The Delaware Division of Public Health (DPH) today announced that the state's vaccine providers can begin administering booster doses of the Pfizer-BioNTech vaccine to certain populations recommended by the Centers for Disease Control and Prevention (CDC). Boosters are not yet authorized for people who received either the Moderna or Johnson & Johnson vaccine as there is not adequate data to support including them at this time. However, Delawareans who have certain immunocompromising conditions are currently eligible to receive a “third dose” of either Pfizer or Moderna vaccines, if they completed their second dose at least 28 days prior. COVID-19 vaccine providers in Delaware may begin administering booster doses of Pfizer immediately or as soon as they are able. FAQs and talking points for health care professionals from CDC's Advisory Committee on Immunization Practices (ACIP) are provided. Questions can also be directed to VaccinePlanning@delaware.gov.

The Centers for Medicare and Medicaid Services (CMS) indicated it will continue to provide coverage for this critical protection from the virus, including booster doses, without cost-sharing, available for eligible people with Medicare, Medicaid, CHIP, and most commercial health insurance coverage.

In follow up to the Centers for Disease Control and Prevention (CDC) recent announcement on COVID-19 booster doses, MSD in conjunction with the Delaware Division of Public Health (DPH) are presenting a virtual event for health care professionals on Tuesday, September 28 from 6:00-7:00 p.m. Karyl Rattay, MD and Rick Hong, MD from DPH will provide updates on the COVID-19 pandemic and outline guidance for administering third doses and booster shots of the COVID-19 vaccine to patients. Registration is required.

On Monday of this week, Pfizer and BioNTech announced its vaccine was safe and effective for children ages 5 to 11 years old, and that it would seek U.S. approval for providing the vaccine to the younger age group. A lower dose was tested, equating to a third of the amount in the vaccine that is given now. The companies have indicated the lower dosage has proved safe, with similar or fewer temporary side effects that teens experience (sore arm, fever, achiness). The goal is to apply to the Food and Drug Administration (FDA) by the end of the month for emergency use authorization for this age group. The FDA has indicated that, once it receives the study results, the agency hopes to evaluate the data in a matter of weeks to determine if the vaccine is both safe and effective for this age group. Topline readouts for the other two age cohorts from the trial – children 2 to 5 years of age and children 6 months to 2 years of age – are expected as soon as the fourth quarter of this year.

With Congress set to return to Washington in the coming weeks, there is much work to be done to save physicians from looming cuts in the Medicare physician payment system. In what amounts to a "perfect storm" of payment reductions going into effect in 2022, several Medicare spending cuts will result in a combined 9.75% payment cut for physician practices on January 1. Representatives Ami Bera, MD (D-CA) and Larry Buschon, MD (R-IN) have recently circulated a "Dear Colleague" letter urging House leaders to extend the 3.75% increase to the Medicare conversion factor that Congress included in the Consolidated Appropriations Act of 2021 to provide continued stability to the physician and provider community as it works toward broader Medicare payment reform. Physicians are encouraged to contact their representatives personally asking to support the letter. You can send an email via the AMA's Physician Grassroots Network alert.

The Centers for Medicare & Medicaid Services (CMS) awarded $15 million in planning grants to 20 states to support expanding community-based mobile crisis intervention services for Medicaid beneficiaries. Delaware was one of the 20 states whose state Medicaid agency was awarded a planning grant. The goal is to connect people who are experiencing a mental health or substance use disorder crisis to a behavioral health specialist or critical treatment. The services will be available 24 hours per day, every day of the year. Funding is provided from the American Rescue Plan (ARP). The period of performance for this grant will be from September 30, 2021, through September 29, 2022. Thanks to the ARP, on April 1, 2022, all states will be eligible for a temporarily enhanced matching rate for implementing a qualified community-based mobile crisis intervention option in their Medicaid Programs.

The American Medical Association (AMA) issued a report showing a 44.4 percent decrease in opioid prescribing nationwide in the past decade. At the same time, the country is facing a worsening drug-related overdose and death epidemic. The report shows that overdose and deaths are spiking even as physicians have greatly increased the use of prescription drug monitoring programs. Yet, the nation continues to see increases in overdose mainly due to illicit fentanyl, fentanyl analogs, methamphetamine, and cocaine. More than 104,000 physicians and other health care professionals have an "X-waiver" to allow them to prescribe buprenorphine for the treatment of opioid use disorder, yet 80 to 90 percent of people with a substance use disorder receive no treatment. The AMA is urging policymakers to stop prior authorization for medications to treat opioid use disorder; to ensure access to affordable, evidence-based care for patients; to better support harm reduction services such as naloxone and needle and syringe exchange services; and improve data collection using standardized data to identify and treat at-risk populations and better understand the issues facing communities.

In a review article published in both the American Journal of Kidney Diseases and the Journal of the American Society of Nephrology, a joint task force of the National Kidney Foundation and the American Society of Nephrology reassessed the long-standing practice of using race-based equations when measuring estimated glomerular filtration rate (eGFR). eGFR adjusts results by race, providing different assessments for Black patients than for others, making Black patients seem less ill. The task force recommended the immediate adoption of race-free eGFR equations.

The Biden-Harris Administration announced a $2.1 billion investment to improve infection prevention and control activities across the U.S. public health and health care sectors. Working through the Centers for Disease Control and Prevention (CDC), the Administration is investing American Rescue Plan funding to strengthen and equip state, local, and territorial public health departments and other partner organizations with the resources needed to better fight infections in U.S. health care facilities, including COVID-19 and other known and emerging infectious diseases. Over the next three years, the CDC will issue $1.25 billion of the total to 64 state, local, and territorial health departments to support this work. Initial awards totaling $885 million will be made in October 2021 to these jurisdictional health departments. The CDC will use the majority of this initial funding in October, $500 million, to support a new force in the fight against COVID-19 to protect our most disproportionately affected population. READ more.

Delaware experienced an outbreak of varicella (chickenpox) among children attending a daycare in the spring of this year. The Delaware Division of Public Health (DPH) Office of Infectious Disease Epidemiology discovered during its investigation that 93% of the associated cases had not been reported to the State upon diagnosis. Early reporting can reduce the risk of transmission and outbreaks, especially in those who are considered high risk. All health care providers, educational facilities, and other congregate settings should report ALL SUSPECTED AND CONFIRMED CASES of varicella to DPH. A Notifiable Disease Report PDF Form should be completed. This form can be mailed or faxed (302/223-1540) to DPH or emailed to: reportdisease@delaware.gov. Additionally, providers that diagnose varicella cases will be asked to complete a varicella surveillance worksheet. After the varicella surveillance worksheet is completed, it should be faxed to DPH at (302) 223-1540. READ more.

The Centers for Disease Control and Prevention (CDC) has issued a Health Advisory recommending that clinicians be on alert for cases of measles that meet the case definition, as well as other infectious diseases, including mumps, leishmaniasis, and malaria, among evacuees (including both Afghan nationals and U.S. citizens) from Afghanistan. Evacuees who are in the U.S. must be vaccinated with MMR and complete a 21-day quarantine from the time of vaccination, according to the health advisory. Clinicians should immediately notify their local or state health department of any suspected cases of measles. As of September 20, 2021, the CDC has been notified of 16 confirmed cases of measles and four cases of mumps among Afghan nationals and U.S. citizens recently arriving from Afghanistan, and continued vigilance is needed. In addition to MMR vaccination, CDC recommends that evacuees are also up to date on vaccinations for varicella, polio, COVID-19, and seasonal influenza.

Governor John Carney last week joined members of the General Assembly and environmental advocates to sign three environmentally-focused bills that will help expand the use of renewable energy, reduce carbon emissions, and protect Delaware's fragile ecosystems from the harmful effects of plastic waste. Senate Bill 2 is designed to accelerate the adoption of community-based photovoltaic systems in Delaware. Governor Carney also signed Senate Bill 21, an amendment to the Delaware Energy Act that encourages the adoption of electric vehicles by creating a more accessible charging-station infrastructure in the First State. This Act limits the locations where the charging infrastructure may be placed by the State to state-owned or state-leased properties used by state employees or visitors. Finally, Governor Carney signed Senate Substitute 1 for Senate Bill 24, legislation that makes it unlawful to intentionally release balloons filled with air or lighter-than-air gases. 

President Biden announced an all-of-government effort to protect workers, children, seniors, and at-risk communities from heat-related illnesses and other public health risks linked to rising global temperatures, ensuring safe and healthy working conditions, providing cooling assistance to homes and neighborhoods, and coordinating with state and local officials to bolster resilience and address the impacts of this threat. The strategy to combat extreme heat will include the development of new federal labor standards aimed at protecting workers from the impact of rising temperatures linked to climate change.

The movement for transformative climate action in Congress is here. Seventy-nine organizations in the health care and public health community, including the Medical Society of Delaware, released a joint letter to Congressional leaders on September 8th outlining the priorities that will most benefit our nation's health. Help amplify the health community's message: major investments are needed to protect and promote health in response to the climate crisis. Join your colleagues and take action in sending a message to Congress.

The U.S. Food and Drug Administration (FDA) has announced a voluntary Pfizer recall of all lots of Chantix 0.5 mg and 1 mg tablets due to the unacceptable levels of N-nitroso-varenicline, a type of nitrosamine. This follows Pfizer halting distribution this summer and then recalling more than a dozen lots of the medicine in August. Chantix supply disruptions led to a shortage. In July, the FDA allowed a global pharmaceutical company to import generics from Canada. The FDA last month approved a U.S. generic from Endo's Par Pharmaceutical. As alternative suppliers have been approved in the U.S., Pfizer is undertaking this precautionary measure.

Green Field Farms Dairy of Fredericksburg, OH announced a voluntary recall of its Whole Chocolate Milk product, with a code date of 9/29/21, due to a laboratory analysis that indicated this product was not effectively pasteurized. Products were distributed throughout nine states, including Delaware, from September 7 through September 16, 2021.

The Delaware Division of Social Services (DSS) will issue emergency benefits for September to eligible households as part of the state's ongoing response to the COVID-19 public health crisis. Benefits will be issued as part of the Supplemental Nutrition Assistance Program (SNAP) and two cash assistance programs - Temporary Assistance for Needy Families (TANF) and General Assistance (GA). The SNAP emergency food benefit will be issued Wednesday, September 29, and TANF and GA households should receive an emergency cash benefit check on or after Wednesday, September 29. The Delaware Department of Health and Social Services (DHSS) has issued emergency benefits each month to eligible households as part of the Families First Coronavirus Response Act of 2020, which was signed into law in March 2020. For more information about DSS’s benefit programs in response to the pandemic, go to the division’s webpage. The announcement is available in English or Spanish.

A new Coverys' report, A DOSE OF INSIGHT: Care Transitions Through the Lens of Malpractice Claims, evaluates events where the care transition directly led to an alleged medical error. It includes data-driven insights, case studies, and recommendations to reduce risk. For more insight on this topic, register for the free webinar based on the report taking place on September 30 from 2:00-3:00 p.m.

The Medical Society of Delaware will hold its Annual Meeting of the Council, Annual Meeting of the MSD Holding Company Board, and educational sessions virtually on November 9, 10, and 11 this year. Watch for more information and registration details coming soon.

Bayhealth is a participant in the Emergency Medical Services for Children (EMSC) program. The goal of this federal program is to reduce sickness and death that result from life-threatening injuries and other medical events in children. The Delaware EMSC program evaluates all of the emergency care facilities in the state on their ability to meet this goal and gives them a Pediatric Care Facility rating from Level 1 to Level 4, with Level 1 being the highest. Bayhealth announced that, as a result of the most recent EMSC performance evaluation, Bayhealth Emergency and Trauma Center, Kent Campus advanced from a Level 3 to a Level 2 rating. To receive a Level 2 rating, an emergency care facility must be able to provide ongoing inpatient pediatric care.

Beebe Healthcare is once again this year hosting free flu vaccination clinics throughout Sussex County. Since demand outpaced supply last year, clinics will be announced in two-week windows, running September through November. The events will have all protocols in place to safely administer the vaccines.

Delaware State News reports that during a virtual town hall event on Wednesday, it was announced that Beebe Healthcare will not require the COVID-19 vaccine for its employees. Beebe plans to incentivize employees rather than mandate the vaccination.

NFL teams are using exercises developed by ChristianaCare to protect their football players from injuries. ChristianaCare physical therapists have developed a trailblazing treatment to prevent muscle strains that has caught the attention of numerous sports teams, including NFL football teams, Los Angeles Rams and Baltimore Ravens. Nearly nine years ago, the therapists began working on ways to increase resilience in core muscles. Through their research, they developed a screening tool, the "core sling screen," which detects weakness in those muscles. A study on the treatment's success was published this spring in the Journal of Sport Rehabilitation.

ChristianaCare patients now have the option to share important everyday health information stored in the Apple Health app directly with their provider. With iOS 15, patients can share certain types of this data in a secure way for more informed, meaningful conversations with their clinician. The feature is designed to meet the privacy and security requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). ChristianaCare is one of the first health systems to offer this new feature with the availability of iOS 15.

Nemours Children's Health and Beebe Healthcare have teamed up to provide pediatric services to the infants, children, and adolescents of Sussex County. Nemours pediatric hospitalists will provide advanced hospital care to include joining the Beebe Women's and Children's Services team to provide care to infants in the Newborn Nursery and at the time of high-risk deliveries in collaboration with Beebe's neonatal nurse practitioners, providing consultation and care in Beebe's inpatient pediatric unit, and providing pediatric consultations in Beebe's Emergency Department in Lewes, available 24 hours a day, seven days a week.

TidalHealth's Outpatient Behavioral Health clinic will move on October 4 to a new location at 200 East Vine Street in Salisbury - across the street from its current home within TidalHealth Peninsula Regional. Patients with appointments scheduled for October 4 and beyond should plan to be seen at the new location.

TidalHealth's new Internal Medicine Residency Program has earned accreditation by the Accreditation Council for Graduate Medical Education. The program will start recruiting medical residents for the program in October with the first class of new physicians starting in July 2022. Residents in the program will also be located at TidalHealth Nanticoke.

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 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 questions or concerns.