Major Investment in Primary Care Continues in 2023

Highmark Blue Cross Blue Shield of Delaware's BluePrints for the Community has awarded a second $1 million grant to the Delaware Medical Education Foundation (DMEF), one of two MSD charitable foundations. This grant continues a collaborative Primary Care Investment Initiative (PCII). The PCII will target independent primary care practices and make financial stimulus awards available to eligible practices who propose an implementation-ready, qualified method to prepare their practice for sustainable success in value-based care. Twenty-four primary care practices were awarded funding through the first grant of $1 million. Read the announcement and learn how to apply. Applications must be submitted to DMEF no later than Tuesday, September 5, 2023. For questions and eligibility information, contact Lori Ann Rhoads, MSD Director of Health System Innovation (LoriAnn.Rhoads@medsocdel.org or 302/224-5182).

US Has New Dominant COVID Variant - EG.5

The Centers for Disease Control and Prevention (CDC) is indicating an uptick in COVID-19 starting early July with the amount of virus being detected in wastewater, the percent of those testing positive for the virus, and the number seeking care for COVID-19. The increases vary around the country, spreading the most in the southeast and the least in the Midwest.

And, a new COVID-19 variant has surfaced on the list of the most prevalent forms of the virus. Nicknamed "Eris," it is the strain EG.5 and last week accounted for 17% of all US COVID infections, up from 12% the week prior. EG.5 is rising worldwide and the World Health Organization has added the strain to its official monitoring list. EG.5 is a descendant of the XBB strains and has the same makeup as XBB.1.9.2, however it carries an extra spike mutation, according to a summary published by the Center for Infectious Disease Research and Policy at the University of Minnesota. There is no indication so far that EG.5 is more contagious or severe than other recent variants, according to a recent podcast from the American Medical Association (AMA).

CDC has indicated that current vaccines protect against the variant and updated vaccines in September will offer protection. Updated vaccines should be available by mid- to late September. The vaccines still need to be authorized by the U.S. Food and Drug Administration and the CDC needs to make its recommendations. The updated vaccines are designed to target the XBB variants that are now the most common in circulation. Virtually all children and adults will be eligible for the updated vaccines. The rollout of these vaccines will also mark three major shifts in the U.S. response to the virus: the end of government-bought vaccine supplies, a simplification of who is eligible to get shots, and a significant change to the recipe used in the vaccines. 

Also, studies have indicated that at least 20% of those who contract COVID are asymptomatic. The AMA podcast touched on a discovery of a common version of a gene that helps some clear the coronavirus faster than others, suggesting this could help inform the development of future vaccines and treatments. Another report released recently identified a direct correlation between blood group A and an increased risk for COVID infection.

Targets Heat-Related Health Resources, Prioritizes Life-Saving Interventions

On Wednesday this week, the U.S. Department of Health and Human Services (HHS) Office of Climate Change and Health Equity (OCCHE), in partnership with the National Highway Traffic Safety Administration (NHTSA), launched a first-of-its-kind online information portal called the Heat-Related Illness EMS Activation Surveillance Dashboard (“EMS HeatTracker”), which maps emergency medical services responses to heat-related illness across the country. The EMS HeatTracker will be used to help state, regional, and local government officials, such as city and regional planners, determine where to prioritize heat mitigation strategies, like street trees, parks, and cool roofs. It will also be used to help mayors and public health officials prioritize interventions like cooling centers and outreach to at-risk populations during periods of extreme heat. In addition to showing state and county-level heat-related EMS activations, the dashboard breaks down patient characteristics by age, race, gender, and urbanicity (e.g., urban, suburban, rural, and frontier). These data underscore which populations experience heat-related health risks most severely.

New Immunization is First Approved and Recommended in US to Prevent Severe RSV in Infants, Toddlers

The Centers for Disease Control and Prevention (CDC) is recommending a new immunization starting this fall to help protect all infants under 8 months and some older babies at increased risk of severe illness caused by respiratory syncytial virus (RSV). Nirsevimab, trade name for BeyfortusTM, was approved last month by the US Food and Drug Administration (FDA). The CDC's Advisory Committee on Immunization Practices (ACIP) voted to include nirsevimab in the Vaccines for Children program, which provides recommended vaccines and immunizations at no cost to about half of the nation’s children. On Thursday last week, CDC Director Mandy Cohen, MD, MPH adopted the ACIP recommendation for the use of nirsevimab. CDC recommends one dose for all infants younger than 8 months, born during or entering their first RSV season (typically fall through spring). For a small group of children between ages 8 and 19 months who are at increased risk of severe RSV disease, such as those severely immunocompromised, a dose is recommended in their second season. Health care professionals will be a key partner in CDC’s outreach efforts. Additional clinical guidance and health care professional education material will be provided by CDC in the coming months.

Could Increase, Improve Treatment of Condition Affecting Many Women

Last week, the U.S. Food and Drug Administration (FDA) approved Zurzuvae (zuranolone), the first oral medication indicated to treat postpartum depression (PPD) in adults. Until now, treatment for PPD was only available as an intravenous injection given by a health care professional in certain health care facilities. Clinical trial data show the oral treatment works quickly, easing depression in as little as three days, faster than general antidepressants, and the treatment effect was maintained four weeks after the last dose. The makers of the drug had sought the FDA's approval to treat major depressive disorder (MDD), or clinical depression, as well as postpartum depression. However, the FDA indicated the New Drug Application for Zurzuvae did not provide substantial evidence of the effectiveness for treating MDD and additional studies are needed to support the approval. Zurzuvae is expected to launch and be commercially available in the fourth quarter of 2023, shortly following scheduling as a controlled substance by the US Drug Enforcement Administration.

Caused by 2 Different Types of Flu Viruses that Normally Spread Among Pigs

Last week, Centers for Disease Control and Prevention (CDC) reported the first two human infections with flu viruses that usually spread in pigs to be detected in people during 2023. These infections both occurred in people exposed to pigs at different fairs in Michigan and were caused by different subtypes of swine flu viruses. CDC recommends that people take precautions around pigs, including guidance for fair exhibitors.

Detected in DNREC's Sentinel Chickens

West Nile Virus (WNV) has been detected in Delaware the first time for 2023 in a sentinel chicken, the Delaware Department of Natural Resources and Environmental Control (DNREC) announced this week. This initial finding was from a sentinel chicken station near Wilmington sampled on July 31 by the DNREC Mosquito Control Section, and then tested and reported virus positive by the Delaware Public Health Laboratory on Aug. 4. While there have been no reported WNV cases in humans this year in the state, Delawareans are reminded that the possibility of contracting mosquito-transmitted diseases, including WNV and eastern equine encephalitis (EEE), will continue until colder autumn temperatures arrive in mid-October or later.

Shows Across Most Causes of Death and in Most Counties

CNN is reporting on a study published in The Lancet that tracked US mortality data across nearly two decades, breaking rates down by race and ethnicity and to the county level. The study found that black parents and their children are more likely to experience unfair treatment when seeking medical care. Researchers found that Black and American Indian people had the highest overall mortality rates each year from 2000 to 2019 and that these groups also had the highest mortality rates for nearly all causes of death nationwide. While the study assesses trends before the COVID-19 pandemic, experts say that events of the past few years put a spotlight on and likely exacerbated longstanding disparities.

Bringing the Joy Back into Medicine

It’s easy for patients to come across bad information about vaccinations. Fortunately, a physician’s recommendation still carries more weight than something found on the internet or heard from a friend. Physicians should ensure their entire team is prepared to address common patient questions and concerns about vaccinations—and reinforce the message that vaccines are safe, necessary and effective. 



LEARN MORE:

• Toolkit: Adult Vaccinations
• Resource: CDC’s Frequently Asked Questions about COVID-19 Vaccination
• Webinar: Marie Brown, MD, Discusses Vaccination Hesitancy
• Success story: Student Health Ambassadors Help Overcome Vaccination Disparities

Consider a Donation to DFMS or DMEF

The 2023 Annual MSD Mission Appeal is under way!  Your generous support allows MSD to provide advocacy, representation, public service, and education to equip doctors with the tools they need to keep our communities healthy. MSD has been working diligently this year on strategic legislation, critical resolutions with the AMA, targeted education, and improving the lives of those in the community. You should have received a letter from us detailing key highlights from 2023. The letter highlights the efforts across the organization to promote the practice and profession of medicine to enhance the health of our communities. Now is the time to support the Annual MSD Mission Appeal to ensure programmatic viability and sustainability. Please consider a donation to Delaware Foundation for Medical Services (DFMS) or Delaware Medical Education Foundation (DMEF). Thank you to all who have already supported the 2023 Mission Appeal. For questions, please contact Lisa Gruss, External Affairs and Development Officer at Lisa.Gruss@medsocdel.org or (302) 893-3907. 

Save on Your Yearly MSD Membership Renewal by Applying

Hospitals, physician practice groups, and affinity groups can take advantage of MSD's group membership renewal discount program and save money on the 2024 regular membership dues! Discounts are applied to those membership categories that are not already discounted. Solo practitioners - get creative and form your own network of physicians to qualify (such as your call group). All physicians within the group must be members of MSD to qualify. Eligibility for the group discount is contingent upon membership application approval for those who are not currently members. Groups must be enrolled in the program by 4pm on Friday October 13, 2023. Groups who participated in the program in previous years must re-enroll annually. If your group is interested, contact Michelle.Seymour@medsocdel.org or (302) 224-4905 for details and to start the enrollment process. Download the enrollment form for the 2024 membership cycle. (Note: one enrollment form is for Hospitals and one is for Private Practices.)

Due to Unexpected Shutdowns

Datascope/Maquet/Getinge is recalling the Cardiosave Hybrid and Rescue Intra-aortic Balloon Pumps (IABPs) because they may shutdown unexpectedly due to electrical failures in the Power Management Board and/or Solenoid Board (Power Source Path). Using an affected pump may cause serious adverse health events, including unstable blood pressure, injury (for example: inadequate blood supply or a vital organ injury), and death. 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. 

Bayhealth

Beebe Healthcare

ChristianaCare

Nemours Children's Health

Isaiah Ailes - Medical Student, SKMC/ChristianaCare Branch Campus

Zowie Barnes, MD - FM, Planned Parenthood of DE (Interim Med. Director)

Jennifer Bolick, DO - Internal Medicine Residency, ChristianaCare

Bethany Dus, MD - OBGYN Residency, ChristianaCare

Raven N. Eberth, MD - Family Medicine Residency, ChristianaCare

Matthew N. Eiman, MD - IM/Peds Residency, ChristianaCare

Gabriana M. Freire, MD - IM/Peds Residency, ChristianaCare

Chinaka N. Joseph, MD - Psychiatry Residency, ChristianaCare

Vincent C. Mack, DO - Internal Medicine Residency, ChristianaCare

Zahra A. Manji, DO - Internal Medicine Residency, ChristianaCare

Raj G. Nathwani, DO - Internal Medicine Residency, ChristianaCare

Victoria E. Powell, MD - IM/Peds Residency, ChristianaCare

Eshita Sharmin, MD - Family Medicine Residency, Bayhealth

Yamini Vepa, DO - Internal Medicine Residency, ChristianaCare

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!

Monica Javadian, MD - Family Medicine Residency, Beebe Healthcare

Sofia F. Perez Delgado, DO - Family Medicine Residency, Beebe Healthcare

Catherine Zorc, MD - Nemours Children's Health, Saint Francis 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 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)

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.