Follow-up for Positive COVID-19 Cases and their Close Contacts Tools for LBOHs June 23, 2020 Hillary Johnson, MHS, Infectious Disease Epidemiologist Scott Troppy, MPH, PMP, CIC, Surveillance Epidemiologist Bureau of Infectious Disease and Laboratory Sciences 1 MA Department of Public Health
Topics Today • MAVEN Updates • MAVEN Online Status Map • Reminder to check the Immediate COVID workflow and your LBOH Pending Workflows • Legionella and COVID-19 co-infection links • How Does the Funded Interpreter Services Work? • Antigen Testing • The Outcome Variable in Clinical QP. • Recovered & Died • Travel & Vacation • Reminder about the Cluster/Outbreak Line 2 list Report – Updated and Better! • Your Questions
Updates for today, Tuesday, 6/23 • MAVEN Status Map – one town to go • CTC Variable updates in the Wizard and QP#8 • Legionella and COVID co-infection link • Reminder to send limited information when you are requesting a de-dup/merge of two events • All we need are the two event ID’s in your email to isishelp@state.ma.us • Don’t send names, DOB, phone numbers • Updated LBOH Final Review Workflow – we have removed 3 COVID-19 events
MAVEN Status Map as of 6/23/2020 4
CTC MAVEN updates 5
CTC Variable Updates • CTC Follow-Up Notes field: CTC will be able to send notes that they take on each case and contact. You will see these in the COVID Wizard and ECR#8 Question Package. • CTC Case outreach outcome variable: Indicates the interview status of the case/contact. Variables Completed Couldn't be reached Partially Completed Refused to interview Referred to LBOH Contact Diagnosed with COVID-19 6
• CTC Case outreach status variable: Case status variables that will show the administrative status of the case/contact. Variable Definition Awaiting Outreach No attempt has been made. Has been assigned to CTC staff and an attempt to contact is being made Outreach for initial case investigation or contact tracing. Underway Home monitoring and Resource Coordinator follow up and ongoing Monitoring and referrals. Starts when there is completion of case investigation or reaching Support out to an exposed contact. When the COVID Community Tracing Team has closed the case and is no Closed longer responsible for following the case/contact. Closed reasons are required for this status and are found in the Investigation Status variable in 7 ECR#8 Question Package.
Electronic Case Report (ECR) QP#8 CTC case information goes into ECR-QP#8 • Race & Ethnicity populates QP#2 • 8
Legionella and Covid co-infection links 9
Immediate Notification workflow (COVID-19 Only) • UPDATE: We have updated the COVID-19 Immediate Notification Workflow • This will allow proper notification of all new COVID-19 events for your jurisdiction. • 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 10 (Final Review).
LBOH Final Review Workflow • LBOH Final Review Workflow: We have updated the workflow to only show non-COVID-19 cases that are still pending. Please review this workflow and complete or close out any older events/cases. • Once you complete Step 5 these non-COVID cases will be removed. 11
LBOH Case Report Forms are Pending Workflow • LBOH Case Report Forms (CRF) are pending: We have updated the workflow to only show non-COVID-19 cases that are still pending. Please review this workflow and complete or close out any older events/cases 12
MAVEN Help Section 13
Tuesday & Friday Webinars for LBOHs Tuesdays & Fridays @ 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. Send Cases to CTC for follow-up if not: • Hospitalized, Deceased, or linked to a Cluster • Facility • Focusing on Priority Activities • Clusters in Facilities in your community need your help. • Call Epi Program to create cluster events. MDPH Epi Program: 617-983-6800 MDPH MAVEN Help Desk: isishelp@state.ma.us MDPH Food Protection Program: 617-983-6712 CTC Help Desk: 857-305-2828 14 MAVEN Help has Guidance Documents and Previous Webinars: http://www.maventrainingsite.com/maven-help/toc.html
Massachusetts Department of Public Health Telephonic Interpreter Services Available to Municipalities for Coronavirus Response June 2020 Vendor Update • Massachusetts has a contract ( PRF63) for telephonic interpretation services. • Six vendors are shown on the next slide. • Cities and towns should reach out to a vendor or vendors and set up an account with them, mentioning the state contract PRF63. • Some vendors will bill DPH directly if they setup a group account for this purpose. • When used for interpreters in response to coronavirus, monthly invoices from the vendors to cities and towns can be submitted to MDPH at the following e- mail address - sli.invoices@state.ma.us • MDPH will pay the vendors directly for telephonic interpretation services utilized by 15 municipalities for coronavirus follow-up through June 2021.
Massachusetts Department of Public Health T elephonic Interpreter Services Available to Municipalities for Coronavirus Response June 2020 – UPDATED VENDOR LIST Vendor Contact Person Phone # Email Certified Languages Dickey McMath 503-484-2317 dmcmath@certifiedlanguages.com International Interpreters and Pamela McMahon 860-730-6149 pmcmahon@ititranslates.com Translators, Inc. JRivera Associates, Jose R. Rivera 209-405-0951 mrr@jriva.com Inc. Language Line Alisa Smith 831-648-7174 asmith@languageline.com Services Lionbridge John Drugan 978-964-9550 John.Drugan@lionbridge.com T echnologies, Inc. T elelanguage Manuela Villa 503-459-5655 mvilla@telelanguage.com 16 No longer available via the state contract: Interpreters Unlimited, Inc. and TransPerfect Global.
Molecular (PCR) and Antigen Testing Molecular Test (PCR) Antigen Test - Newer (still rare) • Detects genetic material of the • Detects certain proteins that are virus using a lab technique called part of the virus. polymerase chain reaction (PCR). • Nasal or Throat swab to get a • Nasal, Throat, or Nasopharyngeal fluid sample Swab or from saliva • Rapid Test - results in minutes on • Test can be a Rapid Test (results site. in minutes on site) • May be accompanied by • Or one to two days if sent to an additional PCR Test outside lab. • Only seeing them with two • Some home test kits have also providers currently: been FDA approved. • Carewell & SouthCoast 17 https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/covid-antibody-tests/faq-20484429
Molecular (PCR) and Antigen Testing Molecular Test (PCR) Antigen Test - Newer (still rare) • Listed in Lab Tab as follows: • Listed in Lab Tab as follows: • 2019-nCoV Real-time RT-PCR • SARS-CoV-2 Ag (Antigen Test) (PCR) • SARS coronavirus 2 RdRp gene (PCR RAPID) Positive Molecular Test: Positive Antigen Test: Case Classification = CONFIRMED Case Classification = PROBABLE 18 Case Classification Manual: http://www.maventrainingsite.com/maven-help/pdf/case-classification-manual/COVID19__05282020_final.pdf
Case Classification Manual • Pages 3&4 • Table on different Lab Reports • Test Type • Specimen Source • Result possibilities • What informatics terms to use for each lab (what you see in the Lab Tab & what the technical IT jargon means) 19 Case Classification Manual: http://www.maventrainingsite.com/maven-help/pdf/case-classification-manual/COVID19__05282020_final.pdf
What is the Public Health Follow-up? PCR, Antigen, & Serology NEGATIVE: (usually unclassified events in MAVEN). • No follow-up needed. But if they were a contact they should complete their quarantine. • Negative PCR or Antigen doesn’t end quarantine early. 20 Testing Interpretation Guidance Document: http://www.maventrainingsite.com/maven-help/pdf/Serology%20Interpretation%20for%20LBOH_ver3.0_June1.pdf
Interpreting Antigen Testing This table just describes likely “interpretation” and is not official case • classification. PER CDC & CSTE Case definition, Antigen tests are still classified as • PROBABLE Antigen testing was most likely pursued for acute diagnosis, so we follow-up like • we would for PCR test results. • PCR or Antigen POSITIVE (serology doesn’t matter): Treat like a new case. Follow-up Accordingly. 21
Flights & Cruises While Infectious If your confirmed or probable case traveled while infectious and may have exposed others via airplane or maritime vessel (cruise or cargo): Do the best you can. Travel 1. Update MAVEN notes dates & flight numbers are key 2. Call Epi program so MDPH can notify the Quarantine Station. even if you don’t have seat number. Travel Information: Key Demographic Data Needed: • Airline or cruise company, • Case Name • Date of Birth • Flight number, • Full address • Seat or cabin number, • Clinical Info: • Departure and arrival locations and • Symptom Onset Date & Specific times, Symptoms • Reason for travel and if they 22 traveled alone or with others.
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