Latest Updates

Page last updated: 6/14/22

Latest COVID-19 Briefing: 6/1/22

Latest COVID-19 Update 5/18/22: Presentation and Recording

Archives:

What's New on the Site? Look for items marked **

Note: Many of our links bring you to UpToDate, high quality content intended for practicing clinicians, made freely available by the publisher for COVID-19 information only

Paxlovid and Molnupiravir are now located at several Walgreens and CVS stores throughout the state. See the therapeutic locator for specific location details.

Tufts Medical Center has a supply of the oral antiviral Paxlovid

For patients who may be candidates for COVID-specific treatment, you may either:

(1) Refer the patient to the Tufts Respiratory Infection Clinic (617-636-3164) whose staff will triage the patient via telehealth or phone and set the treatment in motion, or

(2) Use this flowchart to see which treatment might be appropriate and send a prescription and send to the Tufts Atrium 3 pharmacy. If you would like to speak with a Tufts Pharmacist, please call 617-636-5381 and select option #2.

COVID-19 Answer Center for Tufts Medicine Integrated Network Clinicians and Practice Personnel

Tufts Medicine Integrated Network Clinicians and practice personnel may use this form (OR call (781) 664-5705) to ask question(s). This is NOT a resource for patients to use directly. Our Pharmacy team will do its best to answer questions as soon as received.

  • Hours: Monday-Friday; 8:30 a.m. and 5 p.m.
  • Weekends/holidays will be answered the next business day
Click here to read the Answer Center's most frequently asked questions (FAQ)

Telehealth

 

    NOTICE (Updated 2/22/22): It is required that clinicians use a HIPAA compliant telehealth platform. Although Federal requirements have been lifted through the end of the public health emergency, there are different requirements from commercial payers.  Our largest commercial payer, Blue Cross Blue Shield of Massachusetts, requires a HIPAA compliant platform and they will perform audits.  Any practice not using a HIPAA compliant platform is at risk and should plan to convert to a different platform.

    Infection Control/PPE

    The Biden Administration to give away 400 million N95 masks

    Comprehensive PPE Guidance

    • Removing the requirement to wear eye protection for all patient care encounters
    • Allowing staff to be able to congregate without facemasks when they are in well-defined areas that are restricted from patient access (e.g., staff meeting rooms, kitchen). If staff who are not fully vaccinated against COVID-19 are present, everyone should wear masks.
    • Removing the ability to reuse respirators

    Masks

    Diagnostic Testing 

    COVID-19 Testing

    Differential Diagnosis: testing for other respiratory virus infections including flu

    Commercial test kits are available that detect COVID-19 along with other respiratory pathogens. (NB: Detection of another pathogen does not rule out COVID-19 infection.)

     

    Test Location Finders

    About Free at-home COVID-19 tests from the US Government

    PCR/NAAT (Molecular testing)

    Rapid Antigen

    Test Location Finders

    Data/Clinical Studies

    • Click here to review a study which compares SARS Co-V-2 Nasal RT- PCR and rapid antigen test (BinaxNOW) at a community testing site during an Omicron surge.

    Sequelae/Complications

    Treatment

    MA clinical guidance on therapeutics for COVID-19 and recommendations when supplies are limited. (See link for most up to date DPH guidance which includes a table of treatment recommendations for mild to moderate COVID-19 when supplies are limited.) 


    Outpatient IV Treatments

    Oral antivirals

    CDR Health

    The state has in-home treatment options available for certain patients. Check out this website for more information

    Gothams

    • Patients can call: (508) 213-1380 to speak with a Gothams representative. If they're eligible for COVID-19 treatment, they can schedule an infusion appointment at one of the 7 sites in Massachusetts. Learn more.
    • These treatment facilities and all medications provided are available through a MA DPH initiative and patients will not be charged for services or medications
    • Locations: Athol, Everett, Holyoke, Fall River, Lowell, Pittsfield and Plymouth
    • Starting to acquire oral treatment in addition to monoclonal antibodies
    • Send the form in addition to a prescription for the drug of choice via fax or email

    When the FDA approves a drug, it means the agency has determined, based on substantial evidence, that the drug is effective for its intended use and that the benefits of the drug outweigh its risks when used according to the product’s approved labeling. The FDA can also allow drugs to be used during times of extreme need under an Emergency Use Authorization (EUA).

    Under EUA, “the FDA makes a product available to the public based on the best available evidence, without waiting for all the evidence that would be needed for FDA approval or clearance.” This is a temporary authorization to use a drug for a specific indication and can be revoked or revised by the FDA at any time.

    When the emergency has been deemed to be over, the EUA ends. Additionally, medications cannot be used for “off-label” indications under EUA like they can when they are formally approved. Please see the FDA for more details: Understanding the Regulatory Terminology of Potential Preventions and Treatments for COVID-19.

    Drug-Drug Interaction Guidance for COVID oral treatment options:

    IDSA Management of Drug Interactions With Nirmatrelvir/Ritonavir (Paxlovid®): Resource for Clinicians

    • Ensure the patients medication list is up-to-date and accurate
    • Liverpool COVID-19 Drug-Drug Interaction Checker
    • Tufts Medicine Pharmacy contacts for questions regarding drug-drug interactions
      • Contact Tufts Atrium 3 Outpatient Pharmacy via phone: (617) 636-5381
      • Contact Tufts Medicine CIN Answer Center via form or phone: (781) 664-5705
    • New oral COVID treatment options (such as Paxlovid) may not have been added to the EMR drug database yet, in which case the medication would need to be written as a custom drug and can not be e-prescribed….therefore a drug-drug interaction check would NOT be conducted via EMR
    • The Oral Antivirals For Treatment of COVID-19 guide is available on the Tufts website under Education (see link)
      • Appendix 1 on pages 5-8 list drug interactions to consider when prescribing Paxlovid and clinical comments
      • **Prescribers are encouraged to consult with a pharmacist PRIOR to prescribing Paxlovid to evaluate for drug interactions

    Vaccines, Prevention, Boosters

    • mRNA vaccines approved for 6 months- 5 years
      • Food and Drug Administration advisers voted to recommend authorizing both Moderna and Pfizer-BioNTech’s COVID-19 vaccines for young children
      • CDC recommends COVID-19 primary series vaccines for everyone ages 6 months and older, and COVID-19 boosters for everyone ages 5 years and older, if eligible.
      • Please see the chart from the CDC which summarizes the COVID-19 primary series vaccination for children and teens
    • Novavax COVID vaccine; approved by the FDA  and endorsed by the CDC Advisory Committee on Immunization Practices’ (ACIP)
      • Novavax coronavirus vaccine is a traditional protein-based vaccine, similar to many standard vaccines such as flu and shingles.   It is NOT an mRNA vaccine and it is NOT a live virus vaccine, which may reassure patients who refused prior vaccines for those reasons.
      • This is a 2-shot regimen and will likely be recommended initially for those who are unvaccinated.  Approval for use as a booster will probably follow at a later time.
      • The data used for the clinical trials was looking at older variants

    CDC considerations for COVID-19 Vaccination in relation to infection and treatment

    Coding and Billing for Vaccine Administration

    Moderna announces bivalent booster demonstrating superior antibody response against Omicron with potential approval for Fall 2022. This vaccine will contain an Omicron strain as well as the original Covid vaccine strain.

    Recommendations for general population

    Recommendations for immunocompromised patients

    Epidemiology/Transmission

    Mechanisms of Transmission

    Data/Clinical Studies

    • An editorial published in JAMA discusses significant nosocomial transmission with Omicron.
    • Study finds current vaccines reduce transmission by approximately 70%.

    Practice Materials

    Practice Templates

    Telehealth Materials

    Clinician Wellbeing 

    News

    Massachusetts Department of Public Health (DPH)

    Op-eds

    COVID-19 Activity Statistics and Info Websites

    91-Divoc: Case counts. Countries & US states— total cases, and cases normalized for population

    Washington Post: Countries (Cases, hospitalizations, deaths, vaccination)

    Washington Post: US States (Defaults to Mass. But can be set to any state)

    MWRA Wastewater Viral RNA Surveillance

    IDSA Covid-19 Guidelines (this links to the first section, which in turns links to all the other sections)

    NEJM Covid-19 articles

    AMA Covid-19 information

    CDC COVID-19 Information for Healthcare Providers