Health Advisory

July 2, 2021 • Information for Pierce County Healthcare Providers Communicable Disease Control Communicable Disease Control • (253) 649-1412 3629 S. D St. • Tacoma, WA 98418 (253) 649-1412 • (253) 649-1358 (fax)

COVID-19 Updates for Providers Requested actions • Be aware Washington State Department of Health (DOH) issued a behavioral health provider alert about Fourth of July celebrations and other summertime gatherings. The alert asks providers to give patients information about safe social behaviors and the potential negative effects of impulsive behaviors following the state’s full reopening and the misperception that the COVID-19 pandemic has ended. • Be aware the U.S. Food and Drug Administration (FDA) updated the following Emergency Use Authorization (EUA) fact sheets to include the possible risk of pericarditis and myocarditis following vaccination: o Pfizer fact sheet for healthcare providers. o Pfizer fact sheet for patients. o Moderna fact sheet for healthcare providers. o Moderna fact sheet for patients. • Continue to report any case of myocarditis and pericarditis among people who received COVID-19 mRNA vaccine within the last 2 weeks. o Promptly report cases to the U.S. Vaccine Adverse Events Reporting System (VAERS). o Report cases to the Health Department’s 24-hour reporting line at (253) 649-1413. Include vaccine manufacturer, vaccine lot number, vaccination date, dose number, patient gender, age and history of prior SARS-CoV-2 infection. • Be aware the FDA extended the shelf life of Janssen (Johnson & Johnson) COVID-19 vaccine from 3 months to 4½ months. Visit Janssen’s lot expiry checker to determine the updated expiration of your vaccine. • Vaccinate everyone 12 years or older against COVID-19. o Review all patients’ vaccination records and help them get up to date with vaccines. You can administer COVID-19 vaccine simultaneous with, or within any number of days of, other vaccines. o Refer patients who can’t easily leave home and need COVID-19 vaccine to us at (253) 649-1412, 8 a.m. to 4:30 p.m., 7 days a week—except holidays. We can bring vaccine to them. • Refer medically stable patients in need of quarantine or isolation housing. Call (253) 820-4684, 7 a.m. to 7 p.m., 7 days a week. Intake occurs 8 a.m. to 4:30 p.m., 7 days a week. Background

COVID-19 vaccine As of June 26, Pierce County residents received about 822,874 total doses of COVID-19 vaccine. See our COVID-19 data page for details.

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Promote COVID-19 vaccine

Over 99% of the people who died from COVID-19 in the U.S. in May 2021 were unvaccinated. Nearly every death from COVID-19 was preventable. Yet, misinformation and misperceptions of COVID-19 vaccine are rampant. As new variants circulate in the community and the state reopens, there is an increased risk of more cases of severe illness. It is more important than ever to get people fully vaccinated. An NPR/Ipsos poll found 85% of people trust their healthcare provider most for information about COVID-19 vaccine, regardless of age, gender, ethnicity or personal beliefs. You are uniquely positioned to help people feel confident that COVID-19 vaccines are safe and effective. We have created a slide deck to help you and your staff have these bold conversations and help your patients move off the fence toward vaccination.

Vaccine resources • COVID-19 vaccine locator, DOH. • COVID-19 vaccine for providers, Tacoma-Pierce County Health Department. • COVID-19 vaccine provider toolkit and resources, DOH. • COVID-19 vaccination for providers, CDC. • Clinical considerations for COVID-19 vaccination and guidance for managing anaphylaxis, CDC. • COVID-19 vaccine quick reference guide for healthcare professionals, CDC. • COVID-19 vaccine training module on best practices for providers, CDC. • Janssen (Johnson & Johnson) health alert, CDC. • Association of J&J with Thrombotic thrombocytopenia after vaccination:

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o Vaccine-induced immune thrombotic thrombocytopenia frequently asked questions, American Society of Hematology (ASH). o Diagnosis and management of vaccine-induced immune thrombotic thrombocytopenia webinar, ASH and CDC. o April 15, 2021 Clinician Outreach and Communication Activity (COCA) call: Janssen (Johnson & Johnson) COVID-19 vaccine and cerebral venous sinus thrombosis with thrombocytopenia update for clinicians on early detection and treatment, CDC. • Association of mRNA vaccines with myocarditis and pericarditis after vaccination: o Information for healthcare providers: myocarditis and mRNA vaccines, DOH o Follow-up of patients with myocarditis, consult recommendations, American Heart Association and the American College of Cardiology. o Clinical considerations: Myocarditis and pericarditis after receipt of mRNA COVID-19 vaccines among adolescents and young adults, CDC. o COVID-19 subcommittee of the World Health Organization (WHO) Global Advisory Committee on Vaccine Safety (GACVS) reviews cases of mild myocarditis reported with COVID-19 mRNA vaccines, WHO news release, May 26, 2021. o Myocarditis and pericarditis following mRNA COVID-19 vaccination, CDC. o Selected adverse events reported after COVID-19 vaccination, CDC. o Myocarditis and pericarditis resources for the public, CDC. COVID-19 situation update On July 2, we confirmed 38 new COVID-19 cases and 3 new deaths. Our totals are 51,129 cases and 606 deaths. In the last 14 days, we reported 539 cases. Our 14-day case rate per 100,000 is 68.3. Our 7-day new COVID-19 hospitalization rate per 100,000 is 3.0. You can see this data on the state’s data dashboard. Pierce County COVID-19 data continue to show significant disparities by race and ethnicity, particularly affecting American Indian, Alaska Native, Black, Latinx, and Native Hawaiian and Other Pacific Islander communities. You can see these trends on our data dashboard. COVID-19 vaccine is making a difference in our disease rates, but some areas need to play catch up. The chart below shows our new cases by day. The blue line is a 7-day rolling average to show smoother trends.

COVID-19 testing We have test kits for you. Abbott Laboratories extended all BinaxNOW tests’ shelf life to 12 months. See Abbott’s BinaxNOW COVID-19 Ag Card Product Expiry Update for new expiration dates by lot number. For questions or test kit orders, email [email protected], call (253) 649-1247 or visit tpchd.org/covidtest.

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COVID-19 test processing Labs report varying amounts of time to process COVID-19 tests. To support faster turnaround, we encourage providers to use in-state labs. The table below shows COVID-19 test processing times for in-state private labs. If you have questions about Health Department-facilitated antigen tests, contact [email protected]. Lab Time to process test Tests processed daily FidaLab 24-48 hours 500 Kaiser 24 hours 600-700 LabCorp 24-48 hours Unknown Northwest Pathology 24-48 hours 20,000 Quest 24-48 hours 700 UW Virology 18-24 hours 6,000-8,000 Atlas Genomic 16 hours 10,000

Patient education Share the following materials with patients. • What to do if you have COVID-19. • What to do if you may have been exposed to COVID-19. • What to do if you have COVID-19 symptoms and have not been tested or exposed.

Immediately report COVID-19 • Cases in the following people—call (253) 649-1412. o Healthcare workers (e.g., EMS, medical, nursing, any healthcare facility employee). o Public safety workers (e.g., law enforcement, firefighter). o Live or work in a long-term care facility, senior living center, permanent supportive housing or similar congregate setting (e.g., shelter, correctional facility) housing people at high risk for severe outcomes. o Anyone who dies with COVID-19. o Anyone with suspected MIS-C. • All other cases—Fax the following to (253) 649-1357 or call (253) 649-1413. o Patient—first name, last name, date of birth, gender, race, ethnicity, preferred language, phone number, address and zip code. o Specimen—collection date and type (NP, nasal swab, blood, etc.). o Test—type (PCR, NAAT, antigen, antibody/serology) and result (detected, not detected, inconclusive). o Ordering facility. • For all cases, report the person’s race, ethnicity and preferred language.

Contacting the Health Department • Urgent issues—Call (253) 649-1412. • Non-urgent issues—Call (253) 649-1413 and leave a message. Includes reporting notifiable conditions 24 hours a day, 7 days a week. Leave the patient’s name, date of birth and disease.

Additional resources • Our COVID-19 page for healthcare providers. • Washington COVID-19 risk assessment dashboard. • CDC guidance for healthcare providers and facilities. • DOH COVID-19 data dashboard. • DOH COVID-19 page. • CDC COVID-19 page.

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• Pierce County COVID-19 response and recovery page. • Pierce County PPE requests. • SARS-CoV-2 sequencing and variants in Washington.

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