Health Advisory: COVID-19 Updates for Kitsap Healthcare Providers

| August 18, 2021

**Our transition to distribution of Health Advisory messages via MailChimp has been a bit bumpy. This message is being distributed via GovDelivery and as soon as we are able, we will begin using MailChimp. Please note that all 2021 Kitsap Public Health District Health Advisories are always available on our Provider Resources website: https://providers.kitsappublichealth.org/category/health-advisory/ **

 

ACTIONS REQUESTED

  • Be aware of a dramatic surge in COVID-19 infections amongst Kitsap residents; and an increase in outbreaks, including cases associated with long term care facilities.
  • Be aware of breakthrough cases amongst fully vaccinated individuals.

TESTING

  • Test patients who present with COVID-like symptoms and patients identified as close contacts of a confirmed COVID case whether they present with symptoms or are asymptomatic. Don’t assume a symptomatic close contact patient has COVID, diagnose with testing.
  • Report (required) COVID-19 rapid antigen tests (point of care testing) to WA DOH and KPHD.
    • All point of care (POC) test results (positive & negative) must be reported to WA DOH using this form, instructions are available here.
    • Report positive test results to KPHD by faxing the completed KPHD WA COVID-19 POC result formto (360) 813-1168 or by calling the Health District, (360) 728-2235, 24/7.
  • Advise patients with a positive test result from an over-the-counter test to isolate and report positive results by calling 2-1-1.
  • Be aware of expanded testing options:

PREVENTION AND TREATMENT

  • Prevent transmission of COVID-19 by excluding symptomatic staff from the workplace.
  • Comply with the statewide mask mandate per Washington State Order 20-03. Starting Aug. 23, face masks are now required for everyone over five years old in most public indoor settings regardless of vaccination status. These settings include places like grocery stores, malls, gyms, and community centers. Masks are strongly recommended in crowded outdoor settings like sporting events, fairs, and concerts where physical distancing is not possible.
  • Be aware of updated guidance from WA DOH for the use of Monoclonal Antibody products to treat COVID-19 in patients are 12 years or older and weigh more than 39kg and are at high risk for progressing to severe COVID-19 or hospitalization.
    • Added links to recent research findings on monoclonal antibody treatment.
    • Updated information on the pause in distribution of bamlanivimab and etesevimab.
    • Added information on use of REGEN-COV, including a subcutaneous injection option and expanded EUA for use as post-exposure prophylaxis.
    • Updated information on the EUA for Tocilizumab
    • Added information about Medicare coverage of monoclonal antibody products

 

  • Be aware that CDC distributed an Advisory via Health Advisory Network (HAN) on August 26 about the sharp increase in prescriptions or attempts to obtain veterinary doses of ivermectin to prevent or treat COVID-19. Poison control centers have experienced a 5-fold increase in calls related to ivermectin toxicity. The evidence suggesting ivermectin is safe or effective at treating or preventing COVID-19 is of very low- to low- certainty.

VACCINE

  • Be aware, the US Food and Drug Administration (FDA) granted full authorization to Pfizer-BioNTech COVID-19 vaccine for people 16 years and older. Pfizer-BioNTech continues to be available to people ages 12-15 through emergency use authorization.
  • Comply with the Governor’s proclamation– COVID-19 Vaccination Requirement – stating mandatory full vaccination against COVID-19 by October 18, 2021 for licensed healthcare workers and workers in healthcare and long term care settings.
  • Be aware that the Governor’s proclamation– COVID-19 Vaccination Requirement – also states mandatory full vaccination against COVID-19 by October 18, 2021 for all state employees and workers.
  • Be aware that the Governor has also announced a vaccination requirement as a condition of employment for all employees working in K-12 and most childcare and early learning and higher education settings.
  • Participate in the Washington State Department of Health (DOH) Power of Providers initiative(POP) to motivate and support providers to ask patients’ vaccination status, offer education, give vaccine or a referral, and empower patients to share their vaccination status with others they know. Sign up here to join the campaign (https://fortress.wa.gov/doh/opinio/s?s=POP).
  • Be able to identify, advise and immunize your immunocompromised patients with a third dose for those who have received mRNA vaccines, per revised CDC guidelines.
  • Advise your pregnant women to get vaccinated, as recent data show no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men and benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy. Review the CDC summary of key messages and talking points.
  • Vaccinate everyone 12 years or older against COVID-19.
    • Make COVID-19 vaccination a new vital sign. Review all patients’ vaccination records to help them get up to date with all vaccines. You can administer COVID-19 vaccine simultaneous with, or within any number of days of, other vaccines.
    • If you do not give vaccine, your patients can call the Health District, (360) 728-2235, 8 a.m. to 4:30 p.m., Monday through Friday. We can provide them with a list of places offering the COVID-19 vaccine.
    • Refer patients who can’t easily leave home and need COVID-19 vaccine to us at (360) 728-2235, 8 a.m. to 4:30 p.m., Monday through Friday. We can coordinate with the Dept. of Health to bring vaccine to them.
    • If you need to order smaller quantities of vaccine, please email your request to COVIDvaccine@kitsappublichealth.org.

BACKGROUND

COVID-19 case data show continued increase at a dramatic pace driven by spread of the more infectious Delta variant. We reported more cases last week than we have ever reported in a single Sunday to Saturday period (523 cases, our previous high prior to this surge was 405 for the week ending January 9, 2021).

  • On August 26, we reported a rate of 239.5 cases/100,000 residents/7 days, the highest ever 7-day rate.
  • Transmission is categorized as ‘high’ in all areas of the county.
  • Central Kitsap has the highest rate at 314.2 cases/100k/7 days on August 26.
  • Adults age 19-34 have the highest past month case rate, nearly double the rate of the next highest age group (age 35-64).
  • For July 2021, 80.7% of cases were among those not fully vaccinated, those with 1 of 2 doses or with 0 doses.
  • As of August 21, 44 Kitsap residents were in the hospital (including 26 new admissions this week), the all-time high was 20 hospitalizations, week ending December 26, 2020.

Vaccination data show an uptick, a combined average of over 400 doses given at Kitsap facilities per day over the past week.

  • 8% of the Kitsap population age 12+ has initiated vaccination, 62.8% are fully vaccinated as of August 21.
  • Adults age 19-34 have the lowest rate of vaccination initiation, 49%. Over half of youth ages 12-18 have initiated vaccination (56%), 61% of adults ages 35-64 and 72% of adults ages 65 and older.
  • Vaccination data continue to show disparities by race and ethnicity. Black/African American residents have the lowest vaccination initiation rates, 39% ages 12+ and 59% ages 65+. Among Hispanic/Latinx residents, 46% ages 12+ and 55% ages 65+ have initiated vaccination.

RESOURCES

Kitsap Public Health

  1. COVID-19 Page for healthcare providers
  2. COVID-19 Updates and Resources page
  3. COVID-19 Data Dashboards

WA State Department of Health

  1. COVID-19 data dashboard
  2. COVID-19 page
  3. SARS-CoV-2 sequencing and variants in Washington

Office of Washington State Governor

  1. FAQ’s regarding the Governor’s vaccine mandate

CDC

    1. COVID-19 page