Highlights from the Meeting

Nearly 700 physicians and medical students gathered in Honolulu for the 2022 AMA Interim Meeting to consider proposals across a wide range of clinical practice, payment, medical education and public health topics. The meeting’s opening session began last Saturday and ran through Nov. 15. American Medical Association (AMA) delegates offered testimony on more than 100 reports and resolutions that were up for consideration at this year's meeting. Delegates draw on their expertise, the best evidence in the medical and health policy literature, and the insights of their state medical associations and national medical specialty societies to weigh in on proposals that run the gamut of issues affecting patients and physicians. Actions taken by the AMA House of Delegates include:

• Having declared gun violence a public health crisis, the House of Delegates took action to explore addressing this public health crisis, including a task force focus on gun violence prevention and violence interruption programs.
• Gaps in health insurance coverage result in people missing opportunities to achieve optimal health status. Delegates took steps to address three such gaps to help protect and expand coverage for vaccines under Medicare, PrEP for HIV, and treatments for adult and pediatric obesity.
• Medicare is the single largest payer not subject to laws mandating parity in coverage for mental health and substance use disorder and the benefits for the treatment of other medical conditions. Existing policy was amended to support parity of coverage for mental health and substance-use disorders; enforce and expand the parity and non-discrimination protections of the Paul Wellstone and Peter Domenici Mental Health Parity and Addiction Equity Act of 2008 to Medicare parts A, B, C, and D; require Medicare parts A, B, C, and D to cover all levels of mental health and substance-use disorder care; and require all health insurance plans to implement a compliance program to demonstrate compliance with state and federal mental health parity laws.
• The AMA House of Delegates modified existing policy to encourage implementation of parental, family, and medical necessity leave for medical students and physicians.
• Delegates directed the AMA to make recommendations to the FDA that ensures health care personnel and the public are educated on the limitations of pulse-oximeter technology.
• Regarding the physician's duty to treat during pandemics, the AMA Code of Medical Ethics codified expectations that physicians would accept risk. The Code clarifies this obligation isn't absolute and that physicians also have an obligation to evaluate the risks of providing care to individual patients vs. the need to be available to provide care in the future.
• Having declared climate change a public health crisis at its Annual Meeting in June, delegates added to existing policy a goal to reduce US greenhouse gas emissions aimed at a 50% reduction in emissions by 2030 with existing policy calling for carbon neutrality by 2050.
• With the US drug overdose epidemic continuing to worsen, the delegates modified existing policy for state/county medical societies to advocate for harm-reduction policies that provide civil and criminal immunity for the possession, distribution, and use of drug paraphernalia and to support efforts to increase access to fentanyl test strips and other drug-checking supplies for the purpose of harm reduction.
• The House of Delegates moved to support ending daylight saving time (DST) and shift permanently to standard time.
• The House adopted policy recommending that third-party pharmacy benefit administrators that contract to manage the specialty pharmacy portion of drug formularies be included in existing PBM regulatory frameworks and statutes and be subject to the same licensing, registration, and transparency reporting requirements.

Read the highlights of AMA House of Delegates' actions from the Interim Meeting. Pictured at top is MSD's Delaware Delegation Chair, Janice E. Tildon-Burton, MD, addressing the Southeastern Delegation.

Reveals Current Environment Not Sustainable to Improve Health Outcomes

On Tuesday, The Physicians Foundation released part three of its 2022 Survey of America’s Physicians, which assessed the state of the physician practice and strategies to improve it.



• Approximately one in three physicians has experienced a reduction in staff over the past year.
• Almost one-quarter of physicians stated violence in the workplace as a contributing factor to staff shortages.
• One-third of physicians reported that their current practice is overextended and overworked.
• Nearly half of physicians have stated they are at full capacity in their current practice.
• Eighty-five percent of primary care physicians report administrative burdens (EHRs and prior approval).
• Seventy percent of primary care physicians report lack of insurance for patients.
• Sixty-four percent of primary care physicians report not prioritizing mental health integration.

Physicians have identified what would most support them in ensuring access to high-quality, cost-efficient care for all patients. Approximately nine in 10 physicians identified simplifying/streamlining prior authorization for medical services and prescriptions; reimbursing physicians for providing telehealth services; simplifying access to integrated mental health services and advancing interoperability of EHRs as important.

Additionally, physicians identified the most important strategies to address staff shortages were:

• Removing low-value work
• Eliminating insurance approvals
• Offering customized retention strategies
• Addressing burnout among physicians/staff

Advisory for All Delaware Health Care Facilities

The Delaware Division of Public Health (DPH) issued a health advisory to all Delaware health care facilities to notify them of confirmed infections and colonization cases of Candida auris (C. auris), which were identified in Delaware health care facilities. Since Aug. 17, 2022, there have been two confirmed clinical cases of C. auris identified in Delaware health care facilities. Subsequent screenings have identified 14 colonization cases, as of Nov. 10, 2022. 

Candida auris is a fungus, which is of concern to the Centers for Disease Control and Prevention (CDC) and DPH. C. auris can cause sometimes fatal infections and is often resistant to antifungal drugs, making it difficult to treat. It can spread rapidly in health care settings, leading to outbreaks. Additionally, C. auris can be difficult to identify in laboratories without proper equipment, leading to improper diagnosis and inappropriate management.

People most at risk for C. auris infection and colonization are those who have recently spent time in long term care facilities, especially those who have invasive medical devices such as central lines and feeding tubes. Additional risk factors include recent antibiotic and antifungal use, as well as surgery and diabetes. Risk to healthy people, including health care workers, is low.

C. auris is difficult to identify and is often misidentified as other Candida species. See the CDC’s website on identification for more information. If there is any concern regarding the identification of a Candida species, submit isolates to the Delaware Public Health Lab.

All health care facilities should consider screening patients who are at high risk for C. auris, such as:

• Close health care contacts of patients with a C. auris infection or colonization
• Patients who have had an overnight stay in a long-term care facility, especially in those outside of Delaware
• Patients who have had an overnight stay in a health care facility outside of the U.S., within the past year

All cases of Candida auris, both infections and colonization cases, should be reported to the Delaware Division of Public Health’s Office of Infectious Disease Epidemiology (OIDE). Cases can be reported by phone (302-744-4990, normal business hours; 1-888-295-5156, outside of normal business hours), fax (302-622-4149), or email reportdisease@delaware.gov.

Physicians Voted For Peers Using Secure Online Balloting System

Delaware Today has announced the names of the Top Doctors making a difference in Delaware in 2022. Congratulations to all who made the list!

DPH, Delaware 211 Celebrate Ten Years of Help Me Grow Delaware

The Maternal Child Health Bureau of the Delaware Division of Public Health (DPH), Delaware 2-1-1, and other state and community organizations proudly recognized Help Me Grow Delaware during an event celebrating Help Me Grow's 10th anniversary on Nov. 9 at the Route 9 Library & Innovation Center in New Castle.

Aguida Atkinson, MD, MSD member, was recognized for spending her career advocating for community health. As a Help Me Grow physician champion, she continues to work toward improving Delaware's early childhood system through collaboration and innovation. 

Founded in 2012, Help Me Grow Delaware is a comprehensive and coordinated statewide system for the early identification and referral of children at risk for developmental and behavioral challenges. The program helps families find community-based programs and services to enhance their child's behavior, learning and development. 

MSD Members Recognized for Innovation and Contributions

The Delaware Rural Health Initiative partnered with Beebe Healthcare to celebrate the 12th Annual National Rural Health Day today. Rural health leaders gathered at Beebe Healthcare’s Specialty Surgical Hospital to recognize three innovative physicians and their contributions to healthcare in Sussex County. 

MSD members, Dr. Fabricio Alarcon, CMO, La Red Health Center and Dr. Mark Borer, Psychiatric Access, were honored along with Psychiatrist Dr. Jose Capiro. They have forged the way for integrated primary care and behavioral health services in Sussex. In order to make specialty behavioral health care accessible in the primary care setting for all ages and cultures, this tireless group pressed through uncharted territory, sought nationally acclaimed expertise, completed advanced training and certifications, and advocated for resources and policy to implement needed services. 

The Delaware Rural Health Initiative is a partnership of many community-based, state, private, public, and non-profit organizations who support rural Delawareans through services and programs that expand access to primary care, mental health, and oral health services.  

Pictured from left to right, David A. Tam, MD, MBA, CPHE, FACHE, President & CEO, Beebe Healthcare; Brian Olson, President, Delaware Rural Health Initiative; Dr. Mark Borer, Psychiatric Access; Psychiatrist Dr. Jose Capiro; Dr. Fabricio Alarcon, CMO, La Red Health Center; and Betsy Wheeler. 

Public Health Emergency Declarations Must Be Renewed Every 30 Days

Governor Carney last Thursday formally extended the Public Health Emergency order another 30 days to allow the State of Delaware and medical professionals to continue COVID-19 vaccination and testing programs.

Was Set to Expire in January 2023

The U.S. public health emergency was initially declared in January 2020 when the coronavirus pandemic began and has been renewed each quarter since for 90 day periods. In August, the U.S. government began hinting that it planned to let the public health emergency expire in January 2023. However, according to Reuters (11/11/22, Abouleinein and Mason) the United States will keep in place the public health emergency status of the COVID-19 pandemic that allows Americans to continue to receive free tests, vaccines and treatments. The possibility of a winter surge in COVID-19 cases and the need for more time to transition out of the public health emergency to a private market were two factors that contributed to the decision not to end the emergency status in January. The U.S. Department of Health and Human Services (HHS) has promised to give states 60 days' notice before letting the emergency expire, which would have been done last Friday if it did not plan on renewing it again in January. The agency did not provide such notice.

Expected Reduced Activity Against Certain Emerging Omicron Subvariants

The U.S. Food and Drug Administration (FDA) updated the Health Care Provider Fact Sheet for bebtelovimab with specific information regarding expected reduced activity against certain emerging Omicron subvariants of SARS-CoV-2. This information shows that bebtelovimab is not expected to neutralize Omicron subvariants BQ.1 and BQ.1.1. At this time, bebtelovimab remains authorized in all U.S. regions until further notice by FDA. Prescribers should monitor Centers for Disease Control and Prevention (CDC) regional variant frequency data and refer to the Antiviral Resistance information in the Healthcare Provider Fact Sheet for details regarding specific variants and resistance against SARS-CoV-2 variants in your area, particularly Omicron subvariants BQ.1 and BQ.1.1. There are several treatments that are authorized or approved to treat certain patients with mild-to-moderate COVID-19, which are expected to retain activity against currently circulating variants, including Omicron subvariants BQ.1 and BQ.1.1. Physicians should assess whether these treatments are right for their patient in the event the patient develops mild-to-moderate COVID-19. Read more.

Delaware Stands to Receive $11.8 Million Under Settlement Terms

Attorney General Kathy Jennings announced that Delaware has reached a settlement with Walmart to resolve allegations that the company contributed to the opioid addiction crisis by failing to appropriately oversee the dispensing of opioids at its stores. The settlement will provide $3.1 billion nationally and will require significant improvements in how Walmart's pharmacies handle opioids. The settlement will include:

• $3.1 billion to be divided by states that sign on, local governments, and tribes, which must be used to provide treatment and recovery services to people struggling with opioid use disorder.
• Broad, court-ordered requirements, including robust oversight to prevent fraudulent prescriptions and flag suspicious prescriptions.

Delaware’s portion of the settlement is estimated at $11.8 million. The parties are optimistic that the settlement will gain the support of the required 43 states by the end of 2022, allowing local governments to join the deal during the first quarter of 2023. Further details about how the money will be distributed will be forthcoming. Last month, states confirmed that promising negotiations were also underway with Walgreens and CVS. The parties continue their efforts to achieve those agreements. 

Naloxone May Not Be Able to Reverse Effects

The U.S. Food and Drug Administration (FDA) is aware of increasing reports of serious side effects from individuals exposed to fentanyl, heroin, and other illicit drugs contaminated with xylazine. Physicians and other health care professionals should be cautious of possible xylazine inclusion in fentanyl, heroin, and other illicit drug overdoses, as naloxone may not be able to reverse its effects. Xylazine is FDA-approved for use in animals as a sedative and pain reliever. Xylazine is not safe for use in humans and may result in serious and life-threatening side effects that appear to be similar to those commonly associated with opioid use, making it difficult to distinguish opioid overdoses from xylazine exposure. However, the FDA does not know if side effects from xylazine exposure can be reversed by naloxone. Since it is not known if reversal agents regularly used in veterinary medicine (e.g., yohimbine hydrochloride, tolazoline hydrochloride) are safe or effective in humans, they should not be used. Routine toxicology screens do not detect xylazine, and additional analytical techniques are required to detect xylazine when it might be involved in illicit drug overdoses, particularly when there are other signs or symptoms of xylazine exposure. Health care professionals should continue to administer naloxone for opioid overdoses and consider xylazine exposure if patients are not responding to naloxone or when there are signs or symptoms of xylazine exposure (e.g., severe, necrotic skin ulcerations). Health care professionals should provide appropriate supportive measures to patients who do not respond to naloxone. It is not known at this time whether the xylazine used in these scenarios is illicitly produced (unapproved) or diverted from the animal drug supply. FDA is continuing to investigate the source of xylazine in the illicit drug supply and will provide an update when new information is available. FDA issued a letter to stakeholders providing clinical information about the risks of severe, necrotic skin ulcerations from repeated xylazine exposure, possible withdrawal symptoms, and xylazine’s interference with successful treatment of opioid overdoses.

FDA encourages health care professionals and patients to report adverse events in humans associated with possible illicit xylazine exposure to FDA’s MedWatch Adverse Event Reporting program. Complete and submit the report online at www.fda.gov/medwatch/report.htm; or download and complete the form, then submit it via fax at 1-800-FDA-0178.

Certain Naloxone Products Have Potential to Be Safe and Effective for OTC

The U.S. Food and Drug Administration (FDA) issued a Federal Register notice, Safety and Effectiveness of Certain Naloxone Hydrochloride Drug Products for Nonprescription Use, that may help facilitate the development and approval of certain nonprescription naloxone drug products, including through the switch of certain naloxone drug products from prescription status to nonprescription status. Naloxone is a medicine that can help reduce opioid overdose deaths and when administered timely, usually within minutes of the first signs of an opioid overdose, can counter the overdose effects.

The Federal Register notice includes a preliminary assessment that certain naloxone drug products–up to 4 milligrams (mg) nasal spray and up to 2 mg autoinjector for intramuscular (IM) or subcutaneous (SC) use–may be approvable as safe and effective for nonprescription use. This preliminary assessment is intended to facilitate development and approval of nonprescription naloxone products; however, it is not a final determination that certain naloxone drug products are safe and effective for nonprescription use, and it does not mandate an immediately effective switch to nonprescription/over-the-counter (OTC) availability for naloxone. To make its final determination, the FDA needs additional data, such as product-specific data on the nonprescription user interface design, including packaging and labeling. These data would usually be submitted to the agency in an application for a proposed nonprescription naloxone product. The notice does not cover all naloxone products, as more data are needed on the safety and efficacy for nonprescription use of higher dose naloxone products and naloxone supplied in other presentations (including vials, ampules or syringes without integrated needles) before a preliminary assessment with respect to those products can be reached.

The notice requests comments from the public on whether there is data to support safe and effective nonprescription use of higher dose naloxone products and on potential consequences of a switch from prescription to nonprescription status.

Research Study on Essential Drugs in Hypothetical Post-Apocalyptic Scenario

Imagine you're the health care professional for survivors in a post-apocalyptic world. If you could have a lifetime supply of 20 essential medications to take with you, which drugs would you choose? Georgetown University Medical Center’s PharmedOut is conducting a survey on prescribing choices given this hypothetical scenario, and would greatly appreciate your participation! Find the survey here: https://bit.ly/Top20Drugs. Clinicians found a previous version of this study to be an interesting thought experiment. The researchers are aiming to survey all prescribers (physicians, PAs, and advance practice nurses) and medical students. Georgetown University Medical Center’s PharmedOut advances evidence-based prescribing and educates health care professionals and students about pharmaceutical and medical device marketing practices. PharmedOut provides educational slideshows, videos, events, and information about CME courses free of industry sponsorship. Learn more here www.pharmedout.org. 

DE Ranks Among Top in Nation for Early Diagnosis, Screening

The 2022 “State of Lung Cancer” report reveals that Delaware ranks among the top at 9 in the nation for early diagnosis and 11 for lung cancer screening. The American Lung Association’s 5th annual report, released on Tuesday, highlights the toll of lung cancer in Delaware and examines key indicators including new cases, survival, early diagnosis, surgical treatment, lack of treatment and screening rates. Nationally, people of color who are diagnosed with lung cancer face worse outcomes compared to white Americans, including lower survival rate, less likely to be diagnosed early, less likely to receive surgical treatment and more likely to receive no treatment.   

Measures Payments That Didn't Meet Medicare Requirements

Effective August 11, 2020, the Centers for Medicare & Medicaid Services (CMS) resumed Comprehensive Error Rate Testing (CERT) program activities that were temporarily suspended in response to the public health emergency (PHE) for the 2019-Novel Coronavirus (COVID-19) pandemic. CMS created the Comprehensive Error Rate Testing (CERT) program to measure the rate of improper Fee-for-Service payments. The error rate measures payments that didn’t meet Medicare requirements. It doesn’t indicate fraud. The CERT contractor reviews a sample of processed claims and, should a claim not meet Medicare’s coverage, coding, and billing rules or the physician fails to submit medical records, it’s counted as a total or partial improper payment. Medicare Administrative Contractors analyze CERT error rates to reduce improper payments by updating their internal processes and educating physicians. Due to the cyclical nature of the CERT program improper payment measurement and the statutory timeline required for improper payment reporting under the Payment Integrity Information Act of 2019 (PIIA) (i.e., reporting annually), improper payment measurements cannot pause for an extended period without missing the statutorily required due dates. CMS adjusted CERT program data collection by reducing the sample size for Reporting Year (RY) 2021 and RY 2022 to account for the challenges incurred by physicians and suppliers during the PHE, while continuing to maintain appropriate accountability measures and meet statutory obligations. Claims with dates of service within the COVID-19 PHE were reviewed in accordance with all applicable CMS waivers and flexibilities. The CERT documentation requests identify that the requested documents are to be submitted within 45 calendar days of the request. However, the CERT program has the discretion to grant extensions to physicians and suppliers who need more time to comply with the request. Physicians and suppliers should contact the CERT Documentation Center Customer Service to identify any hardships or additional time needed with responding to a CERT documentation request.

2023: Physician Medical Licensure Renewal Year

Delaware law requires that, in order for medical professionals to renew their license, they must attest that they have completed training on:

• how to recognize child sexual and physical abuse, exploitation and domestic violence
• your reporting obligations under the Medical Practice Act and Regulatory Provisions Concerning Public Health

The 2023 Mandatory Reporting Training for Medical Professionals will be available on January 1, 2023, and features videos from professionals within the child welfare field that walk participants through how to detect and respond to child abuse and neglect.

Licensed physicians must take the 2023 Mandatory Reporting training even if they recently completed mandatory reporting training. This training must be completed before every medical license renewal. Physicians are required to attest to completing the training on their renewal application. Failure to do so will delay the renewal of the medical license.  

This training is provided by the Office of the Child Advocate. To complete the training on or after January 1, 2023, go to https://stateofdelaware.csod.com/default.aspx?c=courts-oca to create an account. If you already have an account, just click the “login in” icon and sign in User ID and Password. Once training is completed, medical professionals can then reapply for licensure through the Division of Professional Regulation's website at https://delpros.delaware.gov/OH_HomePage.

FDA Supports Innovation in Food Supply

The U.S. Food and Drug Administration announced they have completed their first pre-market consultation of a human food made from cultured animal cells. The agency evaluated the information submitted by UPSIDE Foods as part of a pre-market consultation for their food made from cultured chicken cells and has no further questions at this time about the firm’s safety conclusion. Before this food can enter the market, the facility in which it is made also needs to meet applicable U.S. Department of Agriculture (USDA) and FDA requirements. In addition to the FDA’s requirements, including facility registration for the cell culture portion, the manufacturing establishment needs a grant of inspection from USDA-Food Safety and Inspection Service (FSIS) for the harvest and post-harvest portions and the product itself requires a USDA mark of inspection.

The regulation of cell culture technology is being done collaboratively and in close partnership with USDA-FSIS for food made from cultured livestock or poultry cells. Under the March 2019 formal agreement, both agencies agreed to a joint regulatory framework wherein the FDA oversees cell collection, cell banks, and cell growth and differentiation.

Advancements in cell culture technology are enabling food developers to use animal cells obtained from livestock, poultry, and seafood in the production of food, with these products expected to be ready for the U.S. market in the near future.

Focus Group Insights Help Guide Future Enhancements

The Division of Services for Aging and Adults with Physical Disabilities (DSAAPD) is using the findings from a report based on caregiver focus groups held late last year across the state to enhance its current supports and develop a new approach to caregiver services. This includes the formation of the Delaware Action Network for Caregivers, a forum where caregivers can learn and collaborate with agencies supporting caregivers. Its inaugural meeting will be held Nov. 29, 2022, during National Family Caregivers Month. This project was funded through grant support from the National Academy of State Health Policy (NASHP) and the John Hartford Foundation. Read the full report on the DSAAPD website. For more information about the Delaware Action Network for Caregivers, call the Delaware Aging and Disability Resource Center (ADRC) at 1-800-223-9074. 

A CDC EPIC Webinar - Tuesday, November 29, 2-3 p.m. ET

Join Tuesday, Nov. 29, 2-3 p.m. ET, for the next Centers for Disease Control and Prevention (CDC) EPIC webinar, Flu, RSV, COVID-19 and other Respiratory Threats this Fall and Winter. Many respiratory viruses circulate year-round in the United States, with more activity in fall and winter. Right now, the U.S. is experiencing levels of respiratory syncytial virus (RSV), influenza (flu), and rhinovirus/enterovirus (RV/EV) that are higher than usual for this time of year, especially among children. COVID-19 also continues to circulate across the United States.



CDC experts Heidi Moline, MD, Medical Officer, National Center for Immunization and Respiratory Diseases; and Fatimah Dawood, MD, Medical Epidemiologist, National Center for Immunization and Respiratory Diseases, will discuss what CDC is seeing nationwide with these viruses, who’s at higher risk for severe illness, what people can do to protect themselves, their families, and other people around them, and how to care for people who do get sick. More information on this webinar and previous EPIC webinars can be found on the EPIC Webinar website.

A Night of Art, Conversation, and Reproductive Rights



Join Planned Parenthood of Delaware for an evening event showcasing art inspired by social justice and featuring expert speakers from the world of reproductive rights. The event will take place on Tuesday, November 29th beginning at 6:30 p.m. and will be held at the Delaware Contemporary located at 200 S. Madison St., Wilmington. Proceeds help benefit Planned Parenthood of Delaware. If you can't attend and still want to help, donations are accepted. Register here.

Serve Your Community, State, and Nation

The Delaware Air National Guard is your hometown force located in New Castle, Delaware, bringing together people from diverse backgrounds to defend freedom and protect communities – locally and globally. Did you know they also fill a variety of medical roles? There are positions for health care professionals ranging from Physician Assistant to Internist, Flight Nurses, Optometrists and Dentists, and even Flight Surgeons. These specialties are part time, paid military positions with most of the commitment being one weekend per month and 10 to 15 additional training days per year. Read more about how the Delaware Air National Guard serves our local Delaware community. If you would like to learn more about the mission and how you can serve in a way that fits your lifestyle, reach out for an introductory conversation. Contact:

Samuel Lewis, SMSgt, DE ANG

HQ DE ANG Recruiting & Retention Senior Enlisted Leader

(302) 547-6655 or samuel.lewis.2@us.af.mil

ChristianaCare

ChristianaCare will pursue bold targets for emissions reduction and climate resistance by pledging commitment to the White House/HHS Health Sector Climate Pledge, recently shared by a U.S. Department of Health and Human Services delegation to the United Nations Climate Conference (COP27). Under this pledge, part of a nationwide effort led by the White House and U.S. Department of Health & Human Services (HHS), ChristianaCare will take actions to cut its greenhouse gas emissions by 50% by 2030 and achieve net zero emissions by 2050. The health care industry overall is responsible for as much as 4.6% of total greenhouse gas emissions, according to studies by The Commonwealth Fund. Of that, hospital care contributes approximately 36%. ChristianaCare is one of 102 organizations that have signed the pledge.

As part of ChristianaCare’s ongoing evaluation of patient visitation policies and in recognition of the important role of loved ones in a patient’s treatment, ChristianaCare is lifting COVID-19 visitor restrictions and returning to standard visitor policy. Masking requirements for visitors remain in place.

Liann Abu Salman, MD - Nephrology Associates, PA

Amir K. Abdel Kader, MD - Anesth/Pain Med, DE Orthopaedic Specialists

Priyanka Dixit-Patel, MD - FM, Christiana Care Primary Care at Smyrna

Brandt J. Feuerstein, MD - Vascular Surgery, Vein Center at Eden Hill, LLC

Kareem H. Genena, MD - Nephrology Associates, PA

Malene K. Ingram, MD - Bariatric Surgery, TidalHealth General Surgery

Jessica A. Magdeburger, MD - Family Medicine, Dover Family Physicians

MSD's Membership Department is pleased to announce the newest members of the Medical Society of Delaware. Welcome to the third oldest medical society in the country! If you know someone interested in joining MSD, please contact Michelle Seymour at (302) 224-4905 or Michelle.Seymour@medsocdel.org with any questions. You could be eligible for a referral discount!

• DPH Flu Dashboard
• DPH Delaware Weekly Influenza Surveillance Reports by week.
• CDC https://www.cdc.gov/flu/weekly/index.htm
• WHO https://www.who.int/teams/global-influenza-programme/surveillance-and-monitoring/influenzaupdates/current-influenza-update

• DPH Public Health Alerts: de.gov/publichealthalerts
• DPH Hotline - (866) 408-1899 (Monday -Friday, 8:30 a.m. to 4:30 p.m.) or DPHCall@delaware.gov
• Reporting suspected monkeypox rash in Delaware: Contact DPH Office of Infectious Disease Epidemiology (OIDE), at 302-744-4990 (business hours) or 1-888-295-5156 (after hours).
• Delaware health care facilities that require specimen collection kits can order through OEMS@delaware.gov using a SHOC Request form.
• DPH website: de.gov/monkeypox
• DPH Social Channels: Facebook (@DEPublicHealth), Instagram (@depublichealth), DHSS Twitter (@Delaware_DHSS)
• FDA Monkeypox Response Website
• CDC Monkeypox Website
• CDC Case Definitions for 2022 Monkeypox Response
• CDC Considerations for Monkeypox Vaccination for the recommended use of vaccine in the U.S.
• CDC Monkeypox Treatment Information for Healthcare Professionals
• Specimen collection: Follow Lab Advisory: CDC Updates Specimen Collection Guidelines for Monkeypox Virus 

Information as of 4:30 p.m. on Thursday, November 17

• DPH Public Health Alerts: de.gov/publichealthalerts
• DPH COVID-19 Booster Information: de.gov/boosters
• Federal website for information on navigating COVID: COVID.gov
• CDC COVID-19 Quarantine and Isolation Calculator
• COVID-19 Treatment Options
• Medical Provider Guidance for Administering Therapeutics
• COVID-19 Therapeutics Locator
• CDC COVID Data Tracker Weekly Review.
• For testing flyers (available in English, Spanish, Haitian Creole): https://covidmaterialsde.com/resources/community-organizer
• For all testing site referral locations, visit: de.gov/gettested
• For vaccination site referral locations, visit: de.gov/getmyvaccine
• Pfizer/Moderna pediatric vaccine information: de.gov/youthvaccine
• 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
• Know the COVID-19 Community Level where you live
• DPH COVID-19 Vaccine Fact Check Page to help separate fact from fiction.
• Subscribe to the COVID-19 Update podcast - on Apple Podcasts or Simplecast.