Latest Updates

Page last updated: 5/18/22

Latest COVID-19 Briefing: 4/1/22

Latest COVID-19 Update 1/19/22: 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 preprint, 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

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

Recommendations for general population

Recommendations for immunocompromised patients

  • Extra dose vs booster for immunocompromised: The CDC recommends immunocompromised patients receive booster shots in addition to their primary vaccine series. Pfizer and Moderna recipients are recommended to receive a third dose 28 days after the two initial 2 vaccines as part of their primary series, and then a booster is to be given 3 months after the third dose.

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

COVID-19 Temporary Emergency Paid Sick Leave Program

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

https://www.mass.gov/info-details/covid-19-temporary-emergency-paid-sick-leave-program