CDPH Updates Hospital Visitor Guidelines
On March 16, the California Department of Public Health (CDPH) updated its recommendations — not requirements — related to hospital visitors in All Facilities Letter (AFL) 20-38.6. Specifically, CDPH recommends:
- That hospitals permit two visitors per patient per time in counties in the red, orange, and yellow tiers (currently 90% of the state’s population). Each county’s status is available on the state’s Blueprint for a Safer Economy website.
- An increase from one visitor to two for certain patient types (pediatric, labor and delivery, end-of-life, physical, intellectual, and/or developmental disabilities and cognitive impairments) in all counties, regardless of tier status
- Two visitors per surgery patient (a newly added group)
These recommendations are effective Tuesday, March 23. Hospitals may want to assess their visitor guidelines in light of these updated recommendations.
County MOU for Statewide Vaccine Network Released
Today, CDPH announced that 10 local health jurisdictions (LHJ), nine counties and one city, have signed agreements to participate in the State Vaccine Network, managed by the state’s third-party administrator (TPA), Blue Shield of California. These local health jurisdictions have signed the MOU: City of Long Beach, along with Kings, Lake, Los Angeles, Riverside, San Diego, Shasta, Siskiyou, and Ventura counties. Kern County had previously signed the TPA contract.
On March 16, the Government Operations Agency, which manages the TPA, released this clarification letter. It states that “the County/LHJ, using its discretion and subject to approval of the Agency, may distribute portions of vaccines allocated to the County/LHJ to County/LHJ-supported sites. Accordingly, Paragraph C of Section 2 of the MOU is modified consistent with this paragraph.” The MOU can be downloaded here.
CDPH Survey on Hospital Surge Due March 26
CDPH has sent a survey to hospital leaders, seeking feedback about the response to surges of COVID-19 patients. This document provides all the questions in one place. CDPH asks that hospitals submit their responses using the form, but alternatively they can email it to [email protected].
Please note that this is optional and an opportunity for hospitals and health systems, if they would like, to offer feedback on the federal, state, and county support provided during the COVID-19 health care surges to date. However, CDPH earlier this week emailed specific hospitals in the Central Valley and Southern California that had engaged with the State Technical Assistance Teams to request that they, in particular, respond.
Health systems and hospitals with multiple locations are permitted to provide a collective response or have their individual locations respond. CDPH has asked hospitals to complete this survey by March 26.
CDPH sent a similar survey to CHA and other state-level stakeholders. CHA is developing its response and will provide it through Coronavirus Response once finalized.
CDPH Issues Reminder About Vaccine Eligibility and Clarifications
On March 16, CDPH issued a reminder to local health jurisdictions and vaccine providers about vaccine eligibility, eligibility changes, and clarifications. Addressing the expansion of vaccine eligibility that took effect on March 15, this reminder clarifies how to verify eligibility for those ages 16-64 who are deemed to be at highest risk to get very sick from COVID-19 due to specified severe health conditions or developmental or other severe disabilities or illness. According to the reminder, verification of eligibility can occur through self-attestation during online or on-site registration, or through health system providers who invite eligible patients based on electronic health records. Importantly, the reminder states that, to encourage only eligible patients to make appointments, all clinical and vaccine providers should share accurate eligibility criteria.
Additionally, because some vaccine providers may choose to require verification at the vaccination site, patients should be given clear, advanced notice of what documentation to bring. Finally, to facilitate clarity on the part of local health jurisdictions and vaccine providers, the reminder provides links to CDPH’s existing guidance on vaccine eligibility, which includes the vaccine web page where general and new information is posted, its fact sheet for the public, the updated Provider Bulletin elaborating on the qualifying high risk medical conditions and disabilities, the updated COVID-19 Vaccine Eligibility Guidelines clarifying Phase 1A and Phase 1B, and the Clinician Health Information Notice (includes behavioral health).
My Turn and MyCAVax Contacts for Hospitals
The California Department of Technology has shared these contacts for hospitals and other providers seeking assistance with the My Turn and MyCAVax systems. Providers can contact the Accenture (the state’s contractor) operations team lead listed for their geographic area or the Provider Help Desk at (916) 277-9183 or [email protected].
CDPH Recommends Discontinuation of Bamlanivmab Monotherapy
CDPH has recommended that facilities and providers stop distributing and administering bamlanivimab monotherapy. The Health and Human Services Office of the Assistant Secretary for Preparedness and Response (HHS/ASPR) will discontinue distribution of this product to California. The action is being taken based on concerns about use of bamlanivmab monotherapy in regions where certain variants of the COVID-19 SARS virus are circulating. HHS/ASPR is working with the Centers for Disease Control and Prevention (CDC), the National Institutes of Health, and the Food and Drug Administration (FDA) on recommendations for bamlanivimab monotherapy moving forward.
Note that this recommendation only applies to the administration of bamlanivimab monotherapy. The other two authorized monoclonal antibody products for treatment of mild to moderate COVID-19, bamlanivimab plus etesevimab, and casirivimab plus imdevimab, will continue to be available.
ASPR Updates Information on Virus Variants and Antiviral Resistance
HHS/ASPR has notified providers and other stakeholders about key updates related to virus variants and their possible resistance to monoclonal antibody treatments. The updates include:
- The FDA has revised the fact sheets for all three authorized products (bamlanivimab, bamlanivimab with etesevimab, and casirivimab with imdevimab) with information on antiviral resistance.
- The FDA has also released a Centers for Drug Evaluation and Research statement highlighting the changes in the fact sheets.
- The CDC has updated its website with available proportions of SARS-CoV2 variants of concern by state.
Providers are advised to review the antiviral resistance information in Section 15 of the fact sheets for details about specific variants and resistance, and refer to the CDC website, as well as information from state and local health authorities about viral variants of importance in their region to guide treatment decisions.
My Turn Volunteer Opportunities for Vaccination Clinics Seeking Volunteers
California Volunteers has launched the My Turn – Volunteer campaign, a statewide initiative to help accelerate vaccine administration with help from volunteers who can assist vaccinations or support on-site operations. My Turn Volunteer serves as a recruitment tool for vaccination sites that need vaccinators and allows volunteers to sign up for a vaccine distribution site. The volunteers are available for any registered site within the My Turn system and are categorized as either medical or general volunteers. The website also includes FAQs, a vaccination clinic recruitment toolkit, and demonstrations explaining how vaccination clinics can get started, as well as toolkits with materials, videos, posters, and graphics for use at vaccination sites.
Summary of March 16 CDPH Call
CDPH has provided a summary of its recent weekly call with health care facilities.