HomeMy WebLinkAbout12.21.20 FW_ SYASL COVID-19 Update
From:Ring, Brian
To:Alpert, Bruce;Bennett, Robin;Clerk of the Board;Connelly, Bill;Cook, Holly;Kimmelshue, Tod;Lambert, Steve;
Lucero, Debra;McCracken, Shari;Paulsen, Shaina;Pickett, Andy;Ring, Brian;Ritter, Tami;Rodas, Amalia;
Sweeney, Kathleen;Teeter, Doug
Cc:Pickett, Andy;Snyder, Ashley
Subject:FW: SYASL COVID-19 Update
Date:Monday, December 21, 2020 4:49:07 PM
Attachments:SYASL COVID-19 Update 12.21.20.pdf
FYI – update from our State lobbyist on the State’s response to COVID.
Brian Ring
Assistant Chief Administrative Officer
Administration
25 County Center Drive, Oroville, CA 95965
T:
From: SYASL County Info <SYASLCountyInfo@SYASLpartners.com>
Sent: Monday, December 21, 2020 4:47 PM
To: SYASL County Info <SYASLCountyInfo@SYASLpartners.com>
Subject: SYASL COVID-19 Update
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To: County Administrative Officers and Interested Parties
From: Paul J. Yoder and Karen Lange
Date: December 18, 2020
RE: SYASL COVID-19 Update
Please find attached our daily SYASL COVID-19 update.
-Paul and Karen
COVID-19 Updates
www.covid19.ca.gov
December 21, 2020
Newsom Administration - Resources / Mutual Aid / Executive Orders
Today, Governor Newsom reported hospitalization and ICU numbers continue to increase and that the
State has requested continued staffing relief from the federal government and DOD as well as an
extension of existing staffing through January.
Over the weekend, the Western States Scientific Safety Review Group completed its review and
concluded the Moderna COVID-19 vaccine is safe and efficacious for use in the Western States. The
Workgroup provided its confirmation to the Governors of California, Nevada, Oregon, and Washington
Sunday morning, making the Moderna vaccine the second COVID-19 vaccine supported for use in these
states. Shipments are expected early this week.
The Community Vaccine Advisory Committee will meet from 2-4pm on December 23 to discuss Phase
1B of the vaccine distribution prioritization and tiers. View here for details. Per Governor Newsom,
70,258 doses were administered during week one.
Dr. Ghaly reported that the State is keeping a close eye on various strains of covid and do not have any
evidence that the latest strain reported in the United Kingdom has arrived in California or in the United
States.
Governor Newsom and Dr. Ghaly did indicate that based on trending numbers, they anticipate regions
currently under Stay-at-Home orders will likely have those orders extended beyond the three-week time
frame. The Administration is currently preparing to decide at the end of this week or the beginning of
next. They noted they will not make that call until it is time to do so, and they will base the decision on
real-time data.
You may view slides from todays briefing here and SYASL staff notes here.
Governor Newsom has announced the appointment of Jim DeBoo as Executive Secretary. This position
was previously held by Ann OLeary.
Please visit the California Department of Public Health website for the latest guidance documents.
BSCC Seeks County Input on DJJ Realignment Grant
On December 18, the Board of State and Community Corrections, the administering entity for the
Regional Youth Programs and Facilities Grant Program (RYPFGP), issued a Request for Information (RFI)
to solicit information from counties to inform its decision making and identify potential funding
priorities. The RFI ressing
the needs of the realigned population, including infrastructure needs, whether the county intends to
consider out-of-county placement options, and if the county is planning to accept youth from other
counties. Responses to the RFI should be submitted by January 11, 2021. (Note that a single,
coordinated response from each county is requested.) Questions on the RFI can be sent here, or direct
outreach can be made to John Prince, BSCC Deputy Director, at (916) 445-2014.
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December 20, 2020
To: Governors of California, Nevada, Oregon, and Washington State
Governor Gavin Newsom, California
Governor Steve Sisolak, Nevada
Governor Kate Brown, Oregon
Governor Jay Inslee, Washington
From: Arthur Reingold, MD, Chair
Western States Scientific Safety Review Workgroup
Summary of Findings:
The Western States Scientific Safety Review Workgroup, after its thorough review,
Recommends unanimously that the Moderna COVID-19 vaccine be used in our
states, as we conclude that the vaccine is safe and efficacious;
Endorses the transparency and objectivity of the FDA Vaccines and Related
Biological Products Advisory Committee (VRBPAC) and the CDC Advisory
Committee on Immunization Practices (ACIP) review processes and the rigor,
validity and reliability of their analyses;
Concludes that equity has been considered appropriately in the clinical trials
and urges that equity continue to be a guiding principle in immunization
implementation, monitoring and communication; and
Recommends that our states use the Moderna COVID-19 vaccine, in addition to
the Pfizer BioNTech COVID-19 vaccine, to expand our states’ ability to respond
to the COVID-19 pandemic, including in underserved communities.
WESTERN STATES SCIENTIFIC SAFETY REVIEW WORKGROUP
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The Western StatesScientific Safety Review Workgroup was establishedby the
Governors of California, Nevada, Oregon and Washington, to independently
review and assess data on U.S. candidate COVID-19 vaccines and the processes of
federal advisory committees and agencies considering approval of these vaccines
prior to their introduction in the United States.
The Workgroup includes members with diverse relevant expertise, many of whom
have participated in multiple prior VRBPAC and ACIP vaccine reviews. The
Workgroup held two virtual meetings on December 17, 2020 and December 19,
2020 to review the available evidence concerning the safety, immunogenicity, and
efficacy of the Moderna COVID-19 vaccine.
The Workgroup’s deliberations are guided by four considerations:
assuring the safety and efficacy of COVID-19 vaccines that might be used in
our states;
assessing the transparency and objectivity of the FDA VRBPAC and CDC
ACIP review processes and the rigor, validity and reliability of their data
analyses;
ascertaining whether equity has been considered appropriately in the
design, implementation and analysis of the clinical trials; and
avoiding any undue delay in making available to our states’ residents
COVID-19 vaccines deemed by the FDA and CDC to be safe and efficacious.
WESTERN STATES SCIENTIFIC SAFETY REVIEW WORKGROUP
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Wehave focused our review onthe data presented to VRBPAC and ACIP and the
processes and deliberations of those committees.
Phase 3 trial data concerning the safety, immunogenicity, and efficacy of the
Moderna COVID-19 vaccine were presented in open meetings to VRBPAC on
December 17, 2020 and to the ACIP on December 19, 2020. Multiple members
of our Workgroup either directly participated or observed the VRBPAC meeting
on December 17, 2020 and the ACIP meeting on December 19, 2020. These
presentations and discussions were reviewed and discussed by our Workgroup on
December 17, 2020 and December 19, 2020.
Data reviewed by the Workgroup demonstrated that the Moderna COVID-19
vaccine had an efficacy of 94.1% (95% confidence interval: 89.3% - 96.8%) against
COVID-19 disease of any severity. The data presented did not reveal any
differences in efficacy in various subgroups of the population.
Safety data from a two-month follow-up of participants in the Phase 3 trial of the
Moderna COVID-19 vaccine were reviewed by FDA and CDC staff, VRBPAC and
ACIP. Given the escalating rate of COVID-19 hospitalizations and deaths
throughout the U.S., the Workgroup agreed that the two-month review supports
distribution and use according to ACIP recommendations of the Moderna COVID-
19 vaccine under an FDA EUA.
Confirming the safety of COVID-19 vaccines by continued close monitoring and
surveillance of vaccine recipients for adverse health events is of paramount
WESTERN STATES SCIENTIFIC SAFETY REVIEW WORKGROUP
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importance to gain and sustain the public acceptance of COVID-19 vaccination.
The CDC and FDA have implemented multiple systems to rapidly obtain and
investigate reports of adverse health events following receipt of COVID-19
vaccines. The Workgroup endorses these efforts and encourages our states to
support active and regular reporting to these systems, which are already yielding
valuable results.
At the December 19, 2020 ACIP meeting, CDC noted that it is investigating
reports of anaphylactic reactions in six recipients of the Pfizer BioNTech vaccine.
Pfizer BioNTech reported at the FDA VRBPAC meeting on December 10, 2020 that
such reactions had not occurred in any of the 18,000 Phase 3 clinical trial
participants who received the Pfizer BioNTech COVID-19 vaccine. Moderna
reported to ACIP on December 19, 2020 that one participant in the Phase 3
clinical trial had an episode of anaphylaxis 63 days after immunization. The
Scientific Safety Review Workgroup wants to underscore the importance – as with
any vaccine – of providing COVID-19 vaccines in locations that are prepared to
treat anaphylactic reactions or any other unexpected reactions, as noted in
standard guidance from CDC. CDC has produced enhanced guidance to ensure
that appropriate equipment is available in all locations where COVID-19 vaccines
are being administered and that vaccine recipients be monitored for 15 - 30
minutes after vaccination.
The Workgroup noted that several important attributes of the Moderna COVID-19
vaccine remain to be defined, including the duration of vaccine-induced
WESTERN STATES SCIENTIFIC SAFETY REVIEW WORKGROUP
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protection;the efficacyof vaccinationin preventingasymptomatic infection;and
the efficacy and safety of the vaccine in pregnant women and children.
Efficacy and safety of the Moderna COVID-19 vaccine were observed to be
consistent across age, gender, race and ethnicity subgroups in the Phase 3 clinical
trial. Ongoing monitoring of the efficacy and safety of the Moderna COVID-19
vaccine in diverse subgroups of the population, especially by race, ethnicity, age,
and underlying disease status, will be crucial to ensuring confidence in and high
acceptability of the vaccine by a majority of residents in our states.
At its meeting on December 19, 2020, the Workgroup unanimously concluded
that, based on our review of the data submitted to the FDA by the manufacturer
and the VRBPAC and ACIP analyses of the data, the COVID-19 vaccine made by
Moderna meets or exceeds FDA standards for safety, immunogenicity, and
efficacy. Its widespread use in our respective states at this time under an EUA is
justified. Furthermore, our conclusion is that VRBPAC and ACIP adherence to
their usual standards of transparency and evidence-based decision making
warrants full confidence in the recommendations made by these independent
advisory committees for the use of the Moderna COVID-19 vaccine at this time.
The Western States Scientific Safety Review Workgroup recommends that our
states make available to our states’ residents the Moderna COVID-19 vaccine
deemed by the FDA and CDC to be safe and efficacious. We believe that this
vaccine will expand our states’ ability to respond as quickly as possible to the
WESTERN STATES SCIENTIFIC SAFETY REVIEW WORKGROUP
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COVID-19 pandemic and will –along with the Pfizer BioNTech COVID-19 vaccine –
expand access in underserved communities.
We will perform similar assessments of additional COVID-19 vaccine candidates as
they are presented for possible authorization or approval for use in the U.S.
Respectfully submitted:
Members of the Western States Scientific Safety Review Workgroup:
Arthur Reingold, MD, Chair, UC Berkeley School of Public Health
California Members:
Tomás J. Aragón, MD, DrPH, City and County of San Francisco
Eric Goosby, MD, UCSF School of Medicine
Rodney Hood, MD, UC San Diego Alumnus and National Medical
Association
Nicola Klein, MD, Ph.D., Kaiser Permanente Northern California
Grace M. Lee, MD, MPH, Stanford Children’s Health and Stanford University
School of Medicine
Bonnie Maldonado, MD, Stanford University School of Medicine and
Stanford Children’s Health
Mark H. Sawyer, MD, UC San Diego School of Medicine and Rady Children’s
Hospital
Robert Schechter, MD, California Department of Public Health
Peter G. Szilagyi, MD, MPH, UCLA Health and David Geffen School of
Medicine
Matt Zahn, MD, Orange County Health Care Agency
Nevada Members:
Ihsan Azzam, MD, PhD, Chief Medical Officer, State of Nevada
Candice McDaniel, MS, Nevada Department of Health and Human Services
WESTERN STATES SCIENTIFIC SAFETY REVIEW WORKGROUP
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Oregon Members:
Laura Byerly, MD, Virginia Garcia Memorial Health Center
Louis J. Picker, MD, OHSU Vaccine and Gene Therapy Institute
Washington Members:
John Dunn, MD, MPH, Kaiser Permanente Washington
Edgar K. Marcuse, MD, MPH, University of Washington School of Medicine
WESTERN STATES SCIENTIFIC SAFETY REVIEW WORKGROUP
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GGN
I am back in my home office in a 10-day quarantine
We continue to fill hospitals and ICUs
Currently, 607 state staff deployed in 75 facilities
We are trying to extend DMAT staffing who are due to be deployed elsewhere in the US had a
call with he VP to have extended through January
We have specifical asks out to DOD for 10 teams of 20 (200 personnel)
Working with HHS re monoclonal antibodies program
Alternative Care Sites we have 11 sites
62 patients currently in state alternative care sites decompressing hospitals statewide
37,892 cases December 20
43,901 7-day average
May be seeing a very modest decrease in growth rate but we are not reading into that, it is
still too early to tell
329,766 7-day average tests performed
83 deaths December 20, 233 7-day average, 2,741 14-day average
This disease remains deadly
Weekend reporting periods often lag
2.5% statewide current ICU capacity
When in 0% - that means that region is in surge status
Northern CA is the only region not in Stay at Home order
Based on current trends, current stay at home orders will likely be extended in some regions
FDA approved Moderna
As of this moment, 21 sites have received doses
672,600 Moderna doses for CA this week
560,625 Pfizer doses have arrived
327,600 received in San Diego, Redding, Stockton Eureka, Sacramento, and Fresno
A second allocation is anticipated
Week 1: 70,258 doses administered
Upcoming meetings:
o Today: Drafting Guidelines Workgroup
o December 23: Community Vaccine Advisory Committee
Public meeting 2-4pm
Covid19.ca.gov
Please tune in and listen to the discussion on plan 1B
Federal covid relief bill, $900 billion in total
Please note these are initial estimates
Most significant is it is money directly to people
A half a billion in grants and sales tax floats, hiring tax credits etc., will also have some very
significant small biz support, this is in addition to all of that
We have all been waiting for rental assistance, this is not as bog and bold as we hoped for but it
is significant
We cant get people back to work without childcare
We talk a lot about broadband, we will be talking even more about it
It is at the top of our priorities and the legislatures in January
Federal funding will help with our efforts
The new covid strain we are reading about coming out of the UK no evidence of this strain in
CA, and to our knowledge, the US
Underscores the importance of continued surveillance to detect such mutations
We encourage people to active CA Notify on their phones
Dr. Ghaly
We know that viruses are prone to mutations
The new mutated covid virus seems to enter the cell more easily
Exposure may mean you are more likely to become infected than you would be if you were
exposed to the current strain it seems to infect more easily
On a daily basis over the course of months we check thousands of strains
We are concerned because of the unknowns
We will continue to watch and update as info becomes available
Press
(Could not hear the reporters question)
GGN
I think the question was around localism and making sure health professionals are held
accountable regarding the prioritization of distribution
Dr. Ghaly
The fundamental platform is prioritization
Priority Group 1A: healthcare workers and residents at LTC facilities
Some professionals on frontlines are on tier one and some are in tier three
We are working to make sure people get the vaccine in the order that we believe makes sense
in CA
We are watching closely so we can act swiftly if there is any flagrant misuse or people cutting
the line
We are working with counties and partners how we expect to monitor and watch
If there are cases where we are worried about that, we will reach out to community and county
partners and if follow up action is necessary we will move swiftly
GGN
It is important to know we have Plan 1A, and within the tiers there is subpopulations
When it gets to the site, there is some autonomy at each level so support staff and those who
are essential to ICU operations are included
There is room for a judgment call
AP
Projecting 99k hospitalizations by mid-January is this really possible?
GGN
We are requesting another full field medical station
We are anticipating a substantial surge
We are looking to support staffing at alternative care sites and set up more care sites
Dr. Ghaly
We believe 12% of todays cases will be hospitalized two weeks from now and 12% of those will
end up in ICU
We have a well-exercised mutual aid system between counties and regions that we will always
invoke for those needed s we can work across the entirety of CA
We continue to build up hospital capacity
We work hard to make sure systems are in place and we also work hard to make sure those
systems hopefully have to be used
GGN
We have been preparing for months for a significant surge and looking to expand the
healthcare delivery system within itself
The primary issue today and the immediate future is staffing which is why we are being
aggressive in our asks
Are we pursuing the USNS Mercy? Currently, we are not but we are looking for personnel who
would be staffed on the ship to meet our immediate needs
SF Chron
Are regions still transferring patients? We are hearing some accepting transfers
Dr. Ghaly
We continue to work on making sure those transfers happen in a timely way
We continue to make sure supplies are also furnished as people are deeply impacted
We know it will get harder to move patients between regions due to hospitals having their own
surge
The number on strategy is to support hospitals where they are now and expand their existing
footprint
GGN
We have agency and are not just victims of fate
LA Daily News
What is the States position on the 2021 Rose Bowl game being moved?
GGN
I love this tradition but when we have zero ICU capacity, we cannot proceed with a gathering
like this
We are disappointed we had to make that call
LA Times
Can you talk about what exposure you have to staff and what the rules and procedures are?
How long will the stay at home orders be extended?
GGN
We all wear masks; many are teleworking
Very few people in our staff environment have had contact to one another
We wish a speedy recovery to the person who tested positive
We are quarantining and the following protocol
Dr. Ghaly
We are preparing this week to roll out how those determinations will be made so we can roll
them out the beginning of next week
We have tools to make projections
We will look at current ICU capacity, the number of new cases over 7-day period, ow fast the
transmission rate is accelerating or decelerating it is a lot about the individual changes in
behavior that affect the decision, not just the ICU numbers
We will look at all the factors and socialize it with many, starting with San Joaquin Valley and
then the Southern CA region
At the moment, none of our projections indicate regions will be exiting the stay at home order
but we will reassess when the time is right
KCRA
What would be your takeaway to businesses?
Are you quarantining separate from your family? Are you taking vacation? Traveling?
GGN
I am separate from my family in a different room
There will be no vacations
We will try and create conditions where this can be as normal as possible for all families around
the holidays
Thank you to Speaker Pelosi for not taking your eye off the ball over the many, many months
We will continue to update you in the coming days on the new strain, any additional federal
supports, vaccines etc.
rd
I encourage people to tune in on the 23 to the planning for vaccination distribution
I look forward to updating you tomorrow and Wednesday and Thursday. I may spare you on
Friday.