Follow-up for Positive COVID-19 Cases and their Close Contacts - PowerPoint PPT Presentation

Follow-up for Positive COVID-19 Cases and their Close Contacts Tools for LBOHs September 8, 2020 Hillary Johnson, MHS, Infectious Disease Epidemiologist Scott Troppy, MPH, PMP, CIC, Surveillance Epidemiologist Bureau of Infectious Disease and Laboratory Sciences MA Department of Public Health

Topics Today • MAVEN status map • LBOH Confirmed and Probable Report – updated • MAVEN Status Map Overview • Key Documents • Last week’s Recap • Cluster Concepts • Full Cluster Webinar was recorded Friday 9/4/2020. See MAVEN Help to review. • Cluster Tip Sheets • Your Questions 2

Tuesday Webinars for COVID-19 Case Investigation and Follow-up Tuesdays @ 11am • Isolation of Cases and Quarantine of Contacts is the goal until that strategy changes/evolves. • MAVEN is the main reporting source and where you should document your work. • Discuss with your local Institutions of Higher Ed (IHEs) on a process for follow-up among students & staff. * • Understand Cluster Follow-up & Tracking MDPH Epi Program: 617-983-6800 MDPH MAVEN Help Desk: isishelp@mass.gov MDPH Food Protection Program: 617-983-6712 3 MAVEN Help has Guidance Documents and CTC Help Desk: 857-305-2828 Previous Webinars: COVID19CommunityTracingCollaborativeQuestions@mass.gov http://www.maventrainingsite.com/maven-help/toc.html

Updates for today, Tuesday, 9/8  MAVEN Status Map – three towns offline  Florida, Holland, New Ashford  LBOH Immediate Workflow – COVID-19 event only – please check your workflow and clear out the workflow  New “COVID Assistance Set to No (Contacts ) Workflow”  Allows you to send you contact events to CTC  Umbrella Clusters Line List – for Higher Ed (Help Section)  Updated “LBOH Confirmed and Probable Report” – now shows first specimen positive date  Status Map Overview 4

MAVEN Status Map as of 9/8/2020 Holland, New Ashford, Florida 5

Immediate Notification workflow (COVID-19 Only)  UPDATE: COVID-19 Immediate Notification Workflow - 971 events in this workflow today  This will allow proper notification of all new COVID-19 events for your jurisdiction. (Confirmed and Probable Cases)  Please review all events/cases in this workflow and complete your Step 1- LBOH Notification to “Yes” to clear out this workflow.  If you are retaining ownership then complete Steps 2 (Investigation Started) & 3 (LBOH Investigator (name, lboh, phone number)  When you are done then complete Steps 4 (CRF Complete) & 5 6 (Final Review)

“COVID Assistance Set to No Workflow – Contacts”  NEW Workflow  Identifies your contacts where COVID Assistance Requested is not Yes/No (contacts within the past 24 hours)  Open each contact event an if you would like CTC to perform contact monitoring then select the question as Yes  You can use the Bulk Action functionality in the workflow to keep your contacts at your LBOH  The contact will move over to the CRM  The contact monitoring will be managed in the CRM  The contact information will come back to MAVEN once 7 completed in the CRM by the CTC.

Umbrella Clusters Created in MAVEN  Note: Umbrella Cluster event was created for the purpose of data management and does not represent a cluster or outbreak of illness. Any Epi Cluster events associated with this school should be linked to this Umbrella Cluster for tracking purposes. Individual COVID cases should not be linked to this Umbrella Cluster event; school association is captured in individual case events through the variable “Education Institution” in the Risk Question Package. Please call (617) 983-6800 with any questions.  You will only see Umbrella Clusters that you have jurisdictional access to see  A Cluster/Outbreak Webinar occurred on September 4 th – webinar recording and slide set now available – please review 8

 Umbrella clusters have been created for all higher education and boarding schools in Massachusetts  A line list of clusters will be added to the MAVEN Help Section to use as a reference  Umbrella clusters will be searchable under the following general naming convention: 9  SCHL U _[School Name]_[City/Town]  Example_SCHLU_BOSTONCOLLEGE_BOSTON

Additional variables for lab information • Created four new fields in Clinical QKPG #3 for EPI/IMM model. These are not editable by users, MAEDSS-12737 1. Specimen Date of First Positive Test Result 2. Test of First Positive Test Result 3. Ordering Facility of First Positive Test Result 4. Lab Facility of First Positive Test Result 10

Average daily incidence rate = (Cases on Day1/population + Cases on Day 2/population….+Cases on Day14/population)/14 x 100,000. The 14 days over which the cases are drawn is indicated in the footnotes on the dashboard; the most recent 14 day period was 8/16/2020 - 8/29/2020. 11

Approximating the Status Map  Daily incidence rate calculated for 2 week reporting period (ending on previous Saturday)  (# new cases/jurisdiction population estimate)*100,000  Averaged over 14 day timeframe (including zeroes)  Rounded to the nearest tenth decimal point  Multiple sources of variability:  Timing  Data pulled first thing Wednesday morning  Case numbers constantly changing due to revoking, deduplication, reassignment of jurisdiction  Date used to identify cases  Map calculations based on collection date of first positive PCR specimen  May not equal event date - most reports extract based on event date  Confirmed and Probable report now uses first positive specimen date  Population estimates 12  DPH calculates rates per 100,000 population using denominators estimated by the University of Massachusetts Donahue Institute using a modified Hamilton-Perry model (Strate S, et al. Small Area Population Estimates for 2011 through 2020, report, Oct 2016.)

MAVEN Help Section 13

Summary of Key Guidance & Tools • 9/2/2020 Updated COVID-19 Case Classification Manual • Serology positive labs are now classified as “suspect” cases. http://www.maventrainingsite.com/maven-help/pdf/case-classification-manual/COVID19__09022020_FINAL.pdf • Date: 8/22/2020: - COVID-19 PCR and Antibody Testing Public Health Response Recommendations • • Table describes different Public Health Actions based upon different testing results. Big take home: PCR & Antigen positive patients should be treated like cases. • Serology + cases no longer require public health follow-up. • http://www.maventrainingsite.com/maven-help/pdf/COVID- • 19%20PCR%20and%20Antibody%20Testing%20Public%20Health%20Response%20Recommendations%20for%20LBOH %20Ver4.0_Aug22.pdf • Date 8/10/2020: Follow-up for Positive Antigen Test Results http://www.maventrainingsite.com/maven-help/pdf/Antigen%20Results%20Follow-up%20Guidance_ver1.0_August_10.pdf . • Date: 8/9/2020: Updated Isolation & Quarantine Guidelines Documents • • http://www.maventrainingsite.com/maven-help/pdf/COVID19-Isolation-information-and-guidance_ver2.0_August9.pdf • http://www.maventrainingsite.com/maven-help/pdf/COVID-19-Quarantine-information-and-guidance_ver2.0_August9.pdf • Translations Pending Date: 8/7/2020: Updated MA Testing Guidance • • https://www.mass.gov/doc/covid-19-testing-guidance/download 14 • Update says to get a PCR with ANY Antigen test Also says no need to test again in 90 days after initial diagnosis. •

Summary of Key Guidance & Tools • Date: 7/24/2020 - Gov. Baker issued COVID-19 Order No. 45 which issues a mandatory 14 day quarantine period for travelers to MA (including MA residents who traveled outside of MA and are returning). • If travelers (including returning MA residents) don’t fit into one of the 3 Exemption Categories, must quarantine. • There is a form to fill out online. https://www.mass.gov/forms/massachusetts-travel-form More Updated A negative PCR test within 72 hours of travel can excuse you from quarantine. • FAQs. Check https://www.mass.gov/guidance/guidance-for-travelers-arriving-in-the-commonwealth-of-massachusetts • them out! Updated FAQs: https://www.mass.gov/info-details/covid-19-travel-order#potential-other-traveler-scenarios- • • Date: Aug 16, 2020 – Updated CDC Guidance on Duration of Isolation & Precautions for Adults with COVID-19 We do not yet have an 10 Day Isolation Period now has more data supporting it. • updated State Doc reflecting Ignore most additional PCR tests up to 3 months after initial illness onset. • this. But you should use • No need to quarantine up to 3 months after initial illness onset. https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html this CDC updated guidance • for follow-up. • Date: May 7, 2020 – Occupational Exposure & Return to Work Guidance 15 A bit outdated https://www.mass.gov/doc/healthcare-personnel-occupational-exposure-return-to-work-guidance/download • after the new CDC https://www.mass.gov/doc/non-healthcare-workers-occupational-exposure-return-to-work-guidance/download • guidance.