STATE NEWS

KDADS COVID-19 Webinar Friday, April 30^th at 2 PM
KDADS is holding another webinar for COVID-19 updates and discussion this Friday, April 30^th at 2 PM. To avoid the problem of limited participants, the webinar is being held on Microsoft Teams Live. (Don’t worry, Microsoft Teams events can be viewed in your browser without any special software). Part of the discussion will feature idea sharing and stories from providers on how they are handling visitation issues. Join the event here.

Note: The Friday webinar will also include discussion on the brand-new CMS memos concerning testing and indoor dining and activities.

Kansas COVID-19 Cluster Summary     
 Statewide Active COVID-19 Clusters    

• Clusters: 47
• Cases: 3,027
• Hospitalizations: 44

Kansas COVID-19: Case Rates    

• Cases: 308,510
• Total Case Rate Per 1,000: 105.90
• Daily Cases Diagnosed: 153

Long-Term Care Facilities with Active Cluster Case Information

• Clusters: 7          
• Cases: 46
• Hospitalizations: 3

Source: https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas   

Kansas COVID-19 Vaccination Overview    

• 1,110,043 People Vaccinated with One Dose  
• 1,872,482 Total Doses Reported as Administered    
   – First Dose: 1,110,043
   – Second Dose: 762,439
• 2,511,820 Total Doses Distributed    
   – State Distributed: 1,936,940
   – Federal LTC Program: 574,880
• 38.1% of Kansans Vaccinated with One Dose  

Source: https://www.kansasvaccine.gov/158/Data   

FEDERAL NEWS

IMPORTANT Updated Guidance From CDC and CMS
CDC released several pieces of updated guidance yesterday. Some general “public health recommendations” are applicable to our communities, such as travel guidance and masking. Additionally, CDC updated specific healthcare guidance. CMS released 2 revised memos (here and here) consistent with CDC’s recommendations. Here’s the quick and dirty:

1. International travel: International travel should be delayed until you are fully vaccinated. A negative COVID test is required for international travelers seeking entry/re-entry into the US, regardless of vaccination status. Fully vaccinated individuals are no longer recommended to quarantine upon return from international travel and are no longer recommended to be tested within 3-5 days of return from international travel. This means that staff may return to work without quarantine following international travel if they are fully vaccinated. Unvaccinated individuals must continue to quarantine for 7 days, test upon return, and avoid contact with individuals who are at increased risk for 14 days. This means that unvaccinated staff should be restricted from work for 14 days following international travel. More info is available here.
2. Masking: CDC is loosening recommendations on masking. In most cases, fully vaccinated individuals are no longer recommended to mask up outdoors, provided they are not in crowded outdoor spaces, like at concerts or sporting events. Unvaccinated individuals can forego the mask outdoors if they are attending small gatherings with fully vaccinated individuals or exercising (walking, running, biking, specifically). More information and a helpful infographic is available here. It’s important to note that some cities/counties/states have mask mandates in place and individuals must adhere to mask mandates in those areas.
3. Healthcare visitation: Fully vaccinated individuals may now remove their masks when visiting indoors in healthcare settings (like nursing homes, inpatient hospice, and assisted living) provided both the resident and the visitor are fully vaccinated and they are alone in the resident’s room or visitation space. The visitor must continue to mask around other residents, staff, and individuals in the healthcare setting.
4. Activities and dining: CDC is loosening recommendations for masking and social distancing in activities and dining for fully vaccinated individuals. In the healthcare setting, if all individuals attending an activity are fully vaccinated, they may choose to forego masking and social distancing during the activity. If all individuals in the dining area are fully vaccinated, they may choose to forego masking and social distancing during dining. If any individuals in the activity or dining setting are unvaccinated, all must wear masks and social distance. CDC recommends asking individuals to sign up for activities/dining ahead of time so that vaccination status may be determined privately and expectations on masking and social distancing determined. We note that CDC does not recommend separate activities or separate dining for vaccinated vs. unvaccinated residents. CDC also recommends that if an individual’s vaccination status is unknown, recommendations for “unvaccinated” should be followed.
5. Healthcare personnel: Healthcare personnel may follow the guidance above regarding masking and social distancing as it relates to activities such as breaks rooms/staff lounges or in-person meetings. If all present are fully vaccinated, healthcare personnel may forego masking and social distancing. If any are unvaccinated, or if vaccination status is unknown, masks and social distancing are recommended.
6. Testing: Protocols for testing of symptomatic individuals and testing staff and residents in the event of an outbreak have not changed. Recommendations around “expanded screening testing” (routine testing) of staff have been changed. CDC now recommends that fully vaccinated staff may be excluded from expanded screening testing (routine testing of staff according to county positivity rates). Unvaccinated staff must continue to be tested routinely according to county positivity rates. CDC offers additional guidance that individuals who require testing due to exposure should be tested immediately and again within 5-7 days of exposure. CMS has updated regulatory guidance to be consistent with these recommendations, available here.
7. Clarification on outdoor visitation during outbreak: LeadingAge has received several questions about how to handle visitation in the event of outbreak. As you recall, CMS updated visitation guidance in March to allow greater flexibility for visitation during outbreak under certain parameters. This prompted questions about whether outdoor visitation could continue for individuals who were on “affected units”. CMS refers to CDC guidance to clarify that while individuals who are on transmission-based precautions (TBP) are not permitted visitors until TBP have been discontinued, individuals who are on affected units but are not confirmed or suspected positive and who have not had “close contact” as defined by CDC may continue outdoor visitation.

HHS Provided Additional Clarification to LeadingAge Last Night

• Nursing Home Visitation: CMS revised their guidance on nursing home visitation during the COVID-19 pandemic. CMS, in accordance with CDC guidance, recommends that face covering or mask (covering mouth and nose) and social distancing at least 6 feet between persons occur in the home. The document instructs readers to view the current CDC guidance at Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination for information on indoor visitation. Furthermore, the revised guidance states that the CDC has provided additional guidance on activities and dining based on resident vaccination status. For example, residents who are fully vaccinated may dine and participate in activities without face coverings or social distancing if all participating residents are fully vaccinated; if unvaccinated residents are present during communal dining or activities, then all residents should use face coverings when not eating and unvaccinated residents should physically distance from others. See the CDC guidance for information on communal dining and activities.
  • Long Term Care Facility Requirements: CMS revised their guidance for long-term care facilities in regard to testing requirements and COVID-19 focused survey tool. The document clarifies the definition of fully vaccinated and unvaccinated: “Fully vaccinated” refers to a person who is ≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine; “Unvaccinated” refers to a person who does not fit the definition of “fully vaccinated,” including people whose vaccination status is not known, for the purposes of this guidance. The guidance also indicates that both staff and residents, vaccinated or unvaccinated, must be tested for COVID-19 if there is either an outbreak or if they are symptomatic. However, vaccinated staff do not need to be routinely tested. CMS revised the COVID-19 Focused Survey for Nursing Homes tool to reflect the new testing requirements implemented in the IFC. The current Survey/Infection Prevention, Control & Immunization Pathway (CMS-20054) can be found in the LTC Survey Pathways zipfile.
  • Infection Control After Vaccination: CDC updated their information on infection control after vaccination. CDC updated SARS-CoV-2 testing recommendations, to include that anyone with symptoms of COVID-19, regardless of vaccination status, should receive a viral test immediately. CDC updated their visitation guidance to include recommendations for acute care facilities and to describe circumstances when source control and physical distancing are not required during visitation. CDC also added guidance for communal activities and dining in healthcare settings.
  • Events and Gatherings: CDC updated their information on events and gatherings to provide definitions on large and small gatherings. CDC continues to recommend avoiding large events and gatherings. Currently, CDC does not provide numbers to define small and large events. Large gatherings bring together many people from multiple households in a private or public space. Small gatherings are informal in nature and may occur with family and friends you regularly socialize with, often at someone’s residence.
  • COVID-19 Vaccination Program Provider Enrollment: CDC updated guidance for providers on the COVID-19 vaccination program provider enrollment process, including the requirements. Providers enrolling in the COVID-19 Vaccination Program must: sign the CDC COVID-19 Vaccination Provider Agreement; enroll in your jurisdiction’s Immunization Information System (IIS); be trained on how to administer vaccines, report and manage vaccine inventory, store and handle vaccine, report adverse events, report doses administered data, and other essential topics related to the administration of COVID-19 vaccines; and report COVID-19 vaccine inventory daily to VaccineFinder.
  • Guidance for Fully Vaccinated People: CDC updated their guidance for fully vaccinated people. The CDC now provides guiding principles for fully vaccinated people. Fully vaccinated people no longer need to wear a mask outdoors, except in certain crowded settings and venues. CDC provides clarification that fully vaccinated workers no longer need to be restricted from work following an exposure as long as they are asymptomatic. Fully vaccinated residents of non-healthcare congregate settings no longer need to quarantine following a known exposure. Fully vaccinated asymptomatic people without an exposure may be exempted from routine screening testing, if feasible. The CDC’s guidance underscores that immunocompromised people need to consult their healthcare provider about these recommendations, even if fully vaccinated.
  • International Travelers: CDC updated their information on international travel during COVID-19. CDC recommends delaying international travel until you are fully vaccinated. CDC updated their guidance for people who are fully vaccinated and returning from international travel. CDC clarified that this guidance applies to COVID-19 vaccines currently authorized for emergency use by the Food and Drug Administration: Pfizer-BioNTech, Moderna, and Johnson and Johnson (J&J)/Janssen COVID-19 vaccines. This guidance can also be applied to COVID-19 vaccines that have been authorized for emergency use by the World Health Organization (e.g. AstraZeneca/Oxford). The CDC also requires a proof of negative COVID-19 test or proof of recovery from COVID-19 for all air passengers arriving in the United States.If you plan to travel internationally, you will need to get tested no more than 3 days before you travel by air into the United States (US) and show your negative result to the airline before you board your flight, or be prepared to show documentation of recovery (proof of a recent positive viral test and a letter from your healthcare provider or a public health official stating that you were cleared to travel).

LEADINGAGE KANSAS NEWS

Weekly Webinars to Return Next Week on May 7^th
We are pausing our weekly webinars during our Virtual Spring Conference. We will resume on May 7^th. Listen in for information and updates about the coronavirus, Fridays at 10 AM. Register here.

Roger Marshall, US Congressman Talks to Us About Vaccine Advocacy
Watch the video from Dr. Marshall and feel free to share on your social media or anywhere you think would be helpful.

LEADINGAGE NATIONAL NEWS

Mother’s Day Celebrations
This Mother’s Day, many of you, your staff, clients, and residents can enjoy in-person celebrations—whether on, before, or after May 9th. To lift up the positive stories and share the joy of this special holiday, LeadingAge prepared a toolkit with ideas, sample text, public relations templates, and social media tools for your use. We would also like to share in your celebrations at the national level! Please send photos and videos of residents, clients, and staff embodying the #CareIsLove theme to communications@leadingage.org. And tag us on your social media posts, or post quotes that capture the joy in the day. (Coming next: a toolkit to observe Older Americans Month!)