A Time for Reflection and Renewal

Rosh Hashanah marks the beginning of a fresh chapter, a time for introspection, reflection, and the opportunity to set intentions for the year ahead. Let's take this time to appreciate the diversity of our community and the richness that different cultures and traditions bring to our organization. Wishing you a happy and healthy Rosh Hashanah filled with blessings and renewal. Shana Tova! (Rosh Hashanah begins at sunset on Friday, September 15 and continues through sundown on Sunday, September 17.)

The Physicians Foundation, Dr. Lorna Breen Heroes' Foundation Call for Systemic Change to Improve Current and Future Physicians' Wellbeing

Physicians have one of the highest suicide rates of any profession. While physician suicide was a crisis long before COVID-19, the demands of the pandemic have created a sense of urgency to better support physicians’ mental health and wellbeing. We can all help prevent physician suicide. National Physician Suicide Awareness Day (#NPSADay) is a reminder and call to action. Learn more.

The Physicians Foundation announces its new survey, 2023 Survey of America’s Current and Future Physicians, with findings that demonstrate a critical need for systemic changes within the health industry to help improve the future of medicine. Similar to previous years, the state of physician wellbeing remains low; however, residents and medical students report even lower states of wellbeing. In recognition of National Physician Suicide Awareness (NPSA) Day on September 17, The Physicians Foundation and The Dr. Lorna Breen Heroes’ Foundation are accelerating systems change through Vital Signs: The Campaign to Prevent Physician Suicide to improve the wellbeing of physicians at all stages of their careers. 

To better support the future physician workforce, The Physicians Foundation and The Dr. Lorna Breen Heroes’ Foundation launched Dear FutureDoc, a new initiative from the Vital Signs campaign around NPSA Day. The goals of Dear FutureDoc are to encourage future physicians to reflect on their own mental health and wellbeing, to support each other, and share their hopes for the future of physician wellbeing. 

CDC Follows Suit, with Final Decision to Approve for Those 6 months and Up

On Monday this week, the U.S. Food and Drug Administration (FDA) took action approving and authorizing for emergency use updated COVID-19 vaccines formulated to more closely target currently circulating variants and to provide better protection against serious consequences of COVID-19, including hospitalization and death. The actions relate to updated mRNA vaccines for 2023-2024 manufactured by ModernaTX Inc. and Pfizer Inc. Consistent with the totality of the evidence and input from the FDA’s expert advisors, these vaccines have been updated to include a monovalent (single) component that corresponds to the Omicron variant XBB.1.5. Although the XBB.1.5 variant is no longer dominant, FDA determined that it’s close enough to coronavirus strains causing most COVID-19 illnesses today to offer good cross-protection. Health officials noted the vaccine is not a booster shot but actually an entirely new formula. The FDA says most over 4 years old can get a Pfizer-BioNTech or Moderna shot, regardless of previous vaccinations. However, patients should wait at least two months between the last vaccination and 90 days after the last infection. 

On Tuesday, September 12th, the Centers for Disease Control and Prevention (CDC) advisory meeting was held to discuss who should get the new shots, by Pfizer-BioNTech and Moderna. Some members of the CDC advisory panel were unsure about recommending the new COVID vaccines to younger adults, or had misgivings about potential side effects, especially in children and young males. And others worried that endorsing the vaccines for all Americans might undermine messaging about the greater need among those who are at highest risk from COVID, including older adults. A final decision was made not to offer to a targeted audience but recommending that the updated vaccine be available for everyone 6 months and older, citing data showing the short- and long-term risks of COVID at any age. While CDC's recommendation only applies to the COVID-19 vaccines made by Pfizer-BioNTech and Moderna, Demetre Daskalakis, acting director of CDC's National Center for Immunization and Respiratory Diseases, said the voting language was made to be "inclusive" for any vaccines authorized by FDA in the coming months. The updated vaccines should work well against currently circulating variants, including BA.2.86. It is expected the vaccines will be available by the end of this week for everyone who wants them, being shipped to pharmacies, clinics, and health systems nationwide. See new CPT coding for COVID-19 vaccines effective September 11th.

Under the Affordable Care Act, all insurance companies are required to cover vaccines that are recommended by the Advisory Committee on Immunization Practices (ACIP), including the updated COVID-19 vaccines. All children without insurance can get their COVID-19 vaccine under the Vaccines for Children Program. Uninsured or underinsured adults can get their COVID-19 vaccine for free under the Bridge Access Program through the end of 2024 from participating providers, HRSA-supported health centers, and pharmacies. Uninsured or underinsured adults can go to vaccines.gov to find COVID-19 vaccines at no cost to them. The COVID-19 vaccines available at no cost through the Bridge Access Program will become available across the United States at the same time as these vaccines become available through regular insurance and standard mechanisms.

Could Mean Similar Benefits for U.S. Flu Season

Evaluations of flu vaccine effectiveness during the April–September Southern Hemisphere flu season can provide valuable information for countries preparing for the October–May Northern Hemisphere flu season. Investigators found that people from five South American countries who had gotten flu vaccines were half as likely to be hospitalized with flu during the 2023 Southern Hemisphere flu season compared to people who did not get vaccines. These preliminary data suggest that if the same viruses continue to circulate during the upcoming flu season in the United States, U.S. 2023-2024 flu vaccines could provide similar benefits against serious flu disease. 

Saturday, November 18 - Christiana Hilton, Newark

Save the Date! for the 234th MSD Annual Meeting to be held on Saturday, November 18th. This year's meeting will be held at the Christiana Hilton in Newark. MSD's Educational Program Planning Subcommittee is putting together a phenomenal CME program about nutrition. Following a morning of education, the Council will meet with a full agenda anticipated. All MSD members are encouraged to attend. Click here to view the Annual Meeting agenda. American Medical Association (AMA) President, Jesse Ehrenfeld, MD, MPH will present remarks from the AMA and we anticipate other VIPs in attendance. If you're not yet a DELPAC contributor, please consider making a donation to be part of the exclusive DELPAC "Coffee and Conversation" with key legislators and MSD lobbyists. Our evening Inaugural Gala event is on hold for this year, but we expect to resume the social event next year. As a member of MSD, this event will afford you the opportunity to connect with your peers and meet new colleagues. Who knows what a chance meeting may lead to. Watch for future MSD communications for registration information. If you've not been to an Annual Meeting, plan to attend this year!

Thank you to our Council Members for their service to MSD and their constituents.

MSD thanks those supporting organizations that help make this event possible. Please consider them for your personal and professional needs.

Delaware's first WNV Cases of the Year

The Delaware Public Health Laboratory (DPHL) has identified this year’s first human cases of West Nile Virus (WNV) in three men 50 years of age and older, all of whom reside in New Castle County. All three individuals who contracted WNV were hospitalized due to infection from the mosquito-borne illness. At this time, it appears that each WNV victim is likely to have contracted the disease locally, but a public health investigation is ongoing. WNV is a mosquito-borne illness that can cause serious health problems, transmitted by mosquitoes, generally in summer and fall, with a peak period for disease transmissions from mid-August to mid-October. Nearly 80 percent or four in five people infected with WNV will not become ill. While only a little less than 20 percent of those infected with the virus will develop West Nile fever with mild symptoms (fever, headache, body aches, a skin rash on the chest or back and swollen lymph glands), one in 150 people infected will develop severe infection (West Nile encephalitis or meningitis). Symptoms of severe WNV infection include headache, high fever, stiff neck, and/or tremors and muscle weakness. The elderly and those with weakened immune systems are most at risk. Anyone who experiences any of these severe symptoms should seek medical help immediately. Symptoms may progress to stupor, disorientation, coma, convulsions, paralysis and possibly death. To report suspected cases of human WNV, call the Division of Public Health Office of Infectious Disease Epidemiology toll-free at 888-295-5156.   

Faces NCC Executive Matt Meyer in Democratic Primary in 2024

As a nurse, mom and proud Delawarean, I’m running for Governor to make Delaware the best place to live, work, and raise a family,” said Lt. Gov. Hall-Long. “There’s work to do to improve access to health care, create good-paying jobs, protect our rights, and strengthen our education system – and I’m up for the challenge because when you give a nurse a job – that job gets done.” Dr. Bethany Hall-Long has served as Delaware’s 26th Lieutenant Governor since 2017. As a member of the Democratic Party, she served in the Delaware House of Representatives from 2002-2008 and in the Delaware Senate from 2008-2017. She earned a BSN from Thomas Jefferson University, an MSN from the Medical University of South Carolina, and a PhD in health policy and nursing administration from George Mason University. As a lifelong nurse and research scientist, she has dedicated her medical career to addressing health inequities and expanding treatment options and access for mental health care in Delaware. She has been nationally recognized for her research and community service record with at-risk groups such as pregnant teens, diabetics, the homeless, and people facing mental health challenges and substance use disorder. She will face New Castle County Executive Matt Meyer in the Democratic primary next year. Photo of Lt. Gov Hall-Long courtesy of ltgov.delaware.gov.

CMS Announces Savings for Some Medicare Clients on 34 Part B Drugs

On Wednesday this week, the Centers for Medicare & Medicaid Services (CMS) announced the list of 34 prescription drugs for which Part B beneficiary coinsurances may be lower. Under the Inflation Reduction Act, people with Medicare may pay a lower coinsurance for some Part B drugs if the drug’s price increases faster than the rate of inflation. The lower Part B coinsurance on the listed drugs announced will be in effect from October 1, 2023, to December 31, 2023. This coinsurance adjustment applies to certain drugs and biologicals paid under Medicare Part B. The Part B drugs impacted by this coinsurance adjustment may change quarterly. CMS has released information about these 34 Part B drugs and biological products in the quarterly Average Sales Price (ASP) public files, available here. A fact sheet is available here. Should CMS receive feedback that necessitates updates to this list of drugs with adjusted coinsurance amounts, CMS will update the list.

What This Means for Physicians

On June 27, the Department of Health and Human Services Office of Inspector General finalized the regulations around civil money penalties for health IT developers, health information exchanges, and health information networks determined to be blocking information from the 21st Century Cures Act. Enforcement began on Sept. 1. Read this new American Medical Association (AMA) resource to learn more about the impact that this regulation will have on physicians, and what the AMA will be looking for in future regulatory actions.

States to Annually Report on Measures of Quality of Health Care Provided

Medicaid and the Children’s Health Insurance Programs (CHIP) play a significant role in America's health care system and, for the first time, states, the District of Columbia (DC), and certain territories are required to mandatorily report quality measures for health care provided to millions of people nationwide. CMS will use the data to assess access and quality of care furnished by state Medicaid and CHIP programs as part of its ongoing efforts to advance health equity for low-income adults, children, and people with disabilities.

Significant Updates to Section 504 of Rehabilitation Act Rule

Last week the U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), announced a proposed rule that prohibits discrimination on the basis of disability. The rule, Nondiscrimination on the Basis of Disability in Programs or Activities Receiving Federal Financial Assistance, updates critical provisions that help persons with disabilities access health and human services under Section 504 of the Rehabilitation Act of 1973. The rule, originally published in 1977, advances the promise of the Rehabilitation Act and helps to ensure that people with disabilities are not subjected to discrimination in any program or activity receiving funding from HHS just because they have a disability. While the Department is undertaking this rulemaking the current regulation is in effect. HHS encourages all stakeholders to submit comments through regulations.gov. Public comments on the Notice of Proposed Rule Making (NPRM) are due 60 days after publication of the NPRM in the Federal Register. The NPRM may be viewed or downloaded at the Federal Register: https://www.federalregister.gov/public-inspection/2023-19149/discrimination-on-the-basis-of-disability-in-health-and-human-service-programs-or-activities. A fact sheet on the NPRM is available at: https://www.hhs.gov/civil-rights/for-individuals/disability/section-504-rehabilitation-act-of-1973/fact-sheet/index.html. HHS will host a webinar on the NPRM on September 11, 2023, at 1-1:45 pm ET. Register here: https://hhsacl.zoomgov.com/webinar/register/WN_cbLO2lobQzecAJBkLKbP_A.

Informational Call to be Held September 26th

The American Medical Association (AMA) is announcing the creation of a Disability Advisory Group for the American Medical Association (AMA). If you are an AMA member, please consider this opportunity. The AMA will host an informational call on Tuesday afternoon, September 26. Please email william.jordan@ama-assn.org by Thursday, September 21 to receive the calendar invitation. The AMA hopes to assemble a diverse group of 8-16 people to meet virtually every 1-2 months starting in late 2023 for 24 months with possibly one hybrid meeting per year (travel support will be provided). The Disability Advisory Group was called into existence by AMA policy (D-615.977 Advocacy for Physicians and Medical Students with Disabilities). The policy specifies the group will be composed of AMA members (physicians and medical students) who themselves have a disability, and will focus on developing and promoting strategies for inclusion in all AMA activities, educational and training opportunities on disability, tools for physicians and students to advocate in the workplace, and communications to employers on reasonable accommodation. Thank you for considering this opportunity. 

Public Comment Period for This Proposed Rule Ends October 2nd

The proposed rule – published by the Departments of Labor, Health and Human Services, and Treasury – seeks to make it easier to get in-network mental health and substance use disorder care and eliminate barriers to access that keep people from getting the care they need. Read more.

SAMHSA Releases Important Resources in Work to End Overdose Crisis

On Tuesday this week, Substance Abuse and Mental Health Services Administration (SAMHSA) released, in collaboration with RTI International, two important resources intended to aid community practitioners in the ongoing work to end the overdose crisis. “Engaging Community Coalitions to Decrease Opioid Overdose Deaths” and "Opioid-Overdose Reduction Continuum of Care Approach (ORCCA)” are available for free online. These products will equip public health practitioners, coalitions, nonprofits, and other groups working to prevent opioid-related death in their local communities with knowledge and best practices.

AMA Releases the CPT 2024 Code Set

To bridge language barriers and make health care more inclusive and transparent for patients who speak Spanish, the American Medical Association (AMA) now offers Spanish language descriptors for more than 11,000 medical procedures and services. The consumer-friendly descriptors in Spanish were added to the newly released Current Procedural Terminology (CPT^® ) 2024 code set, the nation’s leading data-sharing terminology for medical procedures and services. The annual update to the CPT code set created 349 editorial changes, including 230 additions, 49 deletions and 70 revisions. With 11,163 codes that describe the medical procedures and services available to patients, the CPT code set continues to grow and evolve with the rapid pace of innovation in medical science and health technology. Learn more.

For Deaf and hard of Hearing Callers to 988

The U.S. Department of Health and Human Services (HHS) announced the 988 Suicide & Crisis Lifeline’s addition of nationwide American Sign Language (ASL) services for people who are Deaf and Hard of Hearing, as part of ongoing efforts to expand accessibility to behavioral health care for underserved communities. Since the July 2022 launch, the 988 Lifeline has received more than 5.5 million calls, texts, and chats, following a nearly $1 billion government investment, and will now be available to the millions of Americans who use ASL. To connect directly to a trained 988 Lifeline counselor in ASL, callers who are Deaf, DeafBlind, DeafDisabled, Hard of Hearing, and Late-Deafened can click the "ASL Now" button on 988lifeline.org and follow the prompts. Direct dialing to 988 from a videophone will be available in the coming weeks, and in the meantime, ASL callers can call 1-800-273-TALK (8255) from their videophone to reach ASL services.

Eight Recipients Chosen for Their Efforts to Educate, Inspire, Impact

Delaware Business Times, Delaware Today and Delaware State University announced the inaugural class of Mitchell Award honorees, individuals in the First State who have demonstrated leadership and success in the important areas of Diversity, Equity, Inclusion and Social Justice. Eight recipients of the award were chosen for their efforts to educate, inspire and impact communities across the state. A teacher, two nonprofit executives, the Twin Poets, two LGTBQ+ advocates and a former state legislator have been named the first recipients of Delaware State University’s Mitchell Awards. Named for the late Delaware civil rights pioneers Littleton and Jane Mitchell, the Mitchell Awards showcase those who are championing efforts to improve opportunities for all, regardless of their race, abilities or background. The late Mitchells had a long history in working for equal rights in Delaware through a difficult period in the state’s history, including on the landmark Brown v. Board of Education case that desegregated all American schools. The annual awards program will recognize a handful of advocates who will be honored at a special Nov. 9 event at the Christiana Hilton that will feature an awards presentation and a keynote speaker.

Commitment and Passion for Social and Community Change

The Delaware Secretary of State has begun accepting nominations for the John Lewis Youth Leadership Award. The award recognizes a gifted, civic-minded young Delawarean who has demonstrated leadership abilities, has a passion for social justice, and is improving the quality of life in their community. The John Lewis Youth Leadership Award was established by the National Association of Secretaries of State to honor the extraordinary accomplishments of the late Congressman John Lewis. His courageous achievements during the Civil Rights Movement and his long tenure of public service have inspired and will continue to inspire Americans for generations to come. Nominations for the John Lewis Youth Leadership Award will be accepted beginning on September 5th through October 20th, 2023. An award recipient will be announced in November 2023. To learn more about the John Lewis Youth Leadership Award or to nominate a young individual, visit de.gov/johnlewisaward.

Other Agencies Reported Similar Scams in the Past

According to WDEL, Wilmington Police are issuing a warning about a phone scam that involves a caller pretending to be from the police department. The caller mentions a DNA test as well as a fine. The person who receives the call is sometimes told to pay a "fine" using a payment card or a gift card. City Police said this is a fraud, and the police department would never demand payment or solicit money over the phone. Anyone who receives a call of this nature is asked to contact police at 302-654-5151. That number may also be called to verify the authenticity of any call that claims to be from police. Other agencies have reported similar scams in the past.

FDA Issues Safety Communication

The U.S. Food and Drug Administration (FDA) is working closely with the Centers for Disease Control and Prevention (CDC) to investigate recent reports of a tuberculosis (TB) outbreak caused by Mycobacterium tuberculosis (Mtb) that appears to be linked to a bone matrix product. The FDA issued the communication to increase awareness regarding the risk of transmission of Mtb through use of Human Cell, Tissue and Cellular, and Tissue-based Products (HCT/Ps) in the United States.

Inability to Exit MRI Mode

Abbott Medical is recalling its Proclaim and Infinity implantable pulse generators (IPGs) due to complaints from patients who are unable to exit MRI mode. The Patient Controller may lose the ability to connect or communicate with their IPG while in MRI mode. Example situations where this has occurred include when the PC device’s iOS operating system was updated, the PC app was updated or deleted, and when the IPG was deleted from the list of available Bluetooth devices on the PC device. The U.S. Food and Drug Administration (FDA) has identified this as a Class I recall, the most serious type of recall. Use of these devices may cause serious injuries or death.

FDA Issues Safety Communication

The U.S. Food and Drug Administration (FDA) is providing an update to their recommendations for O&M Halyard surgical N95 respirators to further enable use of existing inventory. The FDA continues to evaluate all available information about the quality and performance of certain models of surgical N95 respirators, surgical masks, and pediatric face masks manufactured by O&M Halyard. They will continue to keep the public informed as new or additional information becomes available. 

Not Opening Properly

Mallinckrodt is recalling its One-Way Valve, 22F x 22M due to devices not opening properly, which prevents or reduces the flow of ventilated air or oxygen. The FDA has identified this as a Class I recall, the most serious type of recall. Use of these devices may cause serious injuries or death. 

Due to Crystallization

Novartis is recalling one lot of its Sandimmune Oral Solution (cyclosporine oral solution, USP), 100 mg/mL in the US due to crystal formation observed in some bottles, which could potentially result in incorrect dosing. No other Sandimmune formulations are impacted. Crystallization of cyclosporine in Sandimmune Oral Solution is likely to result in non-uniform distribution of the cyclosporine in the product, resulting in under-dosing or over-dosing. There is a reasonable probability that under-dosing may result in lower exposures and decrease in efficacy which could ultimately lead to graft rejection and graft loss in transplant patients. Furthermore, over-dosage may manifest itself as cyclosporine toxicity in the long term if over exposure continues. The affected lot number and expiration date is: FX001691 (expiration date 12/2025). This lot was distributed nationwide to wholesalers across the US, beginning in April 2023. Novartis has not received any reports of adverse events related to this recall, to date.

FDA Issues Warning Letters

The U.S. Food and Drug Administration (FDA) has issued warning letters to eight companies (Boiron, Inc.; CVS Health, DR Vitamin Solutions; Natural Ophthalmics, Inc.; OcluMed LLC; Similasan AG/Similasan USA; TRP Company, Inc; and Walgreens Boots Alliance, Inc.) for manufacturing or marketing unapproved ophthalmic drug products in violation of federal law. Eye products addressed in the eight warning letters are illegally marketed to treat conditions such as conjunctivitis (“pink eye”), cataracts, glaucoma and others. Some of the FDA warning letters also cite the companies involved for quality issues related to product sterility. The FDA is particularly concerned that these illegally marketed, unapproved ophthalmic drug products pose a heightened risk of harm to users because drugs applied to the eyes bypass some of the body’s natural defenses. Some of these eye products are labeled to contain silver, which may be characterized as silver sulfate, silver sulphate or argentum. Long-term use of drugs containing silver can cause some areas of the skin and other body tissues, including in the eye, to permanently turn gray or blue-gray, which is called “argyria.” Additionally, unapproved drugs that claim to cure, treat or prevent serious conditions may cause consumers to delay or stop medical treatments that have been found safe and effective through the FDA review process. Consumers currently using eye products included in these warning letters should speak to their health care professional. The FDA encourages consumers and health care professionals to report any adverse reaction to the agency’s MedWatch program. Additionally, the agency has placed some of these companies on import alert to help stop their products from entering the U.S. and reaching consumers. The FDA’s investigation of eye products is ongoing, and the agency may take additional regulatory or enforcement actions, as warranted. 

Request an Appeal if You Believe There is an Error in Calculation

The Centers for Medicare & Medicaid Services (CMS) recently released Merit-based Incentive Payment System (MIPS) performance feedback and final scores for the 2022 performance year, which determine whether a physician will receive a positive, neutral or negative payment adjustment on Medicare services furnished in 2024. Physicians who believe there was an error in the calculation of the MIPS final score have until Oct. 9 to request an appeal. Read more.

Your MIPS Quality Performance Scores Matter!

The end of the year will be here before you know it. Don't wait until it is too late to put your practice in the best possible financial position. This week's Chirpy Bird blog post will enlighten you on a very important aspect that will set you up for financial stability. Learn the answers to these questions:

• What exactly is “MIPS Quality Performance”
• Why should you care about Quality Performance
• How can you best prepare for the end of the year MIPS evaluation

Chirpy Bird provides a free “2023 MIPS Month-by-Month” eBook. Download it here!

Identify and Support At-Risk Physicians

With burnout affecting more than half of U.S. physicians, doctors and practice administrators must know the risk factors and warning signs for suicide. Make it easy for physicians to get help. Fulfillment of CME with coursework on stress management and burnout is encouraged.

LEARN MORE:

• Toolkit: Preventing Physician Suicide
• Resource: Preventing Physician Suicide
• Playbook: Wellness-Centered Leadership

AMA STEPS Forward^® offers a collection of engaging and interactive educational content designed to help put the joy back into medicine.

Bayhealth

Beebe Healthcare

ChristianaCare

Delaware Hospice

Dakota M. Urban, MD

MSD spotlights members throughout the state, highlighting medical students, residents, and practicing colleagues, whether they are new to membership or have been a member over the years.

This week's spotlight is on Dakota M. Urban, MD, plastic surgeon at Dakota Urban, MD, PA - Christiana Cosmetic Surgery Consultants. Read more about Dr. Urban.

If you would like to be featured in a future Member Spotlight, please contact Michelle Seymour, Manager of Membership.

R. Walter Powell, MD

It is with sadness we share the passing of MSD member R. Walter Powell, MD. Dr. Powell passed away on September 9th at the age of 89. Dr. Powell attend the University of Pennsylvania Medical School and practiced Internal Medicine in Wilmington, Delaware, making a memorable impact on the patients he served through his lifelong commitment to medicine and his compassionate care. Services will be private and held at a later date. In honor of Dr. Powell's memory, the family requests that, in lieu of flowers, donations be made to the American Diabetes Association. Read obituary.

Elizabeth Habash - Medical Student, Sidney Kimmel Medical College (2026)

Please join MSD in welcoming the newest members of the Medical Society of Delaware. As the third oldest medical society in the country, MSD has an amazing history. Thank you for taking part in our continued success!

Fabian P. Ngido, MD - Pediatric Hospitalist, Beebe Healthcare

MSD members are afforded a seven-day review period from the date of this publication to comment regarding applicants for membership. Please contact Michelle Seymour at (302) 224-4905 or Michelle.Seymour@medsocdel.org with any comments on the current pending members listed above or if you know of someone interested in joining MSD. You could be eligible for a membership referral dues discount!

The Latin phrase Rerum Cognoscere translates to learn, examine, or become aware of facts or things. In this section, we highlight measurable items of interest in health care from MSD, Delaware, the US, and the world.

CDC Director Rochelle P. Walensky, M.D., M.P.H. adopted the 2023-2024 Advisory Committee on Immunization Practices’ (ACIP) recommendations on annual influenza (flu) vaccination for everyone 6 months and older in the United States on June 27, 2023. There were small changes to the annual recommendations around flu vaccination, including an acknowledgement of the updated flu vaccine composition for the 2023-2024 flu season and a change in the recommendations for vaccination of people with egg allergies. Dr. Walensky’s adoption of the ACIP recommendations makes them official CDC policy, which have been published in the Morbidity and Mortality Weekly Recommendation Report August 23, 2023. Health care professionals should begin vaccinating patients according to CDC’s recommended timing, which remains the same as last season. Read the CDC Vaccine Recommendations for the 2023-2024 flu season.

Flu Vaccination Guidance for Children

Flu can be a serious threat to children. During a COCA call on August 31, 2023, presenters discussed flu prevention and treatment recommendations from the American Academy of Pediatrics and CDC. If you’ve missed it, this recording is a great update on vaccination, coadministration of flu vaccines, coverage, and health disparities.

The national emergency and public health emergency (PHE) declarations related to the COVID-19 pandemic ended on May 11, 2023. The Centers for Medicare & Medicaid Services (CMS) has resources available, some of which have been updated based on recent action by Congress.

• Frequently Asked Questions: CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency (Updated 5/12/2023).
• Provider-specific fact sheets for information about COVID-19 Public Health Emergency (PHE) waivers and flexibilities: https://www.cms.gov/coronavirus-waivers
• Acute Hospital Care At Home
• Loss of Medicaid or CHIP coverage
• FAQs on CMS Waivers, Flexibilities, end of COVID-19 PHE (May 4, 2023)

Updates will continue to be provided as we approach the end of the PHE. You are encouraged to regularly visit the CMS Emergencies Page for the most up to date information.

• Find COVID-19 Vaccines: https://www.vaccines.gov/
• No Cost COVID-19 Testing Locator can help people find current community and pharmacy partners participating in the Increasing Community Access to Testing (ICATT) program.
• FDA At-Home OTC COVID-19 Diagnostic Tests provides a list of all FDA-authorized at-home over-the-counter (OTC) COVID-19 diagnostic tests
• Federal website for information on navigating COVID: COVID.gov
• CDC Isolation and Precautions for People with COVID-19
• COVID-19 Therapeutics Locator
• CDC COVID Data Tracker
• CDC will report regional-level test positivity data from the National Respiratory and Enteric Virus Surveillance System (NREVSS)
• COVID-19 by County Community Level Check (# hospital admissions and beds used and total number of new cases)
• 2nd bivalent COVID-19 Vaccine Booster: Who Should Receive It?
• (Delaware) General Questions: call 211 or email DPHCall@delaware.gov or Vaccine@delaware.gov for vaccine-specific questions.
• Latest information on Delaware's response (testing, treatment, vaccination): de.gov/coronavirus (Updated 2/2023)