Maine Medicine Weekly Update - 12/17/2020  (Plain Text Version)

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In this issue:
•  Advisory Panel Recommends Moderna Vaccine, FDA Expected to Authorize Emergency Use
•  Update to Our Special Edition Wednesday Vaccine Newsletter
•  FDA Authorizes First OTC COVID-19 Test
•  Maine Public Radio Reports 32 COVID-19 Cases Linked To Bangor Hospital Outbreak
•  MaineCare Section 17 Assertive Community Treatment (ACT) Service Cap
•  Attention FQHCs and RHCs: Reimbursing Telehealth Services, CR 98696
•  Current FDA Drug Shortages
•  Not Much COVID Relief Movement from Congress
•  Maine CDC Physicians To Host Regular Clinician COVID Vaccine Info Sessions
•  PPE Available Through the MMA & ActionPPE
•  Maine Medical Association Enduring Education Opportunity
•  MICIS Opioid Prescribing Presentation & Individual Academic Detailing Sessions
•  Hanley's PELI Advanced Course Enrollment is OPEN!
•  A Message from Maine Responds: Volunteer Opportunity
•  State Legislative Committees Announced
•  Upcoming Specialty Society Programs & Meetings
•  Webinar: “Radon Risk Reduction: The Current Policy Landscape in the US and the Maine Perspective” January 12, 2020
•  Caring for LGBTQ+ Youth in Maine - Emphasis on the 'T' - Half-day Symposium on Saturday, January 23
•  MOA VIRTUAL Midwinter Symposium - Feb 12-14, 2021
•  Maine CDC Annual Prevention Professionals Conference - March 2-3, 2021
•  Behavioral Health Clinician
•  Psychiatric Nurse Practitioner
•  Physician (BC/BE in Family Medicine)


Update to Our Special Edition Wednesday Vaccine Newsletter

Our Special Edition Wednesday Newsletter, Maine COVID Vaccines: When, Who, Why...?, broke down the initial phase of Maine’s Vaccination Plan, outlined how potential production and delivery delays may affect the plan, and highlighted the FDA’s process for potentially authorizing the Moderna vaccine.


Our Special Edition Wednesday Newsletter, Maine COVID Vaccines: When, Who, Why...?, broke down the initial phase of Maine’s Vaccination Plan, outlined how potential production and delivery delays may affect the plan, and highlighted the FDA’s process for potentially authorizing the Moderna vaccine. 

Well. Lo and behold, despite reports yesterday that Maine hospitals received extra vaccine doses in first shipments, within hours, another story appeared stating how Maine will get 40% less vaccine than expected for next week. That despite a Wednesday MedPage Today story saying that, COVID Vaccine Delivery Proceeding Smoothly, Officials Say

The MMA also received numerous inquiries from independent physicians practices asking for further details on Maine CDC timeline plans factoring non-hospital based physicians and staff. Maine Medical Association CEO, Andrew Maclean was able to speak directly to the needs of independent physician practices and deliver estimated doses needed as part of a state steering committee. The stakeholder steering committee includes representatives of the Maine Hospital Association, Maine Primary Care Association, & Maine Health Care Association, in addition to MMA. The Governor’s health policy advisor Beth Beausang, Maine CDC Director Shah, & Maine DHHS Commissioner Jeanne Lambrew also participate. The next one will be the week after Christmas. 

In a nutshell, there is not much to add from our Wednesday newsletter, which is summarized below. Unfortunately, the previously referenced delivery complications may make it worse. A New Your Times article posted yesterday (Thursday), (Some Health Care Workers Are Getting the Vaccine. Others Aren’t. Who Decides?) shows your concerns and eagerness are shared by many throughout the country. 

The initial Phase 1a priority groups to be vaccinated according to Maine CDC were developed, “to preserve the critical care infrastructure for COVID patients.": They include:

•            Hospital COVID units

•            Non-COVID ICUs

•            EDs

On Wednesday, Dr. Shah further described Phase 1 during a Maine CDC media briefing:

•             A—hospital, health care personnel, and LTC residents and staff (roughly 100,000 people)—94 skilled nursing facilities should have received first round of vaccine does by the end of the third week of that program (first week of January)

•             B—essential or front-line workers (several hundred thousand)

•             C—older Mainers and serious medical conditions

He added that it may require many months to get through Phase 1b. There is little clarity beyond week 3 for how many doses will be sent to Maine by the federal government. He is hoping 1a and 1b may take only several weeks but may be months.

More immediately, Maine will not receive enough doses this week, or next week combined to first cover all on-site ICUs even at our largest hospitals. Smaller hospitals within large health systems are not likely to receive any doses for their EDs or staff treating COVID patients for the first two weeks, including the outpatient practices affiliated with smaller hospitals that round daily on their own patients.

Therefore, most, if not all., outpatient clinics and specialists, whether hospital-based or not, are very unlikely to have access before the end of next week or before the end of the year. It is also improbable that enough doses will be delivered to Maine to cover specialists throughout the state, who for example, rotate in hospital ICUs or cover call in emergency departments.

Until “full-time unit-based” critical hospital staff are vaccinated with the limited phase 1 doses, seemingly the first opportunity to penetrate patient-facing outpatient offices, hospital based or independent, may be the last week of December if not the first full week of January.

Please reach out to MMA Director of Communications and Government Affairs, Dan Morin with questions, comments, or concerns regardless of practice location or status. It would also be helpful to us if you haven’t already reached out with your vaccine staffing needs to contact Dan so we can continue to have an accurate number as we advocate for all Maine physicians and their staffs.