Friday, July 2, 2021
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While it is too soon to tell how Delta will impact trends in the U.S., new daily reported COVID-19 cases and deaths are increasing — including here in North Carolina — as this more contagious variant becomes dominant. Unfortunately, only 50% of eligible NC residents are fully vaccinated, and this percentage is lower in seven of our WNC counties, some of which are still experiencing significant community spread.
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Five Things
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In this month’s regional report you’ll find
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WNC COVID-19 Trends
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Visit the NCDHHS COVID-19 Dashboard to explore more current COVID-19 data trends
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The pace of vaccination is stalling with only 50% of eligible NC residents fully vaccinated according to the NCDHHS dashboard, and weekly administration of first and second doses is declining rapidly. Here in WNC, Swain and Buncombe Counties have the highest vaccination rates with more than 60 percent of adults at least partially vaccinated as of June 28. In seven WNC counties, 50 to 57 percent of adults have received at least one dose; in the remaining seven counties, between 40 to 50 percent of adults are partially vaccinated according to NCDHHS, federal pharmacy, EBCI, and VA data.
Nationally, North Carolina is one of 12 states with the lowest vaccination rates in the country and one of 11 states where 20% or more of seniors are still unprotected. Vaccination rates and the Delta variant are something to keep an eye on as we move toward fall when regional surges are still possible.
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July “Must Reads”
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In NC, Vaccine Hesitancy Is Only Part of the Problem. This Charlotte Observer editorial highlights some of the barriers that may be contributing to NC’s lagging vaccination rates beyond misinformation and hesitancy, and what we can do to eliminate them.
Spread of Delta Coronavirus Variant Exposes Poorly Vaccinated Regions to Renewed Danger. This Washington Post analysis explores the risk posed by the new more contagious variant where vaccination rates are lower like many of our rural WNC communities.
What Do Americans Think About Getting Vaccinated Against COVID-19? findings from a large nationwide poll shows a majority would prefer to be vaccinated in their doctor’s office, but discrimination remains a barrier. Includes most effective messages for encouraging vaccination.
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It Takes a Village to Vaccinate One
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If you’ve been tracking North Carolina’s vaccination progress, you know we still have a long way to go, especially here in WNC. Our lagging pace, with some counties partially vaccinating as few as 40% of residents, has prompted large statewide cash and college fund giveaways and a visit from President Biden last week. We’re still in a race against variants like Delta, and other states with low vaccination rates like Missouri serve as a sobering warning. We’re not out of the woods yet.
One takeaway is that public health efforts alone can’t end this pandemic. It will take each of us, working together, to help our fellow community members develop confidence in COVID-19 vaccines and to facilitate easy access to them.
If you are a primary care provider here are three ways you can partner with your community:
- Be a Vaccine Champion. Talk about vaccination with all of your unvaccinated patients, neighbors, and community members. Be able to explain how vaccines work. Prepare to answer common questions. Make getting vaccinated easy. This provider toolkit can help.
- Become a Vaccine Provider. When your patients are ready to get vaccinated, make sure you are too. MAHEC’s WNC Vaccine Outreach Coordinator can help you get started and develop strategies for integrating vaccines into your workflow. Email Marty.Stamey@mahec.net.
- Collaborate with Community. Look for opportunities to partner with community and faith-based organizations, community health workers, event sponsors, and media outlets to make education and vaccines widely available throughout your community.
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Beware of COVID Bias
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Remember when the pandemic started and you found yourself sneezing or coughing in public? You might have felt embarrassed or resisted the urge to tell complete strangers “it’s not COVID, it’s ___” (fill in the blank).
During the height of the pandemic, assuming COVID first when presented with respiratory symptoms was a reasonable and necessary strategy. Now that vaccines are widely available, this assumption could lead to a subtle bias that makes your vaccinated patients feel invalidated when they seek treatment for other health concerns.
A good way to avoid this type of bias is to revisit the principles of patient-centered care that include empathy, active listening, clear communication, and collaboration. When patients seek care with COVID-like symptoms, whether vaccinated or unvaccinated, your team can validate their discomfort by sharing the reason for ongoing caution including
- COVID is still circulating in the community
- The need to rule out COVID in order to identify what is really going on
- The small but real possibility of breakthrough infection
Your patients will appreciate a reminder of why you are asking them to submit to yet another test, and you’ll benefit from this opportunity to build trust and rapport.
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COVID-19 Practice Support
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The following guidance has been added to MAHEC’s COVID-19 Library Guides:
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NEW Resources to Help You Serve Your Patients
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Provider Resources
- CDC Confirms 226 cases of Myocarditis after COVID-19 Vaccination in People 30 and Under (AAP) and provides clinical recommendations for suspected cases
- COVID and Flu Vaccines Play Nice Together (MedPage Today) Novavax study found comparable safety and efficacy when vaccines co-administered
- Depression, Anxiety, PTSD, and Suicidal Ideation Among Public Health Workers (MMWR) recent findings show more than 50% of healthcare workers are experiencing mental health symptoms
- Even If You're Vaccinated, The Delta Variant Can Still Impact You (Healthline) explores impacts on other healthcare services, health disparities, and Delta’s impact on children and adolescents
- Johnson & Johnson Vaccine Protects Against Delta Variant (NYT) the vaccine also produces long-lasting immune responses; booster shots seem unnecessary at least for now
- Myocarditis and Booster Shots (Your Local Epidemiologist) cliff notes from the most recent ACIP meeting shed light on the current data on these two vaccine concerns
- Pfizer and Moderna Vaccines Could Offer Protection for Years (NYT) according to a new study; individuals who were infected and vaccinated may have immunity for even longer
- PPE Available Through WCMS. If you would like to request PPE for yourself or your practice, please contact matt@mywcms.org to place an order
- U.S. Pauses Use of Lilly's Monoclonal Antibody Combo for COVID after in vitro data found bamlanivimab and etesevimab combination therapy was not active against COVID-19 variants
- Vaccine Facts Sheets for Pfizer (provider and patient) and Moderna ( provider and patient) revised to include warning of risk for myocarditis and pericarditis in adolescents and young adults
- What Doctors Should Know About Delta (MedPage Today) the latest on transmissibility, virulence, vaccine efficacy, and more
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Equity Resources
- The Battle Against Vaccine Hesitancy (The Asheville View) Elon University’s Stephanie Baker, PhD, and ID specialist David Wohl, MD, from UNC Health debunk vaccine misinformation
- La Conversación (KFF) Latinx doctors, nurses and promotoras provide facts and dispel misinformation about the COVID-19 vaccines
- The Conversation Digital Toolkit (KFF, Black Coalition Against COVID) downloadable graphics, videos, social media content, and printable flyers with information on the COVID-19 vaccine
- The EveryONE Project Toolkit (AAFP) includes screening tools for social needs and a navigation tool to find local resources to address their challenges and advance health equity
- FEMA to Deploy Group to Support Vaccination Efforts in WNC (WLOS) FEMA will bring mobile vaccine resources to WNC in July in an effort to increase regional vaccination rates
- National COVID-19 Resiliency Network (Morehouse SOM) searchable database of COVID-19 equity-focused resources including testing, vaccination, treatment and community resources
- NC HOPE. Rent and utility assistance is available to qualifying households; for more information and to apply visit www.hope.nc.gov or contact the HOPE call center at (888) 927-5467
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Patient Resources
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Women & Children’s Health
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WNC Vaccine Locations (many offering walk-in service)
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NEW & Ongoing COVID-19 Virtual Trainings
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Doulas and Respectful Care: Supporting Models that Support Families | MHLIC
Tuesday, July 13, 1:00 to 2:00 pm
Ethical Issues: Treating Pandemic Trauma | MAHEC
Friday, July 16, 9:00 am to 1:15 pm
Black Men’s Health | MAHEC
Friday, July 16, 12:00 to 1:00 pm
Drop-In Hours with Dr. B: Q&A on Health Equity, COVID Prevention, Vaccines | NCDHHS
Wednesday, July 28 and Aug. 25 at 6:00 pm
Psychological Effects of Long COVID | MAHEC
Thursday, August 5 from 7:00 to 8:00 am
National Maternal Health Innovation Symposium | MHLIC
Monday and Tuesday, August 30–31 (free hybrid virtual and in-person options)
EDI Courses - Fall Semester | Lenoir-Rhyne University
Multiple dates (Sept - Nov) including online health and equity course with Dr. Sharon West
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Archived Trainings
CVMS Provider Portal Training 101 | NCDHHS
Prioritizing Equity: Celebrating and Reflecting During Pride Month | AMA
Vaccine Update: Pregnant Women, Children & Variants | ACMT
Town Hall with US Surgeon General Dr. Vivek Murthy | AAP
What Physicians Need to Know: Vaccine Misinformation Among Patients | AMA
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