocarditis in most cases based on clinical symptoms, normalization of troponin and EKG changes. Four persons had severely reduced ejectiond fractions. The authors estimated that definite or probable cases of myocarditis occurred in the overall Israeli population at a rate of approximately 1 per 26,000 males and 1 per 218,000 females after the second vaccine dose, with the highest risk again among young male recipients. On the basis of data from an Israeli national database, the incidence of myocarditis after two doses of the Pfizer-BioNTech mRNA vaccine was low but higher than the incidence among unvaccinated persons and among historical controls. The risk of myocarditis was driven primarily by the increased incidence after the second dose of vaccine and in young male recipients.

Post-mRNA COVID vaccination myocarditis incidence in the US was 0.8 cases per million following first dose and 5.8 cases per million following second dose

In this retrospective review, authors analyzed data from 2,392,924 Kaiser Permanente Southern California members aged 18 years or older who received at least 1 dose of a COVID mRNA vaccine between December 14, 2020, and July 20, 2021 to evaluate the risk of myocarditis. There were 15 cases of confirmed myocarditis in the vaccinated group (2 after the first dose and 13 after the second), for an observed incidence of 0.8 cases per 1 million first doses and 5.8 cases per 1 million second doses over a 10-day observation window. All were men, with a median age of 25 years. Among unvaccinated individuals in this same Kaiser Permanente network, there were 75 cases of myocarditis during the study period, with 39 (52%) men and median age of 52 years. The incident rate ratio for myocarditis was 0.38 (95% CI, 0.05-1.40) for the first dose and 2.7 (95% CI, 1.4-4.8) for the second dose. Of the patients with myocarditis postvaccination, none had prior cardiac disease. Eight patients received Pfizer-BioNTech and 7 received Moderna. All were hospitalized and tested negative for SARS-CoV-2 on admission. Fourteen (93%) reported chest pain between 1 to 5 days after vaccination. Symptoms resolved with conservative management in all cases; no patients required intensive care unit admission or readmission after discharge.

For the latest recommendations, check out the CDC webpage on myocarditis and COVID-19 vaccines

COVID-19 Speakers’ Bureau

Anyone can request a free presentation for a group interested in learning more about the COVID-19 vaccines available in Alaska.

Aside from COVID-19

CDC and ACIP release recommendations for seasonal Influenza vaccination

Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. Influenza vaccine may be administered at the same time as COVID-19 vaccine. Detailed recommendations for influenza vaccination for persons currently infected with COVID-19 are available from CDC.

Upcoming Events/Conferences/Presentations

Free opioid prescribing education on October 26

On October 26 from 11am-2pm, the Division of Behavioral Health has partnered with Boston University School of Medicine to provide a free opioid prescribing education opportunity. This workshop is intended for physicians, nurse practitioners, registered nurses, physician assistants, nurses, dentists, pharmacists, and allied health professionals who manage acute and chronic pain. SCOPE of Pain is a series of continuing medical education/continuing nursing education activities designed to help you safely and effectively manage patients with acute and/or chronic pain, when appropriate, with opioid analgesics.

  • Effective communication skills and the potential risks and benefits of opioids for managing acute and chronic pain
  • The assessment of opioid misuse risk and recognition and treatment of opioid use disorder
  • Helping you safely and effectively manage patients with acute and/or chronic pain, when appropriate, with opioid analgesics

Registration required at scopeofpain.org (select Core curriculum from the top menu, choose Live conferences, select the red button)

ANTHC Tribal Health Webinar Series

The ANTHC Tribal Health Webinar series occurs on Friday from 12-1pm on Zoom and is open to the public. Here is the upcoming schedule for the fall and the Zoom link. 

10/22: Elisha Brownson, MD: Imaging Decisions in Pediatric Trauma
11/05: Rosalyn Singleton, MD: Respiratory/RSV/COVID Hospitalization trends and future interventions.
11/15: Mary Owen, MD: Tlingit People
11/19: Katie Presser, PharmD: Statewide Antimicrobial Stewardship
12/03: Marah Gotcsik, MD: ANMC Guideline on Preterm Infant Nutrition through 2 Years Old
12/10: Leslie Kerzner, MD: Care of the NICU Grad for Primary Care Providers

Join Zoom Meeting
https://anthc.zoom.us/j/98667611681
Meeting ID: 986 6761 1681
One tap mobile
+16699006833,,98667611681#

Use of Valid Background Check Clearances by Multiple Employers

Providers who have applicants with pending background checks with DHSS BCU may allow individuals to start work prior to the Background Check Program completing their check IF the applicant has documented proof of having a current Alaska DHSS background check (provisional or complete) for another DHSS provider. The applicant must provide their new employer a copy of the final background check eligibility letter for the other provider, and providers are required to maintain a copy of that eligibly document in the employee’s file. Providers who hire employees in this manner MUST provide supervised access to those employees, i.e., to ensure the protection of recipients of services, the provider must maintain a prudent level of awareness of the whereabouts of an individual for whom supervised access is required. Employees working in this way may NOT be the only individual working in a facility or a setting, as another employee must be present to provide the supervised access. The provider’s oversight agency will monitor providers to ensure they are in compliance with these requirements, and providers must submit proof of compliance to those agencies upon request. Questions? Please contact your DHSS oversight division.

CDC Clinical Support: There is a Clinician On-Call Center, a 24-hour hotline with trained CDC clinicians standing by to answer COVID-19 questions. Call 1-800-CDC-INFO (800-232-4636) and ask for the Clinician On-Call Center.

The most up-to-date, evidence based COVID-19 treatment guidelines can be found at:
IDSA Guidelines on the Treatment and Management of Patient with COVID-19
NIH COVID-19 Treatment Guidelines


AK Clinical Reminders — UPDATED October 11, 2021

COVID-19 testing guidelines and test site locator

UAA ECHO

These ECHO sessions are produced and facilitated by
UAA’s Center for Human Development Alaska ECHO project
in partnership with the State of Alaska, Department of Health & Social Services

Session information and recordings of previous ECHO sessions
subscribe to ECHO calendar updates | email: echo@alaskachd.org | website: akecho.org

Upcoming Session Highlights:

Special Pop-Up Session: Alaska Medical Providers: Applying Crisis Standards of Care in Your Practice 
Tuesday, October 12, 7:00-8:00 PM 
Register for this special Pop-Up Event and our regular Alaska Medical Providers Series.

Perinatal ECHO Session: Critical Congenital Heart Defects
Thursday, October 21, 6:00-7:00pm
Register at: https://echo.zoom.us/meeting/register/tJwlce-hqTIjHtAfH-NNvFOK3shfHD3Np92O
This session will feature a didactic presentation on critical congenital heart defects in Alaska by Dr. James Christiansen, pediatric cardiologist, and Chris Barnett, epidemiologist and program manager of the Alaska Birth Defects Registry. We will also have case presentations by pediatric cardiologists, Dr. Scott Wellmann and Dr. Kevin Kollins. As always, we will have ample time for Q&A and discussion with presenters and the hub team.

Regular Series

Alaska Medical Provider ECHO (formerly COVID-19 for AK Healthcare Providers)
Bi-monthly on the 1st and 3rd Tuesday of the month from 7-8 pm
This ECHO aims to increase knowledge and share best practices among medical providers across Alaska as well as to increase access to information for those living in rural areas of the state.
Register for our Alaska Medical Providers ECHO here: https://echo.zoom.us/meeting/register/tJwud-yuqT4pGNSr7F2eJ1jscT16rUsoGAj-

School Health ECHO
Every Monday from 3:30-4:30 p.m Register
The School Health ECHO is a virtual learning network intended for professionals in the education setting (administrators, school-based nurses, etc.) to interface with a team of medical and education experts in Alaska.

Vaccine ECHO for Providers
Weekly on Tuesday from 2-3 p.m. Register
The Vaccine ECHO for providers provides planning and operation updates to vaccine providers across Alaska, while answering any questions you may have.

Palliative Care ECHO
Monthly on the first Tuesday from 12-1 p.m.
This monthly ECHO is for all Alaskan healthcare disciplines supporting patients with serious illness, and aims to provide support and up-to-date information regarding Palliative Care during this period of COVID-19.

Public Science ECHO
Weekly on Wednesday from 12-1 p.m. register via Zoom
The Alaska Public Health Science ECHO is a virtual learning network intended for the general public to interface with our Public Health Leadership Team to explore the science of the COVID-19 virus, other public health topics, and current best practices. Or view via concurrent livestream to Facebook: https://www.facebook.com/akechoprograms

Local Government Public Health ECHO
Monthly on the third Wednesday from 3-4 p.m. Register
The Local Government Public Health Analysis ECHO is a virtual learning environment intended for local Alaska government leaders to interact with the State Public Health Leadership team and focuses on pandemic mitigation tools available, and how to use them.

Long Term Care Facilities ECHO 
Second Wednesday of the month from 4-5 p.m. Register 
Please join other staff and administrators of Alaska’s assisted living homes and residential care facilities to gather, learn, share, and grow. COVID has disrupted the fabric of our daily life and we can always learn from each other as we adjust to the new normal.

Healthcare Specific Situational Awareness ECHO
Weekly on Thursday from 12-1 p.m.  Register
The Healthcare Specific Situational ECHO is a virtual learning network intended for healthcare professionals to interface with our Public Health Leadership Team to explore current best practices and the most recent information related to Public Health.

Perinatal ECHO
Monthly on 3rd Thursday from 6-7 p.m. Register
The Alaska Perinatal ECHO is a virtual learning network intended for medical providers caring for pregnant patients and their newborns.

EMS ECHO
Monthly on the 1st and 3rd Wednesday 1-2 p.m Register
The EMS ECHO is a virtual learning network intended for Emergency Medical Services and related personnel in Alaska to amplify best practices. Sessions are topic-driven and typically include a guest presenter or a brief lecture with an interactive case or process discussion.

AK COVID-19 clinical hotline for physicians: 833-751-4212. Staffed 24/7.
8PM-8AM is for urgent/emergent questions only.
AK Responders Relief Line: 24/7 behavioral health for everyone working in healthcare
during the COVID-19 pandemic: 1-844-985-8275