Back to School 2021-2022 With COVID-19 April 14, 2022 - CMDHD/MMDHD/DHD#10 Jennifer Morse, MD, MPH, FAAFP Medical Director - District Health ...

Back to School 2021-2022
     With COVID-19
      April 14, 2022
   Jennifer Morse, MD, MPH, FAAFP
           Medical Director
      CMDHD/MMDHD/DHD#10

This meeting is for
  School and Health                          If you have questions, please send them to:
   Department Staff                          For Roscommon, Osceola, Clare, Gladwin,
                                                Arenac, Isabella Counties:
                                                info@cmdhd.org
  We have limited time to cover all our
 topics. The slides and recordings will be
available on our websites within 1-3 days.   For Missaukee, Crawford, Kalkaska, Wexford,
                                                Lake, Mason, Manistee, Oceana,
https://www.dhd10.org/coronavirus/school-       Newaygo, Mecosta Counties:
               guidance/                        info@dhd10.org

  https://www.mmdhd.org/covid-schools/
                                             For Montcalm, Gratiot, Clinton Counties:
   https://www.cmdhd.org/novelschools           https://www.mmdhd.org/contact/

Please make sure the information shared today is
 passed along to others who may need it, such as
school COVID-19 liaisons, school secretaries, school
                   nurses, etc.

                     Thank you!

Managing Communicable Diseases in Schools – UPDATED February 2022
    https://www.michigan.gov/documents/mdch/Managing_CD_in_Schools_FINAL_
                                 469824_7.PDF

Summary of Changes for Managing Communicable Diseases in Schools Version 4.0 & 5.0
    Handwashing Procedures: Antibacterial soap is not recommended
    Maintain a Sanitary Setting: Sanitized surface should air dry for the time listed on product
    Maintain a Sanitary Setting: Bleach should be used before or after school in appropriate dilutions
    When to Exclude a Child from School: Added Severely ill, Abdominal pain, Skin sores
    When to Exclude a Child from School: Changed temperature for fever cutoff
    When to Exclude a Child from School: Added recommendation for written exclusion criteria
    When to Exclude a Child from School: Added Flow chart
    Requesting Information from Parents: Newly added section
    Immediate Reporting of Outbreaks: Added definitions of ILI and GI outbreaks
    School Closures due to Illness: Newly added section
    Changes in exclusion criteria: Impetigo, MRSA, Pink Eye, Rash, Ringworm, Scabies, Strep Throat,
     COVID-19
    New links: EPA cleaning guidelines and AAP’s Quick Reference for infectious diseases in schools
    Added information on planning before an outbreak including NIMS and Communication Plan
    Added and updated COVID-19 specific information including updated links                              https://www.michigan.gov/documents/mdch/Ma
                                                                                                          naging_CD_in_Schools_FINAL_469824_7.PDF

Updates regarding expiring test kits in schools: Email April 8, 2022

CDC Authorizes 2nd Booster for those moderately to severely immunocompromised
    or those 50 years of age and above

   Four months after receipt of a first booster dose of Pfizer BioNTech, Moderna or Janssen (Johnson & Johnson),
    the following are now authorized, and individuals may choose to receive:
        A second booster dose of the Pfizer BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine may be
         administered to individuals 50 years of age and older.
        A second booster dose of the Moderna or Pfizer BioNTech COVID-19 vaccine may be administered to
         moderately or severely immunocompromised individuals 18 years of age and older
        A second booster dose of the Pfizer BioNTech COVID-19 vaccine may be administered to moderately or
         severely immunocompromised individuals 12 years of age and older
   The CDC definition for Up to Date on COVID-19 Vaccine is not changed:
        A person is up to date with their COVID 19 vaccination if they have received all recommended doses in
         the primary series and one booster when eligible .
             Getting a second booster is not necessary to be considered up to date at this time

Influenza

            https://www.michigan.gov/documents/MIFluFocus_1_5_06_146893_7.pdf

Influenza

   Influenza Hospitalization
    Surveillance Project (IHSP)
    laboratory-confirmed influenza-
    associated hospitalizations
    from October 1st through April
    30th each year for Clinton,
    Eaton, Genesee, Ingham, and
    Washtenaw Counties
   Since October 1st, 133 (31
    pediatric, 102 adult) influenza-
    associated hospitalizations
    were reported in the
    catchment area for the 2021-
    2022 season.
                                       https://www.michigan.gov/documents/MIFluFocus_1_5_06_146893_7.pdf

Influenza

SARS-CoV-2 Omicron Variant Infection in 10 Persons Within 90 Days of
     Previous SARS-CoV-2 Delta Variant Infection

       A report published April 8 in the US CDC’s Morbidity and Mortality Weekly Report (MMWR) describes 10
        individuals who were reinfected with the Omicron variant of SARS-CoV-2 within 90 days of initial infection
        with the Delta variant.
             Researchers conducted whole genome sequencing on 10 individuals—8 children and 2 adults—to
              determine which variant caused the initial and subsequent infections.
       Only 1 of the patients had received a 2-dose primary vaccine regimen, 2 had received 1 dose, and 7 were
        unvaccinated.
       Of 8 patients with available data on symptoms, 6 experienced symptoms during both infections.
       The authors noted that the patients may have been at increased risk for infection due to lack of
        vaccination and the high likelihood of exposure to SARS-CoV-2 in schools and the work and living settings of
        the adults.

Roskosky M, Borah BF, DeJonge PM, et al. Notes from the Field: SARS-CoV-2 Omicron Variant Infection in 10 Persons Within 90 Days of Previous SARS-CoV-2
Delta Variant Infection — Four States, October 2021–January 2022. MMWR Morb Mortal Wkly Rep 2022;71:524–526. DOI:
http://dx.doi.org/10.15585/mmwr.mm7114a2

*Credible intervals reflect the range of normal uncertainty associated with estimates.
Data: Authors’ analysis

Source: Eric C. Schneider et al., “Impact of U.S. COVID-19 Vaccination Efforts: An Update on Averted Deaths, Hospitalizations,
and Health Care Costs Through March 2022,” To the Point (blog), Commonwealth Fund, Apr. 8, 2022.
https://doi.org/10.26099/d3dm-fa91

See the most up to date data at
      https://www.mistartmap.info/
                 AND
https://www.cdc.gov/coronavirus/2019-
ncov/your-health/covid-by-county.html

Entire Pandemic

Past 6 Months

     https://covid.cdc.gov/covid-data-tracker/#trends_dailycases

https://www.mistartmap.info/mism-indicators

New COVID-19     New COVID-19      Percent of
                                                       Cases Per     admissions per staffed inpatient
                                         County     100,000 people      100,000     beds occupied
                                                     in the past 7   population (7-   by COVID-19
                                                          days         day total)        patients

                                         Arenac           0.0             2.9             0.8%
                                           Clare          9.7             2.9             1.0%
                                          Clinton        85.4             1.6             2.5%
                                        Crawford         21.4             6.4             3.8%
                                        Gladwin           7.9             2.9             1.0%
                                          Gratiot        27.0             4.3             2.7%
                                         Isabella        31.5             2.9             1.0%
                                        Kalkaska         33.3             9.1             3.7%
                                           Lake           8.4             2.4             2.9%
                                        Manistee         24.4             9.1             3.7%
                                          Mason          41.2             2.5             2.2%
                                        Mecosta          18.4             4.3             2.7%
                                        Missaukee         6.6             2.4             2.9%
                                        Montcalm         20.4             4.3             2.7%
                                        Newaygo          14.3             2.5             2.2%
                                        Oceana           18.9             2.5             2.2%
                                        Osceola          34.1             2.4             2.9%

https://www.michigan.gov/coronavirus/
                                        Roscommon        8.3              6.4             3.8%
                                         Wexford         29.7             2.4             2.9%

https://biobot.io/data/

MI COVID Response Data and Modeling
           Update-April 12th

https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_105123---,00.html

More recently,
most specimens
sequenced in MI
have been BA.2
 (RED PORTION)

Next Meeting:
       3 WEEKS
Thursday May 5 , 1pm
               th