‘Crisis Standard of Care’ Activated in Response to Overwhelmed Hospitals
On Tuesday, September 7th, The Idaho Department of Health and Welfare announced that it had activated a ‘crisis standard of care’ policy in two public health district including Boundary, Bonner, Kootenai, Benewah, and Shoshone counties in the Panhandle District 1, and Latah, Nez Perce, Lewis, Clearwater, and Idaho counties in the North Central District 2. This means that hospitals are so overwhelmed by COVID patients in northern Idaho that they are rationing care to patients. Boise Public Radio published two stories on Wednesday that explain the situation in more detail:
"Do Not Get Sick:" Idaho Doctors Explain What Crisis Standards Of Care Means For The State | Boise State Public Radio
What The Move To Crisis Standards Of Care Means For Idaho Residents | Boise State Public Radio
Utah may be next with COVID cases spiking over the last two weeks and many ICU units reaching 100% capacity. For more detail: What to do about Utah’s overwhelmed hospitals? Utah leaders seek ideas - Deseret News.
Oregon and Washington are also struggling this week with hospital capacity due to COVID-19. For more detail: OHSU forecasting predicts state could be hitting peak of COVID-19 hospitalizations (msn.com)
As Hospital Capacity Strains, WA DOH Prepares For The Worst (msn.com)
Our Care Management and Customer Care teams are taking high call volumes about elective surgeries being postponed. We are working with your people to help them understand the situation and explore their options.
How can you help your people? Encourage them wear a seat belt and to avoid other risky behaviors that could land them in the E.R. and consider incenting them to get vaccinated.
Across our region, according to each state’s health department, the full vaccination rate for people age 12 and over in Washington is 67%, Utah is 61.7%, and Idaho is 49.4%. In Oregon, the vaccination rate for age 18 and over is 67.2%.
Employer Vaccine Mandates Gaining Popularity
Now that Pfizer has received full FDA approval of its Comirnaty COVID-19 vaccine for people ages 16 and older, vaccine mandates and proof of vaccination are quickly being adopted by employers, sports stadiums, and school systems. President Biden signed an executive order just last night, Sept 9th, mandating COVID-19 vaccinations for all federal employees and contractors.
Exploring Surcharges for Employees Not Vaccinated Against COVID-19
As the number of COVID-19 infections and hospitalizations rise, employers are concerned about the safety of their workforce, as well as the costs of treatment that could be avoided through vaccination. With vaccination rates stagnant, many are looking for ways to incentivize their employees to get vaccinated. Incentives can take many forms, including paid time off, extra pay, or a premium penalties for participants on the employer’s health plan. Although there are several federal statutes which should be considered, employers struggling to increase COVID-19 vaccination rates among their workforce can implement a premium surcharge for non-vaccinated employees as part of an outcome-based wellness program.
There is no current guidance addressing vaccine wellness programs to date, so it is important to review the HIPAA and PPACA regulations on wellness programs when considering a vaccine surcharge for your health plan. A vaccine wellness requirement could be considered an “activity based wellness program,” which allows a surcharge “incentive” of no more than 30% of the of the total cost of an employee’s health insurance premiums.
Incentives in the form of premium discounts may also be offered to vaccinated employees as part of an eligible activity based wellness program. Employers should note that all wellness incentives are cumulative, which means that adding a vaccination wellness incentive could cause your plan to exceed the maximum allowed incentive amount if penalties or rewards are offered with other wellness programs, such as tobacco cessation. In this instance, the plan would be required to reduce or modify other incentives so that no more than 30% of the employee’s total cost is affected.
Before implementing a vaccination wellness program, employers should consider other restrictions, such as collective bargaining agreements, and labor and employment laws. Specific compliance questions about implementing a vaccination wellness program should be directed to the plan’s legal advisors.
From Delta to Mu
The Delta variant is raging and driving the latest tidal wave of COVID-19 cases. It accounted for 99.1% of all COVID-19 cases in the US for the week ending September 4th according to the CDC’s variant tracker. The CDC began publishing variant tracker data in June 2021. For the week ending June 5th, 2021, the Delta variant accounted for only 14.1% of all COVID-19 cases and it had reached 49 states.
While the Mu variant that we hear so much about has reached 49 states, it currently represents only 0.1% of all U.S. cases. However, on August 30th, the World Health Organization (WHO) listed the Mu variant as a “variant of interest” based on its ability to ‘evade antibodies’ as witnessed by its spread in South America. Read more about Dr. Fauci’s comments on the Mu variant in this Sept 2nd New York Times article.
Booster Vaccines Approved…and Coming Soon
On August 18th the U.S. Department of Health and Human Services (HHS) announced, “We have developed a plan to begin offering these booster shots this fall subject to FDA conducting an independent evaluation and determination of the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines and CDC’s Advisory Committee on Immunization Practices (ACIP) issuing booster dose recommendations based on a thorough review of the evidence. We are prepared to offer booster shots for all Americans beginning the week of September 20 and starting 8 months after an individual’s second dose.”
On September 17th the FDA will meet to discuss Pfizer-BioNTech’s supplemental Biologics License Application for administration of a third (“booster”) dose of Comirnaty (COVID-19 Vaccine, mRNA) in individuals 16 years of age and older. This follows the FDA’s August 12th authorization of an additional vaccine dose for immunocompromised people.
We will continue to closely monitor the FDA’s vaccine approvals and the CDC’s recommendations for COVID-19 vaccine boosters and treatments.
Ivermectin is Not FDA Authorized for COVID-19 Prevention or Treatment
On September 3rd, the FDA published a new webpage titled, Why You Should Not Use Ivermectin to Treat or Prevent COVID-19. If you hear your people talking about this drug, please share this FDA webpage with them. Spoiler alert, there’s a reason it features a picture of a horse and a veterinarian.
- The FDA has not authorized or approved Ivermectin for use in preventing or treating COVID-19 in humans or animals. Ivermectin is approved for human use to treat infections caused by some parasitic worms and head lice and skin conditions like rosacea.
- Currently available data do not show ivermectin is effective against COVID-19. Clinical trials assessing ivermectin tablets for the prevention or treatment of COVID-19 in people are ongoing.
- Taking large doses of ivermectin is dangerous.
- If your health care provider writes you an ivermectin prescription, fill it through a legitimate source such as a pharmacy, and take it exactly as prescribed.
- Never use medications intended for animals on yourself or other people. Animal ivermectin products are very different from those approved for humans. Use of animal ivermectin for the prevention or treatment of COVID-19 in humans is dangerous.
Regular COVID Reporting Continues
All clients currently receive regular reporting on their plan’s COVID-related claims and payments. Please connect with your Account Manager to receive your latest report.
Our focus, dedication, and support remain steadfast as we navigate these unique times with you. Know that our Care Management nurses are reaching out to those members diagnosed with COVID-19 to help them access the care and resources they need to recover safely.
Updated COVID-19 Member Information and Resources on Our Website
We update our COVID-19 information and resource pages for members regularly. Many members call us with questions that are of a more clinical nature. We recommend that members consult their primary care physician for clinical questions. For non-clinical questions, please share this page with members where they will find links to additional resources on self-care, vaccines, and other useful information.n.