The Medical Society of Delaware offices will be closed beginning at 3 p.m. on Friday, May 27th and on Monday, May 30th in observance of the Memorial Day holiday.

Please take time over this holiday weekend to honor the men and women who have died while serving in the U.S. military.

The series of Presidential Receptions kicked off on Wednesday evening, May 25th, at the MSD Conference Center in Newark. A good crowd came out for one of the first in person membership events of the Society since the beginning of the pandemic. Plenty of food, good conversation, and a competitive corn hole spirit filled the evening. We can't wait to see you at the next events planned for June and September!

Come mingle with the President! In light of COVID-19 safety concerns at the time, MSD did not plan a social event in conjunction with our November 2021 Annual Meeting. Our goal was to plan three social events for some time in 2022 when we all felt more comfortable in those in-person social gatherings. That time has come. You and your guest have the opportunity to attend one of the upcoming in-person Presidential Receptions that have been arranged at locations across the state. Find a date and location convenient for you! All events begin at 6:00 p.m. Dress is business casual.

Governor John Carney on Thursday formally extended the Public Health Emergency (PHE) order another 30 days to allow the State of Delaware and medical professionals to continue COVID-19 vaccination and testing programs, and issued the following statement: 

“Positive cases are increasing here in Delaware and it’s important people stay one step ahead of COVID-19,” said Governor Carney. “Keep doing the things we know that work. Stay home if you’re sick and get tested. Mask up in public indoor settings or if you are at a higher risk for illness. Get vaccinated and boosted when you’re eligible.”

DPH’s Immunization program has been working with pediatric providers since February to pre-plan vaccine orders when it was believed that the Pfizer pediatric vaccine would soon be available. Vaccine For Children (VFC) providers who were not already enrolled to administer COVID-19 vaccines were contacted at that time about enrolling. Those practices that did not request doses in February and wish to do so now, can do so by going to https://coronavirus.delaware.gov/shoc-resource-form-for-vaccine-events/ and request doses in the pre-book area of the form. DPH is working to update the form to reflect the anticipated availability of both Pfizer and Moderna vaccines. 

Now that two vaccines are expected to be made available, Immunization program staff will be re-contacting practices that pre-ordered in February to determine if they have a preference or wish for both. DPH will be able to pre-book doses, and orders will ship immediately once the EUA has been approved.  For this phase of the vaccine roll out, the role of pediatric physicians is paramount.  DPH is actively encouraging pediatric offices to vaccinate their own patients. Additionally, a handful of physicians have indicated a willingness to vaccinate non-patients. DPH is not planning to hold mass vaccination clinics for this age group.  Read more.

The Centers for Disease Control and Prevention (CDC) issued a health advisory on May 20th stating the Massachusetts Department of Public Health and the CDC are investigating a confirmed case of monkeypox in the United States. On May 17, 2022, skin lesions that had several features suspicious for monkeypox—firm, well circumscribed, deep-seated, and umbilicated lesions—on a Massachusetts resident prompted specialized Laboratory Response Network (LRN) testing of swab specimens collected from the resident; preliminary testing confirmed the presence of DNA consistent with an orthopoxvirus using Orthopoxvirus generic and non-variola Orthopoxvirus real-time polymerase chain reaction (PCR) assays. This group of viruses includes monkeypox virus (the causative agent of monkeypox). Testing at CDC on May 18 confirmed the patient was infected with a West African strain of monkeypox virus. The patient is currently isolated and does not pose a risk to the public.

The Centers for Disease Control and Prevention (CDC) issued a health advisory on May 24th

to inform physicians and other health care professionals, public health departments, and the public on the potential for recurrence of COVID-19 or “COVID-19 rebound.” The Delaware Division of Public Health has also disseminated the CDC's health advisory to update all health care professionals in the state. Paxlovid continues to be recommended for early-stage treatment of mild to moderate COVID-19 among persons at high risk for progression to severe disease. Paxlovid treatment helps prevent hospitalization and death due to COVID-19. COVID-19 rebound has been reported to occur between 2 and 8 days after initial recovery and is characterized by a recurrence of COVID-19 symptoms or a new positive viral test after having tested negative. A brief return of symptoms may be part of the natural history of SARS-CoV-2 (the virus that causes COVID-19) infection in some persons, independent of treatment with Paxlovid and regardless of vaccination status. Limited information currently available from case reports suggests that persons treated with Paxlovid who experience COVID-19 rebound have had mild illness; there are no reports of severe disease. There is currently no evidence that additional treatment is needed with Paxlovid or other anti-SARS-CoV-2 therapies in cases where COVID-19 rebound is suspected. Regardless of whether the patient has been treated with an antiviral agent, risk of transmission during COVID-19 rebound can be managed by following CDC’s guidance on isolation, including taking other precautions such as masking.

The Delaware Division of Public Health (DPH) has issued a health alert to provide the health care community with information from the Department of Health and Human Services (HHS) about the infant formula shortage caused by supply chain issues. The U.S. Health Resources and Services Administration’s Maternal and Child Health Bureau (MCHB) issued a letter informing physicians and other health care professionals that they can submit an urgent request for specialized formula to Abbott, a primary formula manufacturer. Abbott is releasing some specialty and metabolic formulas on a case-by-case basis.

Physicians and other health care professionals who provide care for children in critical need of a particular specialty formula should contact Abbott directly to request the product by calling 1-800-881-0876 or visiting https://abbottnutrition.com/metabolics.

Recreational Marijuana Bills (HB 371 and HB 372 with HA 1, HA 2)

On Tuesday, Governor John Carney vetoed HB 371. Governor Carney stated, "I recognize the positive effect marijuana can have for people with certain health conditions, and for that reason, I continue to support the medical marijuana industry in Delaware. I supported decriminalization of marijuana because I agree that individuals should not be imprisoned solely for the possession and private use of a small amount of marijuana -- and today, thanks to Delaware's decriminalization law, they are not. That said, I do not believe that promoting or expanding the use of recreational marijuana is in the best interests of the state of Delaware, especially our young people. Questions about the long-term health and economic impacts of recreational marijuana use, as well as serious law enforcement concerns, remain unresolved. I respect the Legislative Branch's role in this process, and I understand that some hold a different view on this issue. However, I have been clear about my position since before I took office, and I have articulated my concerns many times. For the reasons stated above, I am hereby vetoing HB 371 by returning it to the House of Representatives without my signature.”

With COVID-19 cases rising, the Delaware Division of Public Health (DPH) has made available new marketing materials from their newest campaign, "Stay One Step Ahead of COVID-19 - Cases Are Rising." These materials are available in both English and Spanish (the Haitian Creole translations are expected to be available next week) and can be ordered online for free or downloaded from the DPH website covidmaterialsde.com. Included in the materials are a poster, flyer, and social media and digital signage, which your office may find useful in messaging with your patients.

Additionally, DPH has created a new vaccine misinformation page. Visit de.gov/covidfactcheck and learn how to separate fact from fiction!  

The Department of Health and Human Services’ Office of Inspector General (OIG) issued a report in April that showed Medicare Advantage (MA) plans at times delayed or denied beneficiary access to services that meet Medicare’s coverage requirements. While the report drew disapproval from the insurance industry, several lawmakers pressed for mandated electronic prior authorization. The American Hospital Association (AHA) has asked the US Department of Justice (DOJ) to launch a series of probes into commercial payers that routinely deny access to care and services. AHA's letter to the DOJ last week urged for False Claims Act investigations after the OIG found some Medicare Advantage (MA) plans have used prior authorization to deny care in violation of Medicare coverage rules. AHA called on CMS to work with Congress to pass legislation such as the Improving Seniors’ Timely Access to Care Act that would require the adoption of electronic prior authorization amid other reforms. Sponsors of the legislation in the House recently announced the legislation has enough co-sponsors to be fast-tracked through the chamber and quickly move over to the Senate.

In what health officials fear is another consequence of the uncertainty associated with the COVID-19 pandemic, Delaware’s overdose deaths increased more than 15% in 2021 to a record high 515, according to the Delaware Division of Forensic Science’s annual report.

The Division of Forensic Science also reported 425 of the 515 deaths involved fentanyl and that a substantial increase in overdose deaths involved cocaine, with the powerfully addictive stimulant found in 221 of the 515 individuals who died. To help Delawareans cope with stress and address behavioral health needs during the coronavirus pandemic, the Department of Health and Social Services’ (DHSS) Division of Substance Abuse and Mental Health (DSAMH) launched the 24/7 Delaware Hope Line – a single point of contact where callers can connect to a variety of resources and information, including support from clinicians and peer specialists plus crisis assistance. For support, Delawareans can:

Individuals in active substance use are urged to consult with a medical professional immediately or to call the Delaware Hope Line to be connected to trained crisis professionals who can discuss treatment options. For those ready to receive help, they are invited to walk into one of the DSAMH Bridge Clinics for an assessment, or go to TreatmentConnection.com to find out which treatment providers are near. Those in active use are urged to obtain Narcan, which is available through many sources including participating pharmacies – where no prescription is required – at a DSAMH bridge clinic, during a Narcan training session, or through Division of Public Health’s Mail Order Naloxone program. The mail order program is free and available to anyone with a mailing address in Delaware requesting it as a private citizen through https://nextdistro.org/delaware.

The Future of Telemedicine will held on Thursday, June 2nd at 11:00 a.m. ET. Register.

Although it was first published by the Department of Health and Human Services almost 23 years ago, the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule is still resulting in questions, clarifications, and confusion. COVERYS invites you to join moderator Marlene Icenhower, BSN, JD, CPHRM, as discussion takes place on the common, and not-so-common, questions related to the Privacy Rule with attorneys Elizabeth Kastner and Chris Bennington from Epstein Becker Green. When they’re not taking questions from the audience, panel members will discuss the Privacy Rule as it relates to minors, sensitive information, and deceased patients. The 2020 Ciox Health decision—and its impact on medical record copying charges—will also be discussed. This webinar is complimentary to non-policyholders as well—please feel free to share this invitation with your colleagues! No discount code needed. Reserve your spot.

How can you talk with your patients about the health risks of climate change without disrupting the office visit? This important topic can be time-consuming and even controversial. The Medical Society of Delaware's My Green Doctor explains an easy solution that may work well in your practice. Read more. My Green Doctor is a FREE money-saving membership benefit to learn how to adopt environmental sustainability, save resources, and help create healthier communities. Everyone in your practice can register as Partner Society members at www.MyGreenDoctor.org or at www.MyGreenDoctor.es (si, en Espanol) and use the discount code MGDMSD to save $60 instantly and give full access to My Green Doctor for free. Ask your practice manager to register and to put My Green Doctor on your next agenda.

ChristianaCare is the first health system in the Philadelphia region piloting an innovative tool called Moxi, a collaborative robot — or “cobot”— that can assist in the hospital by making deliveries and performing other non-clinical tasks so that nurses and other clinical staff can spend more time focused on what they do best—caring for patients. With a landmark $1.5 million grant from the American Nurses Foundation, ChristianaCare will deploy a total of five Moxi cobots at Christiana Hospital. It is the largest single grant in the history of Nursing at ChristianaCare.

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!

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 member(s) listed above.