CMO Update April 28, 2022
While I thought Groundhog Day was far in the past, it seems like the COVID-19 pandemic keeps hitting the reset button as the highly contagious Omicron BA.2 variant quickly became dominant and is responsible for another surge in cases across the US. Within QualDerm we have numerous healthy/vaccinated/boosted teammates, including several providers, who experienced quite significant symptomatic disease. As immunity wanes, from both vaccine and natural, this recent surge has also been fueled by the nationwide roll-back of mask mandates and distancing protocols combined with increased travel, entertainment, dining and socializing by everyone with COVID fatigue.

The GOOD NEWS is that case severity is no greater with BA.2 and prior vaccination and/or natural immunity is helping prevent severe outcomes, overwhelming hospitalizations, and death. The transition to “endemic” disease occurs when cases rise but the health system is equipped to handle the influx, like the flu season each winter. Although cases are predicted to rise 100% in next two weeks, hospitalizations should remain fairly stable and deaths will continue to decrease, as most experts believe we will soon reach the endemic phase.

  • The Biden administration announced this week plans to increase awareness and availability of the antiviral treatment Paxlovid (nirmatrelvir and ritonavir), which can reduce the risk of COVID-19-associated hospitalization and death by nearly 90% if taken within the first 5 days of symptom onset. The administration has purchased 20 million doses of the treatment from Pfizer, creating a sufficient stockpile, and will work with the manufacturer to speed delivery of the drug to pharmacies nationwide. Additionally, the White House plans to educate providers and the public about the drug’s availability and effectiveness, part of its effort to expand the federal Test-to-Treat initiative. Currently, about 2,200 pharmacies, long-term care facilities, and community health centers are operating as test-to-treat sites.

  • WHO announced it strongly recommends Paxlovid for the treatment of mild-to-moderate COVID-19 in individuals at the highest risk of hospital admission. The WHO’s living guidelines for COVID-19 treatment were updated on April 22, calling Paxlovid “the best therapeutic choice for high-risk patients to date.”
Key Points

  • COVID treatments, once in short supply, are now readily available but many don’t know the drugs exist.

  • Experts point to shifts in the pandemic and a lack of knowledge among physicians as reasons.

  • To be effective, all treatments need to be started as soon as possible after symptoms begin.

  • Vaccinations
  • The seven-day average number of vaccines administered daily was 470,903 as of April 20, a 13 percent decrease from the previous week.

  • As of April 20, about 257 million people — 77 percent of the U.S. population — have received at least one dose of the COVID-19 vaccine, and more than 219 million people, or 66 percent of the population, have received both doses. 

  • Nearly A Quarter Of US COVID-19 Deaths Could Have Been Prevented With Vaccination
  • Research from the Peterson Center on Healthcare and Kaiser Family Foundation (KFF) quantifies the effects of COVID-19 vaccination. Since June 2021, the point at which every American adult had access to coronavirus vaccines, they estimate that just over 234,000 unvaccinated Americans died who could have lived had they been immunized against the virus, which is nearly a quarter of the total death toll from the pandemic.

  • About 100 million additional or booster doses in fully vaccinated people have been reported. However, 50% of people eligible for a booster dose have not yet gotten one
  • PLEASE get a booster if you are vaccinated or have natural immunity from prior infection – it may save your life, your lungs, your heart, or your brain from Long-COVID

  • A 3rd (booster) vaccine shot's marked impact during the Omicron wave in Italy
  • Hospitalizations reduced by 84%
  • ICU admissions reduced by 92%
  • Death reduced by 87%
  • Benefits across all age groups

  • Fewer kindergartners received routine vaccinations against measles, whooping cough and chickenpox during the COVID pandemic, raising concern about potential outbreaks in schools – PLEASE ensure your children are up to date!

  • Most Americans under 50 should wait for the next generation of booster shots rather than getting a fourth dose now to prevent Covid-19 infections, according to several members of a panel of advisers to the CDC. Those “with high risk of grave illness from an infection should consider an extra shot, but most people should hold out for better vaccines later this year, they said.” The Moderna and Pfizer-BioNTech COVID-19 vaccine boosters “offer limited protection against newer strains such as the BA.2 subvariant.

  • Moderna reported preliminary data suggest its updated COVID-19 booster, which adds protection against the Omicron coronavirus variant to its original vaccine, shows promise in fighting Omicron and other coronavirus variants. Moderna hopes to offer a new version of the booster in the fall.


  • While mask mandates have generally been dropped in the general public setting, we continue to follow CDC recommendations for healthcare settings, which include all our prior safety protocols. Nothing has yet been changed within QDP practices regarding universal masking, distancing, hygiene, disinfection.

  • BUT, we are resuming the pre-COVID process of obtaining informed consent for all procedures using written, rather than verbal, consent. Transmission of coronavirus is almost exclusively through the air, rather than surface contact, and advisors have recommended resumption of written consents at this point in the pandemic.

  • Regarding airborne transmission, this recent post from an epidemiology expert provides a very informative discussion about the transmission risk on airplanes, a relevant issue for everyone and your families planning trips this summer.
  • Transmission on planes YLE
Service Excellence Initiative

We are at the beginning stages of launching a company-wide Service Excellence initiative. QualDerm has built an outstanding reputation for quality, and now we want to also be known for outstanding service. This focus on service will exemplify one of our Core Values: that we take pride in serving our patients and our teammates, and that we work to foster a culture of exceptional service throughout the entire organization. More information will be forthcoming from Dr. Dan Pearce who is chairing this committee and Dr. David Brodland, Chair of our physician Quality Council.

Ultimately this initiative will touch every QDP teammate and we look forward to each of you providing input to your unit leadership to create the very best experience for every patient being cared for. A subcommittee of the Quality Council was formed to address this very initiative and we are thankful to the other providers who have joined this subcommittee. Let’s shine here like we do in quality recognition.  
EMR Transition Update

Our company wide initiative to transition our EMR and Practice Management systems to EMA/Modernizing Medicine has begun. Ohio led the way and Tennessee will soon follow. This massive change affects nearly every single teammate in our practices. I am pleased to report that so far it has been an overwhelming success and kudos to the IT and practice support teams for the effort to make the transition as smooth as possible.

Recent research reinforces the main reasons for our EMR change as well as all the other QDP measures to enhance efficiency and productivity in the workflow. We want all QDP clinicians and support teams to feel more empowered to use their time and effort productively, maintain a healthy work-life balance and be less frustrated by documentation burdens and administrative tasks. We believe our enterprise-wide adoption of EMA/Modernizing Medicine will help us fulfill this vision, understanding that there will always be some struggles with any big change initiative.

  • At the beginning of 2020 KLAS Research began asking clinicians in its Arch Collaborative survey how likely they are to leave their organization in the next two years.
  • The top seven drivers for leaving a health system include: "Burnout, chaotic work environments...spending too much time on bureaucratic tasks...frustration with the electronic medical record...lack of effective teamwork...too heavy of a workload,” and a “lack of shared values with organization leadership.”
Please continue staying safe and healthy, for you, your family, your teammates, and our patients. If your local community is surging in cases, resume masking and distancing in public spaces. Use the common-sense measures we have adopted throughout the pandemic to minimize risks, while starting to resume more normal activity. We know how this virus spreads, we know how to protect ourselves and each other, we know vaccinations reduce disease severity and we now have proven medications to treat disease immediately to prevent severe outcomes. There is really no reason that America cannot move past this pandemic once and for all if we all do our small part for the common good.

Be well,
Dr. A
Questions or Comments?
Please send any questions or comments to the QDP Health Information inbox: health@qualderm.com