Tag: Centers for Disease Control and Prevention (CDC)

EMS.gov | On-Demand Webinar | Experts Address the Next Phase of the Pandemic

From EMS.gov on April 21

EMS and Public Health Experts Address the Next Phase of the Pandemic

In last month’s EMS Focus webinar, “What the Vaccine Means for EMS Operations,” Florida’s State EMS Medical Director, Kenneth Scheppke, MD, and Commander Bryan Christensen, PhD, with the US Public Health Service and the Centers for Disease Control and Prevention, tackled topics ranging from PPE to quarantine rules to the long-term impacts of the pandemic on EMS.

Download Slide Deck

Millions of EMS clinicians and members of the public across the nation have now received a COVID-19 vaccine. But exactly what does that mean for EMS systems and organizations? In this webinar, learn what we know, and what we don’t know yet, about how the vaccines are changing our approach to the coronavirus pandemic. You’ll hear from experts helping to create and implement guidance for EMS services during these unprecedented times. They’ll address topics such as:

  • Testing and quarantine implications
  • EMS clinicians who have not been vaccinated
  • Vaccines and coronavirus variants
    Lessons learned for the next pandemic

Presenters:

  • Bryan E. Christensen, PhD, is an epidemiologist and industrial hygienist with the Division of Healthcare Quality Promotion (DHQP) in the National Center for Emerging and Zoonotic Infectious Diseases at the US Centers for Disease Control and Prevention (CDC). He is also an environmental health officer in the U.S. Public Health Service. During the COVID-19 response, Bryan has been deployed in several capacities and has served on the Prehospital/EMS Team as part of the Federal Healthcare Resilience Working Group.
  • Kenneth A. Scheppke, MD, FAEMS, is Florida’s State EMS medical director. A board-certified EMS and emergency physician, he also serves as chief medical officer for several fire-rescue agencies in southeast Florida, and has been a leader in the state’s response to coronavirus.
  • Jon Krohmer, MD, director of NHTSA’s Office of EMS and team lead for the Federal Healthcare Resilience Working Group EMS/Prehospital Team, will moderate.

Updated CDC Guidance for Fully Vaccinated Individuals

This past week, the Centers for Disease Control (CDC) updated their guidance related to the COVID-19 vaccination. The guidance modifies the quarantine restrictions for fully vaccinated individuals who were exposed to COVID-19. The guidance is a small sign of progress for many EMS organizations who have been on the frontlines of the pandemic.

Under the most recent guidance, those individuals who are fully vaccinated (defined as those who are two weeks following the second dose administration), are within three months following the last dose in the series and have remained asymptomatic since the current COVID-19 exposure, are not required to quarantine. Individuals who do not meet all three criteria, must follow the current quarantine guidance. The guidance recommends that individuals who meet all three criteria should continue to monitor for COVID-19 related symptoms for two weeks following the exposure. If symptoms develop, individuals should be tested.

Many EMS organizations have inquired if the administration of the COVID-19 vaccination to their workforce modifies the state-level mask mandates or other bloodborne/airborne pathogen protection practices or procedures that are currently in place at EMS organizations or other healthcare facilities.  While the roll-out of the vaccination is a step in the direction of returning to a “new normal”, employers should know that this does not modify any existing COVID-19 related restrictions or requirements.  Employees should continue to wear masks, socially distance, and follow all other COVID-19 recommended safety precautions.

We will keep you informed of updates to the guidance by the CDC and other regulatory agencies.  Be sure to visit the CDC’s website for more information on the current CDC guidance for COVID-19 or the COVID-19 vaccination.  As always, if you have questions or need assistance, contact the AAA at hello@ambulance.org.

CDC | National Forum on COVID-19 Vaccine

Download CDC Fact Sheet

In support of the Biden-Harris administration’s National Strategy for the COVID-19 Response and Pandemic Preparedness, the Centers for Disease Control and Prevention is organizing a virtual National Forum on COVID-19 Vaccine that will bring together practitioners from national, state, tribal, local, and territorial levels who are engaged in vaccinating communities across the nation.

The Forum will facilitate information exchange on the most effective strategies to:

  • Build trust and confidence in COVID-19 vaccines
  • Use data to drive vaccine implementation
  • Provide practical information for optimizing and maximizing equitable vaccine access

Practitioners include representatives of organizations focused on vaccine implementation in communities from:

  • State, tribal, local, and territorial public health departments
  • Healthcare system providers and administrators and their national affiliate organizations
  • Pharmacies
  • Medical and public health academic institutions
  • Community-based health service organizations

Dates and Deadlines:

  • February 9: Registration opens: www.cdc.gov/covidvaccineforum
  • February 16: Last day to register
  • February 22: Building Trust and Vaccine Confidence
  • February 23: Data to Drive Vaccine Implementation
  • February 24: Optimize and Maximize Equitable Access

Download CDC Fact Sheet

CDC | Essential Workers Vaccine Communication Toolkit

CDC has designed a COVID-19 Vaccination Communication Toolkit for Essential Workers to help employers build confidence in this important new vaccine. The toolkit will help employers across various industries educate their workforce about COVID-19 vaccines, raise awareness about the benefits of vaccination, and address common questions and concerns.

Access Toolkit

The toolkit contains a variety of resources including:

  • key messages,
  • an educational slide deck,
  • FAQs,
  • posters/flyers,
  • newsletter content,
  • a plain language vaccine factsheet (available in several different languages),
  • a template letter for employees,
  • social media content, and
  • vaccination sticker templates.

This toolkit will help your organization educate employees about COVID-19 vaccines, raise awareness about the benefits of vaccination, and address common questions and concerns.
Access Toolkit

CDC ACIP | Reccs for Allocating Initial COVID-19 Vaccines

From the CDC’s Morbidity and Mortality Weekly Report

The Advisory Committee on Immunization Practices’ Interim Recommendation for Allocating Initial Supplies of COVID-19 Vaccine — United States, 2020

What is already known about this topic?

Demand is expected to exceed supply during the first months of the national COVID-19 vaccination program.

What is added by this report?

The Advisory Committee on Immunization Practices (ACIP) recommended, as interim guidance, that both 1) health care personnel and 2) residents of long-term care facilities be offered COVID-19 vaccine in the initial phase of the vaccination program.

What are the implications for public health practice?

Federal, state, and local jurisdictions should use this guidance for COVID-19 vaccination program planning and implementation. ACIP will consider vaccine-specific recommendations and additional populations when a Food and Drug Administration–authorized vaccine is available.

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Dooling K, McClung N, Chamberland M, et al. The Advisory Committee on Immunization Practices’ Interim Recommendation for Allocating Initial Supplies of COVID-19 Vaccine — United States, 2020. MMWR Morb Mortal Wkly Rep. ePub: 3 December 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6949e1

CDC Advisory Committee Recommends EMS for Phase 1 Vaccine Distribution

As reported in various media outlets, on December 1 the Center for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) voted 13-1 to recommend that health care providers, expressly including EMS personnel, be prioritized to receive the COVID-19 vaccines during Phase 1a of the vaccine distribution plan. The complicating factor is that State and local governments have the final say in whether these recommendations are incorporated into their own distribution plans. Thus, we encourage all AAA members to engage actively with their State and local governments to urge the adoption of the CDC recommendation. The AAA has developed a toolkit for members to use in reaching out to their state and local government officials.

View and Download Toolkit Here

The AAA has been engaging with ACIP and other federal policy makers to urge them to prioritize EMS in the vaccine distribution plan. On November 19, the AAA submitted a comment letter to the ACIP advocating that the advisory committee specifically include EMS personnel in their recommendation of groups in the first phase of receiving the vaccination. Even though States and local governments will create their own list, having EMS listed in Phase 1a CDC recommendations is a critically important step toward influencing the State and local process.

During its second emergency meeting in less than a month, ACIP met to develop recommendations on the prioritization of vaccines, given that it will be impossible to provide access to everyone in the United States immediately after the vaccines are approved. In both virtual meetings, Committee members noted the importance of EMS personnel having access to the vaccine in the very top tier for prioritization. Other health care personnel on this list are defined as hospitals, long-term care facilities, outpatient clinics, home health care, pharmacies, and public health. The Phase 1a tier also includes residents of nursing homes, assisted living facilities, and other residential care settings, given that approximately 40 percent of all COVID-19 deaths have occurred in these settings. The final recommendation approved states:

When a COVID-19 vaccine is authorized by FDA and recommended by ACIP, vaccination in the initial phase of the COVID-19 vaccination program (Phase 1a) should be offered to both 1) health care personnel§ and 2) residents of long-term care facilities.

Health care personnel are defined as paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials.

Long-term care facility residents are defined as adults who reside in facilities that provide a variety of services, including medical and personal care, to persons who are unable to live independently.

The CDC plans to publish this recommendation in the Morbidity Mortality Weekly Report as well.

The only controversial issue related to whether long-term care facility residents should receive the vaccine given the limited information available about its effectiveness and safety in these populations.

Because President Trump has indicated that State and local governments do not have to follow the CDC recommendations, it is critically important that AAA members work closely with their State and local governments to ensure that the CDC recommendations with regard to EMS are adopted by them as well. The AAA has posted a tool kit on our website to help our members provide the necessary information to their State and local governments as they are making these decision.

ACIP will continue to evaluate the distribution prioritization for Phase 1b, which will likely be non-health care essential workers, and Phase 1c, which will include adults with high-risk medical conditions and adults 65 years or older.

NPR | COVID-19 In U.S. Weeks Earlier Than Previously Known

From NPR

Coronavirus Was In U.S. Weeks Earlier Than Previously Known, Study Says

The coronavirus was present in the U.S. weeks earlier than scientists and public health officials previously thought, and before cases in China were publicly identified, according to a new government study published Monday.

The virus and the illness that it causes, COVID-19, was first identified in Wuhan, China, in December 2019, but it wasn’t until Jan. 19 that the first confirmed COVID-19 case, from a traveler returning from China, was found in the U.S.

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HHS Non-discrimination During COVID-19 Guidelines

The Department of Health and Human Services (HHS) released guidance today intended to ensure that any healthcare provider who has received financial assistance, especially during the COVID-19 pandemic,  are compliant with the non-discrimination provisions of Title VI of the Civil Rights Act of 1964.  Consistent with the Affordable Care Act Section 1557’s non-discrimination provisions, Title VI ensures that no individual is denied access to benefits or otherwise discriminated against on the basis of race, color, national origin, disability, age, or sex.

HHS’ Office of Civil Rights (OCR) released this guidance to remind healthcare providers that Title VI prohibits both intentional and disproportionate or adverse impact discrimination.  Additionally, HHS is collecting nationwide data to identify the social, behavioral, and economic impacts on health disparities and vulnerable populations specific to the COVID-19 pandemic response.  The guidance specifically mentions ambulance service providers and suggests that they should:

  • Adopt policies to prevent and address harassment or unlawful discrimination;
  • Evaluate existing policies and procedures to ensure that their service delivery does not exclude or otherwise deny individuals based upon their belonging to a protected category;
  • Ensure that individuals are not subject to excessive wait times based upon their racial or ethnic minority group;
  • Provide services to all neighborhoods and individuals regardless of their race, color, or national origin;
  • Appoint individuals to planning or advisory bodies without regard to race, color, or national origin;
  • Provide culturally appropriate messaging to individuals with Limited English Proficiency (LEP)

Most EMS agencies already maintain an ACA Section 1557 Compliance Coordinator and have a Grievance Procedure for those who believe that they have been discriminated against in the provision of EMS mobile healthcare services.  It is recommended that EMS agencies review their current practices, as well as, their response coverage, times, and care provided in all the areas that they serve.  Further, I recommend that these efforts are documented and, if disparities are identified, a plan of correction is drafted, executed, and monitored, to ensure compliance.

Updated Interim CDC Guidance for EMS Services

The Centers for Disease Control (CDC) released updated Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answer Points/Emergency Communication Center (PSAP/ECCs) in the United States During the Coronavirus Disease (COVID-19) Pandemic. The new twelve (12) page guidance is geared specifically for EMS and first responding agencies in response to the COVID-19 pandemic.  This is a summary of the highlights from the Interim Guidance and services are encouraged to review the document with your leadership team as this guidance impacts multiple aspects within an EMS organization.

1) Infection Prevention & Control (IPC) Practices

The CDC recommends that EMS agencies use additional infection prevention and control practices during the pandemic.  These practices are intended to augment your organization’s standard infection control practices with COVID-19 specific protective measures.  The recommendations include:

911 PSAPs Modified Call Queries

CDC recommends the development of modified caller queries to be developed in collaboration with your local state public health officials and your medical director.  The modified caller queries are geared towards identifying if the call concerns an individual who may have COVID-19 symptoms.  Additionally, the recommendations include pre-arrival instructions to include facial coverings, if patient condition permits, and communications with responding units to take the appropriate precautions.

2) Recommendations for EMS Personnel

The CDC identified numerous requirements for EMS Employers including:

  1. Development of IPC policies and procedures for safely donning and doffing PPE
  2. Job-specific education and training on preventing the transmission of infectious disease
  3. Employee training for the appropriate use of PPE, including OSHA required Fit testing
  4. EMS units must have adequate supplies of hand sanitizer, cleaning supplies, and disinfectants
  5. Require all employee to wear facial coverings when in the workplace, at all times. This includes breakrooms, day rooms, etc.
  6. Encourage employees not to change facial covers unless absolutely necessary to reduce exposure.

Screen all EMS Personnel for Signs or Symptoms of COVID-19 at the Start of Each Shift

The Interim Guidance calls for screening of all EMS personnel and visitors for symptoms consistent with COVID-19.  This screening should include active temperature screening and inquiring if they have been advised to quarantine due to exposure.  The guidance suggests restricting workplace access.

Assess all patients for COVID-19 Infection

EMS personnel should don the appropriate PPE when encountering patients, specifically those suspected of being infected with the virus.  The guidance suggests social distancing when possible and limiting how many providers make contact with the patient.  When appropriate, all patients should have the appropriate facial covering, this includes any family members or other persons accompanying the patient at the scene.

Encourage Physical Distancing

The CDC recommends limiting the number of EMS providers that accompany the patient in the ambulance patient compartment and suggests closing any walkthrough access to the driver’s compartment.  The guidance also suggests limiting or prohibiting family members from accompanying the patient in the ambulance.  The guidance also suggests that physical distancing be enforced in all workspaces, including break or eating areas where employees are going to be unmasked.

Implement Universal Use of Personal Protective Equipment

The CDC recommends that EMS personnel working in areas with moderate to substantial community transmission wear an N95 or equivalent or greater level respirator and eye protection.  For EMS personnel working in low transmission areas, the CDC recommends that N95 and eye protection are optional but that personnel should continue to follow the Standard and Transmission-Based Precautions based on any anticipated or suspected exposures.

Create a Process to Address to COVID-19 Exposures Among EMS Personnel & Others

The CDC recommends EMS agencies develop a process for notifying the health department about suspected or confirmed cases of COVID-19 and that each should develop a plan for investigating exposures.  This includes identifying:

  • An individual who is responsible identifying and notifying potentially exposed individuals.
  • How notifications will occur
  • The actions and follow-up required.

3) Recommend IPC practices when caring for a patient with suspected or confirmed COVID-19 infection

The CDC guidance also includes recommendations for the Personal Protective Equipment (PPE) that EMS personnel caring for suspected or confirmed COVID-19 infection should adhere to.  This includes:

  • Hand Hygiene
  • PPE Training
  • PPE Equipment, including:
    • Respirator or Facemask
    • Eye Protection
    • Gloves
    • Gowns

The guidance includes a warning regarding EMS personnel performing Aerosol-Generating Procedures.

4) EMS Transport of a Patient with Suspected or Confirmed COVID-19 Infection to a Healthcare Facility (Including Interfacility Transport)

Lastly, the CDC Interim Guidance included recommended actions when EMS personnel are transporting a patient who is suspected or confirmed to be infected with COVID-19.  It is recommended that the EMS crew notify the receiving healthcare facility prior to arrival to permit them to take the necessary precautions.  Additionally, the guidance suggests the following:

  • Document Patient Care

The patient care record should include documentation of a listing of all EMS personnel and public safety provided involved in the response, the level of contact with the patient, and if PPE was worn.

  • Cleaning EMS Transport Vehicles after Transporting a Patient with Suspected or Confirmed COVID-19 Infection.

The guidance includes additional information which includes guidelines for cleaning and maintaining EMS vehicles and equipment following the transport.

The updated CDC Interim Guidance included practices that most EMS organizations and personnel are practicing currently and have been since the outset of this pandemic.  However, it serves are an important reminder that the risks are very real and that EMS personnel must remain vigilant in their practices to ensure the safety of all individuals.

Updated CDC Guidance for EMS

On July 15, 2020 the Centers for Disease Control issued an updated guidance for EMS personnel in response to the ongoing Public Health Emergency.

Summary of Key Changes for the EMS Guidance:

  • Reorganized recommendations into 2 sections:
    • Recommended infection prevention and control (IPC) practices for routine activities during the pandemic.
    • Recommended IPC practices when caring for a patient with suspected or confirmed SARS-CoV-2 infection.
  • Added recommendations that were included in healthcare IPC FAQs addressing:
    • Universal use of PPE for healthcare personnel working in communities with moderate to sustained transmission of SARS-CoV-2, the virus that causes COVID-19
    • Creating a process for responding to SARS-CoV-2 exposures among healthcare personnel and others.

Read the Full Guidance

CNN | COVID-19 Data Will Be Sent to Trump Administration, Not CDC

From CNN’s “Coronavirus hospital data will now be sent to Trump administration instead of CDC” on July 15.

Hospital data on coronavirus patients will now be rerouted to the Trump administration instead of first being sent to the US Centers for Disease Control and Prevention, the Department of Health and Human Services confirmed to CNN on Tuesday.

The move could make data less transparent to the public at a time when the administration is downplaying the spread of the pandemic, and threatens to undermine public confidence that medical data is being presented free of political interference.

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CDC Chief Says COVID-19 Cases May be 10x Higher Than Reported

From the Washington Post on June 25

CDC chief says coronavirus cases may be 10 times higher than reported

The number of Americans who have been infected with the novel coronavirus is likely 10 times higher than the 2.3 million confirmed cases, according to the head of the Centers for Disease Control and Prevention.

In a call with reporters Thursday, CDC Director Robert Redfield said, “Our best estimate right now is that for every case that’s reported, there actually are 10 other infections.”

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CDC | Testing Guidelines for Nursing Homes

On June 13, the Centers for Disease Control and Prevention issued updated guidance for COVID-19 testing in nursing homes. Thank you to the many  member organizations  providing this vitally important care to our nation’s vulnerable populations. Changes are summarized below:

  • Reorganized recommendations to address:
    • Viral testing of healthcare personnel (HCP)
    • Viral testing of residents
    • Viral testing in response to an outbreak
  • Changed “baseline” testing to “initial” testing, although these terms are interchangeable
  • Added the following recommendations:
    • Testing the same individual more than once in a 24-hour period is not recommended.
    • Clinicians are encouraged to consider testing symptomatic residents for other causes of respiratory illness, for example influenza, in addition to testing for SARS-CoV-2.

CDC Nursing Home Testing

CDC Announces Live Stakeholder Call Schedule

CDC Announces Live Stakeholder Call Schedule

Helping communities plan for, respond to, and recover from the COVID-19 pandemic
Childcare Programs, Youth Programs and Camps, Schools, Workplaces, Mass Transit
Please join us for the stakeholder calls below:

CDC’s Live Stakeholder Call Schedule (Click the links to register for each call.)
Youth Programs and Camps Tuesday, May 19 from 4-5 pm ET
Schools and Childcare Programs Wednesday, May 20 from 4-5 pm ET
Workplaces and Mass Transit Thursday, May 21 from 4-5 pm ET
Youth Sports Friday, May 22 from 4-5 pm ET

Leaders may use the tools below as they make decisions during the COVID-19 pandemic.


Thank you for all you are doing to promote the public’s health during this time.

CDC Elevates First Responders to Highest Priority for COVID-19 Testing

On April 27, the CDC issued an update to its Guidance on “Evaluating and Testing Persons for Coronavirus Disease 2019” in which “first responders with symptoms” are now in the category of “highest priority” as to the prioritization of groups who should be tested for COVID-19. The AAA has been advocating to federal agencies and the Congress to move first responders to the highest level of priority for COVID-19 testing. The update can be viewed at HERE.

CDC: PPE Guidance and Burn Rate Calculator

U.S. Centers for Disease Control |  April 7, 2020

U.S. Strategies to Optimize the Supply of PPE and Equipment

Personal protective equipment (PPE) is used every day by healthcare personnel (HCP) to protect themselves, patients, and others when providing care. PPE helps protect HCP from potentially infectious patients and materials, toxic medications, and other potentially dangerous substances used in healthcare delivery.

PPE shortages are currently posing a tremendous challenge to the US healthcare system because of the COVID-19 pandemic. Healthcare facilities are having difficulty accessing the needed PPE and are having to identify alternative ways to provide patient care.

CDC’s optimization strategies for PPE offer options for use when PPE supplies are stressed, running low, or absent. Contingency strategies can help stretch PPE supplies when shortages are anticipated, for example, if facilities have sufficient supplies now but are likely to run out soon. Crisis strategies can be considered during severe PPE shortages and should be used with the contingency options to help stretch available supplies for the most critical needs. As PPE availability returns to normal, healthcare facilities should promptly resume standard practices.

PPE Burn Rate Calculator

The Personal Protective Equipment (PPE) Burn Rate Calculator is a spreadsheet-based model that will help healthcare facilities plan and optimize the use of PPE for response to coronavirus disease 2019 (COVID-19). Non-healthcare facilities such as correctional facilities may also find this tool useful.

To use the calculator, enter the number of full boxes of each type of PPE in stock (gowns, gloves, surgical masks, respirators, and face shields, for example) and the total number of patients at your facility. The tool will calculate the average consumption rate, also referred to as a “burn rate,” for each type of PPE entered in the spreadsheet. This information can then be used to estimate how long the remaining supply of PPE will last, based on the average consumption rate. Using the calculator can help facilities make order projections for future needs.

 

 

AAA Sends Letter to HHS on COVID-19 Response

On April 6, the AAA sent a letter to Health and Human Services Secretary Azar requesting that the Department distribute direct payments to all ambulance service providers and suppliers who are on the front lines of the COVID-19 pandemic. The AAA requested funding under the $100 Billion Public Health and Social Service Emergency Fund, established by the CARES Act, in the amount of $48,000 per ambulance registered as of April 1. The AAA estimates the payments would represent approximately $2.6 billion in desperately-needed relief for our industry. Read the letter HERE.

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