COVID-19 Updates for Providers
Requested actions
Updated Antiviral Guidance
- Be aware, Centers for Disease Control and Prevention (CDC) updated its COVID-19 monoclonal antibody treatment recommendations.
- Sotrovimab monoclonal antibody formulation retains significant efficacy against Omicron, the dominant circulating variant.
- Other monoclonal antibody formulations under emergency use authorization (EUA)—bamlanivimab and etesevimab and casirivimab and imdevimab—lack clinical benefit against Omicron and should not be used at this time.
- Sotrovimab supplies are currently limited. Prioritize its use for non-hospitalized people with risk factors for progressing to severe COVID-19, including:
- Unvaccinated against COVID-19.
- Has not received all CDC-recommended prime and booster doses of COVID-19 vaccine.
- Clinical risk factors.
- Older age (e.g., 65 years or older).
- Not expected to mount an adequate immune response.
- Use sotrovimab for the above high-risk people when oral Paxlovid is not indicated because of potential severe drug-drug interactions or if Paxlovid is unavailable.
- Sotrovimab monoclonal antibody formulation retains significant efficacy against Omicron, the dominant circulating variant.
- Be aware, Centers for Disease Control and Prevention (CDC) endorsed Advisory Committee on Immunization Practices’ (ACIP’s) decision to strongly recommend a single Pfizer COVID-19 vaccine booster dose for people 12–17 years old at least 5 months after their primary series. This expands the age of booster access and strengthens the existing policy for booster doses in people 16–17 years old.
- Offer COVID-19 vaccine booster doses to everyone 12 years or older least:
- 5 months after completing Pfizer primary vaccine series.
- 6 months after completing Moderna primary vaccine series.
- 2 months after single dose of Johnson & Johnson vaccine.
- Offer a third, additional dose of Pfizer (5 years or older) or Moderna (18 years or older) COVID-19 vaccine to people with compromised immune systems 28 days after receiving their second dose.
- Be aware, a high volume of people are going to local emergency departments seeking COVID-19 testing, increasing the burden on our hospital system. If people are unable to access a testing appointment or home test kit in a timely manner, direct people to stay home and isolate. See WCHD 12/29/21 Health Advisory regarding new shortened isolation and quarantine guidelines.
Background
As Omicron cases surge in our region and healthcare system capacity is strained, we welcome news of additional tools to combat the pandemic and reduce the burden on our healthcare systems. We are working with community partners to establish equitable and accessible distribution of these therapeutics as they become available.
In the original clinical trial, sotrovimab treatment reduced the risk of the composite endpoints of hospitalization and death in high risk patients by 85%. Based on pre-print in vitro data, CDC currently believes sotrovimab is the only monoclonal antibody under EUA that retains efficacy against Omicron variant. Because sotrovimab supplies are limited—we expect to receive 550 doses for the entire state for the next month—it is imperative that we prioritize it for the highest risk individuals. See the risk tiers in CDC’s distribution plan for details.
We hope to have availability of oral antivirals very soon via local partner pharmacies for people in the middle tier high risk group. We plan to have detailed information to help providers access these medications as soon as they become available locally.
Additional information
- Vaccine recommendation changes press release, CDC.
- Sotrovimab EUA.
- Sotrovimab EUA frequently asked questions (FAQs), Food and Drug Administration (FDA).
- Sotrovimab fact sheet for healthcare providers.
- Sotrovimab fact sheet for patients, parents and caregivers.
- Isolation and quarantine guidance for healthcare workers, CDC.
- Isolation and quarantine guidance for the general public, CDC.
- Find more resources on other therapeutics in the COVID-19 monoclonal antibody therapeutics communication toolkit.
COVID-19 vaccine
- Booster dose updates, FDA.
- EUA fact sheets for recipients and caregivers:
- COVID-19 vaccine locator, Washington State Department of Health (DOH).
- COVID-19 vaccine provider toolkit and resources, DOH.
- COVID-19 vaccination for providers, CDC.
- Clinical considerations for COVID-19 vaccination and guidance for managing anaphylaxis, CDC.
- COVID-19 vaccine quick reference guide for healthcare professionals, CDC.
- COVID-19 vaccine training module on best practices for providers, CDC.
COVID-19 testing
COVID-19 therapeutics
Department of Health and Human Services (HHS) allocates monoclonal antibody and oral antiviral supplies to each state. DOH distributes doses to enrolled providers. Providers must enroll in Healthcare Partner Ordering Portal (HPoP) to manage COVID-19 therapeutics. Email mcm@doh.wa.gov to register for HPoP training, held Tuesdays at 9 a.m.
- To request an initial supply of Evusheld monoclonal antibody for pre-exposure prophylaxis (PrEP), complete a smart sheet.
- Read more about Evusheld monoclonal antibody for PrEP.
- Find more resources in the COVID-19 monoclonal antibody therapeutics communication toolkit.
COVID-19 prevention patient education
Share the following materials with patients.
- What to do if you have COVID-19.
- What to do if you may have been exposed to COVID-19.
- What to do if you have COVID-19 symptoms and have not been tested or exposed.
Contacting the Health Department
360-778-6100 Main Call Line – available M-F 8:30am to 4:30pm
360-715-2588 Afterhours Answering Service – available after 4:30pm and weekends
360-778-6150 Communicable Disease Report Line – 24 hours a day 7 days a week
360-778-6103 Confidential Communicable Disease Fax – 24 hours a day 7 days a week
1500 N State Street, Bellingham WA 98225