While youre waiting visit www menti com and

While you’re waiting, visit www. menti. com and enter code 62 88 92 1 to answer the polling questions! Novel Coronavirus (COVID-19): Updates for Clinicians September 18, 2020

Welcome to the TDH COVID-19 Clinician Update! Today’s Doc: Michelle Fiscus, MD FAAP Medical Director, Vaccine-Preventable Diseases and Immunization Program

July 24 Aug 7 Sept 4

Physician Support Line https: //www. physiciansupportline. com/ 8 am – 1 am EST 7 days/week

TN Healthcare Worker Emotional Support Line https: //www. tn. gov/behavioral-health/emotional-support

Sept 4 Sept 17 https: //coronavirus. jhu. edu/map. html

Sept 4 https: //datausa. io/coronavirus https: //coronavirus. jhu. edu/ Sept 17

• 1918 H 1 N 1 Avian Flu (“Spanish Flu”) – 50 M global deaths – 670, 000 US deaths • 1957 -1958 H 2 N 2 Avian Flu (“Asian Flu”) – 1. 1 M global deaths – 116, 000 US deaths • 1968 H 3 N 2 Avian Flu – 1 M global deaths – 100, 000 US deaths • 2009 H 1 N 1 Swine Flu – ~500, 000 global deaths – 12, 469 US deaths SARS-Co. V-2 COVID-19 • 943, 203 global deaths (8. 5 months) • 188, 802 US deaths (6 months)

TDH Response Incident Command System activated Jan 15, 2020 • 247 Days in ICS • 197 Days since first case 24/7 for public health emergencies 615 -741 -7247

www. tn. gov/health Sept 4 Sept 17 Updated regularly at https: //www. tn. gov/health/cedep/ncov. html

https: //coronavirus. jhu. edu/testing/individual-states/tennessee

• 1. 2% case fatality rate % Deaths By Age – 6. 3% if >61 yo – 13. 6% in LTCF 0 -10 yrs 0% 1%2% 4% • 3, 941 pos, 536 fatalities 11 -20 yrs 10% 33% 31 -40 yrs 20% 61 -81+ yrs 83% of deaths 21 -30 yrs 41 -50 yrs 51 -60 yrs 30% 61 -70 yrs 71 -80 yrs Cases 0 -10 yo = 8, 698 (5%) Cases 11 -20 = 23, 290 (13%) 81+ yrs

https: //coronavirus. jhu. edu/data/new-cases-50 -states

Cases by Age Group 25000 20000 15000 10000 5000 0 22 -май 22 -июн 22 -июл 0 -10 yo 11 -20 yo 22 -авг

. 2 02 7. 21 0. 2 02 7. 23 0. 2 02 7. 25 0. 2 02 7. 27 0. 2 02 7. 29 0. 2 02 7. 31 0. 2 0 8. 20 20 8. 4. 20 20 8. 6. 20 20 8. 8. 20 2 8. 10 0. 2 02 8. 12 0. 2 02 8. 14 0. 2 02 8. 16 0. 2 02 8. 18 0. 2 02 8. 20 0. 2 02 8. 22 0. 2 02 8. 24 0. 2 02 8. 26 0. 2 02 8. 28 0. 2 02 8. 30 0. 2 0 9. 20 1. 20 20 9. 3. 20 20 9. 5. 20 20 9. 7. 20 20 9. 9. 20 2 9. 11 0. 2 02 9. 13 0. 2 02 9. 15 0. 2 02 9. 17 0. 2 02 0 7. 19 400 350 300 250 200 150 100 50 0

https: //districtinformation. tnedu. gov/covid-information/search/-1

• • Varying mask requirements Overwhelming contact tracing Parents are not always forthcoming Most infections are contracted outside of school Public/political pressure Staffing issues Spread within athletics

9/4: 1, 864 cases at 59 schools 9/10: 2, 768 cases at 59 schools

• Difficult to influence behavior • Student housing facilitates spread – Dorms – Sororities – Fraternities • Spread within athletics • Some try to circumvent the system • Logistics of quarantine/isolation

EVERYTHING is subject to change.

• Moderna – m. RNA vaccine causes production of spike protein – 4 weeks between doses – Frozen storage • Pfizer/Bio. NTech – m. RNA vaccine causes production of spike protein – 3 weeks between doses – Ultra-cold storage • Astra Zeneca/University of Oxford – Chimpanzee viral vector causes production of spike protein – Phase 3 paused d/t case of transverse myelitis, now resumed

• Pfizer/Bio. NTech Vaccine – – – Ultra-cold (-700 C) storage Once thawed, must be refrigerated and used within 24 -48 h Required onsite reconstitution with diluent Once reconstituted, must be used within 6 h For use in public health closed PODs and possible mobile clinics • Moderna Vaccine – – Frozen (-200 C) storage Once thawed must be refrigerated and used within 7 -14 d Stable at room temperature for 6 h For use in clinics, occupational health clinics, public health closed PODs and mass vaccination clinics

• Lots of questions – Will the vaccine confer immunity? • If so, how long? – – Is re-infection possible? Will it become seasonal? What are the long-term effects? What treatments will be developed?

FIGHT FLU TN 2020 • Fight. Flu. TN 2020 to prepare for community COVID vaccination operations – – – Nov. 19, 2020 Focus will be on high flow drive through Engage County Emergency Management Agencies Support for Traffic control Leverage all information systems Engage public/private sector partners as additional sites

Enter your questions in the chat box. We’ll answer as many as we can!

www. tn. gov/health www. cdc. gov/coronavirus See you in 2 weeks!