Local Public Health Teams Meeting COVID-19 Response 9, 2021

1. Welcome Juanita Estrada – Welcome and overview of the agenda

2. Epidemiology Vivian Leung – Epi Update • You have seen the Institute of Higher Education (IHE) guidance that came out on Friday from CDC. There are discussions about the K – 12 guidance that’s expected to follow shortly. • Considerations for Institutions of Higher Education (IHEs) (cdc.gov)

Nursing Home Update (PowerPoint) • The Healthcare Associated Infections and Microbial Resistance Program will be reaching out first to those jurisdictions with the NACCHO funding for Infection Control and Prevention, and later this summer we will be engaging all local health departments that are interested in coordinating with our program on health care facility response in their jurisdictions. • Out of 209 nursing homes, 21 have cases among staff or residents in the past 14 days, that is 10% of our nursing homes. • Our care partners testing program will be ending at the end of the month. Nursing homes will be responsible for either doing their own testing or creating their own contracts with testing partners. • Of the 21 nursing homes that have had cases in the past 14 days, there were 4 resident cases in the past week and 9 nursing homes with resident cases in the past two weeks. The residents census of nursing homes across the state has risen a little bit in the past few months. There was one nursing home resident death last week. There were five nursing home staff cases last week. This is the lowest number we have seen yet. • There are 134 assisted living facilities that have licensed healthcare services that DPH follows. There were 12 cases in the past 2 weeks, and last week we had zero resident cases and 4 staff cases. This is best we have seen. • CMS will start enforcing mandatory reporting of vaccination coverage in nursing homes across the US and this data will be published on the CMS website. Out of our 209 nursing homes, less than half are reporting. They are gearing up to learn the reporting system.

Kristin Gerard – Contact Tracing/K-12 testing • Sprint 19 will be deployed in production tonight and you'll see the changes tomorrow morning. As usual, all our updated resources will be posted to SharePoint • Please continue to submit helpdesk tickets for merging and deduplication of records. LHD Teams Meeting 6/9/2021

• For K-12 testing, we are soliciting summer requests for testing for eligible summer camps or summer schools, and then we are planning for Fall testing.

3. Immunizations Benjamin Bechtolsheim • A reminder if you would like to stand up mobile vaccine clinics in community centers, parades, with employers etc., the DPH yellow cars remain an option for that and you can reach out to the Immunizations program or go to DPH Van Clinics (ct.gov). • If you're looking for vaccine data, as well as other EPI and health related data, check the open data portal.

4. Public Health Preparedness and Local Health Admin Ellen Blaschinski • Just a reminder that funding applications and updated work plans for your ELC1 final payments are due by June 17th. • The local health call will be bi-weekly starting in . A new invitation will be sent to all local health directors.

Francesca Provenzano • Cyber Security – We’ve received several alerts through the cyber security infrastructure services agency (SISA), and we’ve been sharing those with healthcare and other private industry partners. Today we were alerted that vaccine and virology production locations, not necessarily vaccine clinics but vaccine manufacturing virology type labs, are said to be a potential target by North Korean actors.

Krista Veneziano • A reminder about tomorrow morning's meeting with the directors of health or acting directors of health regarding your SFY 2019 local health annual report summary feedback form that was emailed to you on May 28th.

5. Joint Operations Team (JOT) Susan Hacking • As of today, various federal COVID funds provide direct funding of around $60 million to local health and out of that, 10.6 million has already been disbursed to you. • The workplans for the ELC 1 second payment are due by June 17th and this will cover the remaining 12 million of ELC 1 grant. • Keep in mind that with these funds that they don't all have the same end date. ELC 1 funding ends in 2022, ELC 2 funds go through to July 2023, and some of the immunization grants go to July 2024. • We are now looking at the processes that we need to put in place for ELC 2, and we will communicate the application criteria to you all as soon as we get them finalized.

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LHD Teams Meeting 6/9/2021

6. Environmental Health and Drinking Water/Re-Open CT Lori Mathieu • DPH has been working on communications with the Public Water Systems. EPA nationally will be looking to change a federal law to address cyber security for public water. It has become a serious issue and threat. Local health directors will be copied on the information that we send out to our public water systems. DPH is also planning on standing up a webpage. • DPH is working with others on school guidance; more will come on this.

Tom St. Louis • We are working on changing the wording of the Commissioners order pursuant to Executive Order 12A. It says that everyone has to wear a mask inside a K-12 school building, and it does not say when to wear a mask in a school. Masks are to be worn during school activities and not at all times for all people when no one is in the building. • We been getting a lot of question regarding the heat and wearing of a mask. The Governor has been clear on this matter that if you have a particular student or staff person who is medically fragile and can't wear a mask, maybe because of the heat, then individual accommodations should be made for that person.

7. Other updates Matt Cartter • This may be of interest: Mandatory SARS-CoV-2 Vaccinations in K-12 Schools, Colleges/Universities, and Businesses | Law and Medicine | JAMA | JAMA Network

8. Questions Who can I send questions regarding the Vaccine Equity grant? Agnes Nabasirye is the point of contact for the VEPF. Please feel free to contact her with any questions regarding the grant at [email protected].

How can schools utilize antigen tests to address symptomatic students to provide differential diagnosis from COVID? Especially among the younger students who cannot be vaccinated at this time...need a simple solution for this. In order to do Binax resting, an entity must have a CMS registration, be considered a laboratory to do tests on other people. and meet the reporting requirements. If schools cannot put this structure in place, schools can contract with a provider for school-based testing.

DPH has received money for K-12 testing. We are putting together a proposal for testing in K-12 schools in .

Is it possible to provide vaccination coverage for LTCF and ALF by health department or town where facilities are located? DPH does not collect vaccination coverage for ALFs (they are not regulated as healthcare facilities). For nursing homes, we expect those data to be published here next week: COVID-19 Nursing Home Data | Data.CMS.gov. To make it easier to find data for CT, we

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LHD Teams Meeting 6/9/2021

plan on taking vaccination coverage data from the CMS website and including the data in our weekly nursing home report published on Thursdays here: Nursing Homes and Assisted Living Facilities Data (ct.gov)

As we look to the future and begin to think about vaccination for children under the age of 12, is there any way that local health departments could get a list of the pediatric practices in their jurisdictions that are or have applied to be CoVP providers? We are not accruing primary practices or pediatric practices as quick as we had hoped, but DPH will look into this request.

Will homebound requests be ending? I have completed all my lists and any new requests may end up waiting for a while or not able to receive vaccine due to lack of demand. We won't be ending homebound efforts yet. We have on average of 100 requests/week so we will still be sending out the reports to LHDs.

Are there any current restrictions on public pool capacity or other pool activities? I believe there are guidelines now that have been updated for pool operators, but the general guidance around capacity for pools and capacity for deck areas have reverted to our general guidelines for masking in public places outdoors.

Has Grossman Solutions started canvassing yet in concert with the Griffin vans? They are canvassing a few days prior and the day of a clinic. If you have further questions, please contact [email protected].

We haven’t received an clear answer on how long an individual needs to wait to receive a PPD test after receiving the COVID vaccination? Please refer to https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19- vaccines-us.html#laboratory-testing

Who is DPH’s Public Information Officer? His name is Christopher Boyle, [email protected] . Chris Boyle joined DPH on June 1stas our new Director of Communications. He comes to DPH from Bristol Health where he has worked as Director of Public Relations since 2012.

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Nursing Home Resident Incidence, statewide 16, 2020 – , 2021 New Resident Cases Resident Census: 18,430 Date Reported (diagnosed that week) 9- 33 16- 23- 30- 6- 13- 20- 27- 4- 11- 18- 25- 1-Jun2 4 8-Jun 5 Facility Metrics #Nursing Homes New res. cases, last 2 weeks 6 (-3)

No new res. cases, >2 weeks 203 Nursing Home Resident Deaths, statewide , 2020 – June 8, 2021

Note: Light blue= OCME lab-confirmed and suspected deaths due to COVID-19, Darker blue= NHSN data

6/2/21-6/8/21 7 Assisted Living Resident Census: 7,031

8 9 10 NHSN COVID Vaccination Rates (6/7-6/13) Resident Vaccination Rates Staff Vaccination Rates • 105 NHs Reported • 101 NHs Reported • Average 89%, Median 91%​ • Average 68%, Median 69%​ • Range 47-100%​ • Range 34-95%​ Overall- 90% of the reporting Overall- 32% of the reporting NHs have a resident vaccination NHs have a staff vaccination rate of 75% or higher rate of 75% or higher received their 1st dose

• HAI program continues to provide guidance on correct case definitions and reporting. • Note the time frame for the COVID Vaccination Module is different than the NHSN case reporting module. Ongoing Surveillance: COVID-19 in Nursing Homes

• NHSN: Weekly case surveillance, vaccine coverage, resource needs • Daily NH Portal: case surveillance, vaccine/hospitalization/death data • Vaccine Breakthrough Surveillance • Identify any unusual patterns (trends in age or sex, the vaccines involved,underlying health conditions, or which of the SARS-CoV-2 variants made these people sick) • To date, no unusual patterns have been detected • Vaccine Effectiveness Studies: CDC and partners conducting studies in various populations, locations, and settings.