COVID-19 UPDATE #275

December 6, 2022

As flu and other respiratory illnesses continue to rise across the nation, routine preparedness, including continuing to offer long term care (LTC) residents ongoing immunizations, is critical to help reduce severe disease and death, particularly in the older adult population. Staff vaccinations can also help reduce resident exposures, reduce staff illnesses, and preserve LTC capacity. There have already been seven influenza-associated flu deaths this year in Washington, much higher than we have seen since before 2010-2011.  

Important points to consider in the U.S.:

• There have been 12 pediatric flu-associated deaths so far this year 
• Hospitalization rates are higher than previous years during for this same period
• The CDC estimates that, so far this season, there have been at least 6.2 million illnesses, 53,000 hospitalizations, and 2,900 deaths from flu

The following grab and go tools, and updates and CDC flu links are included below so you can use them to help make a difference. 

1. Updated Bivalent COVID-19 Booster Flyer
2. The DOH LTC Bivalent Booster and Flu Tool Kit Resource Document
3. Provider Discussion Guide Boosters
4. CDC: Flu/Information for health professionals
5. CDC: Flu Activity National Map  
6. CDC: U.S. Influenza Surveillance Report
7. CDC: Post-acute and Long-term Care Facility Toolkit: Influenza Vaccination among Healthcare Personnel 

For more information from AHCA regarding respiratory viruses and treatment, click here.

After much thought and discussion, the Department of Health (DOH) has decided to end the weekly LTC calls starting January 2023. DOH stated the webinars may no longer be as effective as they once were due to where we are in the pandemic. DOH started by reducing the meeting frequency in November and December to monthly. The last call will be held on December 15. After December, the meeting series will end. DOH will continue to reevaluate the need for future calls as needs change in 2023.

DOH will remain a proactive and supportive resource for long term care facilities (LTCFs) across the state by providing the following:

• DOH Infection Preventionists (IPs) will be available for support, information, and guidance including directly by email and via the COVID mailbox (see page 2 of this document for contact information).
• DOH will still offer updates on guidance changes on any IP topic relevant to LTCFs. If there are big guidance changes, DOH will schedule a webinar or webinar series to review the guidance and answer questions.
• DOH will provide links to resources and educational opportunities that are available.
• DOH has other focused educational initiatives in the works that will provide infection prevention education and training for LTCFs.

AHCA/NCAL is hosting a webinar for its members on Friday, December 9, at noon PDT. The webinar focuses on practical steps long term care facilities can take to prepare for the increase in respiratory viruses anticipated this winter. Dr. Ashish Jha, Coordinator of the White House COVID-19 Response team will be joining this webinar to share his insights with webinar participants.

This webinar will also feature Dr. David Gifford, AHCA/NCAL's Chief Medical Officer, Steven M. Creasy, Pharm, Director, Clinical Services at PharMerica, and Kenneth Daily, LNHA, President of the Elder Care Systems Group. These experts will share their expertise and best practices on vaccines, treatments, and indoor air quality. Registration information and more details can be found here.

The webinar will be recorded, and all registrants will receive an email when the recording is available.

Please email educate@ahca.org with any questions or if you need assistance registering.

Public Health Emergency Reporting and Notification Requirements for COVID-19, and Public Health Emergency Voluntary Personal Protective Equipment Usage

The Department of Labor & Industries (L&I) continues to respond to the 2021 passage of Substitute Senate Bill 5254 (SSB 5254), codified as RCW 49.17.485, regarding voluntary use of personal protective equipment (PPE) during a state of emergency, and Engrossed Substitute Senate Bill 5115 (ESSB 5115), also known as the Health Emergency Labor Standards Act (HELSA) and codified as RCWs 49.17.062 and 49.17.064. This rulemaking maintains new sections of WAC, which require notification to employees of potential exposures, reporting of outbreaks to L&I's Division of Occupational Safety and Health, and protections for high risk workers.

This emergency rule supersedes WSR 22-17-009 filed on August 4, 2022.

The emergency rule includes requirements for when there is a public health emergency for an infectious or contagious disease and as such, the requirements are applicable to COVID-19.

Under the emergency rule, employers with more than 50 covered employees at a workplace or worksite are required to report infectious or contagious disease outbreaks of 10 or more employees to L&I. Several definitions were added and/or simplified for implementation. Employers are required to notify employees in writing of potential exposures within one business day, and employees and contractors must be permitted to voluntarily use personal protective equipment

In order to meet the requirements of HELSA, L&I must include notification requirements for health care facilities as defined in RCW 9A.50.010.

• Employers must notify any employee, as well as their union representative (if any), with known or suspected high-risk exposure to the infectious or contagious disease within 24 hours;
• Period of transmission/isolation requirements have been simplified; and
• Requirements for how employees are notified of potential high-risk exposure are clarified.

The HELSA is currently enforceable under RCW 49.17. SSB 5254 gives employees the voluntary option to protect themselves from transmission of COVID-19 by use of PPE in circumstances where the PPE does not pose a safety or security issue for the employer. COVID-19 continues to be recognized as a very serious workplace hazard and until permanent rulemaking for infectious and contagious diseases is adopted, this temporary measure will help to reduce the transmission of this disease in the workplace.

For more information, view the full bulletin here.

On December 5, 2022, the Tacoma-Pierce County Health Department sent a bulletin for providers of long term care facilities about the rise in respiratory syncytial virus (RSV) and influenza (flu). LTCFs and homes should prevent, prepare, and plan for an outbreak. Learn about updates to help navigate infectious disease outbreaks and emergencies here.

The bulletin also provides information on the following:

• Vaccinations
• Outbreak Reporting
• Infection control
• Testing
• Medical Test Site Waiver Application
• Respiratory Protection Program
• ICAR
• COVID-19 Treatments

In addition, you may register to attend the December 8 DOH COVID-19 Q&A call for LTCFs here. It's a chance to connect, ask questions and learn about infection prevention guidance. You may view the full bulletin here. Email longtermcare@tpchd.org to sign up for notifications.