COVID-19 UPDATE #107
December 2, 2020
DOH WAREHOUSE - PCR TESTING SUPPLIES AVAILABLE
WHCA was able to confirm that assisted living and skilled nursing facilities can obtain PCR testing supplies from the Department of Health (DOH) warehouse ordering website. From what we have been told, there is no cost for these supplies.
DOH POSTS UPDATED GUIDANCE ON ACTIVITIES, DINING, AND VISITATION FOR LTC FACILITIES
The Department of Health (DOH) has posted updated guidance on their website specific to long term care. The guidance documents are designed to help long term care providers navigate the challenges of COVID-19.
CHELAN-DOUGLAS HEALTH DISTRICT
The Chelan-Douglas Health District issued a letter stressing the need for long term care facilities to follow Phase 1 guidance of the state’s Long-Term Care Safe Start Plan effective immediately. The letter noted that because of the increasing number of COVID-19 cases in the communities, increased stress on the local health care system, and an increase in the number of outbreaks at licensed long term care facilities, skilled nursing facilities, assisted living facilities, adult family homes, enhanced service facilities, intermediate care facilities for individuals with intellectual disabilities, and certified community residential services and supports, follow Phase 1 of the Long Term Care Safe Start Plan effective immediately.

Under Phase 1 of the state’s Long Term Care Safe Start Plan, outdoor visitation is limited to two (2) visitors per day and indoor visitation is limited to end of life or, if a resident is unable to participate in outdoor or remote visits, an essential support person is allowed to visit once daily only for a compassionate care reason. In addition, group activities are restricted and communal dining is not recommended. If you have questions about the Chelan-Douglas County Public Health directive, please contact Elena Madrid or Vicki McNealley.
LTC RESIDENTS PLACED AT VACCINE HIGHEST PRIORITY
On Tuesday, December 1, the Centers for Disease Control (CDC) Advisory Committee on Immunization Practices (ACIP) voted to include long term care residents at the highest level of priority for the first distributions of a COVID-19 vaccine. This includes residents of skilled nursing centers, assisted living communities and other residential care settings.  

Long term care residents are now included with health care workers in Phase 1a. This is extremely important because going into the meeting, our residents were Phase 1b, just after health care workers. View the materials that were discussed during the ACIP meeting. 

Unfortunately, the reality is that there will not be enough doses in the initial batches of vaccine for everyone in the top tier to be vaccinated immediately. Pfizer projects they can produce only 6.5 million initial doses of their vaccine. There are at least 21 million health care workers and three million long term care residents.  

In addition, states are not required to follow these guidelines. It will now be up to each state to decide how to allocate its limited supply of vaccine. AHCA/NCAL and its state affiliates are hopeful that the evidence supporting the ACIP decision will help make the case to governors that our residents and employees should be first to receive the vaccine. If governors prioritize long term care settings, they can cut the overall COVID-19 death rate in their state by almost half in the next 60 days. Our argument is strengthened by this decision, but our work is not done. AHCA/NCAL will keep fighting for our residents and staff and won’t stop until everyone in our buildings has access to the vaccine. 
CDC UPDATES STRATEGIES FOR OPTIMIZING FACEMASK SUPPLY
The Centers for Disease Control and Prevention (CDC) has made several updates on guidance for facemasks for health care personnel (HCP). AHCA/NCAL encourages providers to review the latest updates. 

The updates include:  
  • ​Additional considerations for returning to conventional capacity practices.
  • Conventional capacity strategies: Clarified HCP use of facemasks for source control and as PPE to protect their nose and mouth from exposure to splashes, sprays, and respiratory secretions. 
  • Contingency capacity strategies
  • ​Added clarifications on extended use of facemasks as PPE. 
  • Added clarifications on restriction on facemask use by HCP as PPE rather than by patients for source control. 
  • ​Crisis capacity strategies
  • ​Revised section on limited re-use paired with extended use. 
  • Deleted the strategies of designating convalescent HCP for the provision of care of patients with SARS-CoV-2 infection, use of expedient patient isolation rooms, and mechanical headboards. 

Please visit Strategies for Optimizing the Supply of Facemasks to learn more. Please contact covid19@ahca.org with any questions.
NATIONWIDE RESPIRATOR AND CARTRIDGE GIVEAWAY FOR HEALTHCARE AND FIRST RESPONDERS
The National Institute for Occupational Safety and Health (NIOSH) is planning a nation-wide give away of hundreds of thousands of elastomeric half facepiece respirators and replacement cartridges in early 2021 to healthcare establishments (e.g., hospitals, nursing homes, long term care facilities) and first responders (e.g., EMTs, law enforcement, fire fighters).

To be eligible, you will need to send NIOSH a “Statement of Interest” by the recently extended deadline of December 14, 2020, and include: 
  • institution size, location, and contact information
  • how, why, and where you would use these elastomeric respirators including training and fit-testing

Send your statement to either ppeconcerns@cdc.gov or mail to NIOSH, Attention: Dr. Lee Greenawald, 626 Cochrans Mill Road, Building 141, Pittsburgh, PA 15236.

In exchange for receiving elastomeric respirators, participants would provide feedback about their experiences using the respirators to NIOSH to help them improve future best practice guidance for healthcare and first responders. For further details, see the Federal Register Notice, page 56618 (third column).
MONOCLONAL ANTIBODY AVAILABLE TO SNF FACILITIES
The federal government is sending Washington State a monoclonal antibody product to the Department of Health (DOH). Kathy Lofy, MD, State Health Officer for DOH, has indicated that DOH will be distributing it to skilled nursing facilities that are interested in receiving the product. If you are interested, you can access this investigational drug and have ability to give the infusion. Information about the product and how to access it is available here

Any health care facility able to abide by the requirements in the provider fact sheet will be eligible to receive the medication. If you have questions, please email Jennifer Dixon at DOH.
ADDITIONAL RESOURCES
WHCA continues to post resources and information as it becomes available on our website. If you have questions or need additional information, please call the WHCA office at (800) 562-6170.