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COVID-19 Update

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COVID-19
Disease Management

State Experiences Extreme Differences In COVID-19 Prevalence By County

Staff Contact: Mat Reidhead or Jackie Gatz

Since the first confirmed case of COVID-19 in Missouri on March 7, the pandemic has moved in and out of Missouri’s communities at disrupted intervals. Early on, the disease largely was centered in urban areas of the state. Since the Fourth of July, community spread shifted largely to rural areas of the state. Most recently, transmission is widespread statewide, regardless of the rural-urban divide. Differences in the incidence of COVID-19 for different populations is not solely a function of population density – it is largely dependent on the attitudes and behaviors of individual residents. Understanding differences in outcomes related to local public health interventions, such as masking, hand hygiene and physical distancing, is critical in bending the epi-curve in Missouri. Additionally, taking lessons learned from communities that have been successful in moderating spread is similarly important. The top and bottom five counties for the overall prevalence of COVID-19 in Missouri are largely located in rural areas where masking is not as widely accepted compared to urban areas. However, the rate of confirmed COVID-19 cases in the top five counties is more than triple the combined rate in the bottom-five (6,575 versus 1,973 cases per 100,000 residents).

Top and Bottom Fice Missouri Counties for COVID-19 Cases

Interactive Hospital-Specific COVID-19 Dashboards Now Available

Staff Contact: Mat Reidhead or Jackie Gatz

Last week, HIDI announced the availability of new hospital-specific COVID-19-focused dashboards through HIDI Analytic Advantage^® in static format. The confidential hospital-specific dashboards now are available in an interactive format powered by Microsoft Power BI. The dashboards are designed to provide the following C-suite-level situational awareness on hospital-level trends.

the submission of key COVID-19 data elements to the U.S. Department of Health and Human Services’ TeleTracking data portal
a distillation of weekly compliance for your hospital, as reported by HHS
operational impacts and recent hospital activity related to influenza- and COVID-19-like illnesses

Dashboards are available for download to authorized users of HIDI Analytic Advantage^®. If you need a user ID and password or have questions about accessing these dashboards, please contact hidi@mhanet.com.

HIDI is hosting a webinar at 10 a.m. Friday, Nov. 20, highlighting the new dashboards. This event is complimentary to any hospital team member, and registration is required.

Advocacy

MHA Submits Additional Waiver Requests

Staff Contact: Jane Drummond or Sarah Willson

MHA submitted an additional waiver request to Gov. Parson, which would help hospitals respond to the COVID-19 pandemic. The request, if supported, would address capacity and liability challenges. MHA encourages hospitals to continue reaching out with waiver requests and other like needs.

Certain Health Plans Waive Prior Authorization For Skilled Care

Staff Contact: Sarah Willson or Andrew Wheeler

Based on feedback from several member hospitals about difficulties working with health plans to obtain prior authorizations for skilled nursing care. MHA has reached out to several plans to improve these practices. United Health Care informed MHA they are waiving prior authorization into skilled nursing facilities from Nov. 13 to Sunday, Dec. 13. CVS Health/Aetna also confirmed they are waiving the prior authorization process for skilled nursing facility care for an unknown duration. MHA will continue to inform and advocate for other plans to do the same.

Clinical Guidance

CDC Recommends Use Of Cloth Masks To Control The Spread Of COVID-19

Staff Contact: Keri Barclay or Jessica Stultz

The Centers for Disease Control and Prevention published a Scientific Brief and summary of the science around the community use of cloth masks to control the spread of SARS CoV-2. The CDC recommends masks primarily as “source control” to reduce the amount of virus-laden droplets and to help provide protection for the wearer by reducing the likelihood of inhaling infectious droplets. Masks especially are important in reducing the spread of the virus in asymptomatic and presymptomatic persons.

Education

NETEC Hosts COVID-19 Therapeutics Webinar

Staff Contact: Jackie Gatz or Keri Barclay

The National Emerging Special Pathogen Training and Education Center is hosting a webinar on COVID-19 therapeutics at noon on Wednesday, Nov. 18. The discussion will highlight current evidence surrounding clinical trials for COVID-19 therapeutics and describe the U.S. Food and Drug Administration’s Coronavirus Treatment Acceleration Program when determining new COVID-19 treatments that are deemed safe and effective.

AHA, CDC Host Project Firstline Q & A Session

Staff Contact: Jessica Stultz or Alison Williams

The American Hospital Association and Centers for Disease Control and Prevention is hosting an event, “Project Firstline Q & A: Providing Safe Care to COVID-19 Patients,” at 1 p.m. CST Friday, Nov. 20, on how to provide safe care to COVID-19 positive patients in various settings. Participants also will learn about the recent release of COVID-19 therapeutics being offered in outpatient centers.

Project Firstline is a national collaborative led by the CDC to provide infection control training and education to front-line health care workers and public health personnel. AHA’s Center for Health Innovation is a national partner on the work.

Hospital Operations

ASHE Provides Tips For Maintaining Safety During The Pandemic

Staff Contact: Jackie Gatz or Keri Barclay

The American Society For Health Care Engineering gathered input from facilities and put together five tips facility managers should consider while preparing for cold weather during the pandemic. The tips can be found under the “Life Safety/Staff Safety” tab on the COVID-19 FAQs page.

Rural Resources

Cox Monett Creates Long-Term Innovation Opportunity

Staff Contact: Dana Dahl

With a new hospital under construction and scheduled to open in January 2021, Cox Monett is using the lessons of COVID-19 to transform health care delivery to their community. Due to the COVID-19 pandemic, the new hospital’s design continues to be evaluated to respond to COVID-19 and the future needs of all patients. New features have been added to the design, such as four additional emergency department rooms with negative pressure, four additional negative pressure Med/Surg rooms, and surgery suites that have the ability to become positive or negative pressure.

To respond to the present challenges and short-term health care needs of the community, Cox Monett modified their existing facility and delivery processes. The hospital purchased iPads for physician-to-patient communication to facilitate provider conservation of personal protective equipment. The iPads also are used for communicating with the nurse inside the negative pressure rooms to identify medication and supply needs of the nursing staff and for patients to communicate with visitors. Other ways that Cox Monett increased access to health care was establishing a triage and treatment tent outside the hospital, as well as distributing packaged home kits with pulse oximetersand thermometers to patients that did not need admission, but needed the ability to be closely monitored for decline, which would initiate follow-up by medical staff by phone. In addition, the hospital has used telehealth carts to increase communication between staff and providers, and to add support for the local hospitalist team.

Testing, Reporting & Treatment

Missouri Hospitals Receive First Allocation Of Bamlanivimab

Staff Contact: Jane Drummond or Jackie Gatz

Last week, after learning of a new antibody therapy from Eli Lilly receiving emergency use authorization approval, MHA hosted a call with Dr. Turabelidze, State Epidemiologist with the Missouri Department of Health and Senior Services, to discuss distribution of bamlanivimab.

The following information was relayed to participants.

Eli Lilly has made 350,000 doses available in Phase 1 to be distributed before the end of the calendar year.
Allocations to state and territorial health departments will be made weekly, based on the previous seven days of confirmed COVID-19 hospitalizations and community case counts.
DHSS will utilize hospitalization data submitted to TeleTracking to inform allocations.
The first allocation by DHSS was submitted Nov. 13, and shipments should arrive to Missouri hospitals throughout this week.

A playbook and informational slides are available for hospital use.

Vaccine Updates

Pharmacy Partners Increase Access To COVID-19 Vaccines

Staff Contact: Leslie Porth or Jackie Gatz

To maximize access to COVID-19 vaccines for all Americans, the U.S. Department of Health and Human Services announced partnerships with large chain pharmacies and networks that represent independent pharmacies and regional chains, increasing future COVID-19 vaccine access throughout the country, particularly in underserved areas. Currently, there are no authorized COVID-19 vaccines; however, this pharmacy partnership is being established in anticipation that one or more COVID-19 vaccines will be authorized or approved and recommended for use in the U.S. before the end of 2020.

CMS Issues COVID-19 Vaccine Codes And Other Guidance

Staff Contact: Andrew Wheeler

The American Medical Association, working with the Centers for Medicare & Medicaid Services, created new codes for the administration of COVID-19 vaccines and updated the PC-ACE software. The PC-ACE update includes the coding structure, currently comprised of both an HCPCS level I CPT coding issued by AMA and HCPCS level II coding issued by CMS. Hospitals will need to download and install the new release of PC-ACE if they intend to “roster bill” for the service.

Fight Flu: Get Vaccinated Against Flu This Season.

COVID-19 Update | November 17, 2020