Indulge in Fine Food Prepared by Renowned Local Chef

Registration is now open for the MSD 2024 Interim Council Meeting to be held on Thursday, April 18th at the Smyrna Opera House, located at 7 W. South St., Smyrna, DE. The evening will begin at 6:00 p.m. with sign-in and a half-hour cocktail social, followed by the Interim Council business meeting beginning promptly at 6:30 p.m. As a member of MSD, this event affords you the opportunity to connect with your peers and meet new colleagues, all the while enjoying fine food and beverage at a historic Delaware location!

We have secured a wonderful catering group, led by Robbie Jester, to complement the evening’s experience. Robbie took home top honors as the winner of Netflix’s “Pressure Cooker,” squared off with and beat celebrity chef Bobby Flay, and was featured on the Food Network show “Guy’s Grocery Games.” He has also catered events for then Vice President Biden and the King and Queen of Sweden. Come enjoy great food and network with your peers!

Consider submitting a resolution. Resolutions are a vehicle to submit to Council your issues for change. Learn more about writing a resolution from the MSD Resolution Writing Guide or the brief training video developed. Resolution submission deadline is Friday, April 5th. Please email resolutions to Mary.LaJudice@medsocdel.org. Plan to attend this year!

To register go to: https://reg.planetreg.com/INTERIM2024. Absolute registration deadline is Thursday, April 11 by end of business day.

Alert for Delaware and Pennsylvania

The Overdose Response Center is distributing Tianeptine Alerts, recently published by the Poison Control Center and the Center for Forensic Science Research and Education (CFSRE), for your information/awareness. Substance abuse treatment professionals, clinicians, and partners should be aware of the dangers associated with the consumption of tianeptine. Incidents of poisoning and overdose have been increasing in our area, as reported to the Poison Control Center. Tianeptine, at higher doses, has opioid-like effects and can lead to similar overdoses and withdrawl. Treatment professionals and clinicians are encouraged to report suspected tianeptine cases to the Poison Control Center at 1-800-222-1222. In addition, information and insights can always be confidentially shared with the Overdose Response Center (ORC@delaware.gov or 302-255-2773).

BA.2.87.1 Detected in South Africa

BA.2.87.1, a new variant of the virus that causes COVID-19, was detected in South Africa by the country’s National Institute for Communicable Diseases. CDC is closely tracking this variant because of the large number of mutations when compared to previous variants. At this time, BA.2.87.1 has not been identified in clinical specimens outside South Africa. Because this is a newly emerging variant, there is not as much additional data about its potential impact. So far, the public health risk for this new variant appears low. CDC continues to track the appearance and spread of new variants around the world through national genomic surveillance. CDC is monitoring this new variant closely and will provide updates as more information becomes available. 

PAXCESS Patient Support Program for Those Prescribed Paxlovid

New data from CDC show that the updated (2023-2024) COVID-19 vaccines were effective against COVID-19 during September 2023 – January 2024, including against variants from the XBB lineage, which is included in the updated vaccine, and JN.1, a new variant that has become dominant in recent weeks. To estimate vaccine effectiveness of the updated COVID-19 vaccine, CDC analyzed data from the Increasing Community Access to Testing (ICATT) COVID-19 pharmacy testing program. The protection provided by the updated vaccine was compared to not receiving an updated vaccine, regardless of a person’s infection history or the number of previous COVID-19 vaccines received. 

V-safe is one of several systems CDC uses to closely monitor the safety of vaccines in the United States. V-safe registration is now open to anyone who gets a 2023-2024 updated COVID-19 vaccine or an RSV vaccine. Participants who enroll in V-safe within 6 weeks of vaccination will receive confidential health check-ins via text message or email to share how they feel after vaccination. People can sign up for V-safe using their smartphone, tablet, or computer at vsafe.cdc.gov.

COVID-19 antiviral treatment can reduce the risks of hospitalization and death if a patient is at increased risk of getting very sick, regardless of their vaccination status. For patients prescribed Paxlovid, the PAXCESS Patient Support Program provides insurance verification, live PAXCESS support representatives who can help with program eligibility, and help with identifying financial assistance. Enrollment takes about 5 minutes. Patients can enroll online by visiting the PAXCESS website, or by phone by calling 1-877-C19-PACK (1-877-219-7225).

Percent Positivity for Influenza B Increased Slightly

Seasonal influenza activity remains elevated nationally, with increases in some parts of the country. Eight flu-related deaths in children were reported for week ending February 10th, bringing the total this season to 82. CDC continues to recommend flu vaccination at this time. Learn more.

DE AG Jennings Co-Led Coalition

Attorney General Kathy Jennings co-led a coalition of 19 attorneys general filing an amicus brief with the U.S. Court of Appeals for the 3rd Circuit. The coalition urged the court to revisit an opinion striking down a Pennsylvania law prohibiting individuals under the age of 21 from carrying concealed weapons in public and imposing additional restrictions during declared states of emergency. Delaware, New Jersey, and Illinois were the lead states on the brief. In the brief, AG Jennings asks the full court to review a recent opinion in Lara v. Commissioner of the Pennsylvania State Police, a lawsuit challenging a Pennsylvania law that restricts the issuance of concealed carry weapons permits to people ages 21 and up. The court’s opinion, if not corrected, will raise questions about the constitutionality of similar statutes in more than 30 other states with age restrictions on firearms access. The coalition explained in the brief that those statutes are constitutional because they are consistent with our country’s historical tradition because similar laws have existed for over 150 years. Jennings and the attorneys general argued that the opinion should be revisited because the court’s reasoning, if adopted elsewhere, could threaten the states’ ability to defend and enforce all manner of firearms regulations. 

Lt. Governor Outlines Recommendations as Chair of Subcommittee

On Monday this week, Lt. Governor Bethany Hall-Long outlined an actionable roadmap to protect state retirees’ health care and promote fiscal sustainability during a joint House and Senate Health Committee hearing. Meeting before the House Health and Human Development Committee and Senate Health and Social Services Committee, Lt. Governor Hall-Long, chair of the Retiree Healthcare Benefits Advisory Subcommittee (RHBAS), shared findings and recommendations from the subcommittee’s inaugural report analyzing retiree health care benefits and long-term funding sustainability. The General Assembly established the subcommittee in 2023 in response to concerns about retiree health care benefits for current and retired state workers and how to address a growing unfunded liability for those benefits. Sen. Bryan Townsend and Rep. Paul Baumbach serve as vice-chairs. The Subcommittee recommendations include that the state should neither request nor consider a Medicare Advantage plan going forward. The RHBAS will continue to meet this year to further discuss the issue of retiree health care benefits and explore solutions.

Supports Delaware Families, Children from Birth to Age 5

The Delaware Division of Public Health (DPH) and Delaware Healthy Mother & Infant Consortium (DHMIC) want families to know about the Home Visiting Program. This free voluntary service connects parents of children ages 0 to 5 with Family Support Specialists, in the comfort of their own home — or a location of their choice. Family Support Specialists discuss important topics with parents, including child development milestones, safe-sleep practices, and learning activities. They can even help families locate important resources like cribs, diapers, and car seats.

In 2021, there were 14,454 home visits provided statewide, including 6,008 virtual visits, supporting approximately 1,363 households in Delaware. Families who participated in the program reported experiencing the following:

• Improved maternal and child health
• Early detection of possible developmental delays or disabilities
• Improvement in school readiness and achievement
• Regular visits with health care providers
• Lower stress levels

To learn more about the Home Visiting Program or share the information with a new parent you know, please visit DEThrives.com/programs/home-visiting to explore all that the program has to offer. There is also digital materials to download that can be used when communicating with your patients about the program. The digital materials also contain the Home Visiting Referral Form for health care professionals to refer patients to the home visiting program, however, potential clients can self-refer.

Patient Rights, Complaint Resolution, Medical Waste Disposal

Effective July 1, 2024, The Joint Commission has approved revisions to several elements of performance for critical access hospitals (CAHs) and hospitals related to patient rights and complaint resolution. In addition, Environment of Care (EC) Standard EC.02.02.01, EP 19, has been revised for both CAHs and hospitals to clarify that organizations need to account for the disposal of regulated medical waste in their procedures. Read more.

Contact MSD If You Are Interested In Serving

On April 1, 2005, the Delaware Department of Health and Social Services (DHSS) began implementing a preferred drug list (PDL). The PDL is composed of drugs that are medically appropriate and less expensive than other drugs in the same class. The drugs are chosen for inclusion on the list by a Pharmaceutical and Therapeutics Committee (P&T Committee). The P&T membership includes clinicians from various specialty areas and includes public advocates. The P&T Committee meets to make recommendations to the Division regarding drugs to be considered for inclusion on (or deletion from) the PDL.

MSD has been asked to nominate a physician for consideration in serving on the Delaware P&T Committee. Currently, the state is looking for nominations of an oncologist, gastroenterologist, or pulmonologist to serve. However, if you are interested but do not practice in these subspecialty areas, they welcome all! The P&T Committee meets four times a year on Thursdays from 11:30 a.m. to 2 p.m. There are three scheduled virtual meetings and one meeting in person that the committee member can either attend or otherwise participate virtually. Physician appointments are made by the Secretary of the Delaware Department of Health and Social Services. Terms are for three years. If you are interested, please email Mary.LaJudice@medsocdel.org and provide an updated CV. It is appreciated to receive a response by Friday, February 23th.

MSD is pleased to highlight one of our 2024 Premier Educational Program Partners. CURI has been a part of the effort to keep our professional medical and public education programs growing through its partnership with MSD as a Premier Educational Program (PEP) Partner.

Curi (curi.com) is the premier provider of products, services, and experiences for physicians and those who support them. From professional liability and other lines of insurance, to wealth management and advisory services, the company—built by doctors for doctors—has been passionately curious about identifying new ways to meet the ever-evolving needs of physicians since it was founded as Medical Mutual Insurance Company of North Carolina in 1975. Contact—Gabe Roco, Curi’s VP of Business Development, 484 220 1644, gabe.roco@curi.com or https://curi.com/.

If you would like to become a PEP Partner, please contact Lynn Robinson, Director of Professional Education. 

Integrated Pharmacy Services

Integrating pharmacy services into your practice can help offer extra support to the clinical team and improve care. In an ambulatory care clinic environment, clinical pharmacists can help manage patients with chronic conditions and improve medication use and adherence. Pharmacists can also promote patient education, such as teaching patients with hypertension how to monitor their blood pressure at home. 

Toolkits:

• Embedded Pharmacists
• Team-Based Care

Success Stories:

• Embedding Pharmacists into Primary Care Practice in the Indian Health Service
• Embedding Pharmacists into the Practice in Ann Arbor, MI

AMA STEPS Forward^® offers a collection of engaging and interactive educational content designed to help put the joy back into medicine.

MSD Academic Channel Can Help With Publishing

David Savage, MD, PhD, says the research conducted during his MD-PhD track is the hardest thing he’s ever done. He suggests picking a mentor who has a good track record of helping students graduate and get published. Think hard about your passions and try to align your research with those passions. There are many other kinds of research besides basic science work. In other words, you can publish more easily if you’re working on questions that you care about and not just doing lab work because you think that’s what’s expected of you! Read more.

MSD can help you get published! MSD has worked with the team of the Cureus Journal of Medical Science and established a designated online "Academic Channel" for MSD on the Cureus site. We invite you to review the Medical Society of Delaware Academic Channel and consider submitting your original research, review article, case report, or technical report for publication. Guidelines to submitting articles through the MSD Academic Channel have been created to help you better understand the process and how authors are more engaged in the submission and review procedure. And it's free!

Newell R. Washburn, MD

It is with sadness we share that MSD member Newell R. Washburn, MD passed away on February 4, 2024, at the age of 85. Specializing in obstetrics and gynecology, he practiced for over 25 years in Milford and then Lewes before retiring in 2007. Dr. Washburn obtained both law and medical degrees from the University of Michigan. He started medical residency at the University of Miami/Jackson Health in Florida and then relocated to Delaware to finish his residency at ChristianaCare in Newark. In his free time, Dr. Washburn could be seen running on the beach, bird-watching, horseback riding, and doing yard work. He also spent time volunteering for Delaware State Parks. Visitation will be held from 11 a.m. to 1:45 p.m. on Saturday, February 24th at Greenwood Mennonite Church in Greenwood, with a memorial service beginning at 2 p.m. In lieu of flowers, the family requests donations to Delaware Hospice. Read obituary.

Information on Recent Product Recalls

Recall of Nordic Naturals Baby's Vitamin D3 Liquid

Nordic Naturals is voluntarily recalling one lot of Nordic Naturals Baby’s Vitamin D3 Liquid, 0.76 fl. oz. (22.5 mL), 400 IU (10mcg) D3. This recall is being conducted due to a manufacturing error that resulted in an elevated level of Vitamin D3 dosage or super potent dose. The affected lot number is 234909, with an expiration date of December 2025. Prolonged use of the recalled Baby’s Vitamin D3 Liquid could potentially lead to elevated vitamin D levels, resulting in vomiting, loss of appetite, increased thirst, frequent urination, and inability to thrive in infants.

Update for Medtronic Electromyogram Endotracheal Tubes

On Wednesday this week, the FDA provided an update to help ensure health care professionals in the operating room setting are aware of Medtronic’s follow-up customer letter for the NIM CONTACT Reinforced EMG Endotracheal Tube and NIM Standard Reinforced EMG Endotracheal Tube. The new information includes updated instructions for use and new training material on what to do when airway obstruction has occurred.

Measuring Blood Glucose Via Smartwatches, Smart Rings

On Wednesday this week, the FDA issued a safety communication warning consumers, patients, caregivers, and health care professionals of risks related to using smartwatches or smart rings that claim to measure blood glucose levels (blood sugar) without piercing the skin. These devices are different than smartwatch applications that display data from FDA-authorized blood glucose measuring devices that pierce the skin, like continuous glucose monitoring devices (CGMs). The FDA has not authorized, cleared, or approved any smartwatch or smart ring that is intended to measure or estimate blood glucose values on its own.

Beebe Healthcare

ChristianaCare

March 5 - 2024 State of the State Address by Governor Carney, 2:00 p.m., House of Representatives Chamber in Legislative Hall. The event will be livestreamed on de.gov/sots and on the Governor's YouTube channel.

March 9 - 28th Annual Diabetes Update, 8:00 a.m.-2:00 p.m., John H. Ammon Education Center, ChristianaCare Newark Campus. Registration deadline March 1st. This activity has been approved for a maximum of 4.75 AMA PRA Category 1 credit/4.75 ABIM MOC.

March 15 - 6th Biennial Perinatal Palliative Care Symposium: Aspects of Trauma in Perinatal Palliative Care, 8:00 a.m.- 4:00 p.m., John H. Ammon Education Center, ChristianaCare Newark Campus. This activity has been approved for a maximum of 5.5 AMA PRA Category 1 credit.

March 26 - Strategies for Improving Maternal and Infant Health Due to Opioid Use, 12-1 p.m., virtual webinar. This activity has been approved for a maximum of 1 AMA PRA Category 1 credit.

April 9 - SAVE THE DATE! Delaware Cancer Consortium Retreat, 8:30 a.m.-3:30 p.m., Bally's Dover Casino Resort.

April 13 - SAVE THE DATE! Delaware Academy of Family Physicians Annual Meeting, Bayhealth SIM Center, Dover.

April 17 - 18th Annual Delaware Healthy Mother & Infant Consortium Summit, 8:30 a.m.-4:00 p.m., Chase Center on the Riverfront.

October 29 - SAVE THE DATE! 28th Annual Delaware Healthcare Forum, 8:30 a.m.-4:30 p.m., Bally's Dover Casino Resort, Rollins Center, Dover.

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.

The Delaware Division of Public Health (DPH) encourages you to sign up for Delaware Health Alert Notifications through the Delaware Health Alert Network (DHAN). The DHAN is an electronic notification system to health care professionals through emailing and faxing. The system is activated when a CDC HAN email message is received. The message is sent out to the distribution lists selected by DPH subject-matter experts. Learn more about Delaware's Health Alert Notification system. If you are not currently receiving health alert messages directly and would like to sign up to receive, please self-register in the Health Alert Delaware system.

• 2024 Adult Immunization Schedule (for ages 19 years or older) - www.cdc.gov/vaccines/schedules/hcp/imz/adult.html (includes new recommendations for RSV vaccine, Mpox vaccine, and pentavalent meningococcal vaccine)

• 2024 Child and Adolescent Immunization Schedule (for ages 18 years or younger) -https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html (includes new recommendations for RSV vaccine, RSV monoclonal antibody, Mpox vaccine, 20-valent pneumococcal conjugate vaccine, and pentavalent meningococcal vaccine)

• Information for from the My Healthy Community Website (updated on Thursdays) - https://myhealthycommunity.dhss.delaware.gov/portals/flu/locations/state/seasons/2023-2024/overview
• Find a Flu Shot

• Information for Delaware Medical Professionals - https://publichealthalerts.delaware.gov/mpox/

• PAXCESS Patient Support Program - for patients prescribed Paxlovid. Provides insurance verification, live PAXCESS support representatives to help with eligibility and financial assistance. Patients can enroll online at the PAXCESS website, or by phone by calling 1-877-C19-PACK (1-877-219-7225).
• Updates to Clinical Testing Guidance Algorithms - CDC has updated several testing guidance pages for patients with acute respiratory illness (1) not being hospitalized, (2) being hospitalized, and (3) hospitalized and non-hospitalized patients when SARS-CoV-2 and influenza viruses are co-circulating. Clinicians can use these updated resources to inform clinical decision making. (12/8/2023)
• Ellume tests available for those who are blind or have low vision (free at-home COVID-19 tests) https://acl.gov/accessibletests
• Find COVID-19 Vaccines: https://www.vaccines.gov/
• No Cost COVID-19 Testing Locator can help uninsured people (or those adults without full vaccine insurance coverage) who are symptomatic or exposed 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)
• (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)