HEALTH ADVISORY: Update on COVID-19 Therapeutics and Vaccination from SCCPHD
DATE:
May 27, 2022
TO:
All community providers
FROM:
Sara H. Cody, MD
Health Officer
George S. Han, MD, MPH
Deputy Health Officer
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Santa Clara County is experiencing a surge in COVID-19 cases, which may be attributed to waning immunity from vaccination and infection, combined with increasingly contagious subvariants. This health advisory outlines ways that providers can improve patient outcomes, reduce stress on healthcare facilities, and save lives by offering early treatment options and preventative measures to eligible patients.
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Providers are requested to:
1. Stay updated on COVID therapeutics -- There are readily available treatment options that can reduce a patient’s risk for hospitalization or death. Additional information is available on the CDPH COVID-19 Treatments website.
- Paxlovid is an oral antiviral and the first-line treatment option for patients who test positive for COVID, are symptomatic, and are at increased risk of progression to severe COVID-19. This includes anyone at least 65 years of age and those with very common conditions such as being overweight, physical inactivity, hypertension and diabetes, which will apply to most symptomatic cases. Paxlovid must be started within 5 days of symptom onset. You may consider a positive result from an over the counter test as adequate proof of infection and do not need to re-test the patient, as this may result in the patient falling outside the authorized treatment window.
Paxlovid supply is currently not a concern, and prescriptions can be filled at
most pharmacies. It is recommended that providers check for drug-drug
interactions with Paxlovid to see if it interacts with any agent on a patient’s
medication list, requiring medication adjustment or alternative treatment.
For more information about clinical eligibility, please refer to the following
resources:
- Evusheld is a monoclonal antibody intramuscular injection for pre-exposure prophylaxis in patients with moderate to severe immune compromise or those who had a severe adverse reaction to a COVID-19 vaccine. Evusheld is not a substitute for vaccination.
- Use online maps maintained by the federal government to find locations where COVID therapeutics and Test to Treat sites are available. These maps are based on each site’s self-reported inventory and are updated daily.
- The COVID-19 Therapeutics Locator has all therapeutics (monoclonal antibodies and oral antivirals) across the country. You can narrow your search by therapeutic name using the “Therapeutic Selector” in the top right corner of the map.
- The COVID-19 Test to Treat locator is specific to finding Test to Treat sites and pharmacies with a supply of COVID-19 antivirals. For more information visit the Office of the Assistant Secretary for Preparedness and Response (ASPR) Test to Treat website.
2. Encourage COVID-19 vaccination for all eligible individuals – Vaccination against COVID-19 continues to be the best way to prevent severe illness and death. All eligible individuals should be vaccinated and boosted in accordance with the CDC’s recommended COVID-19 vaccine schedule.
- Everyone ages 5 years and older should get at least 1 booster after completing their COVID-19 vaccine primary series.
- 2nd boosters: The FDA authorized and the CDC recommends a 2nd booster dose for the following groups:
- Individuals aged 50 years and older
- Individuals aged 12 years and older who are moderately to severely immunocompromised
- Individuals aged 18 to 49 years initially given a Janssen vaccine whose 1st booster was also a Janssen vaccine
- Verify COVID-19 vaccination status at every patient encounter. If patients remain hesitant to receive the vaccine, provide information and support, and encourage a plan for vaccination in the near future.
- If you do not offer COVID-19 vaccines at your practice, you can:
3. Consider becoming a COVID vaccine provider to serve the youngest patient population – The last age group that has yet to be vaccinated against COVID-19 (< 5 years old) is up for FDA and CDC review in June. Begin the onboarding process nowto become a vaccine provider so that you are ready to receive vaccine at the time of the authorization, since very young children may not be able to be vaccinated at most pharmacies.
4. Recommend that patients use higher quality masks (e.g., N95, KN95, KF94) indoors to reduce the spread of highly contagious COVID subvariants – Masks that offer the best fit and filtration such as N95, KN95, and KF94 are highly recommended, and remain a critical tool to prevent COVID-19 infection and slow community transmission.
5. Promote prompt testing for anyone who might have been exposed and/or is experiencing COVID symptoms – Testing is easier and faster with the increased availability of over the counter and at-home test kits. Many pharmacies and insurance companies now provide home antigen tests to patients, and every household in the U.S. is eligible to order up to 16 free at-home tests. Patients may visit http://covidtests.gov to order in-home tests from the U.S. government. |
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