OSHA and CDC Updates
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orIn 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.
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:
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:
Practitioners include representatives of organizations focused on vaccine implementation in communities from:
Dates and Deadlines:
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.
The toolkit contains a variety of resources including:
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
From the CDC’s Morbidity and Mortality Weekly Report
Demand is expected to exceed supply during the first months of the national COVID-19 vaccination program.
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.
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.
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
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.
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.
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:
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.
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.”
The CDC has compiled a list of financial resources to support states, tribes, localities, and territories.CDC Financial Resources List
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:
This document briefly summarizes CDC’s initiatives, activities, and tools in support of the Whole-of-Government response to COVID-19.
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.
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.
U.S. Centers for Disease Control | April 7, 2020
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.
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.
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.
The AAA has sent a letter to CMS on how the agency can most help ground ambulance service providers and suppliers be better prepared to respond to potential cases of COVID-19. The AAA has requested priority access to personal protection equipment for EMS personnel and COVID-19 test kits and results, as well as easing Medicare and Medicaid policies on alternative destinations and treatment in place. The letter was also sent to the National Highway Traffic Safety Administration (NHTSA) and the Assistant Secretary for Preparedness and Response (ASPR). Read the letter HERE.
On March 10, the CDC issued the following changes to its interim guidance pm COVID-19.