Missouri’s hospitals reported 3,732 patients hospitalized with COVID-19 on Jan. 12 — the highest level seen throughout the pandemic and 30% higher than the 2020-2021 peak surge of 2,862 patients. During the past five days, statewide hospitalizations have remained relatively stable. New record-level hospitalizations may continue to occur as the Omicron variant continues to move rapidly through the state’s population. New cases precede hospitalizations and ICU admissions by roughly two weeks.
During the first week of 2022, the state notched a record 74,635 suspected and confirmed cases of COVID-19. During the second week of 2022, the number of new cases fell by 7.4% to 69,110; however, there may be a reporting lag in some cases. Compounding the current crisis is Omicron’s ability to evade vaccine- and infection-induced immunity, with breakthrough cases and reinfections accounting for nearly half of all cases in the new year. Despite the overwhelming majority of hospitalized patients being unvaccinated, demand for vaccines in Missouri has steadily declined since Dec. 1, 2021.
All Missourians have a stake in helping maintain access to hospital care. The current surge coupled with severe staffing challenges is constraining hospitals’ capacity to provide care. Masking, hand hygiene and physical distancing will reduce infection. Vaccination — and boosters for vaccinated Missourians — will protect individuals and communities.
WPS, the CMS administrative contractor servicing most of Missouri hospitals, released guidance about billing Medicare for VEKLURY (remdesivir) antiviral medication in an outpatient setting. Code J0248 should be used for administration coding and to identify the medication. Other details include place of service reporting, reporting of units, pricing per unit and ICD-10 diagnosis coding. The guidance applies to claims with dates of service on or after Dec. 23, 2021.
CMS issued updated guidance for states related to its vaccine mandate after the U.S. Supreme Court decision allowing the rule to proceed. The guidance includes updated information related to compliance timeframes and surveyor guidance for the 24 states, including Missouri, in which the rule previously was enjoined.
In addition to the guidance, providers will find additional information on the CMS website specific to the provider type. Hospitals have until Monday, Feb. 14, to ensure policies and procedures are in place, all affected staff have received at least one dose of the two-dose vaccine or the one-dose vaccine, and exemptions have been reviewed and processed. Surveyors may begin surveying for compliance the same day.
The FDA authorized an expiry extension for BinaxNOW tests for three months from the current expiration date listed on the external box. Components inside the box will have varying expiration dates; however, the only date to reference is on the outside of the box by the hourglass icon. There is no guarantee another extension will be granted, so DHSS encourages shared use if test kits will not be used before the end of the extended expiry date.
With the supply constraints of BinaxNOW tests and other COVID-19 testing supplies, Zest Health is offering hospitals free testing services to test staff. Additional details, including how to enroll, are available.
The ongoing COVID-19 patient surge continues to impact outpatient clinical decisions given fewer available therapeutic options for the Omicron variant. HHS and ASPR published a COVID-19 Outpatient Therapeutic Decision Guide that is helpful when determining the most appropriate treatment option. In addition, NIH released guidelines when there are logistical or supply constraints. These recommendations are based upon keeping persons with COVID-19 from hospitalization and severe disease.
What We’re Reading
The Kansas City Star went inside University Health’s COVID-19 response system, talking to the staff that assists the public with testing and vaccination, and the caregivers that provide inpatient and ICU treatment. The story and accompanying video provide readers with insight into how hospital staff are managing the surge.