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COVID-19 Update | March 12, 2021
Important Highlights
Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination 
CDC has updated select healthcare infection prevention and control recommendations in response to COVID-19 vaccination, which are summarized in this guidance. The update covers: 
  • Visitation 
  • Work restriction for asymptomatic healthcare personnel and quarantine for asymptomatic patients and residents – including guidance for fully vaccinated HCP, inpatients, residents; quarantine and travel recommendations.
Recommendations for SARS-CoV-2 Testing and use of personal protective equipment remain unchanged. Updated recommendations will be added to this page regularly as new information becomes available. 
 
New recommendations for safe visitation in long-term care facilities 
CMS in coordination with CDC published key updates for long-term care visitation policies including: 
  • Outdoor Visitation – CMS continues to encourage all visits be held outdoors whenever practicable because of the lower risk of transmission due to increased space and airflow. 
  • Indoor Visitation – The agency now says indoor visits should always be permitted for residents, regardless of whether the resident or visitor has received a vaccine. However, CMS details three scenarios under which indoor visitation should be limited, including for: (1) Vaccinated residents, if the nursing home’s COVID-19 county positivity rate is more than 10 percent and fewer than 70 percent of residents in the facility are fully vaccinated; (2) Vaccinated or unvaccinated residents with confirmed COVID-19 infection until they meet criteria to discontinue Transmission-Based Precautions; and (3) Vaccinated or unvaccinated residents in quarantine, until they meet criteria for release from quarantine.
Importantly, the agency also notes that residents who are fully vaccinated may choose to have close, physical contact with visitors, as long as both parties are masked and hands are washed before and after contact. 
  • Indoor Visitation During an Outbreak – CMS explains that nursing homes should start outbreak testing and immediately cease all visitation after a new case of COVID-19 is identified until at least one round of facility-wide testing has occurred. The agency says that visitation can start again in other units of the facility if outbreak testing indicates there are no additional COVID-19 cases in those areas. However, if outbreak testing detects one or more COVID-19 cases in other units of the facility, the facility must stop visitation for both vaccinated and unvaccinated residents until it can meet criteria to end outbreak testing.  
  • Visitor Testing and Vaccination – The agency does not require the testing of visitors, but continues to encourage facilities in medium or high-positivity counties to test visitors, if possible. CMS notes that facilities may also encourage visitors to be tested prior to visiting and provide proof of a negative test. Similarly, the agency suggests facilities encourage visitors to get vaccinated but not require vaccination.  
  • Compassionate Care Visits – The agency explains that compassionate care visits are required under federal disability rights law and should be allowed at all times for both vaccinated and unvaccinated residents, even during an outbreak.
  • Survey Considerations – CMS notes that federal and state surveyors are not required to be vaccinated and must be allowed to enter facilities unless they display signs or symptoms of COVID-19 infection.  
Beyond the considerations detailed above, CMS continues to advise that all visitors adhere to the core principles of COVID-19 infection prevention, which include practices such as symptom screening, hand washing, wearing a mask, social distancing, instructional signage, and routine cleaning.
SHEA Coronavirus News
 
SHEA Converse & Convene: COVID-19 Variants and its Impact on Testing and Prevention Measures (Open to SHEA Members)   
REGISTER HERE
This members-only networking event will focus on questions related to the variants and the impact it has on testing and prevention measures. Please note this event is not recorded and is intended for members to have an open, candid discussion around this topic.   
Moderator: Bhagyashri Navalkele, MD, FACP, University of Mississippi Medical Center 
Technical Guidance, Standards and Resources
Vaccines 
 
MMWRs 
 
Infection Prevention and Control 
 
Testing and Cases 
 
PPE  
 
Incident Management 
 
Payment and Reimbursement Policy 
 
 
Research 
Trade Press, Journal Articles and White Papers
CDC Interim Recommendations for Fully Vaccinated People: An Important First Step. Christie A, Mbaeyi SA, Walensky RP. JAMA. Published online March 10, 2021. doi:10.1001/jama.2021.4367  
News Highlights
‘Falling through cracks’: Vaccine bypasses some older adults (Associated Press)  
  
Biden team plots the country’s first national Covid testing strategy (Politico)  
Featured Social Media
Federal Policy Updates
American Rescue Plan COVID-19 Relief Bill is Signed Into Law 
President Joe Biden signed the American Rescue Plan for COVID-19 relief into law March 11. Key provisions of interest to SHEA include: 
  • Funding for COVID-19 Vaccine Activities at CDC (Sec. 2301) – Provides $7.5 billion (available until expended) for activities to plan, prepare for, promote, distribute, administer, monitor, and track COVID-19 vaccines, including the expansion of staffing support, community vaccination centers, mobile vaccination units, and information technology, data, and reporting enhancements.  
  • Funding for Vaccine Confidence Activities (Sec. 2302) – Provides $1 billion to CDC (available until expended) to improve vaccine confidence and vaccination rates through activities that include providing further information and education.  
  • Funding for COVID-19 Vaccines and Therapeutics Supply Chain (Sec. 2303) – Provides $6.05 billion (available until expended), an increase of $850 million compared to the House-approved bill, to support research, development, manufacturing, production, and the purchase of vaccines, therapeutics, and ancillary medical products and supplies to prevent, prepare, or respond to COVID-19 and any variant.  
  • Funding for COVID-10 Vaccine, Therapeutics, and Device Activities at the FDA (Sec. 2304) – Provides $500 million (available until expended) for activities related to the emerging COVID-19 variants and evaluating the performance of existing authorized therapeutics, vaccines, and diagnostics, as well as the oversight of the supply chain and mitigation of shortages.  
  • Funding for COVID-19 Testing, Contact Tracing, and Mitigation Activities (Sec. 2401) – Provides $47.8 billion, an increase of $1.8 billion compared to the House-approved bill, (available until expended) for activities to detect, diagnose, trace, and monitor COVID-19. These activities include: (1) the implementation of a national testing and contact tracing strategy; (2) technical assistance, guidance, and grants to state, local, and territorial public health departments for testing and contact tracing; and (3) enhancing information technology and data modernization.  
  • Funding for SARS-COV-2 Genomic Sequencing and Surveillance (Sec. 2402) – Provides $1.75 billion (available until expended) to strengthen and expand activities and workforce related to the genomic sequencing and disease surveillance of new COVID-19 strains, as well as grants to state, local, and territorial health departments to support their capacity in identifying and sequencing new strains.  
  • Funding for Global Health (Sec. 2403) – Provides $750 million to the CDC (available until expended) to combat COVID-19 and other emerging infectious diseases worldwide, including activities related to global health security, global disease detection and response, global immunization, and global coordination on public health.  
  • Funding for Data Modernization and Forecasting Center (Sec. 2404) – Provides $500 million to the CDC (available until expended) for the purposes of public health data surveillance and analytics infrastructure modernization initiatives. The CDC is also to establish, expand, and maintain efforts to modernize the U.S. disease warning system to forecast and track hotspots for COVID-19, its variants, and other emerging threats.  
  • Funding for Public Health Workforce (Sec. 2501) – Provides $7.66 billion (available until expended) for efforts to establish, expand, and sustain a public health workforce through making awards to state, local, and territorial public health departments. Positions include investigators, contact tracers, social support specialist, community health workers, public health nurses, disease intervention specialist, and epidemiologist, among other professionals. The funding also supports personal protective equipment (PPE), data management, and administrative costs.  
  • Funding for Infection Control Support to Skilled Nursing Facilities (Sec. 9401) – Provides $200 million (available until expended) to HHS to support infection control activities at skilled nursing facilities through contracts with quality improvement organizations.  
  • Funding for Strike Teams in Skilled Nursing Facilities (Sec. 9402) – Provides $250 million to HHS (available until expended) for the purposes of allocating funding to States (including the District of Columbia and each territory) to support the creation and implementation of strike teams to respond to COVID-19 outbreaks in skilled nursing facilities.  
  • Funding for State Strike Teams for Nursing Home Safety (Sec. 9818) – Provides $250 million (available until expended) to the U.S. Department of Health and Human Services (HHS) for allocating funding to states to establish and implement COVID-19 strike teams for deployment to nursing facilities that include diagnosed or suspected cases of COVID-19. Strike teams will provide assistance with clinical care, infection control, or staffing.
Hearing: Examining Our COVID-19 Response: An Update from the Frontlines (Senate HELP Committee)  
 
Murray Re-Introduces Public Health Infrastructure Save Lives Act As New Report Looks At Gaps In Preparedness (Senate HELP Committee) 
 
Senator Patty Murray (D-WA), Chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee re-introduced on March 10 the Public Health Infrastructure Saves Lives Act (PHISLA). PHISLA would establish a core public health infrastructure program to strengthen the country’s public health system—including the nation’s ability to respond to the COVID-19 pandemic—through grants to State, territorial, local, and Tribal health departments and increased investments at the Centers for Disease Control and Prevention (CDC). The bill also supports development and implementation of national public health accreditation. The funding for the program would ramp up over five years to $4.5 billion annually and then remain at that level, and the program would be aimed at specifically addressing eight core capabilities: 
  1. Public health assessment  
  2. Preparedness and response 
  3. Policy development and support 
  4. Communications 
  5. Community partnership development 
  6. Organizational competencies 
  7. Accountability 
  8. Equity
In a letter led by Trust for America’s Health (TFAH), SHEA endorsed the bill. Read the fact sheet here
SHEA Education and Events
New this week:
  1. Podcast: South Africa Perspective on COVID & Variants
  2. Town Hall Round 43 (Long-Term Care focus) 
    Special COVID-19 Israeli perspective presentation by Dr. Mitchell Schwaber
    Sunday, March 14, 2021 | 3:00 pm ET 
    REGISTER HERE or watch live on Facebook
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