NOVEL CORONAVIRUS (COVID-19) - Provider & Partner Update Randall Culpepper, MD, MPH Frederick County Deputy Health Officer May 6, 2021
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NOVEL CORONAVIRUS (COVID-19)
Provider & Partner Update
Randall Culpepper, MD, MPH
Frederick County Deputy Health Officer
May 6, 2021
Direct Scheduling at Mass Vaccination Sites
• Immediately book appointment at covidvax.maryland.gov
• Call Maryland’s COVID-19 Vaccination Support Center at
1-855-MD-GOVAX (1-855-634-6829)
Pre-registration ended April 29. All Marylanders who have already
pre-registered will be contacted for an appointment.
Frederick County Health Department
Oak Street Vaccination Clinic
• Schedule appointments
– http://FrederickCountyMD.gov/CovidVaccine
– Call 301-600-7900
• Walk-in, no appointments available.
• Appointments are fast! In-and-out in less
than 30 minutes.
• Enter only from Himes Ave, next to Dutch's
Daughter Restaurant
– Wednesday, May 5 from 9am - 1pm
– Friday, May 7 from 9am - 1pm
Worldwide Cases and Deaths: COVID-19 (May 5, 2021)
https://covid19.who.int/ accessed May 5, 2021
0
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
1-Aug
8-Aug
15-Aug
22-Aug
29-Aug
5-Sep
12-Sep
19-Sep
26-Sep
3-Oct
10-Oct
17-Oct
24-Oct
31-Oct
7-Nov
14-Nov
21-Nov
28-Nov
5-Dec
12-Dec
7 day ∆
19-Dec
26-Dec
2-Jan
9-Jan
16-Jan
23-Jan
30-Jan
6-Feb
13-Feb
20-Feb
27-Feb
6-Mar
13-Mar
20-Mar
27-Mar
3-Apr
10-Apr
17-Apr
24-Apr
Global 7-Day Rolling Average Cases (May 5, 2021)
1-May
Globally 807,436 daily cases (905K max) India 382,146 daily cases (402K max)
Global COVID-19 Update (May 5, 2021)
Global Cases: 154,618,960 Global Deaths: 3,232,776
1. United States: 32,546,124 1. United States: 579,125
2. India: 18,762,976 (↑1.9M last week)* 2. Brazil: 411,588
3. Brazil: 14,856,888 3. India: 226,188 (↑ 18K last week)*
4. France: 5,767,537 4. Mexico: 216,447
5. Turkey: 4,955,594 (inc. again) 5. United Kingdom: 127,830
6. Russia: 4,792,354 6. Italy: 122,005
7. United Kingdom: 4,441,638 7. Russia: 110,022
8. Italy: 4,070,400 8. France: 105,792
* Decreased from prev. week; other countries
* Other countries ↑ only by 2 - 4K deaths/week
↑ only by 70 - 200K cases/weekDecreased vaccine coverage
Lessening restrictions
Lack of face covering mandates
Increased vaccine coverage
Continued mitigation measures
Widespread face covering useUnited States COVID-19 Cases and Deaths (May 5, 2021)
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1,600,000
1,800,000
2,000,000
1-Aug
8-Aug
15-Aug
22-Aug
29-Aug
5-Sep
12-Sep
19-Sep
26-Sep
3-Oct
10-Oct
17-Oct
24-Oct
31-Oct
7-Nov
14-Nov
21-Nov
28-Nov
5-Dec
12-Dec
7 day ∆
19-Dec
26-Dec
2-Jan
9-Jan
16-Jan
23-Jan
30-Jan
6-Feb
13-Feb
20-Feb
27-Feb
6-Mar
13-Mar
20-Mar
27-Mar
3-Apr
10-Apr
17-Apr
24-Apr
U.S. 7-Day Rolling Average Cases (May 5, 2021)
1-May0
5,000
10,000
15,000
20,000
25,000
1-Aug
8-Aug
15-Aug
22-Aug
29-Aug
5-Sep
12-Sep
19-Sep
26-Sep
3-Oct
10-Oct
17-Oct
24-Oct
31-Oct
7-Nov
14-Nov
21-Nov
28-Nov
5-Dec
12-Dec
7 day ∆
19-Dec
26-Dec
2-Jan
9-Jan
16-Jan
23-Jan
30-Jan
6-Feb
13-Feb
20-Feb
27-Feb
6-Mar
13-Mar
20-Mar
27-Mar
3-Apr
10-Apr
17-Apr
24-Apr
U.S. 7-Day Rolling Average Deaths (May 5, 2021)
1-MayU.S. COVID-19 Case Rate per 100K Last 7 Days (April 28 and May 5,2021)
US: New COVID-19 Hospital Admissions (May 3, 2021)
Regional 7-day Moving Average New Cases (PA, DC, MD, VA, WV) (April 28 and May 5, 2021)
U.S. percent population ≥ 18 years given ≥ one dose (April 29 and May 5, 2021)
Maryland Daily Trends in Number of COVID-19 Deaths (May 5, 2021)
Maryland - Current Trends (May 5, 2021)
Confirmed cases Deaths (confirmed and probable)
Note: different scales on graphs.
https://coronavirus.maryland.gov/0
5,000
10,000
15,000
20,000
25,000
1-Aug
8-Aug
15-Aug
22-Aug
29-Aug
5-Sep
12-Sep
19-Sep
26-Sep
3-Oct
10-Oct
17-Oct
24-Oct
31-Oct
7-Nov
14-Nov
21-Nov
28-Nov
5-Dec
12-Dec
7 day ∆
19-Dec
26-Dec
2-Jan
9-Jan
16-Jan
23-Jan
30-Jan
6-Feb
13-Feb
20-Feb
27-Feb
6-Mar
13-Mar
20-Mar
27-Mar
3-Apr
10-Apr
17-Apr
24-Apr
1-May
Maryland 7-Day Rolling Average Cases (May 5, 2021)0
50
100
150
200
250
300
350
1-Aug
8-Aug
15-Aug
22-Aug
29-Aug
5-Sep
12-Sep
19-Sep
26-Sep
3-Oct
10-Oct
17-Oct
24-Oct
31-Oct
7-Nov
14-Nov
21-Nov
28-Nov
5-Dec
12-Dec
19-Dec
7 day ∆
26-Dec
2-Jan
9-Jan
16-Jan
23-Jan
30-Jan
6-Feb
13-Feb
20-Feb
27-Feb
6-Mar
13-Mar
20-Mar
27-Mar
3-Apr
Maryland 7-Day Rolling Average Deaths (May 5, 2021)
10-Apr
17-Apr
24-Apr
1-MayMaryland – Current ICU and Acute Hospital Beds for COVID-19 (May 5, 2021)
Maryland : COVID Vaccinations (May 5, 2021)
Frederick County (May 5, 2021)
0
200
400
600
800
1,000
1,200
1,400
1,600
1-Aug
8-Aug
15-Aug
22-Aug
29-Aug
5-Sep
12-Sep
19-Sep
26-Sep
3-Oct
10-Oct
17-Oct
24-Oct
31-Oct
7-Nov
14-Nov
21-Nov
28-Nov
5-Dec
12-Dec
7 day ∆
19-Dec
26-Dec
2-Jan
9-Jan
16-Jan
23-Jan
30-Jan
6-Feb
13-Feb
20-Feb
27-Feb
6-Mar
13-Mar
20-Mar
27-Mar
3-Apr
10-Apr
17-Apr
24-Apr
1-May
Frederick County 7-Day Rolling Average CasesFrederick County, MD COVID-19 Hospital Statistics:
Acute Beds, ICU Beds of COVID+ Patients
COVID-19 Patients in Acute Beds COVID-19 Patients in ICU Beds
70
# of Patients with COVID-19
60
50
40
30
20
10
0
3/25/2020 4/25/2020 5/25/2020 6/25/2020 7/25/2020 8/25/2020 9/25/2020 10/25/2020 11/25/2020 12/25/2020 1/25/2021 2/25/2021 3/25/2021 4/25/2021Frederick County COVID-19 Deaths by Week (May 5, 2021)
FCPS COVID Cases in Staff and Students (May 5, 2021)
COVID Variant Strains
Variants – Key Points
• CDC-designated “variants of concern” and “variants of interest” now majority of
sequenced SARS-CoV-2 specimens in Maryland
o Increased infectiousness
o Increased severity of illness
o Reduced protection from acquired immunity from vaccination or previous
infection
o Reduced neutralization by convalescent and post-vaccination sera
o Reduced neutralization by some EUA monoclonal antibody treatments
• Exponential growth, primarily driven by B.1.1.7 (“UK Variant”)
• Key points on B.1.1.7:
o Increased transmissibility
o Increased severity of illness
o Current vaccines offer comparable protectionSARS-CoV-2 Variants
Variants of Interest Variants of Concern
• B.1.525 (New York) (E484K) • B.1.1.7 (United Kingdom) (some E484K)
• B.1.526 (New York) (some E484K) • B.1.351 (South Africa) (E484K)
• B.1.526.1 (New York) (L452R) • P.1 (Brazil) (E484K)
• B.1.617 (India) (E484Q and L452R) • B.1.427 (California) (L452R)
– B.1.617.1 • B.1.429 (California) (L452R)
– B.1.617.2
– B.1.617.3
• P.2 (Brazil) (E484K) L452R or E484K substitutions in the spike protein impact
susceptibility to EUA monoclonal antibody treatments.Frederick County Variants of Interest and Concern
45
40
40
35
30
25
20
15
15
10
6
5
3
2
0
B1.117 B1.429 B1.525 B1.526.1 B1.526Indian SARS-COV-2 Variant B1.617
• Current surge in cases seen over the last 6 weeks in parts of India shows a
correlation with the rise in the B1.617 lineage of SARS CoV-2
o Double mutation carries two signature genetic changes known as
E484Q and L452R that allow the virus to escape the immune system
and spread faster.
o South African variant (B1.351) has been seen mostly in Delhi and
Telangana but its presence is much lower than the UK B1.117 variant
• Spread to at least 17 countries
• Includes U.S., Britain, Switzerland and Iran
• Several governments have closed their borders to travelers from India,
including the United States.CDC and MHD Updates
Governor Hogan Lifts Outdoor Mask Mandate, Ends
Restrictions on Outdoor Dining
• Effective Wednesday, April 28:
o OUTDOOR MASK MANDATE. Masks and face coverings are no longer
required outdoors in the State of Maryland.
o Face coverings still required at all large ticketed venues as well as indoors
at all public and private businesses and when using public transportation.
o Unvaccinated strongly encouraged to continue wearing masks, especially
when physical distancing is not possible.
• Effective Saturday, May 1:
o OUTDOOR DINING. Standing service may resume outdoors at bars and
restaurants and all restrictions related to outdoor dining capacity and
distancing will be lifted. Seated service and physical distancing
requirements will remain in place indoors at bars and restaurants.CDC COVID-19 Travel Recommendations by Destination
CDC Domestic Travel Recommendations Quick Reference
CDC International Travel Recommendations Quick Reference CDC recommends delaying international travel until you are fully vaccinated.
CDC: Updated Healthcare Infection Prevention and Control Recommendations- HCP Mask Use • Generally, fully vaccinated HCP should continue to wear source control while at work. • Fully vaccinated HCP could dine and socialize together in break rooms and conduct in-person meetings without source control or physical distancing. • If any unvaccinated HCP are present, everyone should wear source control and unvaccinated HCP should physically distance from others.
CDC: Updated Healthcare Infection Prevention and Control
Recommendations- Communal Activities
• Group activities:
o If all patients/residents participating in the activity are
fully vaccinated, then they may choose to have close
contact and to not wear source control during the activity.
o If unvaccinated patients/residents or unvaccinated HCP are
present, then all participants in the group activity should
wear source control and unvaccinated patients/residents
should physically distance from others.CDC: Updated Healthcare Infection Prevention and Control
Recommendations- SARS-CoV-2 Testing
• Regardless of vaccination status
o Anyone with symptoms of COVID-19 should receive a viral test
immediately.
o Asymptomatic HCP with a higher-risk exposure and
patients/residents with prolonged close contact with someone
with SARS-CoV-2 infection should have a series of two viral
tests for SARS-CoV-2 infection.
■ Testing is recommended immediately and 5–7 days after exposure.
■ Exception: people with SARS-CoV-2 infection in the last 90 days do not
need to be tested if they remain asymptomatic, including those with a
known contact.COVID Vaccine News
COVID-19 Coverage Assistance Fund (CAF) • HHS reimbursement program for COVID-19 Vaccine administration fees not covered by insurance • For patients enrolled in health plans that either do not cover vaccination fees or cover them with patient cost-sharing. • Addresses outstanding compensation needs for providers vaccinating underinsured patients
Pfizer-BioNTech coronavirus vaccine expansion • Early May 2021: FDA will likely authorize use of the vaccine in adolescents 12 to 15 years old; focus on making vaccines available via pediatricians and family physicians • Late May 2021: Pfizer plans to apply for full FDA licensure (approval) for ages 16-85 • September 2021: Pfizer Chairman/CEO Dr. Albert Bourla (D.V.M., Ph.D) expects to request FDA EUA authorization for children ages 2-11 • 4th Quarter 2021: Request FDA EUA authorization for ages 6 months to 2 years • July August 2021: Expects to have Phase 2 safety data on pregnant women • Currently: Addressing cold storage requirements and submitted new data to FDA that could result in storage at standard refrigerator temperatures for up to 4 weeks
Janssen Vaccine Use Considerations
Johnson and Johnson COVID-19 Vaccine
• FDA added a warning to the J&J COVID-19 vaccine EUA fact sheets
and prescribing information
o Rare clotting events might occur after vaccination, primarily
among women aged 18–49 years.
• Provider and patient counseling is critical
• Ensure that women agedMandatory Requirements For Janssen Covid-19 Vaccine Administration Under Emergency Use Authorization (EUA) To mitigate risks of using this unapproved product under EUA and to optimize the potential benefit of the Janssen COVID-19 Vaccine, the following items are required: 1. Janssen COVID-19 Vaccine is authorized for use in individuals 18 years of age and older. 2. Vaccination providers must communicate to individuals receiving Janssen COVID-19 Vaccine or their caregiver, information consistent with the “Fact Sheet for Recipients and Caregivers” prior to individual receiving the vaccine.
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