On Tuesday, the Centers for Disease Control and Prevention (CDC) recommended that vaccinated people who live in "areas of substantial or high transmission" of the coronavirus should resume wearing masks in indoor public spaces. The CDC published an online map showing which areas qualify. The CDC defines substantial transmission as 50-99 cases per 100,000 people in a seven-day period and high transmission as equal to or more than 100 cases per 100,000. CDC data as of Tuesday indicates Sussex County has "substantial" risk of virus transmission and New Castle and Kent counties remain at "moderate" risk, which for the latter two counties would not trigger mask recommendations per the CDC. The recommendations also advise that those vaccinated who have vulnerable people in their households, including young children and those who are immunocompromised, wear masks indoors in public spaces. In addition, the CDC is urging universal masking for all teachers, staff members, and students in K-12 schools, regardless of vaccination status and community transmission of the virus. MSD reported last week that the American Academy of Pediatrics had released updated guidelines recommending universal masking in schools. The American Medical Association explains the reason for the CDC's change in guidance.

In addition to its mask guidance revisions, the CDC also updated its testing recommendations for those who are fully vaccinated, recommending vaccinated individuals be tested for the virus if they come into contact with someone with COVID-19, even if they have no symptoms. The CDC had previously stated that the fully vaccinated did not need to be tested after exposure unless experiencing symptoms.

A joint statement issued by over 50 organizations, including the American Medical Association and various national medical specialty groups, called for mandatory vaccinations of all U.S. health care personnel against the coronavirus, citing the ethical commitment of all health care workers to put patients as well as residents of long-term care facilities first and take all steps necessary to ensure their health and well-being.

The Department of Veterans Affairs announced it would mandate coronavirus vaccines for medical employees including Veterans Health Administration facilities staff, the first federal agency to do so.

President Biden indicated his administration is considering a coronavirus vaccine mandate for all federal employees, amid a surge in COVID-19 cases and as the Centers for Disease Control and Prevention (CDC) urged vaccinated Americans in areas of high transmission to resume wearing masks indoors.

The Division of Public Health (DPH) is finalizing a toolkit for health care professionals and their staff to use in promoting the COVID-19 vaccination to their patients. The toolkit includes flyers on vaccine hot topics such as variants, myocarditis, and the vaccine and pregnancy and fertility, materials for health care professionals to improve vaccine awareness among staff, instructions on how to hold a Facebook Town Hall for patients, and an order form to have materials sent free of charge. The Centers for Disease Control and Prevention (CDC) has just issued a Health Alert Notice (HAN) to notify of the urgent need to increase COVID-19 vaccination to prevent surges of cases through the late summer and early fall months.  This toolkit from DPH will help support you and your staff in these efforts.

Mental Health Parity laws at both the state and federal levels aim to eliminate coverage discrimination between policyholders seeking mental illness or substance abuse care and those seeking physical care. Insurance Commissioner Trinidad Navarro announced the completion of additional Mental Health Parity examinations on regulated health insurers in Delaware. Combined with two examinations completed in 2020, Delaware's largest health insurers have been fined a total of $1,332,000 for not treating mental and behavioral health care equally to other forms of needed care.

Proposals to update the neurology content (Chapter 13) of the AMA Guides are being considered for adoption by the AMA Guides Editorial Panel in 2022. Specific topics addressed in the proposed update include emotional and behavioral impairment associated with neurological disorders, removal of the Global Assessment of Functioning from impairment rating methodology, and update to the mild traumatic brain injury content. Public comment is tentatively scheduled for August 2-27. For more details and to participate.

Ginger, the on-demand mental health care startup, has a new offering designed for users age 13 to 17. "Ginger for Teens" resembles the primary platform with the inclusion of digital self-care materials, behavioral health coaching, therapy, and psychiatry accessible through a smartphone app, tweaked to specifically address adolescents. Coaches and clinicians who are matched through the service will have experience working with teens. Parents enroll their teens in the program and also receive support tailored around supporting their child. Read more.

The next ten years are a critical window of opportunity to avoid the worst consequences of the climate crisis. MSD has joined with major national medical societies as a member of the Medical Society Consortium on Climate and Health. Since launching in 2016, the Consortium's membership has grown to 33 national medical societies representing more than 60 percent of U.S. physicians. Our shared goal is to create a future where all people have clean air, clean water, and nutritious food, and where the climate has returned to a stable state. MSD is proud to announce its representative to the Consortium's Steering Committee is David P. Donohue, MD, MS, DipABLM. Stay tuned as we gear up and learn more through this exciting opportunity for Delaware physicians to get involved to help overcome the challenges of climate change. (Pictured is Dr. David Donohue.)

Less than two-thirds of Black adults say they have been vaccinated against COVID-19 or plan to do so. The legacy of the U.S. Public Health Service Syphilis Study at Tuskegee and other instances of medical racism is often considered to be one reason for uncertainty in Black communities. More than 100 men died from syphilis or its complications by the end of the Syphilis Study, which continues to have an important impact on perceptions and trust to this day. The American Medical Association highlights a short documentary featuring descendants of the men involved in the study and sets the record straight on what happened, what has changed, and what current generations can learn from the experience to build confidence in public health within Black communities, especially as it relates to the COVID-19 vaccines.

In findings published online in a research letter in JAMA Internal Medicine, people of color are consistently less likely to see medical specialists than are white patients. Black Americans, Hispanic Americans, and Asian Americans had significantly fewer visits to doctors of various specialties but were in line with visits to primary care physicians. One theory for these findings is the disparity in the ability to pay.

In comparison, data published in JAMA Network indicates Medicare eligibility may reduce racial and ethnic disparities in health care coverage. Researchers found that the coverage gap between Black beneficiaries and White beneficiaries dropped to around 2.7 percent, while the gap between White beneficiaries and Hispanic beneficiaries also dropped by 51 percent.

As reported to our members in the June 17 issue of eNews and Views, Delaware Insurance Commissioner Trinidad Navarro has released a consumer alert for users of respiratory devices manufactured by Philips. An estimated four million Philips Continuous Positive Airway Pressure (CPAP) and Bi-Level Positive Airway Pressure (BiPAP or BiLevel PAP) devices, as well as mechanical ventilators manufactured prior to April 26, are being recalled due to potential health risks associated with the sound abatement foam in the devices that may degrade and be inhaled and could contain cancer-causing chemicals. The Department of Insurance issued the notice after the company's recall notification and lack of communication to consumers and facilities has caused concern. Recalled devices include those listed as providing respiratory treatment or support for COVID-19 patients.

The U.S. Food and Drug Administration (FDA) has approved biosimilar medications to treat conditions such as cancer, diabetes, Crohn’s disease, colitis, rheumatoid arthritis, psoriasis, and more. Recently, the FDA approved the first interchangeable biosimilar product, Semglee (insulin glargine-yfgn), as a diabetes treatment. Biologics include medicines that generally come from living organisms. A biosimilar is a biologic that is highly similar to, and has no clinically meaningful differences from, another biologic that’s already FDA-approved. Read more. The FDA offers a variety of health care professional outreach materials to help promote understanding of biosimilars and interchangeable products.

As of July 26, the Delaware Division of Medicaid and Medical Assistance opened the postpartum food box delivery program to all postpartum Medicaid members enrolled in a managed care organization (MCO). To be eligible, postpartum mothers must be enrolled in Highmark Health Options or AmeriHealth Caritas of Delaware and less than eight weeks postpartum. Members can receive two packs of diapers and one pack of wipes with their food box delivery. The Division is asking all providers to be active in spreading the word about this program and encouraging members to contact their MCO to sign up. Access the flyer.

Highmark announced a new wholly-owned subsidiary to assist other companies achieve large-scale transformation through elimination of inefficiencies, creation of revenue opportunities, and delivering enhanced customer outcomes. Lumevity helps businesses develop self-funding, tangible transformation programs that simultaneously improve employee engagement and increase measurable outcomes. By linking outcomes with culture and culture with outcomes, employees drive innovation by engaging with work in new ways. The company will identify potential uses for automation, harness agile methodology, and provide on-site and virtual ideation sessions for new solutions.

Not all physicians who treat Alzheimer's disease will prescribe the new Alzheimer's drug aducanumab (Aduhelm). MedPage Today reports that at the 2021 Alzheimer's Association International Conference a group of physicians and researchers issued recommendations for what they consider appropriate use, proposing to choose the right patients, manage them, monitor safety, and communicate with patients and families. A critical piece of the guidance is who should not be treated with the drug and proving the presence of amyloid before administration. The treatment suggestions were presented at the Conference and published simultaneously in the Journal of Prevention of Alzheimer's Disease.

The Medical Society of Delaware presents the next Hot Topic CME on "COVID-19 Update and Myocarditis," taking place on Tuesday, August 3 beginning at 6:00 p.m. MSD is co-hosting this virtual event with the Delaware Division of Public Health and the Delaware Chapter of the American Academy of Pediatrics. This activity has been approved for a maximum of 1.5 AMA PRA Category 1 Credit™. To Register.

The Society of Critical Care Medicine is offering the Fundamental Critical Care Support course to prepare those who do not specialize in critical medicine to manage patients for the first 24 hours or until consultation can be arranged. The course will be offered in hybrid format, with self-directed online modules followed by an in-person series of skill stations/case discussion to be held on September 11 at Bayhealth Kent Campus in Dover. For details and to register.

ChristianaCare announced today that it will join a growing number of health care systems and hospitals across the nation that are requiring all caregivers to be vaccinated for COVID-19. All caregivers must receive their first dose of a two-dose vaccine or their single dose of Johnson & Johnson by Tuesday, September 21st. Caregivers are defined as all employees, Medical-Dental staff, residents, students, contracted employees, temporary labor, volunteers, and vendors. Exemptions will be limited to specific medical conditions and religious beliefs.

As the Voluntary Initiative Program (VIP) celebrates its 20^th year serving our communities, we take this opportunity to say, "Thank You!" to all of our generous physicians for your service! If you are a VIP physician, MSD staff has recently reached out to you via email to update our records. Ensuring we have current information is critical to the success of this important safety net program. Please be sure to check your SPAM folders and reply with any needed updates. You may choose to complete a new registration form. Please send completed forms to Pam Taylor at Pam.Taylor@medsocdel.org. If you would like informational pamphlets to provide to your patients or have any questions or concerns - we are here to help! If you are interested in joining this great group of physicians to serve the uninsured in Delaware or would like to learn more about the Voluntary Initiative Program, please contact Michelle Seymour, Manager of Membership and Community Outreach, michelle.seymour@medsocdel.org or (302) 224-4905.

This week's spotlight is on Ryan Montgomery Johnson DO, Diagnostic Radiology Resident at ChristianaCare. Read more.

If you would like to be featured in the Spotlight section, please contact Michelle Seymour, Membership Manager.

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 or concerns.

MSD's Members are afforded a seven-day review period from the date of this publication to comment regarding an applicant for membership. Please contact Michelle Seymour at (302) 224-4905 or Michelle.Seymour@medsocdel.org with any questions or concerns.