COVID-19 Alaska Clinical Update: Thursday, May 5, 2022

DHSS Clinical Update

COVID-19 Alaska Clinical Update – April 8
Thursday, May 5

Graph taken from State of Alaska’s COVID-19 Cases Dashboard         

FDA schedules meeting for early June to review data on COVID vaccines for children 6 months to 5 years

The FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) is scheduled to meet on June 8 to discuss updates to the Moderna and Pfizer-BioNTech EUAs for their COVID-19 vaccines to include children 6 years and younger. In late April, Moderna submitted an EUA request to the FDA for its COVID-19 vaccine for children age 6 months to 6 months. Pfizer-BioNTech, which revised its study protocol for children 6 months to 5 years to include a third vaccine dose after two doses didn’t generate an adequate immune response, has said that it plans to submit data on its three-dose regimen to the FDA in late May or early June.

Pfizer-BioNTech submit EUA application for booster COVID vaccine for children age 5 through 11 years

On April 26, Pfizer-BioNTech submitted an application to the FDA for EUA for a third COVID-19 vaccine booster dose 6 months after the second dose for children age 5 through 11 years. Currently, third doses of the Pfizer-BioNTech vaccine are authorized for children aged 5 to 11 who are moderately to severely immunocompromised.

Remdesivir approved for treatment of COVID-19 in children age 28 days and older who are hospitalized or not hospitalized but have mild-moderate COVID-19 and are at high risk for progression to severe COVID-19

On April 25, the FDA expanded the approval of the COVID-19 treatment Veklury (remdesivir) to include pediatric patients 28 days of age and older weighing at least 3 kilograms (about 7 pounds) with positive results of direct SARS-CoV-2 viral testing who are hospitalized or not hospitalized but have mild-to-moderate COVID-19 and are at high risk for progression to severe COVID-19, including hospitalization or death. While remdesivir had been available to this population previously under an EUA, it is now the first approved COVID-19 treatment for children less than 12 years of age.

Albuterol solution shortage

Albuterol concentrated inhalation solutions (0.5% 5mg/mL) is nationally in short supply and quantities are being allocated by distributors.  The shortage is expected to last through ~late June 2022.  The 0.083%  (0.83mg/mL) and 0.1% (1mg/mL) are available as well as alternative agents such as levalbuterol and ipratropium-albuterol (DuoNeb).  With this shortage you may want to stress to patients the importance of disease control, maintenance medication adherence, and following their current asthma action plan.   More information on drug shortages can be found here:  https://www.ashp.org/drug-shortages

COVID antigen test sensitivity appears to peak 4 days after symptom onset

This prospective cohort study was conducted from January to May 2021 in San Diego County, California, and metropolitan Denver, Colorado to evaluate the diagnostic performance of home antigen tests compared with reverse transcription–polymerase chain reaction (RT-PCR) and viral culture by days from illness onset. The convenience sample included adults and children with RT-PCR–confirmed infection who used self-collected home antigen tests for 15 days and underwent at least 1 nasopharyngeal swab for RT-PCR, viral culture, and sequencing. This study enrolled 225 persons with RT-PCR–confirmed infection who completed 3044 antigen tests and 642 nasopharyngeal swabs. Antigen test sensitivity was 50% (95% CI, 45%-55%) during the infectious period, 64% (95% CI, 56%-70%) compared with same-day RT-PCR, and 84% (95% CI, 75%-90%) compared with same-day cultures. Antigen test sensitivity peaked 4 days after illness onset at 77% (95% CI, 69%-83%). Antigen test sensitivity improved with a second antigen test 1 to 2 days later, particularly early in the infection. Six days after illness onset, antigen test result positivity was 61% (95% CI, 53%-68%)

Among adults admitted to the hospital with COVID-19, only 28% report feeling fully recovered at 1 year

In this prospective, longitudinal cohort study of adults ≥18 years discharged from hospital with COVID-19 across the UK, patients’ recovery was assessed using self-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge. 2320 participants discharged from hospitalization between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32.7%) participants completed both the 5-month and 1-year visits. 279 (35.6%) of these 807 patients were women and 505 (64.4%) were men, with a mean age of 58.7 years, and 224 (27.8%) had received invasive mechanical ventilation. The proportion of patients reporting full recovery was unchanged between 5 months (501 [25.5%] of 1965) and 1 year (232 [28.9%] of 804). The most common ongoing symptoms were fatigue, muscle pain, physically slowing down, poor sleep, and breathlessness. The major risk factors for not feeling fully recovered at 1 year were female sex, obesity, and receiving invasive mechanical ventilation during the acute illness.

Estimated 234,000 deaths could have been prevented with COVID-19 vaccinations since June 2021

In this analysis from the Kaiser Family Foundation, researchers estimate the number of adult deaths that could have been prevented by timely vaccination. They claim that approximately 234,000 deaths since June 2021 could have been prevented with primary series vaccination. These vaccine-preventable deaths represent 60% of all adult COVID-19 deaths since June 2021, and a quarter (24%) of the nearly 1 million COVID-19 deaths since the pandemic began.

Paxlovid trial shows no significant benefit when given as post-exposure prophylaxis to prevent COVID-19 infection

In late April, Pfizer announced results from its Phase 2/3 EPIC-PEP study evaluating Paxlovid for post-exposure prophylactic use. This study enrolled 2,957 adults who had a negative SARS-CoV-2 rapid antigen test result and were asymptomatic household contacts with exposure within 96 hours to an individual who was symptomatic and recently tested positive for SARS-CoV-2. Each patient was randomized (1:1:1) to receive Paxlovid for five days followed by placebo for 5 days, Paxlovid for ten days or placebo for ten days. Compared to placebo, patients who took Paxlovid for five days had a 32% reduced risk of contracting COVID-19 and those treated for 10 days had a 37% reduced risk. These results, however, were not statistically significant and, as such, the primary endpoint of reducing the risk of confirmed and symptomatic COVID-19 infection in exposed adults was not met.

No statistical difference between Moderna and Pfizer-BioNTech mRNA COVID vaccines for protection against hospitalization, ICU admission, or death

In this study, authors compare the real-world efficacy of the Moderna and Pfizer-BioNTech mRNA COVID vaccines. Using deidentified administrative claims for Medicare Advantage and commercially insured individuals in a research database, they examined over 3.5 million fully vaccinated individuals, including 8,848 individuals with SARS-CoV-2 infection, with a follow-up period between 14 and 151 days after their second dose. Of the 8,848 confirmed infections, 3090 (35%) received Moderna and 5758 (65%) received Pfizer-BioNTech vaccines. At 90 days after vaccination, there are no statistically significant differences between the predicted probabilities of the two vaccines for the composite outcome of hospitalization, ICU admission, death, or transfer to hospice. Immunization with Moderna, compared to Pfizer-BioNTech, provides slightly more protection against SARS-CoV-2 infection that reaches statistical significance at 90 days with a number needed to vaccinate of >290. These results suggest that for every 1 million individuals vaccinated with the Pfizer-BioNTech vaccine compared with the Moderna vaccine, this would represent 3,448 additional care-seeking cases of COVID-19 at 90 days.

CDC Health Advisory reinforces outpatient COVID-19 treatment options and reiterates that systemic corticosteroids are not recommended for the outpatient treatment of COVID-19 and antibiotics are not recommended in the absence of another indication

On April 25, the CDC released a Health Advisory to update healthcare providers, public health departments, and the public about the availability and use of recommended therapies for COVID-19 and to advise against using unproven treatments that have known or potential harms for outpatients with mild to moderate COVID-19. For patients with mild to moderate COVID-19 who are not hospitalized and who are at increased risk for severe COVID-19 outcomes, several treatment options, including antiviral medications and monoclonal antibodies, are now widely available and accessible. Systemic corticosteroids are not recommended to treat patients with mild to moderate COVID-19 who do not require supplemental oxygen; patients who are receiving dexamethasone or another corticosteroid for other indications should continue therapy for their underlying conditions as directed by their healthcare providers. Antibacterial therapy is not recommended for the treatment of COVID-19 in the absence of another indication.

The Alaska DHSS website on COVID-19 therapeutics is regularly updated for providers and has everything you need to evaluate which therapeutic is right for your patient and the tools to prescribe these medications.

Worldwide, measles cases have increased significantly in 2022, likely due to COVID-related interruptions in global vaccination campaigns

During the first two months of 2022, the number of reported measles cases worldwide increased 79% compared to the same period in 2021, according to UNICEF and the WHO. In 2020, 23 million children missed out on routine childhood immunizations, the highest number since 2009, as the COVID-19 pandemic interrupted routine childhood vaccinations globally. Countries with the largest measles outbreaks since the past year include Somalia, Yemen, Nigeria, Afghanistan, and Ethiopia. Insufficient measles vaccine coverage is the major reason for outbreaks, wherever they occur.

Alaska Health Alert – Counterfeit pills containing fentanyl can cause an overdose death

Governor Mike Dunleavy, with the Alaska Department of Health and Social Services, is alerting Alaska residents, families, and schools about the threat of overdose due to counterfeit pills containing fentanyl. Alaska has seen a 71% increase in overdose deaths based on preliminary 2021 data, with 75% of all of the opioid overdose deaths involving fentanyl. In Alaska, fentanyl is commonly seen in blue pills made to look like pharmaceutical oxycodone. People who sell or purchase drugs may call these pills “M-30s,” “blues,” or“dirty 30’s”.

These fake pills are usually blue in color and stamped to look like real oxycodone pills you would get from a pharmacist. In 2021, Alaska experienced one fentanyl-related overdose death among youth aged 0-17 years and 15 fentanyl-related overdose deaths among young adults aged 18-24 years (preliminary data).

Alaska Influenza Snapshot – April 17–April 23, 2022

The State of Alaska DHSS Section of Epidemiology publishes a weekly snapshot of influenza surveillance and activity during the flu season. The report from Week 16: April 17, 2022 – April 23, 2022 was recently published.

COVID-19 Deaths – Flag Memorial on National Mall in Washington, D.C.

The New York Times published a short documentary exploring a participatory art project by Suzanne Brennan Firstenberg titled “In America: Remember” at the National Mall in Washington, D.C. In September 2021, more than 660,000 white flags were planted on the National Mall with each white flag representing a life lost to COVID in the United States.

MMWRs

As of February 2022, almost 60% of the US has COVID-antibodies from prior infection

In this MMWR, researchers use from CDC’s national commercial laboratory seroprevalence study and the 2018 American Community Survey to examine U.S. trends in infection-induced SARS-CoV-2 seroprevalence during September 2021–February 2022, by age group. During December 2021–February 2022, overall U.S. seroprevalence increased from 33.5% (95% CI = 33.1–34.0) to 57.7% (95% CI = 57.1–58.3). Over the same period, seroprevalence increased from 44.2% (95% CI = 42.8–45.8) to 75.2% (95% CI = 73.6–76.8) among children aged 0–11 years and from 45.6% (95% CI = 44.4–46.9) to 74.2% (95% CI = 72.8–75.5) among persons aged 12–17 years. Seroprevalence increased from 36.5% (95% CI = 35.7–37.4) to 63.7% (95% CI = 62.5–64.8) among adults aged 18–49 years, 28.8% (95% CI = 27.9–29.8) to 49.8% (95% CI = 48.5–51.3) among those aged 50–64 years, and from 19.1% (95% CI = 18.4–19.8) to 33.2% (95% CI = 32.2–34.3) among those aged ≥65 years. As of February 2022, approximately 75% of children and adolescents had serologic evidence of previous infection with SARS-CoV-2, with approximately one third becoming newly seropositive since December 2021. The greatest increases in seroprevalence during September 2021–February 2022, occurred in the age groups with the lowest vaccination coverage. These findings illustrate a high infection rate for the Omicron variant, especially among children. Seropositivity for anti-N antibodies should not be interpreted as protection from future infection.

Disparity in COVID-19 age-adjusted death rates decreased significantly for most racial and ethnic groups from 2020 to 2021

This analysis used U.S. provisional mortality data from death certificates collected by CDC’s National Vital Statistics System to estimate changes in COVID-19–related age-adjusted death rates (AADRs) by race and ethnicity during 2020–2021. Total COVID-19 deaths (and crude death rates) increased from 350,831 (106.5 per 100,00 population) in 2020 to 411,465 (124.9) in 2021. From 2020 to 2021, disparities in AADR ratios from COVID-19 decreased significantly by 14.0%–40.2% for most racial and ethnic groups, including non-Hispanic White persons, who accounted for 59.6%–65.2% of all decedents; and increased nonsignificantly (7.2%) for non-Hispanic Native Hawaiian and other Pacific Islander persons (0.2%–0.3% of all decedents) compared with non-Hispanic multiracial persons. In 2020, AADR was lowest among multiracial persons (29.6 per 100,000 population). In 2020, compared with multiracial persons, the AADR ratio (relative disparity) was 5.9 for AI/AN, 2.1 for Asian, 4.8 for Black, 5.3 for Hispanic, 3.8 for NH/OPI, and 2.3 for White persons. Overall AADR increased by 19.2% from 85.0 in 2020 to 101.3 per 100,000 U.S. residents in 2021, including 3.8% among AI/AN, 57.1% among multiracial, 68.3% among NH/OPI, and 35.1% among White persons; and decreased by 1.9% among Asian, 6.1% among Black, and 1.2% among Hispanic persons. In 2021, the AADR relative disparity decreased by 34.0% for AI/AN, 37.6% for Asian, 40.2% for Black, 37.1% for Hispanic, and 14.0% for White persons. The increase among NH/OPI persons was not statistically significant (7.2%, from 3.8 in 2020 to 4.1 in 2021). Using non-Hispanic White persons as the referent group yielded significant decreases in AADR ratios for AI/AN (−23.2%), Asian (−27.4%), Black (−30.5%), and Hispanic persons (−26.9%), but a significant increase for NH/OPI persons (24.6%). Compared with multiracial U.S. residents, who had the lowest COVID-19–related death rate, disparity in COVID-19 AADRs decreased significantly for most racial and ethnic groups from 2020 to 2021. Reductions in disparities in AADR for most racial and ethnic groups reflect the widespread impact of effective interventions, including vaccination, deployed since January 2020 to prevent SARS-CoV-2 infection and severe COVID-19 disease and death. Because AADR increased 57.1% among multiracial persons (the referent group for measuring disparity) from 2020 to 2021, percent reductions in AADR ratios for the other racial and ethnic groups were approximately 10% larger than they would have been had non-Hispanic White persons been used as the referent group and larger than they would have been if the AADR for the multiracial group had decreased or remained constant from 2020 to 2021.

COVID-19 hospitalization rates for children age 5-11 were 2.3 times higher during Omicron peak than during Delta peak

In this MMWR, COVID-19–Associated Hospitalization Surveillance Network (COVID-NET) data were analyzed to describe characteristics of COVID-19–associated hospitalizations among 1,475 U.S. children aged 5–11 years throughout the pandemic, focusing on the period of early Omicron predominance (December 19, 2021–February 28, 2022). Among 397 children hospitalized during the Omicron-predominant period, 87% were unvaccinated, 30% had no underlying medical conditions, and 19% were admitted to an ICU. The cumulative hospitalization rate during the Omicron-predominant period was 2.1 times as high among unvaccinated children (19.1 per 100,000 population) as among vaccinated children (9.2). Non-Hispanic Black (Black) children accounted for the largest proportion of unvaccinated children (34%) and represented approximately one third of COVID-19–associated hospitalizations in this age group. Children with diabetes and obesity were more likely to experience severe COVID-19. The potential for serious illness among children aged 5–11 years, including those with no underlying health conditions, highlights the importance of vaccination among this age group. Increasing vaccination coverage among children, particularly among racial and ethnic minority groups disproportionately affected by COVID-19, is critical to preventing COVID-19-associated hospitalization and severe outcomes. During the Delta- and Omicron-predominant periods, weekly hospitalization rates of children aged 5–11 years peaked during the weeks ending September 25, 2021 and January 22, 2022, respectively; the Omicron-predominant peak (2.8 per 100,000 children) was 2.3 times the Delta-predominant peak (1.2). Peak ICU admission rates were 1.7 times as high during Omicron predominance (2-week period ending January 25, 2022 [1.2]) than during Delta predominance (2-week period ending October 2, 2021 [0.7]).

Of the hospitalized children, 67% had one or more underlying medical conditions. Across periods, 32% of hospitalized children aged 5–11 years had severe COVID-19; 44% of Black children and 26% of Hispanic children experienced severe disease, compared with 22% of White children, but the association between severe COVID-19 and race or Hispanic ethnicity was not statistically significant. The risk for severe COVID-19 among hospitalized children was significantly higher among those with diabetes (aRR = 2.5) and obesity (aRR = 1.2). Risk for severe disease was lower among children with asthma (aRR = 0.8), immunocompromising conditions (aRR = 0.7), and those hospitalized during the Delta-predominant (aRR = 0.8) and Omicron-predominant periods (aRR = 0.6). Other conditions were not significantly associated with severe COVID-19 among hospitalized children.

At least half of Asian, Black, and multiracial U.S. high school students report experiencing racism during their life

Throughout the COVID-19 pandemic, communities of color have been disproportionately affected by severe outcomes of COVID-19 (e.g., hospitalizations, intensive-care admissions, or in-hospital deaths) and limited access to quality health care. Structural racism is associated with inequities in COVID-19 morbidity, hospitalization, and mortality. In spring 2021, CDC implemented the Adolescent Behaviors and Experiences Survey (ABES), a nationally representative sample of high school students, included a single-item measure of perceived racism. Using ABES data, this report examines perceived racism and the extent to which perceptions of racism are associated with behavioral health outcomes among adolescents. During January–June 2021, approximately one third (35.6%) of all high school students reported they were “ever” treated badly or unfairly in school because of their race or ethnicity during their lifetime (i.e., perceived racism). Perceived racism was highest among Asian students (63.9%), followed by Black (55.2%) and multiracial students (54.5%). Prevalence of perceived racism for Asian, Black, NH/OPI, Hispanic, and multiracial students was higher than perceived racism for White (22.5%) and AI/AN students (26.7%). Higher prevalences of perceived racism were reported among students with poor mental health (38.1% versus 23.6%); those with difficulty concentrating, remembering, or making decisions (44.1% versus 28.6%); and those that did not feel close to persons at their school (40.7% versus 29.6%). The ABES nationally representative findings demonstrate that at least half of Asian, Black, and multiracial U.S. high school students reported experiencing racism during their life. Notably, perceived racism was reported by students belonging to all racial and ethnic groups, with higher prevalence among students who reported poor mental health during the COVID-19 pandemic, not feeling close to persons at school, and difficulty concentrating, remembering, or making decisions than those who did not report such mental health and behavioral characteristics.

Approximately 1/3 of US high school students experienced poor mental health during the COVID-19 pandemic and during the past 30 days

To understand the impact of COVID-19 on youth mental health and to identify potential protective factors, this study examines U.S. high school students’ mental health and suicidality during the COVID-19 pandemic, including the relation between mental health and connectedness to school, family, friends, and community groups. Approximately one in three high school students experienced poor mental health (most of the time or always) during the COVID-19 pandemic (37.1%) and during the past 30 days (31.1%). During the 12 months before the survey, 44.2% experienced persistent feelings of sadness or hopelessness; that is, had ever felt so sad or hopeless almost every day for two weeks or more in a row that they stopped doing some usual activities. The prevalence of poor mental health during the pandemic, poor mental health during the past 30 days and persistent feelings of sadness or hopelessness were higher among female than male students. Although differences by race and ethnicity were detected for each of these three variables, no consistent patterns were found. The prevalence of poor mental health during the pandemic was higher among gay, lesbian, or bisexual students and other or questioning students than among heterosexual students. Heterosexual students had the lowest prevalence. During the 12 months before the survey, 19.9% of students had seriously considered attempting suicide, and 9.0% had attempted suicide. The prevalence of having seriously considered attempting suicide and attempting suicide was higher among female students than male students and varied by race and ethnicity. The prevalence of having seriously considered attempting suicide was higher among White students than Black or Asian students and higher among multiracial students than Black students. The prevalence of having attempted suicide was higher among AI/AN students than White, Black, Hispanic, or Asian students. The prevalence of having seriously considered attempting suicide and attempted suicide was highest among gay, lesbian, or bisexual students, followed by other or questioning students. At the time of the survey, 46.6% of students strongly agreed or agreed that they felt close to persons at school. 44.2% of students experienced persistent feelings of sadness or hopelessness, almost 20% seriously considered suicide, and 9.0% attempted suicide during the 12 months before the survey.

Routine childhood vaccination rates decreased in 2021-2020 compared to 2019-2020

This report summarizes data collected for the 2020–21 school year by state and local immunization programs on vaccination coverage among children in kindergarten in 47 states and DC, exemptions for kindergartners in 48 states and DC, and provisional enrollment or grace period status for kindergartners in 28 states. Nationally, 2-dose MMR coverage was 93.9% (median = 93.7%; range = 78.9% [DC] to ≥98.9% [Mississippi]). Coverage ≥95% was reported by 16 states and <90% by 7 states and DC. DTaP coverage was 93.6% (range = 78.5% [DC] to ≥98.9% [Mississippi]). Coverage ≥95% was reported by 16 states, and coverage <90% by eight states and DC. Varicella vaccine coverage nationally was 93.6% (range = 78.0% [DC] to ≥98.9% [Mississippi]), with 17 states reporting coverage ≥95% and nine states and DC reporting <90% coverage. Compared with the 2019–20 school year, vaccination coverage decreased by approximately one percentage point for all vaccines. Although 2.2% of kindergartners had an exemption from at least one vaccine, an additional 3.9% who did not have a vaccine exemption were not up to date for MMR. The COVID-19 pandemic affected schools’ vaccination requirement and provisional enrollment policies, documentation, and assessment activities. During the 2020–21 school year, vaccination coverage among kindergartners nationwide was lower than during the 2019–20 school year at approximately 94% for MMR, DTaP, and varicella vaccines, a level just under the target of 95%; coverage for all three vaccines decreased in a majority of states.

RECURRENT TOPICS

Providing COVID-19 vaccinations

All Alaskans and people who work or live in Alaska who are aged 5 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

Free self-paced online course available to promote COVID-19 vaccine confidence in Alaskan Communities

Two online courses are available for free through the UAA Alaska Center for Rural Health & Health Workforce in partnership with the State of Alaska Department of Health and Social Services Division of Public Health. These courses are designed to provide participants the knowledge and skills to promote COVID-19 vaccine confidence among clients, family, friends, patients and/or community members in Alaskan communities. For those who complete the online course, there is an option to attend the live practical session to apply what they learned.  These will occur monthly until the end of June and the live sessions are also free. 

The Provider course is designed for licensed, or license eligible healthcare providers (1 contact hour, Interprofessional Continuing Education credit [ANMC]).

The Community course is aimed at entry level healthcare professionals and the interested public (approximately 3 hours)

Oral COVID-19 Antivirals

The FDA has authorized two oral antivirals – Paxlovid and Molnupiravir - for the treatment of mild-to-moderate COVID-19 in adults 18 years and older who are at high risk for progression to severe COVID-19. Paxlovid is also authorized for children age 12-17 years.

Monoclonal Antibodies

Currently, only Eli Lilly’s bebtelovimab monoclonal antibody shows high activity against the BA.2 Omicron subvariant. It is approved to treat mild-moderate COVID-19 in individuals 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.

For the latest recommendations, check out the NIH COVID-19 Treatment Guidelines

Pregnancy

The CDC strongly recommends 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. In addition, JAMA has published a one-page patient information sheet on COVID-19 and pregnancy.

Post-acute Sequelae of COVID-19 (PASC)

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

COVID-19 Speakers’ Bureau

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

Aside from COVID-19

No Surprises Act Overview for Alaska Providers and Payers

On May 10 from 11AM-12p.m. there is a webinar co-hosted by the Centers for Medicare & Medicaid Services, the Alaska Division of Insurance, and the Division of Retirement and Benefits to provide information and answer questions about the No Surprises Act. The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.

Registration link: https://regtap.cms.gov/reg_events_view.php?class=526

IMPORTANT NOTE: This webinar requires registration through REGTAP in advance. If you are a new user to REGTAP, you will need to create an account. Registration for this webinar CLOSES at 3:00 p.m. ET on Monday, May 9. Register today to ensure a smooth webinar experience. 

You must register by 3:00 p.m. May 9, 2022, to attend this event. Please register by visiting the following link:  https://regtap.cms.gov/reg_events_view.php?class=526

To register, click the link above and complete these steps:

  • Log in to REGTAP or create a new account if  you do not already have one.
  • Select ”Training Events” from 'My Dashboard'.
  • Select the “View” icon next to the event titled: No Surprises Act Overview for Alaska Providers and Payers
  • Select “Register Me”. Need Help? Email Registrar@REGTAP.info or call 1 800 257 9520.

Provider Relief Fund – Request to report late

The Provider Relief Fund (PRF) Request to Report Late Due to Extenuating Circumstances process is intended for providers who were required to report in an applicable reporting period, but extenuating circumstances prevented them from submitting a report by the required deadline. For each PRF Reporting Period, a provider may request an opportunity to complete their report after the reporting period deadline based on attestation that one of the following allowable extenuating circumstances applies at the time of the deadline: severe illness or death, impacted by natural disaster, lack of receipt of reporting communications, failure to click “submit,” internal miscommunication or error, or incomplete targeted distribution payments.

CDC Health Advisory: Recommendations for Adenovirus Testing and Reporting of Children with Acute Hepatitis of Unknown Etiology

On April 21, the CDC released a Health Advisory for US clinicians who may encounter pediatric patients with hepatitis of unknown etiology to consider adenovirus testing and to elicit reporting of such cases to state public health

authorities and to CDC. In November 2021, clinicians at a large children’s hospital in Alabama notified the CDC of five pediatric patients with significant liver injury, including three with acute liver failure, who also tested positive for adenovirus. All children were previously healthy. None had COVID-19. Two patients required liver transplant; no patients died. A possible association between pediatric hepatitis and adenovirus infection is currently under investigation.

Public Naloxone Training

DHSS OSMAP Project HOPE are conducting public naloxone trainings as a community outreach and to increase awareness and access. Email projecthope@alaska.gov.

Harm reduction strategies and resources

The Alaska Native Tribal Health Consortium (ANTHC) HIV/STD Prevention and Substance Misuse Prevention programs host free virtual gatherings to discuss harm reduction strategies and resources in Alaska. Guest speakers are Alaska-based experts in the field of harm reduction. Recordings of harm reduction trainings can be found here.

Several useful materials specific to Alaska opioid safety are at the following webpage. Check it out and print out information to hang up in your community.

CPT1A Arctic Variant Refresher

The CPT1A Arctic Variant is a genetic mutation that is commonly in many Alaska Native people. Among the Yu’pik and Inupiaq Alaska Native people it is the most common form of CPT1A. During an illness where children have reduced fluid and caloric intake, children with CPT1A Arctic Variant are at increased risk of hypoglycemia, seizures, and death. ANTHC has published a brief video explaining this condition for physicians, other health care providers, and anyone else interested. In addition, Dr. Matthew Hirschfeld, Medical Director of Maternal Child Health Services at Alaska Native Medical Center, has published slides from a recent presentation on CPT1A Arctic Variant and COVID-19 in Kids.

Caring for women Veterans in the community

Women Veterans are the fastest growing Veteran population in the VA healthcare system. They have unique health care needs that may require different assessments, care and resources compared to non-Veterans. For example, issues such as military sexual trauma, musculoskeletal pain, and post-deployment readjustment can impact women Veterans differently.  To get the highest-quality care, women Veterans must have access to clinicians who are trained in women Veteran’s health. Community providers might not be aware of the special areas of concern that need to be addressed. To this end, the VA’s Office of Women’s Health has created a one-hour web-based training module Caring for Women Veterans which trains community care clinicians to provide Veteran and gender-specific care. Community Care Providers can take this training (CME available) and learn ways to talk about patients’ military history and address physical, mental, and reproductive health challenges unique to women Veterans.

Upcoming Events/Conferences/Presentations

CDC COCA Call - Evaluating and Supporting Patients Presenting with Cognitive Symptoms Following COVID

On May 5 from 2-3p.m. ET, presenters will discuss post-COVID conditions (PCC), an umbrella term for the wide range of health consequences that are present four or more weeks after infection with SARS-CoV-2, which includes long COVID. Cognitive symptoms, often described by patients as “brain fog”, are frequently reported following SARS-CoV-2 infection. The American Academy of Physical Medicine and Rehabilitation (AAp.m.&R) has recently published a Multi-Disciplinary Collaborative Consensus Guidance Statement on the Assessment and Treatment of Cognitive Symptoms in PCC that provides practical guidance to clinicians in the assessment and treatment of individuals with cognitive symptoms and a history consistent with PCC. The burden of PCC is expected to reflect the disproportionate burden of infection by race, ethnicity, and socioeconomic status and to highlight ongoing inequities in health care. The Health Equity Work Group of the AAp.m.&R has developed guidance to highlight the central role that principles of diversity, equity, and inclusion play in delivering quality health care.

Webinar Link: https://www.zoomgov.com/j/1603316732
Passcode: 828356

Dial In:
US: +1 669 254 5252
or +1 646 828 7666
or +1 551 285 1373
or +1 669 216 1590

One-tap mobile:
US: +16692545252,,1603316732#,,,,*828356#  or +16468287666,,1603316732#,,,,*828356#
Webinar ID: 828356

Drug Addiction Treatment Act (DATA) Waivers ECHO

UAA Center for Human Develop.m.ent and the State of Alaska Division of Behavioral Health are pleased to offer a new Project ECHO for medical providers who are currently DATA waivered and/or medical providers who are interested in obtaining a DATA waiver. 

  • May 11 at 12:00 p.m. — Behavioral Health - Psychosocial adjuncts to MAT
  • June 8 at 12:00 p.m. — Polysubstance use
  • July 13 at 12:00 p.m. — Tapering or stopping buprenorphine treatment
  • August 10 at 12:00 p.m. — Prenatal/OB MAT
  • Sept 14 at 12:00 p.m. — Understanding and reducing buprenorphine diversion

Registration link for DATA Waivers ECHO:
https://echo.zoom.us/meeting/register/tJYqce-gqDovGdDitNu5EPxMU1UOPrBth7Wv

Hosted and facilitated by UAA’S Center for Human Develop.m.ent Alaska ECHO Project in partnership with the State of Alaska Division of Behavioral Health. For questions, please contact echo@alaskachd.org

ANTHC Tribal Health Webinar Series

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

  • May 6: Jessie Downes, MSN, DNP, RN. Alaska DHSS. Alaska Hypertension Program
  • Friday, May 13th: Ryan Moore, MD. ANMC Orthopedics. The Perfect Knee Injection & Canes- Which Hand?
  • Friday, May 20th: Graham Milam, MD. ANMC Orthopedics. Anesthesia for Hand Injuries
  • Friday, May 27th: John Clark, MD. ANMC Pulmonology. Bronchiectasis in Alaska
  • Friday, June 3rd: ANTHC Hepatology: HCV Simplified Treatment Training Course.

In light of participant feedback, we will not have any webinars throughout the remainder of June or in the month of July since many individuals will be participating in subsistence activities during these months. We will resume the series in August.

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

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:

NIH COVID-19 Treatment Guidelines

IDSA Guidelines on the Treatment and Management of Patient with COVID-19

Alaska Responders Relief Line (844) 985-8275

Your well-being matters. Your behavioral health colleagues are standing by to talk 24/7: 844-985-8275

Recognizing the unique stressors that providers face, the Division of Behavioral Health has established a 24/7 support line, (844) 985-8275, for healthcare and behavioral professionals impacted by COVID personally and professionally. Staff supporting the call line recognize callers are often first responders and will allow callers to openly express their experiences and feelings serving Alaskans impacted by COVID.

This service is also available to immediate family members of first responders who may be experiencing stress, anxiety and other hard to label emotions as a result of their loved one engaging on the front lines.