Elevating the Post-Acute and
Long Term Care Profession

March 29, 2021

CDC Report Shows Vaccine Prevents SARS-CoV-2 Infections Among Health Care Workers. An extremely important study came out today in the Centers for Disease Control and Prevention's (CDC's) Morbidity and Mortality Weekly Reporter (MMWR). It is widely known that the COVID-19 vaccine clinical trials found that the vaccines are highly effective in preventing symptomatic disease. Questions remained, however, about how effective the vaccines are in preventing infection by the SARS-CoV-2 virus, which could lead to the infected person unknowingly transmitting the virus to others. The difference is performing COVID-19 tests vs. reporting symptoms. Recently, CDC published results in MMWR finding that the first shot of the BioNTech/Pfizer vaccine was 63% effective in preventing SARS-CoV-2 infection, as shown by testing, in a study of 463 SNF residents. 

In what may be a key breakthrough, CDC reported today that in a much larger study of health care workers, vaccines showed strong effectiveness in preventing infection on both the first and second shots. CDC summarized its findings as follows:

Prospective cohorts of 3,950 health care personnel, first responders, and other essential and frontline workers completed weekly SARS-CoV-2 testing for 13 consecutive weeks. Under real-world conditions, mRNA vaccine effectiveness of full immunization (=14 days after second dose) was 90% against SARS-CoV-2 infections regardless of symptom status; vaccine effectiveness of partial immunization (=14 days after first dose but before second dose) was 80%.

Both the Moderna and Pfizer vaccines featured in this study.

CMS Positivity Rates Move in Wrong Direction. Today saw the Centers for Medicare and Medicaid Services (CMS) release their weekly county-level COVID-19 positivity rates. Unfortunately, this week's Ohio rates followed the mixed results last week with a tendency toward higher positivity. All of last week's red counties (Clermont, Licking, Portage, Stark, and Summit) stayed red, while Belmont and Butler Counties changed from yellow to red. Five counties moved from green to yellow (Athens, Auglaize, Guernsey, Harrison, and Sandusky) while only one (Richland) made the transition from yellow to green. Red and yellow county status have impact on visitation and eye protection requirements, respectively, for SNFs.

Latest on Non-Respondent List. Last Thursday, the Department of Aging (ODA) published a list of SNFs and assisted living communities they believed had not responded to the state's request to report, via Survey Monkey, plans to vaccinate additional staff and residents not covered in the earlier clinics. This step, together with Governor Mike DeWine's comments at his press conference announcing the list's posting, were quite upsetting to OHCA members who felt unfairly chastised. OHCA shared these concerns with the Administration. ODA published updated versions of the list, the latest of which (dated yesterday at 6:00 p.m.) showed only 79 facilities instead of the original 207.

DODD and ODH to Split ICF Licensure Reviews. Today, Ann Weisent from the Department of Developmental Disabilities (DODD) clarified how the state will handle licensure reviews for ICFs/IID. These reviews were postponed during the pandemic, resulting in a significant backlog. Ms. Weisent wrote: 

The Ohio Department of Health (ODH) has resumed certification and licensure reviews of ICFs. Because of the volume of licensure reviews that must be completed by the end of the year, DODD will be collaborating with ODH to assist in the completion of the licensure reviews. By December 31, 2021, we intend to complete all licensure reviews that were put on hold during 2020 and complete the reviews for ICFs with a license term ending in 2021. DODD and ODH will divide the reviews in order to achieve this goal.

If your licensure review has been assigned to DODD for completion, you will be contacted by a DODD reviewer to coordinate the review. All reviews completed by DODD will be conducted virtually.

DODD is finalizing an abbreviated process for the completion of ICF licensure reviews for the period of July 1, 2021–December 31, 2021. More information regarding the modified process will be shared with providers prior to resuming the reviews. DODD will also schedule a webinar to share additional information.

New Articles on Reducing Vaccine Hesitancy. While staff vaccination rates have improved over time, for many long-term care facilities they remain below where they would like them to be. Two recent articles, one in a medical journal and another in the media, provide information and suggestions about vaccine hesitancy among facility staff. Both pieces are specific to SNFs, but the learning applies more broadly. The first is from the Journal of the American Geriatrics Society entitled, "Lessons Learned from Frontline Skilled Nursing Facility Staff Regarding COVID-19 Vaccine Hesitancy," co-authored by AHCA/NCAL's Dr. David Gifford. The second is a success story entitled, "Getting to Yes: A Nursing Home’s Mission to Vaccinate Its Hesitant Staff," that appeared in the New York Times today. This article explains strategies a SNF in Washington, D.C., used to increase its staff vaccination rate.