CHEAC wishes you a very happy holidays and a happy new year! Our CHEAC Weekly Digest will go on a brief hiatus during the next two weeks due to the winter holidays; publication will resume during the week of January 3, 2022.
December 17, 2021 Edition
Amid a 47 percent increase in COVID-19 cases since the Thanksgiving holiday, the California Department of Public Health (CDPH) on Monday announced masks will be required to be worn in all indoor public settings irrespective of vaccination status. The public health order, issued by CDPH Director and State Public Health Officer Dr. Tomás Aragón, took effect on Wednesday and remains in place through January 15, 2022.
State officials noted the seven-day average case rate increased by almost half and hospitalizations have increased by 14 percent since the late November holiday. The increases in cases and hospitalizations, combined with the potential for a surge in Omicron variant cases, led CDPH to issue updated guidance in an attempt to prevent a winter peak.
In addition to the statewide mask mandate, CDPH updated requirements for attending mega events, including concerts and sporting events. Prior to attending an event, attendees will now require either proof of vaccination, a negative antigen COVID-19 test within one day of the event, or a negative PCR test within two days of the event.
CDPH issued a new travel advisory, effective immediately, recommending that all travelers arriving in California test for COVID-19 within three to five days after arrival, regardless of vaccination status.
State health officials urged residents to receive their COVID-19 vaccine or booster, observe COVID-19 precautions, and remain vigilant against the virus. Vaccines and temporary measures, according to CDPH, will allow residents to spend the holidays together more safely.
Additional information on CDPH’s latest guidance announcements is available here.
The U.S. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) this week officially recommended mRNA COVID-19 vaccines over Johnson & Johnson’s COVID-19 vaccine. ACIP, in a unanimous vote, issued its clinical preference following a robust review of the latest evidence on vaccine effectiveness, safety, and rare events.
At issue is the potential for a rare but serious blood clotting disorder known as thrombosis with thrombocytopenia syndrome (TTS). According to new data from the U.S. Food and Drug Administration (FDA), both men and women may be at an elevated risk for TTS after receiving the Johnson & Johnson COVID-19 vaccine. The risk was highest among women ages 30-49. Nine deaths have occurred due to the disorder, and the FDA this week updated its face sheets indicating that the vaccine should not be used in people who experienced clotting problems after a first dose.
Recall, earlier this year, federal officials placed a temporary pause on the vaccine after reports of TTS. Several weeks later, the pause was lifted, allowing administration of the vaccine to resume nationwide.
CDC Director Dr. Rochelle Walensky, following the ACIP recommendation, endorsed the clinical preference for mRNA COVID-19 vaccines over Johnson & Johnson’s COVID-19 vaccine. The CDC move follows similar recommendations issued by other countries, including Canada and the United Kingdom. The CDC indicates the Johnson & Johnson vaccine will remain on the market, and the ACIP reaffirmed that receiving any vaccine is better than being unvaccinated.
California Health and Human Services Agency (CalHHS) Secretary Dr. Mark Ghaly and California Department of Public Health Director Dr. Tomás Aragón issued a joint statement on the Western States Scientific Safety Review Workgroup’s recommendation on the preferred use of Moderna and Pfizer COVID-19 vaccines over the Johnson & Johnson vaccine. State officials urged residents to receive their COVID-19 vaccine and booster to prevent a winter surge.
Additional information on the updated recommendation is available here.
On Tuesday, California reached its one-year anniversary of administering its first vaccine against COVID-19. Since beginning administration on December 14, 2020, California local health departments and providers have administered more than 62 million doses to residents, leading the nation in vaccination efforts.
To mark the occasion, the California Department of Public Health (CDPH) held a “December Week of Action” this week to strongly urge Californians to take necessary steps to slow the spread of COVID-19 during the winter holiday season, including by receiving a COVID-19 vaccine or booster and following the state’s recently announced indoor masking and testing requirements. The CDPH Vaccinate All 58 Campaign and local partners hosted a series of events and activities in vulnerable communities throughout the week to promote the state’s public health measures, harm reduction best practices, and whole family vaccinations.
Similarly, Governor Gavin Newsom, on the state’s one-year anniversary, penned a column urging Californians to protect themselves and others from COVID-19, particularly ahead of the winter holidays. The Governor highlighted several of his Administration’s efforts in reaching residents with COVID-19 vaccines, returning students to in-person instruction, and protecting workers from the virus.
Additional information from CDPH is available here.
This week, the United States reached the tragic milestone of 800,000 deaths due to COVID-19. The figure, the highest of any country in the world, comes one year after COVID-19 vaccines began to be administered. More than 200 million Americans are vaccinated against COVID-19, though the country continues to experience challenges with the virus and its mutating strains. In California, nearly 80,000 residents have died of the disease since its arrival in 2020.
President Joseph R. Biden, Jr. issued remarks to commemorate the milestone of the pandemic, expressing grief and remembering the lives that were lost. President Biden additionally called on all Americans to remain vigilant against the disease by receiving their vaccine and booster and observing COVID-19 precautions.
On Thursday, the California Division of Occupational Safety and Health (Cal/OSHA) Occupational Safety and Health Standards Board (OSHSB) convened to review the COVID-19 Prevention Emergency Temporary Standards (ETS) governing COVID-19 protocols for most California workplaces.
OSHSB considered revisions to its existing ETS, including the latest recommendations from the California Department of Public Health (CDPH). The revisions to the ETS will take effect on January 14, 2022, and remain in place for 90 days. The following revisions were made during Thursday’s meeting:
- COVID-19 Cases in the Workplace – Employers must continue to properly notify employees, employee representatives, and any other workers at a worksite of possible COVID-19 exposure within one business day. This section was updated to provide employers clearer instructions on how to notify workers who were at the same worksite as the COVID-19 case during the high-risk exposure period.
- Face Coverings – The definition of face coverings was updated to include more detail on the different types of acceptable face coverings for workplace settings.
- Testing and Exclusions – The ETS was revised to be more consistent with current CDPH recommendations:
- Employers are now required to make COVID-19 testing available at no cost and during paid time to employees who were fully vaccinated before the “close contact” with a COVID-19 case occurred, even if they are asymptomatic
- During outbreaks and major outbreaks, employers must now make weekly testing (outbreaks) or twice-weekly testing (major outbreaks) available to asymptomatic fully vaccinated employees in the exposed group
- Employees who have recently recovered from COVID-19 and those who are fully vaccinated are not required to be excluded from the workplace after “close contact” but must wear a face covering and physically distance for 14 calendar days from the last date of contact
- Return to Work Criteria – The period of time before an employee can return to work after close contact or COVID-19 infection has been revised to be consistent with CDPH guidelines. Time frames will automatically update if CDPH updates their guidelines, pursuant to the Governor’s Executive Order N-84-20.
Other critical workplace requirements remain unchanged in the updated COVID-19 Prevention ETS. Employers must continue to maintain an effective COVID-19 Prevention Program that includes identifying and evaluating employee exposures to COVID-19 health hazards, training employees on how to prevent hazards, and implementing procedures to correct unsafe conditions.
Additional information from Cal/OSHA is available here.
The California Department of Public Health (CDPH) recently partnered with well-known celebrities, influencers, and trusted messengers in promoting COVID-19 vaccines and boosters among populations disproportionately impacted by the COVID-19 pandemic.
In promoting COVID-19 vaccines among Latino populations in California, CDPH has partnered with celebrated cartoonist Lalo Alcaraz. The Los Angeles-based artist is most known for his contributions as a cultural consultant for “The Casagrandes” on Nickelodeon and the 2017 Pixar movie, “Coco.” He is also the creator of the nationally syndicated comic strip, “La Cucaracha.”
During the COVID-19 pandemic, Alcaraz has used his talents to reach the Latino community by blending humor and culturally relevant themes to deliver facts about COVID-19 and vaccines. As the principal artist for CovidLatino, his art helps address pervasive vaccine hesitancy and misinformation among California’s Latino communities.
In promoting vaccination among Black and African American Californians, CDPH has partnered with actor and producer Jaleel White and former NFL player and host of “The Talk” and “American Ninja Warrior” Akbar Gbajabiamila. These celebrities are sharing their COVID-19 vaccine experiences through candid conversations to help reduce hesitancy in Black and African American communities throughout the state.
The four-part conversation details their vaccination journeys, including their experiences with mild side effects, getting a booster, and why getting the facts is important for someone to make their decisions on getting vaccinated. In addition to the four-part series, the partnership includes a comedic skit written by White that supports the Vaccinate All 58 campaign and addresses concerns surrounding vaccinations and booster shots.
CDPH’s partnerships are part of a comprehensive effort to reach California’s most vulnerable communities with resources and messaging to achieve higher COVID-19 vaccination rates and reduce COVID-19 hospitalization and death. All videos will be shared on various digital and social media platforms, including CDPH’s Twitter account.
Governor Gavin Newsom this week issued Executive Order N-23-21 related to the COVID-19 pandemic. Specifically, the order temporarily allows corporate shareholder meetings to be held virtually during emergencies.
The order additionally authorizes and extension of the COVID-19 safety requirements to protect workers in the COVID-19 Emergency Temporary Standard (ETS). The move comes after the Occupational Safety and Health Standards Board (OSHSB) readopted an ETS that is effective from January 14 to April 14, 2022. The Governor’s order enables a subsequent third readoption of the ETS.
Today, the U.S. Centers for Disease Control and Prevention (CDC) released two reports in its Morbidity and Mortality Weekly Report highlighting the use of test-to-stay practices used in schools to minimize absenteeism and learning loss which can occur during traditional quarantine at home.
The CDC has added information on test-to-stay practices in its K-12 Transmission Science Brief and its K-12 webpages. Test-to-stay, according to the CDC, is another valuable tool in a layered prevention strategy that includes promoting vaccination of eligible students and staff, requiring everyone ages two and older to wear a mask indoors, keeping at least three feet of physical distance between students, screening testing, ventilation, handwashing, and staying home when sick.
The CDC continues to recommend everyone ages 5 and older receive a COVID-19 vaccine to protect against SARS-CoV-2. Adolescents ages 16 and older can get a booster dose at least six months after a primary series.
Additional information is available here.
This week, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the distribution of approximately $9 billion in Provider Relief Fund (PRF) Phase 4 payments to health care providers who have experienced revenue losses and expenses related to the COVID-19 pandemic. More than 69,000 providers in all 50 states will receive Phase 4 payments, which began to be issued this week. Under Phase 4, California is allocated $894 million in funds.
Additional information is available here.
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), this week encouraged hospitals to implement evidence-based patient safety practices for managing obstetric emergencies along with interventions to address other key contributors to maternal health disparities. The announcement by CMS follows last week’s first White House Maternal Health Day of Action, commemorated by Vice President Kamala Harris.
In support of delivering equitable, high-quality maternity care, CMS encourages hospitals to review their policies and procedures for incorporation, where appropriate, of best practices. One such practice for improving patient safety and quality of care has been “maternal safety bundles” for use in cases of obstetric hemorrhage, severe hypertension in pregnancy, and non-medically indicated Cesarean deliveries. Bundles have also been associated with narrowing the racial disparity gap in certain perinatal outcomes.
Additional information from HHS is available here.
This week, the Biden-Harris Administration released its Lead Pipe and Paint Action Plan, representing a historic effort to deploy resources from the recently enacted Bipartisan Infrastructure Law to deliver clean drinking water, replace lead pipes, and remediate lead paint. The plan includes over 15 new actions from more than 10 federal agencies with the goal of making rapid progress toward replacing all lead pipes in the U.S. in the next decade.
As part of its plan, the Biden-Harris Administration seeks to partner with local, state, and federal partners to address lead sources, particularly in disadvantaged communities. Among the new actions announced this week are:
- Collaborating with local, state, and federal partners to accelerate the replacement of lead pipes over the next decade;
- CDC closing gaps in childhood lead testing through the Childhood Lead Poisoning Prevention Program;
- Establishing a new cabinet-level partnership for lead remediation in schools and childcare centers;
- EPA allocating $3 billion in Bipartisan Infrastructure Law funding for lead service line replacement in 2022 and calling on states to prioritize underserved communities;
- EPA launching new regulatory process to protect communities from lead in drinking water;
- HUD awarding grants to remove lead paint and other home health hazards in low-income communities to protect children and families; and
- HUD, USDA, and DOI committing to remove lead service lines and paint hazards in federally assisted housing.
Funding as part of the Bipartisan Infrastructure Law builds upon $350 billion provided in the American Rescue Plan Act (ARPA) that states, localities, and tribes can use for lead pipes and the replacement of faucets and fixtures inside schools and childcare centers.
Additional information, including the full action plan, is available here.
On Wednesday, the U.S. Centers for Medicare & Medicaid Services (CMS) approved State Plan Amendment 21-0019 for dental components as part of the sweeping California Advancing and Innovating Medi-Cal (CalAIM) initiative. The amendment, effective January 1, 2022, authorizes supplemental payments for select preventive dental services and dental examination services for continuity of care.
The amendment additionally authorizes two new statewide benefits, also effective on January 1. Caries risk assessment and silver diamine fluoride services will be added to the dental fee schedule.
DHCS awaits full approval of the State Plan Amendment for the broader CalAIM initiative which is set to begin on January 1, 2022.
The CMS approval letter for the CalAIM dental components is available here.
This week, Governor Gavin Newsom released the 2021 second annual Social Innovation Impact Report, detailing California’s multisector approaches to addressing the state’s most persistent challenges, including the COVID-19 pandemic. According to the Newsom Administration, California has led 44 public-private partnerships totaling more than $4 billion in corporate and philanthropic contributions and engaging more than 1,600 community-based organizations. In 2021, public-private partnerships invested more than $138 million in communities throughout the state.
The most notable partnerships occurred across the following areas:
- COVID-19 Vaccine Equity and Outreach – The Newsom Administration details partnerships with the California Community Foundation, Public Health Institute (PHI), and Sierra Health Foundation to provide COVID-19 vaccine appointment assistance, at-home vaccinations and transportation services, and targeted community outreach. According to the Governor’s Office, these partnerships have funded and mobilized over 700 community-based organizations across the state to each 14 million residents.
- Housing for Individuals Experiencing Homelessness – Governor Newsom highlights the state’s expansion of Homekey, investing $2.75 billion to purchase and rehabilitate housing, including hotels, motels, and vacant apartment buildings to convert them into interim or permanent, long-term housing.
- Support for Migrants, Refugees, and Asylum Seekers – California launched the California Dignity for Families Fund to support migrants and asylum seekers, including unaccompanied children. A partnership with Grantmakers Concerned with Immigrants and Refugees (GCIR), the fund supports integration of new arrivals and their families to California.
- Climate Resilience and Disaster Relief – The Newsom Administration highlights historic climate-related investments made this year and hints at more public-private partnerships to be announced in 2022, including the High Road Training Fund, Community Economic Resilience Fund, Drought Recovery and Resilience Fund, and Wildfire Relief.
Additional information, including the full 2021 Social Innovation Impact Report, is available here.
The California Governor’s Office of Emergency Services (Cal OES) recently released a new grant opportunity to prevent sexual and domestic violence. The purpose of the grant program is to prevent sexual and domestic violence through primary and secondary prevention efforts, prioritize marginalized and underserved populations within communities, and build the capacity of local organizations.
The two-year grant will award up to $300,000 per applicant. The submission deadline for the grant opportunity is February 9, 2022.
Additional information is available here.