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9/8/21: COVID-19 UPDATE

Nebraska COVID-19 Dashboard for Nursing Homes by County:  The number of Covid-19 cases in Nebraska Nursing Homes has increased this week.  The number of counties in the "red" zone has increased again from four to seven.  As reported in the Statewide COVID 19 Briefing on 9/7/21, the vaccination rate across Nebraska is slowing, although it is proving to be an effective deterrent to hospitalization. At this point in time 1-2 out of 100,000 people vaccinated are hospitalized in Nebraska.  It was also reported that 94% of cases of covid, 95% of hospitalizations and 96% of deaths are among the unvaccinated. Unvaccinated persons are 17 times more likely to require hospitalization from COVID-19. Community spread in an area is a better indicator of the increase in risk to facilities across Nebraska.  A full list of all counties in the United States can be found at https://data.cms.gov/covid-19/covid-19-nursing-home-data. Data for the Nebraska counties has been summarized below.

August 18 to August 31st Data Set for Nebraska Counties 
August 11 to August 24 Data Set for Nebraska Counties
August 4 to August 17 Data Set for Nebraska Counties
July 28 -August 10 Data Set for Nebraska Counties
July 14 - July 27 Data Set for Nebraska Counties
July 21- August 3 Data Set for Nebraska Counties
9/8/21: Statewide community numbers updated: September 1, 2021 The following COVID-19 metrics will be reported by DHHS every Wednesday, unless stated otherwise. These numbers include all vaccinations that took place in Nebraska last week, including through federal entities, such as the Indian Health Service, the Department of Veterans Affairs, the Department of Defense, and the Federal Retail Pharmacy Program.  

Statewide Cumulative COVID-19 Testing (3/7/2020 - 8/31/2021)
- 245,111 Cases (+5,083 from prior week)
- 3,400,074 Tests (+68,828 from prior week)
- 342 Active Hospitalizations (+28 from prior week) 2,330 Deaths (+16 from prior week)
- 8.6% Percent of Tests Positive on Tests August 22-28, 2021 (+2.1% from prior week)

Statewide Cumulative COVID-19 Vaccinations (3/7/2020 - 8/31/2021)
- 2,034,852 Total Administrations (+28,091 from prior week)
- 90.1% Allocated Doses Administered (-0.6% from prior week)
- 52.8% of Nebraska Citizens Fully Vaccinated (+0.8% from prior week)
- 5.1% of Nebraska Citizens Partially Vaccinated (-0.1% from prior week)  

Statewide Vaccine Breakthroughs (01/01/2021 - 08/28/2021)
- 69,408 Cases - Not Fully Vaccinated
- 4,838 Cases - Fully Vaccinated
- 2,715 Hospitalizations - Not Fully Vaccinated
- 148 Hospitalizations - Fully Vaccinated
- 775 Deaths - Not Fully Vaccinated
- 32 Deaths - Fully Vaccinated  

National Nursing Home Data: Submitted data as of the week ending 08/22/2021
- National Percent of Vaccinated Residents per Facility: 83.6%
- National Percent of Vaccinated Staff per Facility: 61.8%
- Total Resident COVID-19 Confirmed Cases: 675,807
- Total Resident COVID-19 Deaths: 134,463
- Total Staff COVID-19 Confirmed Cases: 615,516
- Total Staff COVID-19 Deaths: 2,013
9/8/21: 2021-2022 Influenza Vaccination Recommendations and Guidance on Coadministration with COVID-19 Vaccines: During this COCA Call, presenters will provide updates on the Advisory Committee on Immunization Practices (ACIP) recommendations for the 2021-2022 influenza vaccination season and guidance for coadministration of influenza and COVID-19 vaccines. If you are unable to attend the live COCA Call, the recording will be available for viewing on the COCA Call webpage a few hours after the live event ends. The slide set will be available under "Call Materials" on the COCA Call webpage.

Date: Thursday, September 9, 2021
Time: 2:00 pm - 3:00 pm (ET) A few minutes before the webinar starts, please click on the Zoom link below to joinhttps://www.zoomgov.com/j/1610456908?pwd=cFI3YzIvMWZzOFE4bmEwakswaUZsdz09
Or One tap mobile:  US:+16692545252,,1610456908#,,,,*220280# or +16468287666,,1610456908#,,,,*220280# 
Or Telephone: US: +1 669 254 5252 or +1 646 828 7666 or +1 551 285 1373 or +1 669 216 1590
Webinar ID: 161 045 6908
Passcode: 220280 International numbers availablehttps://www.zoomgov.com/u/ab2UFvSsCs    

9/8/21: Update from TMF: Melody Malone from TMF described information that has changed on the NHSN reporting. She indicated the best way to avoid a referral or citation from CMS is to assure that reports are made in the NHSN system on a consistent basis, including the same time every day. Data submitted should also be reviewed to assure that all components match up consistently. All LTC staff are encouraged to complete the CMS training- Driving Healthcare Quality- QSEP - Driving Healthcare Quality (cms.gov)   Facilities are encouraged to have self-imposed plans in place to assess risk for potential situations that occur in the community or with people coming into the facility. This should include guidelines for mitigation after high-risk events, use of masks within the facility with visitors and residents when in common areas.  

Information on the update to NHSN can be found at: - LTC Weekly COVID19 Vaccination Retraining August 9.5.5.4 Release 082021 (cdc.gov)  

LTC facilities can track weekly COVID -19 vaccination data for residents and Health care personnel through NHSN: Weekly HCP & Resident COVID-19 Vaccination | LTCF | NHSN | CDC   

CDC has updated the Interim Clinical Considerations for use of COVID-19 vaccines on August 31, 2021: Interim Clinical Considerations for Use of COVID-19 Vaccines | CDC    All Nebraska Facilities are encouraged to report through NHSN, although Assisted Living facilities can report using the state guideline. Cases reported through NHSN do not need to be reported to the state separately.    

9/8/21: Important Information for PPE Use: Facilities should be following the guidance below   Conventional capacity strategies- PPE should not be reused at any time. Once it is used it should be discarded as the standard and preferred method of PPE use. This is highly recommended at this time. Contingency Capacity Strategies- When facilities are uncertain about future supply, they can practice extended use of items like respirators, etc. Once you take it off, you should not put it back on.   Crisis Capacity- this is not recommended at this time. Should not be reusing PPE or disinfecting PPE for reuse at this time. CDC burn rate and PPE needs is online and the burn calculator should be used to determine PPE needs and communicating it to your supplier. As a reminder to members, the FDA has revoked the emergency use of KN95 masks and they are not for use as a respirator. KN95 masks cannot be used in red or yellow zones. They can continue to be used for source control as long as they fit appropriately, however they are not considered to be used for high risk situations. Facilities should have identifying information in place so that staff know the difference. N95 is required for Red and Yellow zones and the conventional capacity strategy above is the preferred use method. OSHA states Employees need to have a medical clearance before wearing a N95 respirator.   Binax Now Testing Supply Update: Information provided by the US Department of Health & Human Services.  

The following handout provides information regarding the HHS COVID BinaxNOW Testing supply distribution for LTCFs. VA FSS Instructions for Test Ordering  

1. Currently, the HHS Program is directly supplying BinaxNOW tests for LTCF staff only. The shipments to test LTCF staff are occurring automatically and are based on staffing numbers provided by CMS and county positivity (dictating testing frequency). We're aware that some sites may have requested to be removed from the list of sites receiving automatic shipments at some point in the past (when COVID-19 burden was lower and some sites had excess tests).
- If a site previously requested to be removed from the list and would
like to request to be placed back onto the automatic shipping list,
please contact binax.team@hhs.gov.
- Sites should closely read any instructions that come with their
BinaxNow shipments. Depending on the number of needed tests and
the quantity per package, HHS may direct sites to save some of their
shipments to be used in future weeks (example: 30 staff need to be
tested; 40 tests shipped due to 20-test packages; save the extra 10 for a
future week).
- Sites SHOULD NOT be using these tests for anyone other than staff.  

2. Additional BinaxNow tests can be purchased at $5.35 a test through the Federal Supply Schedule, on a first-come first-serve basis.Currently, Abbott is supplying 10 million units a month through the FSS; 8 million of these are designated for state purchase. Right now, there is sufficient supply available through FSS.
- Additional instructions for using the FSS are linked above.
- To set up an FSS account to purchase tests at the negotiated rate
($5.35/test, including shipping), please email  Mark Douglas
mark.douglas@abbott.com  

3. The Johns Hopkins Center for Health Security has developed the COVID-19 Testing Toolkit to help determine the testing services that fit your specific needs: Testing Services | COVID-19 Testing Toolkit (centerforhealthsecurity.org) [centerforhealthsecurity.org]