04/27/22 Health Advisory: CDC Treatment Updates and ACIP discusses eligibility for second booster dose of COVID-19 vaccine

hands in blue medical gloves holding a syringe and drawing from a vile

Requested actions

  • Be aware, on April 25, 2022, Centers for Disease Control and Prevention (CDC) issued a Health Alert Network (HAN) advisory about the availability and use of recommended COVID-19 therapies. It also advised against using unproven treatments that have known or potential harm.
  • Be aware, on April 20, 2022, CDC’s Advisory Committee on Immunization Practices (ACIP) discussed those who are eligible to get a second booster dose of COVID-19 vaccine (i.e., 50 years or older; 12 years or older and moderately to severely immunocompromised; got Johnson & Johnson vaccine for their primary series and first booster). It is especially important for these people to get a second booster dose if they:
    • Have certain medical conditions that increase the risk of severe disease.
    • Are moderately or severely immunocompromised.
    • Live with a person who is immunocompromised, at increased risk of severe disease, or cannot get COVID-19 vaccine because of age or contraindication.
    • Are at increased risk of COVID-19 exposure because of occupational, institutional or other activities.
    • Live or work in an area with medium or high COVID-19 community level.
  • Be aware, in partnership with Washington State Department of Health (DOH), we offer Test-to-Treat services to uninsured and underinsured Pierce County residents. Give the Test-to-Treat flyer to patients who test positive for COVID-19 and are at high risk of severe illness.
    • Link patients to free COVID-19 testing locations to help them get COVID-19 medication for free, no insurance needed.

Background

Early outpatient treatment of COVID-19 can prevent serious, potentially life-threatening illness and reduce burden on the healthcare system. CDC issued a HAN advisory on Dec. 31, 2021 to address using therapeutics in the outpatient setting for people with COVID-19. At that time, Omicron cases were rapidly increasing in the United States and some therapeutics were in short supply. Now antivirals for COVID-19 are widely available and accessible by prescription at pharmacies and Test-to-Treat locations nationwide.

Data from CDC (highlighted in a Feb. 13, 2021 CDC Infectious Diseases Society of America COVID-19 clinical call) and Food and Drug Administration (FDA) suggest use of systemic corticosteroids and antibiotics to treat outpatients with COVID-19 is increasing. However, these drugs can cause harm and provide no demonstrated benefit in patients with COVID-19 with no supplemental oxygen requirement or bacterial coinfection. Systemic corticosteroid short courses are associated with adverse events like hyperglycemia, gastrointestinal bleeding, psychosis, infection and long-term effects.

NIH provides COVID-19 treatment guidelines. The guidelines panel provides treatment options and recommends against using systemic corticosteroids to treat patients with mild to moderate COVID-19 who do not require supplemental oxygen. Patients who receive dexamethasone or other corticosteroids for other indications should continue therapy as directed by their healthcare provider. NIH recommends systemic corticosteroids for hospitalized patients with COVID-19 who require supplemental oxygen or higher-level respiratory support.

The guidelines panel also recommends against using antibacterial therapy for COVID-19 in the absence of another indication. Antibacterial drugs have no benefit in treating viral infections and can cause harm.

More information

COVID-19 vaccine information

COVID-19 testing

COVID-19 test processing

Labs report varying amounts of time to process COVID-19 tests. To support faster turnaround, we encourage providers to use in-state labs. The table below shows COVID-19 test processing times for in-state private labs.

LabTime to process testTests processed daily
FidaLab24 hours300
Kaiser24–48 hours3,000
LabCorp24–48 hoursUnknown
Northwest Pathology12–24 hours3,000
Quest24–48 hours700
UW Virology24–72 hours5,000–7,000
Atlas Genomic24–48 hours10,000

COVID-19 therapies

Department of Health and Human Services (HHS) allocates monoclonal antibodies and oral antivirals to each state. DOH distributes doses to enrolled providers. Providers must enroll in Healthcare Partner Ordering Portal (HPoP) to manage COVID-19 therapies. Email mcm@doh.wa.gov for support enrolling.

Once enrolled, to request a supply of monoclonal antibodies or therapeutics, complete a smart sheet. Providers can now order treatments directly through HPoP.

Additional information

COVID-19 prevention

Share with patients:

Immediately report COVID-19

  • Cases in the following people—call (253) 649-1412.
    • Healthcare workers (e.g., EMS, medical, nursing, any healthcare facility employee).
    • Public safety workers (e.g., law enforcement, firefighter).
    • Live or work in a long-term care facility, senior living center, permanent supportive housing or similar congregate setting (e.g., shelter, correctional facility) housing people at high risk of severe outcomes.
    • Anyone who dies with COVID-19.
    • Anyone with suspected MIS-C.
  • All other cases—fax the following to (253) 649-1357 or call (253) 649-1413.
    • Patient—first name, last name, date of birth, gender, race, ethnicity, preferred language, phone number, address and zip code.
    • Specimen—collection date and type (NP, nasal swab, blood, etc.).
    • Test—type (PCR, NAAT, antigen, antibody/serology) and result (detected, not detected, inconclusive).
    • Ordering facility.
  • For all cases, report the person’s race, ethnicity and preferred language.

Contacting the Health Department

Questions?
  • For urgent issues call (253) 649-1412.
  • For non-urgent issues call (253) 649-1413 and leave a message.
    • Includes reporting notifiable conditions 24 hours a day, 7 days a week.
    • Leave the patient’s name, date of birth and disease.

Additional resources