May 3, 2022

NEED TO KNOW

VMS Supports Reproductive Access in Light of Draft Supreme Court Opinion

The Vermont Medical Society today joined a statement with other health care organizations denouncing the draft Supreme Court opinion which indicates it may overturn Roe v. Wade and Planned Parenthood v. Casey.  VMS strongly supports the preservation of access to abortion services in the United States.  The statement adds that every person should have the right to control their own health care decisions, including the right to abortion care.  As a health care organization, we strongly believe that abortion services should be treated like any other health care service.  The consequences of overturning Roe v. Wade would block millions of people from the health care they need, especially those who have less ability to take time from work or pay the expenses to travel.  Read the full statement here.

Legislature Enters Final Scramble with Next Weekend Eyed for Adjournment

As the legislature continues to seek agreement on key legislation, the notion of adjournment on Friday, May 6th is quickly becoming an unrealistic ideal. The House and Senate conference committee has not completed their work on the FY23 Budget and the two chambers are still at odds on S.11, the new version of a workforce bill, which contains significant funding for Vermont’s health care workforce. The VMS Policy team is still advocating on a number of bills which are still in flux, including: H.548, the miscellaneous cannabis bill and S.285, the health reform bill. Whether we adjourn this week or next, the VMS will be providing full details of 2022 health care policy in our Final VMS Legislative Bulletin after the fall of the gavel.

Administration Press Conference Addresses Roe v. Wade, COVID-19, Avian Flu

At today’s press conference, Governor Phil Scott opened with remarks regarding the draft Supreme Court decision released last night overturning Roe v. Wade.  Governor Scott commented that while reproductive rights will be protected in Vermont, such a decision would be a huge step backwards for civil rights, with ramifications for rolling back other fundamental rights to marry or LGBTQ protections. He issued a statement on the decision earlier in the day.  

Commissioner of Health Mark Levine, MD, addressed increasing COVID-19 case counts and stated that this is the time for people to use additional caution and consider wearing a higher quality mask especially in indoor, crowded conditions. When asked directly by the press if he was “recommending” everyone to mask, he said this is a decision based on personal risk factors such as age, health conditions and household members at risk.  The state has received an additional 2000 Paxlovid doses this week, compared to a typical allocation of 200, and doses will be distributed to new pharmacies as well as a higher supply to existing pharmacies.  Dr. Levine emphasized that everyone eligible should receive a booster and call their PCP right away with a positive test to consider treatment.   He also stated that avian influenza has been identified in Vermont – both in a backyard flock and wild birds – and the State is working to investigate and follow up on reports of exposure.  Full notes from the press conference can be found here.

Other COVID-19 updates from the past week include:

  • The Vermont Vaccine Program (VVP) Update for April has been released and addresses topics including COVID-19 vaccine for those under 5, additional boosters, ordering guidance and general vaccine program updates. Vaccine for those under 5 years old is expected to be available in late May or June and access to vaccine for children outside of primary care will be minimal. All practices that offer other state-supplied vaccines are encouraged to participate. AAP-Vermont is still offering grants for immunization clinics. Updates can also be found on the Immunization Program Website.
  • Sensitivity of Antigen Testing: In this prospective cohort study published in JAMA Internal Medicine, 225 adults and children with reverse transcription–polymerase chain reaction (RT-PCR)–confirmed SARS-CoV-2 infection, antigen test sensitivity was 64% and 84% when compared with same-day RT-PCR and viral culture, respectively. Antigen test sensitivity peaked 4 days after illness onset (77%); a second test 1 to 2 days later showed improved sensitivity (81%-85%)
  • Long COVID: A study supported by the National Institute of Allergy and Infectious Diseases (NIAID), the National Center for Advancing Translational Sciences, and the National Institute on Drug Abuse assesses the risk factors for long COVID.
  • Seroprevalence of Infection-Induced SARS-CoV-2 Antibodies: CDC released an MMWR on seroprevalence of infection-induced SARS-CoV-2 antibodies in the United States from September 2021 to February 2022. During December 2021–February 2022, overall U.S. seroprevalence increased from 33.5% to 57.7%. Over the same period, seroprevalence increased from 44.2% to 75.2% among children aged 0–11 years and from 45.6% to 74.2% among persons aged 12–17 years. These findings illustrate a high infection rate for the Omicron variant, especially among children.

Updated Version of the Vermont Child and Teen Vaccination Schedule for School and Childcare is Now Available

The Immunization Program will disseminate hard copies among District Health Offices in the coming weeks. It is encouraged to communicate this updated resource as appropriate within your networks. The document now includes COVID-19 under recommended vaccines, inclusion of both RV1 and RV5 for Rotavirus vaccination and other clarifications.  View the updated version here: Vermont Required and Recommended Vaccination Schedule (healthvermont.gov). Reference the CDC 2022 Child and Adolescent Immunization Schedule for full recommendations.

CDC Health Alert Network (HAN) Health Advisory: Highly Pathogenic Avian Influenza A(H5N1) Virus: Recommendations for Human Health Investigations and Response

A person has tested positive for avian influenza A(H5) virus (H5 bird flu) in the U.S., as confirmed by the Centers for Disease Control and Prevention (CDC) and reported by the Colorado Department of Public Health and Environment on April 28, 2022. This case occurred in a person who had direct exposure to poultry and who was involved in the culling (depopulating) of poultry with presumptive H5N1 bird flu.

Recommendations for Clinicians: 
Clinicians should consider the possibility of HPAI A(H5N1) virus infection in persons showing signs or symptoms of respiratory illness who have relevant exposure history. This includes persons who have had contact with potentially infected birds; direct contact with water or surfaces contaminated with feces or parts of potentially infected birds; and persons who have had prolonged exposure to potentially infected birds in a confined space. Clinicians should contact the state public health department to arrange testing for influenza A(H5N1) virus, collect respiratory specimens using personal protective equipment (PPE), consider starting empiric antiviral treatment (see below), and encourage the patient to isolate at home away from their household members and not go to work or school until it is determined they do not have avian influenza A virus infection. Testing for other potential causes of acute respiratory illness should also be considered depending upon the local epidemiology of circulating respiratory viruses, including SARS-CoV-2.

Read the Full Alert Here.

MISC.

Green Mountain Care Board Receives Mental Health Capacity Updates

The Green Mountain Care Board held a meeting last Wednesday focused on an update on in-patient mental health capacity and emergency department wait times.  They heard from the Department of Medical Health regarding their immediate, mid-term and long-term priorities for reducing emergency department wait times, such as expanding community-based crisis response programs and additional support for suicide-prevention programs.  The UVM Health Network also updated the Board on the mental health in-patient unit in the planning phases for Central Vermont Medical Center.  The Network concluded that while it is ready to complete a $21 million down payment on the project, three other things would have to be in place for the Network to move forward on construction of the full unit: the UVM Health Network and CVMC must be on firmer financial footing; another $78 million or more in capital is needed for construction; and they must have rates from all payers that allow the Network to provide ongoing staffing and services to the Unit.  The presentation cited how in-patient psychiatric services already operate at an annual loss of $12.7 million due to reimbursement under cost from all payers and the loss would grow by $25 million per year with a larger unit. 

Presentation materials can be found here:

NBRC Announces Grant Round To Support Region’s Rural Health Network

The Northern Border Regional Commission (NBRC) announced that health care providers and organizations across Northern New England and New York will soon be able to apply for grant funds from the agency’s partnership with the Department of Health and Human Services’ Health Resources and Services Administration (HRSA). HRSA’s Federal Office of Rural Health Policy will present an informational webinar on Thursday, May 5, 2022, from 11-12 PM. This webinar will provide an overview of this funding opportunity focused on increasing access to care, workforce, and value-based efforts through technical means. No registration is required.

To learn more about this Department of Health and Human Services’ Health Resources and Services Administration (HRSA) partnership grant opportunity for providers and May 5, 2022 webinar, please visit the Northern Border Regional Commission News Release.

EVENTS

Join us every 1st and 3rd Thursday of the month from 12:30pm to 1pm as Commissioner of Health, Mark Levine provides us with the most pressing COVID-19 information affecting the state and nation. You will have the opportunity to submit questions to Dr. Levine who will answer them, time-permitting.

You can join the zoom meetings beginning in January here or add to your calendar by following this link and clicking download (you will then need to open the downloaded file and click save to add to your calendar).

No Cost Well-Being Workshops

VMS is continuing our partnership with Doug Wysockey-Johnson of LumunosWellBeing to offer no-cost clinician wellbeing workshops at up to 10 Vermont medical staffs/practices over 2022. There are 3 remaining slots available this spring.  New topics for 2022 include A Clinician’s Guide to Recovering from the COVID Marathon and A Realistic Look at ‘Work-Home Balance’ for Clinicians. See the full list and additional details here.  Members can contact jbarnard@vtmd.org or doug@lumunos.org for more information or to schedule a workshop. 

The Upstanders, An Indieflix Film About Cyberbullying

May 4, 2022, 6pm to 7:30pm

The Upstanders explores all sides of cyberbullying, from bully to victim, bystanders, and family members. 

This film screening and panel discussion is hosted in partnership with Champlain Community Services. This event is part of The Marna and Stephen Wise Tulin Spring Community Education Series presented by the Howard Center. Read more about the series here.

Register here.

Northern New England Society of Addiction Medicine 2022 Scientific Session and Business Meeting

May 7, 2022, 8am to 4:15pm

Virtual

Join NNESAM for presentations including Telehealth the New Normal, Opioid Risk in Recovery Residences, and more on May 7th for a maximum of 6 AMA PRA category 1 credits. The business meeting will be held from 8am to 9am followed by the scientific meeting from 9am to 4:15pm.

To register and view the complete brochure with the schedule of events, click here.

Virtual Film Screening of Someone You Love: The HPV Epidemic

May 11, 2022, 7:30am to 9:30am OR May 26 2022, 2pm to 4pm

Virtual

Join the Bi-State Primary Care Association for a free virtual film screening of Someone You Love: The HPV Epidemic followed by discussions with experts in the fields of pediatrics and public health. Someone You Love is a powerful documentary showing the impact that preventable HPV-related cancers can have. 

The events are open to all, regardless of where you live or your profession. CE credits will be available. You can view information about the sessions here. 

Register here.

Clinician Information Sessions: New 2022 DNR/COLST Form

May 11, May 26, 2022, 12pm to 1:15pm

Virtual


On June 1, 2022, the Vermont Department of Health will be launching a new and improved DNR/COLST form for use across the state. Join the Vermont Ethics Network's Executive Director & Clinical Ethicist, Cindy Bruzzese, MPA, MSB, HEC-C, to learn about the new Vermont DNR/COLST form and review best practices for completing medical orders.

Register here.

How Can We Make Vermont More Welcoming and Inclusive for Our Diverse Community?

May 18, 2022, 6pm to 7:30pm

Vermont is one of the least diverse states in the nation. With that as our starting point, how can Vermont attract more people with diverse backgrounds and help them find community so they decide to stay? Join a panel of professionals working to promote diversity and equity in area businesses and institutions.

This event is part of The Marna and Stephen Wise Tulin Spring Community Education Series presented by the Howard Center. Read more about the series here.

Register here.

Caring for Adolescents and Young Adults with Disordered Eating: A Multidisciplinary Training

May 23, 2022, 9am to 4:00pm

Virtual

Learn how to apply a multi-disciplinary approach to caring for adolescents and young adults with disordered eating, identify best practices for case conceptualization, assessment, and intervention to apply, and more with presenters from the UVMMC Eating Disorder Consultation Clinic, The Adams Center, UVM, and panelists from the field. View the full flyer with the learning objectives and agenda here.

Register here.

The 48th Annual Family Medicine Review Course

June 7-10, 2022

In-Person and Virtual

Course Director Dr. Anya Koutras invites you to this intensive four-day program for family physicians and other primary care professionals. The program will focus on current issues in the practice of Family Medicine, with special attention to new contributions. Attendees will have a choice between in-person at the DoubleTree by Hilton Hotel, Burlington, VT and virtual participation. TOPICS include: genomics testing, Parkinson’s disease, hypothyroidism, headache management, valvular heart disease, type-2 diabetes, HPV disease, bipolar disease, endometrial cancer, LARC, skin biopsies, end of life care, knee exam, substance use disorder, gender-affirming care, geriatric psychiatry, urgent care cases

Registration information, full agenda and accreditation details can be found here.

Vermont Medical Society Annual and Collaborative Meeting

November 4th and 5th, 2022

The 209th VMS Annual Meeting will be held on November 4th and 5th in person at Topnotch Resort, Stowe, VT, with virtual options. The weekend will be filled with educational content, time to spend with colleagues, policy-setting meetings, and the opportunity to honor physicians and other health care leaders across the state. VMS’ Annual Meeting, hosted in collaboration with the American Academy of Pediatrics Vermont Chapter, the Vermont Academy of Family Physicians and the Vermont Psychiatric Association, is a celebration of the unwavering commitment Vermont clinicians have to their practice and to the deep connection VMS members have with each other.

To view more information or submit nominees for 2022 leadership awards, please click here. Registration information will be shared in the future.

UVM will have more primary care conferences in Fall 2022. Sign-up to get updates via email for topics that are of interest here.

VTMD.ORG

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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