Weekly Summary

Highlights

As of December 15, 2022, DPH has revised its reporting of vaccination rates for skilled nursing home residents and staff to reflect the up-to-date vaccination definition. See the “Resident and Staff Vaccination” tab for more information.

For any questions related to this report, please contact the HAI Program ().

Guidance Updates

Strike & Support Team Office Hours

  • DPH has partnered with Alliant Health Solutions to offer infection control trainings.

  • Skilled nursing facilities (SNFs) and physicians will have sessions on the 3rd Friday of every month from 11am - 12pm. All other long-term care facilities will have sessions on the 4th Friday of every month from 11am - 12pm.

  • Please register here, if you’re interested

Booster Vaccination Assistance

  • If your facility does not have access to the new COVID-19 Pfizer or Moderna bivalent booster vaccines for their patient and staff populations, please complete the survey below to partnered with a pharmacy that will assist in providing the new booster.

  • LTCF COVID-19 Vaccine Bivalent Booster Administration Assistance Survey: https://www.surveymonkey.com/r/LTCFVaxAssist

  • Additional questions regarding DPH vaccine support can be sent to: .

Health Department Vaccine Scheduling Resources

  • Vaccination is our top priority to reduce spread of COVID-19.

  • DPH provides a resource line to assist with scheduling COVID-19 vaccine appointments. The resource line is available from 8 a.m. – 8 p.m. ET on weekdays and 8 a.m. – 5 p.m. ET on weekends. Languages other than English are available.

  • Call (888) 457-0186 or visit dph.ga.gov/covid-vaccine to schedule a vaccine appointment.

  • DPH urges COVID-19 vaccination for everyone 5 years of age and older.

Outbreaks

COVID-19 outbreaks are reported to Georgia’s State Electronic Notifiable Disease Surveillance System (SendSS) through the Outbreak Management System (OMS). All long-term care outbreaks by week are included in the graph below; the proportion of long-term care facilities include assisted-living facilities, personal care homes (25 beds or greater), and skilled-nursing homes.

Figure 1. COVID-19 Outbreaks

Community Transmission

As of 9/10/2021, CDC recommends using its County-Level Community Transmission Data Tracker to determine community transmission level: https://covid.cdc.gov/covid-data-tracker/#county-view. This transmission tracker includes county-specific transmission indicators, which include High (red), Substantial (orange), Moderate (yellow) and Low (blue).

The summary below provides community transmission levels based on data reported to the Centers for Disease Control and Prevention. Case rate is based on data from August 02, 2022 – August 08, 2022 and percent positivity is based on data from August 04, 2022 – August 10, 2022.

Table 1. Community-Level Transmission for the State of Georgia

Variable Values
Cases 11,387
% Positivity 20-24.9 %
Cases per 100,000 107.2
Deaths 117
% of Population >=5 Years of Age Fully Vaccinated 60.6%
New Hospital Admissions (7-day Moving Average) 193.86

Figure 1. Community Transmission Map

For a more detailed report on community transmission levels please visit https://covid.cdc.gov/covid-data-tracker/#county-view%7CGeorgia%7CRisk%7Ccommunity_transmission_level

Proportion Estimates of COVID-19 Variants

Proportion estimates of COVID-19 variants are provided to DPH by the Centers for Diseases Control and Prevention (CDC). We have included data for the nation and the Southeast region.

Figure 3. Nationwide Proportion Estimates of Variants

Figure 4. Southeast Region Proportion Estimates of Variants

  • DPH encourages the vaccination of individuals aged 5 and up to protect against COVID-19

For more details about variants proportions, please visit here

Resident and Staff Cases and Deaths

Resident and staff case and death counts are gathered from the CDC’s National Healthcare Safety Network (NHSN). All 365 skilled-nursing facilities in Georgia are required by the Centers for Medicare & Medicaid Services (CMS) to report case and death counts to NHSN. A confirmed COVID-19 case is defined as a resident or staff newly positive for COVID-19 based on a viral test result. The test result may be from a NAAT/PCR or an antigen test. A COVID-19 death is defined as a resident or staff who died from SARS-CoV-2 (COVID-19) related complications and includes resident deaths in the facility AND in other locations, such as an acute care facility, in which the resident with COVID-19 was transferred to receive treatment. Data is presented for the 7-day period with the week start date.

Table 2. Summary of NHSN COVID-19 Case and Death Counts

Cumulative Total since March 02, 2020
No. Resident Cases 36410
No. Resident Deaths 3918
No. Staff Cases 31006
No. Staff Deaths 69

Figure 4.

Figure 5.

Figure 6.

Figure 7.

Resident and Staff Vaccination Data

The data below summarizes the percentage of residents and staff that have up-to-date COVID-19 vaccinations in Georgia skilled nursing homes. As defined by CDC, up-to-date vaccination includes:

  • Received an updated (bivalent) booster dose

OR

  • Received their last booster dose less than two months ago or

  • Completed their primary series less than two months ago.

CDC has revised its vaccination definitions over time; see https://www.cdc.gov/nhsn/pdfs/variable_labels.pdf

To view a list of vaccination rates for all US nursing homes, go to: https://data.cms.gov/covid-19/covid-19-nursing-home-data

Figure 8.

Figure 9.

See CDC currents recommendations regarding booster doses: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html

Additional Vaccination Resources

Options for COVID-19 in High-risk, Non-Hospitalized Patients

Table 2a shows the NIH’s recommendations for non-hospitalized adults. Nonhospitalized Adults: Therapeutic Management | COVID-19 Treatment Guidelines (nih.gov)

IDSA shows precautions with therapeutic agents. https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/#toc-22

Oral antivirals

NIH offers guidance on management of drug-drug interactions with Paxlovid. https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ritonavir-boosted-nirmatrelvir--paxlovid-/paxlovid-drug-drug-interactions/

IDSA offers guidance on management of drug-drug interactions with Paxlovid. https://www.idsociety.org/paxlovid

Two oral antivirals, Paxlovid™ and molnupiravir, have been approved under EUA to be taken by mouth twice daily for five days and must be started within 5 days of symptom onset. HHS has provided a therapeutics locator for Paxlovid™ and molnupiravir https://covid-19-therapeutics-locator-dhhs.hub.arcgis.com/

Monoclonal antibodies

On Nov 30th 2022, the Food and Drug Administration (FDA) announced bebtelovimab is not currently authorized for emergency use in the United States. Bebtelovimab is not expected to neutralize Omicron subvariants BQ.1 and BQ.1.1., according to data included in the Health Care Provider Fact Sheet. Eli Lilly and the company’s authorized distributors have paused commercial distribution of bebtelovimab until further notice. The US Government recommends all product be retained if SARS-CoV-2 variants susceptible to bebtelovimab, which are currently circulating in the US at a lower prevalence, become more prevalent in the future. Retained product must be appropriately held in accordance with product storage requirements.

Remdesivir

The FDA expanded the EUA for Remdesivir (Veklury™) to include non-hospitalized, high-risk outpatients. Remdesivir should be given within seven days of symptom onset intravenously x 3 days. https://www.fda.gov/news-events/press-announcements/fda-takes-actions-expand-use-treatment-outpatients-mild-moderate-covid-19. Remdesivir ordering is not managed through DPH. Contact your pharmacy vendor for ordering.

Convalescent Plasma

On 3/9/22 IDSA revised its recommendation for convalescent plasma for ambulatory patients with mild to moderate COVID at high risk for progression who had no other treatment options. IDSA suggests FDA-qualified high-titer coalescent plasma within 8 days of symptom onset. The FDA EUA authorizes use only in immunocompromised individuals. Ordering convalescent plasma is not managed through DPH.

Reported Staff Shortages in Skilled Nursing Facilities

In NHSN, skilled nursing homes can report additional data on resource needs. The data below summarizes staffing shortages. Definitions for the categories are below.

  • Aides: certified nursing assistants, nurse aide, medication aide, or medication technician
  • Nursing staff: registered nurse, licensed practical nurse, or vocational nurse
  • Clinical staff: physician, physician assistant, or advanced practice nurse
  • Other staff: these personnel may include, but are not limited to, environmental services, cook, dietary, pharmacists, pharmacy techs, activities director, care givers, wound care, physical therapy, shared staff, etc.

Figure 14. Skilled Nursing Facilities in Georgia Reporting Shortages in Staff, 12/19/2022 – 12/25/2022

Infection Prevention

The Department of Public Health Infection Preventionist teams are available for Administrative order review, outbreak assistance for COVID and other infections that require infection control measures. This team is also available to review policies and procedures related to infection prevention.

Table 4. IP Contacts

Region Resource Contact
North (Rome, Dalton, Gainesville, Athens) Sue Bunnell and Mary Whitaker ,
Atlanta Metro (Cobb-Douglas, Fulton, Clayton, Lawrenceville, Dekalb, LaGrange) Teresa Fox and Renee Miller ,
Central (Dublin, Macon, Augusta) Southwest (Columbus) Theresa Metro-Lewis and Karen Williams ,
Southeast (Valdosta, Albany) Connie Stanfill
Southwest (Savannah, Waycross) Regina Howard
Backup/Nights/Weekends Jeanne Negley and JoAnna Wagner ,