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COVID-19 Status Update for 08/02/2021

Marin County COVID-19 Status Update for August 2, 2021 includes Bay Area Counties Require Masking Indoors for Everyone; Reduce Your Risk; and updated local COVID-19 data. 

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Information for Healthcare Providers

Content

Overview

The content on this page is intended for medical and health care providers in Marin County.  On this page, you will find information on:

Vaccines

🔹 Quick Links

🔹 Communication Materials

Marin Public Health offers fact sheets/fliers to inform healthcare teams and other staff. Medical centers, clinics, and clinicians can use or adapt these downloadable fact sheets/fliers to build confidence about COVID-19 vaccination among healthcare teams and other staff.

Step 1: Educate healthcare teams and other staff.

Step 2: Give them the tools they can use to educate patients and answer their questions about the vaccines.

For additional details to inform your communication with staff, read the Advisory Committee on Immunization Practices Considerations for COVID-19 Vaccination of Healthcare Personnel and Long-Term Care Facility Residents.

Testing Information

🔹 Testing Guidelines

On May 1st, California Department of Public Health (CDPH) issued new guidance on prioritization of COVID-19 testing. Prioritized groups now include symptomatic and asymptomatic healthcare workers, first responders, and other essential workers.

Healthcare provider should offer telehealth evaluations for patients with mild or moderate illness to discuss the need for testing. Advise ill persons to stay home and away from others until they have been asymptomatic and afebrile without the use of fever-reducing medications for the most recent 24 hrs; AND for at least 10 days since symptoms first appeared, i.e., the minimum length of time will be 10 days.  Providers should review quarantine and isolation guidance with patients referred for testing. We also have the guidance available in Spanish. See the standing order for congregate testing. 

🔹 Test Eligibility Criteria

  • Symptomatic patients;
  • Symptomatic and asymptomatic residents of congregate living facilities;
  • Asymptomatic essential workers;
  • Able to travel in their own vehicle to a centrally located testing site in Marin.

🔹 Congregate Testing

See the standing order for congregate testing.

See the Public Health Order for COVID-19 Testing of Residents and Personnel at Certain Residential Facilities.

🔹 BinaxNOW Program Participant Information - December 4, 2020

BinaxNOW Antigen Testing

Abbott BinaxNOW is a rapid point of care (POC) antigen test for COVID-19 diagnosis. This test is now available to Marin County healthcare providers to use in narrowly defined clinical settings, through Marin County Public Health at no cost. This advisory provides guidance on the clinical use of BinaxNOW and instructions for requesting test kits. The test has received Emergency Use Authorization from the FDA. On September 28, the federal government announced the distribution of 100 million rapid BinaxNOW tests nationwide. Marin County Public Health has received its allocation from the supply sent to California and is now distributing to qualifying healthcare partners county-wide. After December, kits will be available for purchase on the private market at a cost of approximately five dollars per test.

BinaxNOW and PCR Reflex Testing

The “gold standard” for clinical diagnostic detection of SARS-CoV-2 remains RT-PCR. Thus, it may be necessary to confirm a rapid antigen test result with a nucleic acid test, especially if the result of the antigen test is inconsistent with the clinical context.   As part of the BinaxNow Test Kit distribution plan Public Health provides the following guidance for the use of BinaxNOW Rapid Antigen and reflex PCR:

Testing of Symptomatic Persons
  • If the antigen test is positive, no confirmatory test is necessary.  Patient should isolate and close contacts instructed to quarantine.
  • If the antigen test is presumptive negative, perform confirmatory RT-PCR test immediately.  Patient should quarantine until negative RT-PCR test is confirmed.
Testing of Asymptomatic Persons
  • Confirm close contact with infected person.  Do not test until five days after last exposure.
  • If the antigen test is positive, no confirmatory test is necessary.  Patient should isolate and close contacts instructed to quarantine.
  • If the antigen test is presumptive negative, perform confirmatory RT-PCR test immediately.  Patient should quarantine until negative RT-PCR test is confirmed.

When BinaxNOW and PCR test results are discordant, PCR results are presumed accurate. When confirming an antigen test result with a RT-PCR test, it is important that the time interval between collection of samples for the two tests is less than two days, and there have not been any opportunities for new COVID-19 exposure. If more than two days separate the two collections, or if there have been opportunities for COVID-19 exposures, the nucleic acid test should be considered a separate test – not a confirmatory test.

Decision Tree regarding interpretation of BinaxNow test results

To Receive BinaxNOW Test Kits, you must meet the following requirements

To participate, your facility must:

  • Have a Clinical Laboratory Improvement Amendments (CLIA) waiver. 
  • Have staff trained to properly administer the tests, both PCR and antigen
  • Adhere to requirements to report rapid antigen test results for tests performed onsite to the California Department of Public Health (CDPH) using the CalREDIE Manual Lab Reporting Module (MLRM) within 8 hours of conducting the test.
    • PCR test reporting will continue through your facility's current lab arrangements.
  • Share your institutional protocol for utilizing BinaxNow, reflecting adherence and understanding to the guidance above. (Send to MHOAC via email, mhoac@marincounty.org or fax, 415-473-3950).

Reporting Results to CDPH

PCR test results will be reported through the laboratory. For POC antigen tests, all positive results must be reported to CDPH using CalREDIE’s Manual Lab Reporting Module (MLRM) within 8 hours of conducting the tests.

To Request BinaxNOW Test submit your request to the Medical Health Operational Area Coordinator (MHOAC) using this order form. Initial orders are currently limited to 120 kits per facility, excepting those with pre-approval from Marin County Public Health.

For questions, please email Marin County Public Health at COVID19CDLead@marincounty.org.

Isolation and Quarantine Information

🔹 Public Health Orders for Quarantine and Isolation

🔹 Guidance Documents for At Home Isolation and Quarantine

🔹 CDC Guidelines

CDC regularly updates clinical criteria for patients under investigation (PUI). Health care providers should refer to CDC's interim guidance for healthcare professionals.  Health care providers should review and implement infection prevention and control guidance specific to COVID-19.  CDC also regularly updates Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with 2019 Novel Coronavirus.  This interim guidance is intended to assist with assessment of risk, monitoring, and work restriction decisions for healthcare personnel (HCP) with potential exposure to COVID-19. CDC has also published educational materials for healthcare personnel - "What healthcare personnel should know about caring for patients with confirmed or possible 2019-nCoV infection."

EMS Resources

Vaccine Resources

🔹 Note From Marin County Public Health

Our local situation is rapidly evolving. The Marin Operational Area Emergency Operations Center (EOC) has been activated to support and plan emergency response. Marin County Public Health is now shifting from containment to mitigation of COVID-19. We are now implementing community mitigation strategies to flatten the curve. There is now sustained community spread in the United States. For daily updates, visit https://coronavirus.marinhhs.org/updates. Marin Health and Human Services Community Epidemiology program is also regularly providing COVID-19 Surveillance Reports: https://coronavirus.marinhhs.org/surveillance.  

Marin County Public Health will continue to monitor this situation closely and will provide updates when they become available. The health and well-being of our community is our highest priority.

 

 

Public Health Updates

Marin County Public Health sends out Health Alerts, Advisories, and Updates to Marin County clinicians, via email, regarding communicable disease outbreaks, immunization updates, and emerging infectious diseases.