COVID-19 Public Health Action Webinar - Understanding the Safe Access O'ahu Program - Hawai'i ...
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COVID-19 Public
Health Action Webinar
Understanding the Safe Access O‘ahu Program
Presented by Sandra P. Chang, PhD
Catherine M. Pirkle, PhD
Amy Asselbaye
Wednesday, September 8, 2021
1:00 PM – 2:00 PM
ZOOM HOUSEKEEPING ITEMS: 1. For all questions, please utilize the Chat box or Question & Answers box located at the bottom of your screen. 2. NO continuing education credits will be provided during this webinar series. 3. All webinars will be available on the Hawai’i Public Health Training Hui’s YouTube channel -https://www.youtube.com/channel/HawaiiPublicTrainingHui
Understanding the Safe Access O‘ahu Program
Sandra P. Chang, PhD Catherine M. Pirkle, PhD Amy Asselbaye
Professor & Graduate Program Chair Associate Professor Executive Director
Dept. of Tropical Medicine, Medical & Specialization Head Office of Economic Revitalization
Microbiology & Pharmacology Health Policy and Management CIty & County of Honolulu
John A Burns School of Medicine Office of Public Health Studies
University of Hawaiʻi at Mānoa
COVID-19 VACCINES: SARS CoV-2 Variants & Booster Doses Sandra P. Chang, PhD Department of Tropical Medicine, Medical Microbiology & Pharmacology John A. Burns School of Medicine - University of Hawai‘i at Mānoa
94% VE
95% VE
Aug., 2021
>217M infected
>4.5M deaths
Cell, 2021
Effectiveness of vaccines in general population COVID-NET Surveillance system that collects data on laboratory-confirmed COVID-19-associated hospitalizations in 250 hospitals in 14 states
SARS CoV2 Variants
IMPACT OF MUTATIONS
The Pharmaceutical Journal, Apr. 29,2021
SARS CoV-2 Variants
• How do variants arise?
• Every time a virus replicates, errors
(mutations) occur in its genetic
material.
• Most changes have no impact or are
harmful to the virus
• On rare occasions, a change can give
the virus an advantage, leading to
Variants of Concern, like the Delta
variant
• Allow it to spread more easily
(Delta is twice as transmissible as
the original SARS CoV-2)
• Give it an ability to produce more
severe disease (Delta may cause
more severe disease)
Adults ≥ 75 years of age
Summary • COVID-19 vaccines continue to maintain high protection against severe disease, hospitalization, and death • Protection against infection (including asymptomatic or mild infections) appears lower in recent months • Difficult to distinguish role of time since primary series and Delta variant • Top priority should be vaccination of unvaccinated individuals • Priority for booster dose policy: • Prevention of severe disease in at-risk populations • Critical to wait for additional safety data and regulatory allowance for booster doses • FDA meeting to consider complete dataset for booster doses on Sept. 17, 2021
For more information
• Sandra Chang, email: sandrac@hawaii.edu
• IT’S UP TO YOU – COVID-19 Vaccination Education
• https://getvaccineanswers.org
• State of Hawaii COVID-19 Vaccine Information
• https://hawaiicovid19.com/vaccine/
• City & County of Honolulu Vaccine Information
• https://www.oneoahu.org/vaccine
• Centers for Disease Control and Prevention (CDC)
COVID-19 Vaccine Information
• https://www.cdc.gov/coronavirus/2019-ncov/va
ccines/index.htmlPfizer/BioNTech Phase 3 study of booster
rd
(3 ) dose of COMIRNATY
• 306 participants, 18-55 y who received booster dose between 4.8 to 8
mo after completed two-dose primary regimen
• Median follow-up time of 2.6 mo post booster
• 3.3-fold increase in SARS CoV-2 neutralizing titers compared to titers after
second dose
• Safety
• Mild to moderate adverse events similar or better than dose 2: injection site pain,
fatigue, headache, muscle & joint pain, chills
Pfizer/BioNTech press release, Aug. 25, 2021; unpublished dataTackling Covid-19 in
th
Hawaiʻi during the 4
wave
Catherine M. Pirkle, PhD
Office of Public Health StudiesWhy do we urgently need to slow the spread of COVID-19?
“health is among the most important conditions ●Prevent premature mortality of human life and ●Protect vulnerable populations a critically significant ●Good health a prerequisite for other pursuits constituent of ●Long-term effects of COVID-19 illness unknown human capabilities ●Limited pediatric data which we have reason to value” -Amartya Sen Sen, A. (2002) Why health equity? Health economics. [Online] 11 (8), 659–666.
Health system
crisis – Need
to flatten the
curve
Siouxsie Wiles and Toby Morris, CC BY 4.0 , via Wikimedia
Commons●Acute
Too much ● Shortages of ICUs, ventilators, etc.
pressure on ● Shortages of oxygen, medications, etc.
the health ● Redistribution of personnel, equipment, etc.
system leads ● Compromised quality of care
to acute and ●Long-term
● Health professional burn-out, psychological harms
long-term ● Long-terms losses of health professionals
consequences ● Economic and staffing ramifications50 to 100% increase
Examples of in maternal
health system mortality
collapse
already exist
Simões E, Paraguassu L. Healthcare collapse imminent, brazil's Sao Paulo warns, as COVID-19 cases surge. Reuters. https://www.reuters.com/article/us-health-coronavirus-brazil-idINKBN2C1229. Published April 14, 2021.
Accessed September 8, 2021.
Francisco, R. P. V. et al. (2021) Obstetric Observatory BRAZIL - COVID-19: 1031 maternal deaths because of COVID-19 and the unequal access to health care services. Clinics (São Paulo, Brazil). [Online] 76e3120–e3120.During the pandemic, there were some times in which it seemed we were
living in a The hospitals were so beyond their capacities
that they decided to because
they had no place for further patients. …In the Amazonas state,
…Even those with
private health insurance were struggling to find proper health assistance
(of note, only less than 25% of the Brazilian population has access to it).
My sister’s friend was one of them. When she needed medical assistance
The grim because of the Covid, all private hospitals were full and she ended up …in
a crowded public emergency care unit. Some days later, she was admitted
reality from in a temporary hospital from the state government that was implemented
only to treat patients with Covid. During the whole time, her friends,
the ground including my sister and I, were trying to find a place in a private hospital
for her because the state hospital was struggling with lack of medications
and infrastructure. Only after several days she was transferred to a
private hospital, but she was already too ill at that point.
Dr. SMA Câmara, Natal, BrazilPharmacological and non-pharmacological strategies
our most important tool, but other tools available too
requires all employees, contractors, and
volunteers of businesses, such as restaurants,
bars, gyms, movie theaters, museums, arcades
and other similar establishments
Safe Access
Oʻahu each week in
Program order to operate. In addition, customers must
show proof of full vaccination or a negative
COVID-19 test result taken within the previous 48
hours in order to enter the establishment. Children
under 12 years old are exempt.
Safe access Oahu. One Oahu. https://www.oneoahu.org/safe-access-oahu. Accessed September 7, 2021.●Previously, absence of verifiable means to stratify
Epidemiological population according to risk
● Restrictions applied to entire jurisdiction or country
rational for
vaccine/test ●Vaccine/test passes allow more targeted
passes restrictions based on risk
● Vaccinated individuals much less likely to be
hospitalized and strain health systemOther ●Safer means to return to normality, a sense of
justifications security, and to stimulate economy
●Some evidence of success in Denmark
for vaccine/test ●Policy effectiveness increased with higher
passes vaccination rates
Associated Press Reporter. Vaccine passes in Europe face pockets of resistance. Irish Examiner. 1 Aug 2021. Accessed September 6, 2021.
https://www.irishexaminer.com/world/arid-40350236.html
Murray A. Coronapas: The passport helping Denmark open up after Covid. BBC News. 21 April 2021. Accessed September 7, 2021. https://www.bbc.com/news/world-europe-56812293●Incentive for vaccination
Other ●Vaccination demand increased 200% in
justifications some regions of Italy
for vaccine/test ●5 million got first dose and 6 million got
passes second dose in France
Associated Press Reporter. Vaccine passes in Europe face pockets of resistance. Irish Examiner. 1 Aug 2021. Accessed September 6, 2021.
https://www.irishexaminer.com/world/arid-40350236.html●Extent and duration of protection against
SARS-CoV-2 infection and severe illness has
Considerations not been established
for vaccine/test ●Vaccination does not fully prevent infection
passes and onward transmission
●Ethical and data security concernsNeed to complement Safe Oʻahu Program with other important tools against infection and illness
●Masks protect those around you (source control)
● Block 50-70% of exhaled small droplets and particles
● >50% or more transmissions from asymptomatic or
pre-symptomatic
Masks ●Masks offer some protection to you
● Barrier to large respiratory droplets
● Partially filter small droplets and particles
Brooks, J. T. & Butler, J. C. (2021) Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2. JAMA : the
journal of the American Medical Association. [Online] 325 (10), 998–999.
NeoBatfreak, CC BY-SA 4.0 , via Wikimedia Commons (image)Lots of evidence for masks
●Low cost non-pharmacological intervention with
high benefit
Indoor mask ●Especially important when indoors and when social
mandates distancing is not possible
essential to
maintain and
enforce
Brooks, J. T. & Butler, J. C. (2021) Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2. JAMA : the journal of the American Medical
Association. [Online] 325 (10), 998–999.Ventilation
●Viral particles more concentrated indoors than
outdoors
Indoor ●Ventilation mitigation strategies can reduce
transmission particle concentration
major concern ●Less concentrated particles less likely viral
particles can be inhaled
Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/community/ventilation.html. Accessed September
7, 2021.●Increase the introduction of outdoor air
●Fans to increase the effectiveness of open
Example windows
●Ensure ventilation systems operate properly for
ventilation the occupancy level
mitigation ●Make sure air filters are properly sized and within
strategies their recommended service life
●Increase use of outdoor spaces
Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/community/ventilation.html. Accessed September
7, 2021.Ventilation-fo ●Improved occupational health for workers
cused
●Reduced risk of other airborne infections
strategies
may have
other benefitsPedestrian Mall in St. John’s Newfoundland
Maximizing outdoor environments for shopping & recreating
●Strategies that reduce contact between people
● Physical distancing
● Capacity limits
Other tools ● Work/educate from home
● Stay at home orders
Etc.●Increase risk for one priority
need to balance with risk
reduction in other
activities/sectors
Need to
●Absent near universal
balance risks vaccination, complete
removal of restrictions
unlikely advisable in near
futureHeightened risk due to delta variant, waning immunity over time, AND
Mahalo!
Hawaiʻi Public Health Institute Webinar
Safe Access Oʻahu
September 8, 2021AGENDA
1. Safe Access Oʻahu
○ Employees
○ Customers
○ Requirements for businesses
2. Insights from our guests
3. Q&AVACCINATIONS
● Vaccinations are our best weapon against COVID and our goal is to
get as many people fully vaccinated as possible.
● 66% of the island is fully vaccinated.
● Many businesses agree. A survey of about 900 local businesses by
the University of Hawaiʻi Economic Research Organization shows
that:
○ More than 80% report that most of their employees have been
fully vaccinated.
○ 65% said that they already do or likely will require employees to
be vaccinated.EMPLOYEES
Employees ● Safe Access Oʻahu starts Monday, September 13, 2021. ● Require full vaccination for employees, contractors, and volunteers at: ○ Entertainment and recreational settings. ○ Restaurants and bars. ○ Fitness establishments and group physical activities. ● Does not apply to establishments that offer take out only.
Proof of Vaccination Proof of full vaccination: ● A hard copy of a vaccination card approved by the Hawaiʻi department of health or the department of health in another state. ● Or a picture of a vaccination card approved by the Hawaiʻi department of health or the department of health in another state. ● a Hawaiʻi state-approved digital/smart device application confirming full vaccination status (including via the Safe Travels program/application).
Proof of Vaccination
Alternative: Proof of Negative COVID Test ● Workers who aren’t fully vaccinated will have to provide proof of a negative COVID test each week with an FDA-approved test. ● Employees must also provide ID with the same information as the proof of vaccination or proof of a negative COVID test. ● FDA-approved COVID tests can also include home tests purchased at drug stores. It must be FDA-approved.
Proof of Identification
● Identification must contain either:
○ Their name and photo.
○ Or name and date of birth.
● Acceptable forms of identification:
○ Driver’s license.
○ Non-driver government ID card
○ Passport.
○ School or work ID card.Individuals on-premises for less than 15 minutes ● For individuals on-premises for less than 15 minutes, you do NOT need to check proof of vaccination or proof of a negative COVID test for individuals picking up items such as food for takeout or delivery. ● These individuals must wear a face mask.
CUSTOMERS
Customers ● Full vaccination for customers at: ○ Entertainment and recreational settings. ○ Restaurants and bars. ○ Fitness establishments and group physical activities. ● Does not apply to establishments that offer take out only.
Proof of Vaccination
Alternative: Proof of Negative COVID Test ● Customers have the option of providing proof of a negative COVID test taken within 48 hours using an FDA-approved test. ● Also provide ID with the same information as the proof of vaccination or proof of a negative COVID test. ● FDA-approved COVID tests can also include home tests purchased at pharmacies. It must be FDA-approved.
Proof of Identification
● Identification must contain either:
○ Their name and photo.
○ Or name and date of birth.
● Acceptable forms of identification:
○ Driver’s license.
○ Non-driver government ID card.
○ Passport.
○ School or work ID card.Customers On-Premises for Less than 15 Minutes ● For individuals on-premises for less than 15 minutes, you do NOT need to check proof of vaccination or proof of a negative COVID test for individuals picking up items such as food for takeout. ● These individuals must wear a face mask.
REQUIREMENTS FOR BUSINESSES
Requirements for Businesses
● Self-certify at
oneoahu.org/test-attestation.
● Post highly visible signage.
● Have written policy about Safe
Access Oʻahu.
● Businesses that don’t meet the
program requirements can be cited,
fined, and in some cases, shut down.RESOURCES
Resources ● All requirements and FAQ: oneoahu.org/safe-access-oahu. ● Vaccination sites: oneoahu.org/find-vaccine. ● COVID testing: oneoahu.org/covid19-testing.
QUESTIONS??
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