From DHW Director Dave Jeppesen: An update on improving the Developmental Disabilities Crisis System

Making progress toward Strategic Goal 2: Protect children, youth, and vulnerable adults

As part of the department’s mission to strengthen the health, safety, and independence of Idahoans, we strive to consider what this means for all Idahoans, including those with developmental disabilities (DD).

A specific focus we have is how to best serve people with developmental disabilities who are experiencing a crisis, often due to complex needs that can include mental health or medical needs. When these individuals are in crisis, it is essential that they receive services that are person-centered, trauma-informed, and delivered in the least restrictive environment possible. We believe we can improve the Idaho crisis system that serves Idaho’s adults with DD.

The Developmental Disabilities Crisis System Improvement Project is well under way to establish a long-term system of care by July 1, 2022, for people with developmental disabilities who exhibit severe behaviors. 

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COVID-19 Q&A: Obesity significantly increases risk of severe illness from COVID-19

Obesity is a common and serious disease that puts people at risk for many other serious diseases and increases the risk of severe illness from COVID-19.

  • A study of COVID-19 cases shows that hospitalizations, intensive care unit (ICU) admissions, need for ventilators, and deaths are higher with a higher body mass index (BMI).
  • A higher risk for having to be admitted to the hospital or death was really apparent in those younger than age 65. 
  • More than 900,000 adult COVID-19 hospitalizations happened in the United States between the beginning of the pandemic and Nov. 18, 2020. Models estimate that 271,800 (30.2 percent) of these hospitalizations were attributed to obesity.

Why focus on obesity when there are other serious chronic health issues that also can make it more likely someone will get seriously ill with COVID-19?

Adults with enough extra weight to be considered obese are more likely to also have additional health issues that make it more likely they will wind up in the hospital or worse if they get sick with COVID-19.

Extra weight puts extra strain on our bodies, and it’s important for people to know that so they can make well-informed decisions about how to continue to protect themselves during the COVID-19 pandemic. According to the Centers for Disease Control and Prevention (CDC), having obesity may triple the risk of hospitalization due to a COVID-19 infection.

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From DHW Director Dave Jeppesen: Wishing you all a Happy Thanksgiving

These past 20 months have been overwhelmingly difficult due to the impact of the pandemic. Everyone has given up something for the greater good, and we all have worked together to slow the spread of COVID-19.

It’s easy to go down a path of negativity, to focus on the impact of the pandemic, the loss of life, and the stress this has caused all Idahoans.

However, I am cautiously optimistic about the light I see at the end of the tunnel. COVID-19 trends are going in the right direction with fewer cases, hospitalizations, and a decrease in percent positivity in most regions of Idaho.

As we approach this season of gratitude, this week dedicated to giving thanks, I am thankful for the healthcare workers, teachers and students, families, business owners, public health officials, and the many others in Idaho who have stood together against this pandemic. You are appreciated.

Finally, during this season of thanks, I would encourage all of you to take time to recharge, spend time with your families, and do those things that bring you joy. I wish you a very Happy Thanksgiving.

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COVID-19 Q&A: Vaccines are safe and recommended for pregnant women

The Centers for Disease Control and Prevention recommends COVID-19 vaccination for those who are pregnant, breastfeeding, trying to get pregnant now, or who want to become pregnant in the future. Women who have questions about this should discuss their concerns with their healthcare providers. In the meantime, here are some common questions and answers.

Why is it so important for women who are pregnant, breastfeeding, trying to get pregnant now, or who want to become pregnant in the future, to get vaccinated?

Pregnant and recently pregnant women are at an increased risk for severe illness from COVID-19 compared with women who are not pregnant. (Severe illness requires hospitalization, intensive care, a ventilator, or special equipment to breathe, or results in death.) Pregnant women with COVID-19 are also at increased risk of preterm birth and might be at increased risk of other adverse pregnancy outcomes, compared with pregnant women without COVID-19.

Is there a possibility the COVID-19 vaccine would keep a woman from getting pregnant?

There is no evidence that COVID-19 vaccination causes any problems with conception or pregnancy, including the development of the placenta. During vaccine trials, the rate of pregnancy among women who received the COVID-19 vaccine was the same as the rate among women who got a placebo vaccine. There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men.

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From DHW Director Dave Jeppesen: When will Idaho exit crisis standards of care; encouraging pregnant women to choose to get the COVID-19 vaccine

When will Idaho be able to exit crisis standards of care?

That is a question I receive quite frequently. When Gov. Brad Little and I answered questions through the AARP Town Hall earlier this week, several people asked us about this and shared stories of postponed surgeries and delayed healthcare that caused them frustration and distress. That is not what anyone wants. We all want healthcare availability to return to normal.

The short answer to that question is that Idaho will deactivate crisis standards of care when the surge of COVID-19 patients ends and the number of patients no longer exceeds the healthcare resources available.

Below are a few examples that will let us know we can leave crisis standards of care:

  • Non-clinical or non-traditional spaces or rooms are no longer being used to care for patients in hospital and healthcare systems settings
  • Patients who should be admitted to the hospital are admitted to traditional hospital rooms, and are no longer being kept for long periods in emergency rooms
  • Instead of large hospitals transferring patients to small hospitals, we can return to normal where small hospitals can transfer critical care patients to large hospitals as needed
  • At least some postponed, less critical surgeries can continue (we are starting to see this happen in some hospitals in Idaho)
  • Staff-to-patient ratios can return to normal
  • The trend of new cases and hospitalizations continues to decline

When the situation changes in Idaho, crisis standards of care will be deactivated, and the public will be informed immediately.

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From DHW Director Dave Jeppesen: Making progress toward our Strategic Goal 1 to ensure affordable, available healthcare that works‎

The Department of Health and Welfare (DHW) is pleased to announce the launch of a groundbreaking program, designed to change how Medicaid pays for healthcare. This long-awaited, trailblazing program called “Healthy Connections Value Care” is a collaboration between DHW and healthcare providers that seeks to make sure Idahoans have access to healthcare that makes them healthier. It is designed to turn around the system where Medicaid pays for medical procedures, community-based services, and supports for people with disabilities, but does not link payments to actual health outcomes for the people we serve.

By contrast, the Healthy Connections Value Care program rewards healthcare providers when they provide high-quality and cost-effective healthcare. These hospitals and primary care providers, called Value Care Organizations (VCOs), work together with DHW to keep healthcare costs in check. Part of the deal is that VCOs agree that if their healthcare costs exceed a target they will return a portion of that money to the Idaho Medicaid program. This approach incentivizes healthcare providers to deliver quality healthcare that is also a good value for state taxpayers. Ultimately, we anticipate a win-win outcome for both Medicaid participants and providers.

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COVID-19 Q&A: Some COVID-19 infections in vaccinated people are expected

What is a vaccination breakthrough case of COVID-19?

A COVID-19 vaccination breakthrough case is when someone who is fully vaccinated tests positive for COVID-19 more than 14 days after getting the second dose of Moderna or Pfizer vaccines, or more than 14 days after getting the Johnson & Johnson vaccine.

Are breakthrough cases common?

Breakthrough cases are expected, but they are not common. No vaccine is 100 percent effective at preventing illness, and that includes the COVID-19 vaccines.

Let’s do some math.

In Idaho, 826,587 people were fully vaccinated as of Oct 27. Of those, 13,285 had experienced a breakthrough case. That means 1.6 percent of fully vaccinated people have experienced a breakthrough case. Or 98.4 percent of fully vaccinated people haven’t experienced a breakthrough case.

The Department of Health and Welfare tracks breakthrough cases in Idaho on its COVID-19 data dashboard at the bottom of the Case Characteristics page.

Do breakthrough cases mean the COVID-19 vaccines don’t work?

The vaccines are working. They are especially effective against hospitalization and death, and they greatly reduce your chances of getting COVID-19 in the first place. If you do have a breakthrough case, it further reduces the likelihood that you will be sick enough to have to go to the hospital or die.

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From DHW Director Dave Jeppesen: The facts about breakthrough cases – they are a normal part of all vaccines and are not evidence that vaccines do not work

The COVID-19 vaccine is an important tool against the pandemic. However, no vaccine for any disease is 100 percent effective at preventing illness. At DHW, we track cases among Idahoans who have contracted COVID-19 after they are fully vaccinated (i.e. breakthrough cases). Breakthrough cases are expected, but they do not mean the vaccine is ineffective.

Let’s look at the data. One way is to look at the total number of Idaho COVID-19 cases in 2021 and see how many of those are breakthrough cases. In Idaho, there have been 142,655 cases of COVID-19 reported during 2021, of which 13,285 have been breakthrough cases. That means that 9.3 percent of all cases in 2021 have been breakthrough cases. However, looking at the data this way can sometimes be distorted by the number of people vaccinated vs. the number of people not fully vaccinated.

A better way to look at the data is to look at the number of breakthrough cases among those who are fully vaccinated. This is a better measure since it tells you directly, if you get vaccinated, how likely you are to get a breakthrough case. 

In Idaho, there are 826,587 people who are fully vaccinated as of Oct 27, 2021, of which 13,285 have experienced a breakthrough case. That means 1.6 percent of fully vaccinated people have experienced a breakthrough case. Or said differently, 98.4 percent of fully vaccinated people haven’t experienced a breakthrough case.  I don’t know about you, but I will take those odds any day of the week.

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COVID-19 Q&A: An update on vaccine booster doses

The Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) have approved and recommended booster doses for Moderna, Johnson & Johnson, and the Pfizer/BioNtech COVID-19 vaccines for certain people.

Who is at highest risk of having breakthrough infections, even if they are fully immunized?

Seniors 65 and older and people with weakened immune systems caused by certain health conditions or treatments (including organ transplants, HIV, and some cancers and chemotherapy) are more likely to have breakthrough infections. These groups are strongly recommended to get a booster dose when they are eligible.

Who is now eligible for a booster dose?

Booster doses are available for these groups at least six months after their second dose of the Pfizer or Moderna vaccines.

  • People who should get a booster dose: 65 and older; 18+ living in long-term care facilities; 50+ with underlying health conditions, or disabilities.
  • People who may get a booster dose: 18+ who have underlying health conditions, disabilities; 18+ who live or work in high-risk settings. 

Adults 18 or older who received the Johnson & Johnson COVID-19 vaccine two or more months ago also are recommended to get a booster dose.

Is it OK to get a different vaccine as a booster than you received at first?

Eligible people may choose which vaccine they get as a booster dose. Some people may prefer the vaccine type they originally received, and others may prefer to get a different booster. CDC’s recommendations now allow for mix-and-match dosing for booster shots.

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From DHW Director Dave Jeppesen: Correcting misinformation about COVID-19 vaccines; and a reminder to take our COVID-19 impact survey

Are there any deaths in Idaho that have been caused by the COVID-19 vaccine?

That is a question we are getting a lot. Across social media and other communication channels, misinformation is being shared that connects the COVID-19 vaccine to deaths in Idaho. This is simply not true.

In Idaho, no death certificate has identified the COVID-19 vaccine as the underlying cause of death in 2020 and 2021. The “underlying cause of death” means the actual event or disease that caused the death. 

We have had six deaths in people ranging from 69 to 86 years of age, for whom the death certificates mentioned the COVID-19 vaccine. All of those death certificates identified other underlying causes of death such as cancer and heart disease. Two listed the vaccine as a potential complication. The others just noted the person had received a COVID-19 vaccine.

So, what about deaths caused by vaccination reported to the federal Vaccine Adverse Event Reporting System (VAERS)?

As you likely know, VAERS is an open system where anyone can report information. Information listed there is not confirmed on that site – it is a repository to collect information that is analyzed for serious events and trends that will be followed-up on as needed.

Serious events in VAERS, such as deaths that reportedly occurred after the COVID-19 vaccine, are investigated. The results of those investigations in Idaho have found other causes explaining the death, including cancer and heart disease. Which brings me back to the point made above – the COVID-19 vaccine has not been identified as the underlying cause of death on any Idaho death certificates.

DHW recently did a blog about VAERS and you can read it at: https://dhwblog.com/2021/10/05/covid-19-qa-vaccine-information-on-vaers-cancer-and-efficacy/

CDC guidance on VAERS is located at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vaers.html).

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