Page last updated: 6/14/22
Latest COVID-19 Briefing: 6/1/22
Latest COVID-19 Update 5/18/22: Presentation and Recording
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
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.
Materials for Patients
Test Location Finders
Guidance on Which Test to Take:
Antibody Tests Can’t Give Answers You Want About COVID-19 Immunity, Washington Post
Opinion: Let Kids Take Their Masks Off After the Omicron Surge, New York Times
- 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
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
PCR/NAAT (Molecular testing)
- Medicare to Start Covering Antigen Tests, New York Times
- NEJM clinical review on antigen testing
- Antigen testing for COVID-19 diagnosis
- Key Points on Use of Antigen Testing for COVID-19 (especially At Home Testing)
- Ordering Rapid Antigen tests through the State DPH
- Massachusetts Department of Public Health (DPH) is making BinaxNOW rapid test kits available for use in all provider settings. You may order tests now by filling out this form and emailing the completed form to COVID19.Resource.Request [at] mass.gov (). Delivery timelines may vary based on DPH delivery capacity. Clinicians should generally expect to receive requested test kits within 1 week of a request being submitted.
- Private Healthcare Providers are now eligible to order tests through the Operational Services Division Click here for purchasing information.
Test Location Finders
- 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.
Long COVID-10 Clinics
Long COVID-19/Long haul COVID-19/post-acute sequelae of COVID-19 (PASC)
- Information for providers about therapeutic treatments for COVID-19
- Infectious Disease Society of America (IDSA) Guidelines on Treatment of COVID-19
- Outpatient evaluation and management of acute COVID-19 illness in adults
- Management of acute COVID-19 illness in ambulatory children
- Management of acute COVID-19 illness in nursing homes
- Indications for 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
- Through Tufts Med Ctr Resp Infec Clinic: 617-636-3164
- At state contracted sites run by Gothams (See orange tab below: State Sites for IV treatments and oral antiviral distribution)
- Additional locations if treatments are not available or accessible through Tufts (note, this is not an all-inclusive list, please refer to monoclonal antibody locator link above as information is rapidly evolving.)
The state has in-home treatment options available for certain patients. Check out this website for more information
- 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:
- 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
- A well-performed study showed fertility was the same among vaccinated and unvaccinated individuals
- Recommendations and Messaging for Clinicians: COVID-19 Vaccines and Pregnancy Conversation Guide
- Available formulations and CDC recommendations
- Contraindications and precautions to COVID-19 vaccines
- How to Find a COVID-19 Vaccination Site
- Digital Vaccine Card
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 from the European Society for Breast Imaging re axillary lymphadenopathy in the context of breast imaging relatively soon after COVID-19 vaccine
- Delayed localized reaction to Moderna mRNA vaccine
- V-Safe (After Vaccination Health Checker from CDC)
- VAERS (Required Adverse Effects Reporting)
- Management of Anaphylaxis After COVID-19 Vaccination (from CDC)
- Available Epinephrine Auto-Injector Formulations
- Protect yourself, your family, and your community from COVID-19
- Downloadable Website/Portal Message and Voicemail Script
- What to Do When You Think You Need The Emergency Room
Massachusetts Department of Public Health (DPH)
Click here for current and archived Mass DPH Weekly Provider COVID-19 Bulletins
General Massachusetts COVID-19 webpage including state regulations and policies with regard to COVID-19
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)