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Linda Cannon – Regulatory Compliance Specialist: COVID-19 11.1

MSDS Newsletter Series 38
Staff of MSDS wish you to Stay Safe, De-Stress and Stay Active! 
Linda, Anee, Saba, Ifra, Chelsie and Patrick (no photo)
       MSDS views all of our Dental Clients as Healthcare Providers!  We Thank all of you for your Outstanding work and all that you do!!  11.1 Covid-19 Newsletter – 


Confirmation from 

Virginia Department of Labor (Va OSHA or Vosh) on

N95’s Initial Fit Testing 




 Scroll down to see some sample invoices to help understand MSDS’ process!  

 
Question Posed to:



Virginia Occupational Safety and Health (VOSH) –  
on completing the Initial Fit Test:

Questions:  I was under the impression that the State VOSH complies with all Federal Guidelines.  However, the State can become stricter.  Am I correct?  

And if Virginia complies with all Federal OSHA guidelines, is the information in this federal .pdf poster correct for VOSH also?
 
https://www.osha.gov/SLTC/covid-19/covid-citations-lessons.pdf

If you are equal to federal, and a Dental/ Medical office wants to wear, or needs to wear an N95 due to aerosols, then they have to complete an Initial fit test per Federal OSHA, correct?

Or if they decide not to wear an N95 with aerosol procedures then they would have to quarantine if they find out a patient did in fact have COVID during the same procedure.  Am I correct on this also?



From: “Rose, Jennifer” <[email protected]>
Date: Tuesday, December 15, 2020 at 1:38 PM & 5:14 PM


Per your questions, Virginia does follow Federal OSHA standards and we do have some that are more strict. The Federal OSHA pdf contains similar information, however they do not have a COVID standard, unlike Virginia, where we have a COVID standard and enforce requirements related to that.

Yes, a fit test is required for employees that wear N95 respirators
If an employee is exposed to a positive person, they would be required to quarantine

Jennifer L. Rose, CSP

VOSH Cooperative Programs Director

Virginia Department of Labor and Industry



MSDS cannot stress how important this is. 

Even though MSDS has negotiated many times for Dental Healthcare Providers (DHP), referring dentists who have been referred to MSDS with citations looming.Wease really doubt Federal or any State OSHA will negotiate the citation.  Especially, for any violations that have to do with Covid.  Not to forget the Board of Dentistry, chances are, they will not negotiate either.    


   
 MSDS can teach the Dental Healthcare Provider (DHP or Dentist) how to fit test their own staff members.  
 
Here is how it works.   MSDS schedules your office for the Initial Fit Test. Please know that it can be for 3 people or the whole staff.  Just let us know (1)How many staff will be fit tested with MSDS’ help and (2) How many total clinical staff will be filling out the confidential Medical Clearance Questionnaire.  MSDS Schedule coordinator, Saba, will send you a Preliminary invoice so that there are no surprises.  We complete the class on Zoom, and I will guide the DHP step by step to make sure they have everything they need to be successful.  
 
With our background in Healthcare (Rescue Squad, and Flight Nurse/Paramedic) we have been able to answer any and all questions up to date.  Even staff with claustrophobic tendencies, have done extremely well. As many of you know, I do have the gift of gab!   
 
 You will need a hood, 2 manual nebulizers, and saccharine.   
We typically schedule two weeks out to make sure that the staff gets their approval from their medical questionnaire, the office receives the products in time, and also receive the RPP Manual in time.  Otherwise, if you’re going to finish up the rest of the staff they won’t know what to do because they don’t have the manual.  
The Products are as follows: 

A. Fit Testing Hood – you will need one (1)
https://www.msdssafety.com/product/fit-testing-hood-59-ea

B. Fit Testing Bulb Nebulizer – you will need two (2)
https://www.msdssafety.com/product/fit-testing-bulb%E2%80%A6izer-69-ea-m9934/

C. Saccharine to make
Threshold (.83%) &  Fit Test Solution. (83%) – Premade will be sent out with no additional charge (if you purchase the rest of the products)
https://www.msdssafety.com/product/fit-testing-saccharine-powder-23-30ml-m3335/

D. N95’s  – you will need one (1) for every staff member to be Initially Fit Tested.  They come in a box of 20.  If you purchase two boxes of N95’s you get a package of 10 isolation gowns for free.  (Special through January) 
https://www.msdssafety.com/product/n-95-respirator-mask-m9920/

E. FIT TESTING N95’s for your Personalized Respiratory Protection Program for the Dental Healthcare Provider  – (3) needed if you want MSDS to train the DHP. 
https://www.msdssafety.com/product/personalized-respiratory-protection-program-for-the-dental-healthcare-provider-m9918/

E. Personal Respiratory Protection Program Manual for the Dental Healthcare Provider – If you purchase the Entire Training System, you will get $200 off of our RPP manual. Just email for a coupon code.  
https://www.msdssafety.com/product/personalized-respiratory-protection-program-manual-for-the-dental-healthcare-provider-m9926/

F. Occupational Health Physician Clearance & Secure Backup – This is for all staff members who will be wearing the N95 or White Listed KN95’s. This includes a Occ Healthcare Provider reviewing and potentially speaking with the staff.  It also includes the mandatory backup for 30 years past the staff members last day of employment.  
https://www.msdssafety.com/product/secure-backup-of-the-medical-questionnaires-and-occupational-clearance-m9922/

G. UV Lamp – The Newsletter will guide you on the fascinating study on this type of UV Lamp, destroying Covid in 60 seconds!
https://www.msdssafety.com/product/ultravoilet-light-uv-light-499-ea-1-m9923/
 

MSDS only has 6 cases of N95’s left, but enough to get all of my clients Initially Fit Tested and will track down more if needed.  I know all of the dental reps also have them available.  They must be NIOSH Approved. We are currently selling them for $4.50 each.  

I have had a lot of Clients state they were told –   level 3 masks with a full face shield if there is no N95’s. This is not going to fly anymore – as Dental Suppliers have NIOSH approved respirators available as does MSDS.    
 

** Links to accessories to help with UV light: 
 – Aluminum sheet (To Help reflect the UV light off a wall)
https://www.amazon.com/VIVOSUN-Mylar-Diamond-Highly-Reflective/dp/B01N5MHXQD/ref=redir_mobile_desktop?ie=UTF8&%2AVersion%2A=1&%2Aentries%2A=0
 
 
                                                                      VDH Announces New Contact Tracing Prioritization and Reduced Quarantine Guidelines

Virginia is Following Newly-Issued CDC Guidance
The Centers for Disease Control and Prevention is shortening the recommended quarantine period from 14 days after a person has been exposed to the coronavirus, offering two alternatives, the agency said Wednesday.

The first alternative is to end quarantine after 10 days if no symptoms are reported, Dr. Henry Walke, the CDC’s Covid-19 incident manager, said on a call with reporters. The second option is to end quarantine after seven days if an individual tests negative and also reports no symptoms.
https://www.vdh.virginia.gov/blog/2020/12/07/vdh-announces-new-contact-tracing-prioritization-and-reduced-quarantine-guidelines/

Dental Assistants
 are considered in the Numbers for receiving vaccinations, along with Dentists and Hygienists. 
  From the Virginia Department of Health:  

Dental assistants will indeed be included in Phase 1 of the vaccines.  

Dental Healthcare Providers will be section 4 of Phase 1. 

DVH states “Direct Care of Patients” for those in the Dental Healthcare numbers.  Question (1) about Covid-19 Vaccine 


Will N95’s be needed if Healthcare Providers get vaccinated?

Yes. While experts learn more about the protection that COVID-19 vaccines provide under real-life conditions, it will be important for everyone to continue using all the tools available to us to help stop this pandemic, like covering your mouth and nose with a mask, washing hands often, and staying at least 6 feet away from others. Together, COVID-19 vaccination and following CDC’s recommendations for how to protect yourself and others will offer the best protection from getting and spreading COVID-19. Experts need to understand more about the protection that COVID-19 vaccines provide before deciding to change recommendations on steps everyone should take to slow the spread of the virus that causes COVID-19. Other factors, including how many people get vaccinated and how the virus is spreading in communities, will also affect this decision.

There is not enough information currently available to say if or when CDC will stop recommending that people wear masks and avoid close contact with others to help prevent the spread of the virus that causes COVID-19. Experts need to understand more about the protection that COVID-19 vaccines provide before making that decision. Other factors, including how many people get vaccinated and how the virus is spreading in communities, will also affect this decision.

Note:  For additional info on what to expect after you take the vaccine can be found here.  

https://www.aappublications.org/news/2020/12/14/covid19-hcp-vaccination-121420



Question (2) Who has to pay for the vaccine?

You won’t have to pay for a COVID-19 Vaccine, At least in the beginning 
 People in the United States won’t need to pay for a coronavirus vaccine.It’s unclear how much the vaccine could cost on the other side of the pandemic.Uninsured people will also be able to get vaccinated for free during the pandemic.  It’s official: The COVID-19 vaccine will be free for all, regardless of whether you have private health insurance, are uninsured, or are on Medicare.

That is, people in the United States won’t need to shell over any cash for a coronavirus vaccine.

Many have wondered if the vaccine will come with unexpected costs, such as copays or administration fees. But private insurers and the Health Resources and Services Administration (HRSA) have confirmed the vaccine and appointment will be free, at least throughout the pandemic.

It’s unclear how much the vaccine could cost on the other side of the pandemic, but health insurance experts suspect people privately insured or on Medicare will still be able to get vaccinated at no cost.

After the pandemic, there may be a higher price for uninsured individuals.

Paying for the Vaccine if you have private insurance or Medicare
 The vaccine will be covered for people with private insurance, according to guidelines released by the Centers for Medicare and Medicaid Services (CMS).“Health insurers whose plans are subjected to the coverage of preventive services without cost-sharing requirement under the Public Health Service Act are not allowed to bill patients for the administration of the COVID-19 vaccine,” said Anh Nguyen, PhD, a health economics expert and assistant professor of economics at Carnegie Mellon University’s Tepper School of Business.Nguyen noted that this applies to both in-network and out-of-network providers.Private insurers such as Blue Cross Blue Shield (BCBS) and Oscar Health confirmed members will pay $0 for the vaccine.“If the primary purpose of a patient’s visit is to receive the COVID-19 vaccine, BCBS companies will cover the vaccine, administration services, and the office visit at no cost-share to the patient, even if the appointment is out-of-network, per regulations issued by CMS,” a BCBS spokesperson told Healthline.If the doctor’s visit includes health services unrelated to COVID-19, the person may be charged.“If a patient receives additional, non-COVID-19 care at the same appointment, patients will be covered for those services in accordance with their health plan,” the BCBS spokesperson said.Oscar Health, too, has committed to providing the vaccine for free to its members. There will be no charge for the vaccine itself or for the doctor’s visit associated with the immunization, Oscar Health confirmed.“People receiving the COVID-19 vaccine will not be billed with copays or unexpected administrative fees,” an Oscar Health spokesperson said. “Based on guidance so far from the federal government, plans and issuers must cover COVID vaccines without cost sharing.”According to Nguyen, this coverage benefit doesn’t apply to certain alternative healthcare plans, such as short-term limited duration insurance. Individuals on alternative plans may be subjected to copay or administration costs related to the vaccine.Some states may require these plans to cover costs related to COVID-19 similarly to how they did with testing for the disease.The CMS also states there will be no vaccine costs, administration fees, or deductibles for people on Medicare.Any COVID-19 vaccine that receives Food and Drug Administration (FDA) authorization “will be covered under Medicare as a preventive vaccine at no cost to beneficiaries,” the CMS states on its website.
 “During the pandemic, the COVID-19 vaccine will be free for all, regardless of whether you have private health insurance, are uninsured, or are on Medicare.

Administration fees for immunization-related appointments will be free as well.

After the pandemic, the vaccine will likely be covered as a preventative service for people on Medicare or private insurance. However, those who are uninsured may see a bigger price tag.”


https://www.healthline.com/health-news/you-wont-have-to-pay-for-a-covid-19-vaccine-during-the-pandemic?fbclid=IwAR3Ao2RDYsc34VPir1827mowFvZwZxu80uswT5529MLuVilzj-A8zJPtv8kQuestion (3) about Covid-19 Vaccine 

Since It will be available to Dental offices very soon, What do we do if a staff member refuses or fails to get vaccinated?



 Companies are considering compulsory Covid vaccination requirements as a condition of employment.“Under the law, an employer can force an employee to get vaccinated, and if they don’t, fire them,” said Rogge Dunn, a Dallas labor and employment attorney.Anti-discrimination laws would enable eligible employees to request an exemption from a company-wide coronavirus vaccine mandate. The country’s first Covid vaccine could be authorized for emergency use as soon as Thursday. If Pfizer and BioNTech get the green light, distribution is set to begin within days.But as difficult as the research, development and distribution stages have been, some experts argue the hardest part of fighting the virus is actually what comes next: convincing the U.S. population to take the vaccine.Roughly four in ten Americans say they would “definitely” or “probably” not get a vaccine, according to a recent survey by the Pew Research Center. While this is higher than it was two months ago, to achieve herd immunity, experts say that about 70% of the population needs to be vaccinated or have natural antibodies. Employers, however, may not be taking “no” for an answer.

“Under the law, an employer can force an employee to get vaccinated, and if they don’t take it, fire them.”Rogge Dunn
DALLAS LABOR AND EMPLOYMENT ATTORNEY  (even though this states Dallas Tx, it is Federal, not state)
“A couple of my corporate clients are leaning toward making the Covid vaccine mandatory,” said Rogge Dunn, a Dallas labor and employment attorney.His clients range from companies in manufacturing to food and beverage — industries that have been battered for months due to the pandemic and government-mandated lockdowns. A vaccine promises employers a return to some form of normal, which is desperately needed as businesses look to recover profits.

Note:  Please review with your Malpractice Insurance. Hospitals in the past gave options to the staff.  Malpractice can tell you the safest way to offer any type of options.Mandating the vaccine in the workplaceOne of Dunn’s clients in the restaurant sector thinks a compulsory inoculation requirement could be a game changer for business.“They think it gives them a competitive advantage,” explained Dunn. “They could say to their customers, ‘Hey, our restaurant is safe. All of our employees have been vaccinated.’”It may be, in part, a PR tactic, but Dunn said it is totally within an employer’s rights to implement this kind of requirement.“Under the law, an employer can force an employee to get vaccinated, and if they don’t take it, fire them,” said Dunn. Dorit Reiss, a professor at the University of California Hastings College of Law, said that private businesses have pretty extensive rights. “Requiring a vaccine is a health and safety work rule, and employers can do that,” said Reiss. Take the health-care system. Dr. Hana El Sahly, who oversees a clinical trial for Moderna’s vaccine candidate, believes hospitals could eventually make Covid inoculation a condition of employment, similar to how the annual influenza vaccine is required of all medical staff.“We all have to demonstrate that we took our flu shot before we go out and see our patients on the wards,” said El Sahly. “When we are sick, we cannot deliver vital functions to the community.”A few exceptionsThere are, however, a few notable exceptions to this kind of blanket requirement. If a work force is unionized, the collective bargaining agreement may require negotiating with the union before mandating a vaccine.Anti-discrimination laws also provide some protections. Under the Americans with Disabilities Act, workers who don’t want to be vaccinated for medical reasons are eligible to request an exemption. In this case, an employer would have to provide reasonable accommodation, such as allowing the employee to work remotely. Under Title VII of the Civil Rights Act of 1964, if taking the vaccine is a violation of a “sincerely held” religious belief, they, too, would potentially be able to opt out.  

Note from MSDS:  Talk to your Malpractice Insurance.  Make sure you are okay with the directions you are taking.  
https://www.cnbc.com/2020/12/07/covid-vaccine-update-your-boss-can-fire-you-if-you-refuse-the-coronavirus-shot.html?fbclid=IwAR03M0xYLIbXYzyi_rklmqT2AfBNEm–L0ntihLhzx-0z3Jm-RansLxjWm8
 

Covid Vaccine with Booster in three (3) weeks, along with side effects and benefits.

 We may still not know precisely how long immunity to the new coronavirus lasts, but researchers don’t think it’s forever.”With human coronaviruses,  you can get repeatedly infected — you’re not immune for life, you’re immune for some time,” Florian Krammer, a vaccinologist at the Icahn School of Medicine at Mount Sinai, told Business Insider.”There’s no reason to think this coronavirus will behave differently,” he added.That means that even after coronavirus vaccines become available and get widely distributed, we’ll likely need booster shots to stay protected over time.”If immunity does turn out to be fleeting, we’ll need a plan of a vaccination plus a booster, or revaccination at periodic intervals,” Marm Kilpatrick, a disease ecologist, previously told Business Insider. Two shots to start, then perhaps boosters, tooThe two leading coronavirus vaccine candidates so far, from Moderna and Pfizer, both require two shots. Moderna’s two doses are administered a month apart, while Pfizer’s are given three weeks apart.The more shots we need, however, the harder it is to ensure everyone gets them.Plus, a two-dose vaccine regimen comes with supply-chain challenges: it requires twice as many vials, syringes, refrigerators, and clinic visits at a time when such resources are already limited.

 But even after all those problems are mostly solved, a new challenge will arise: the need to figure out when our immunity fades, and if — or when — a booster shot is needed. 
 “Once we start seeing vaccine failures increasing, then we can consider booster doses,” Walt Orenstein, the former director of the US National Immunization Program, previously told Business Insider. He added, though, that “we don’t know at this stage whether that will be necessary.”Some viruses, like hepatitis A or measles, are a one-and-done deal: Once you’re infected (or inoculated), you’re immune for life. But with coronaviruses, reinfection is possible after a period of months or years, according to the Mayo Clinic. That only happens to a fraction of people, though, and their second illness is usually mild.Indeed, limited evidence suggests people could get reinfected with the new coronavirus. Some research has found that coronavirus antibodies decline after a period of months, which could mean our immunity might be similarly transient. Given that the efficacy of a vaccine hinges on its ability to prompt the body to generate antibodies, it’s therefore unlikely coronavirus shots will be a one-time affair. But our immune systems do have more than just antibodies defending us from future infection, and a recent study suggests those other defenses stick around for at least six to eight months. Time will tell if we’ll need boostersIt’s not a deal-breaker if people become susceptible to reinfection.”This happens for a lot of vaccines,” Krammer said. “It’s not a problem. You can get revaccinated.”That’s what booster shots are for. Your tetanus vaccine, for example, requires a booster every decade. The question is how frequently follow-up coronavirus shots might be needed, but experts won’t be able to answer that until vaccines are widely distributed.


 For now, Orenstein said, public-health officials should start making a plan now to keep track of how well the shots work long-term:
 “It’s critical, as the vaccine is rolled-out, to have continued evaluation,” he said, adding, “we need to measure vaccine effectiveness in observational studies to see whether it declines or not.”That work, he said, should begin alongside the earliest vaccine rollouts.”We don’t want to wait two, three, four years before doing so,” Orenstein added. Monitoring will also be crucial to determine whether the vaccine efficacy that Moderna and Pfizer have found in their trials — 94.5% and 95%, respectively — hold up outside of clinical conditions in the first place.For example, researchers could implement a surveillance system that looks at new COVID-19 cases and notes how many infections are diagnosed in vaccinated versus unvaccinated people, Orenstein said.”If the rates are comparable, that’s a sign of waning immunity, he said. “That’s when we’d need to determine whether boosters are necessary, and if so, how often.”
 But if it turns out that people need to be revaccinated regularly, that decreases the likelihood that people will get the shots they need to stay protected.”The more complicated the schedule, the more difficult it is to get people to come in,” Orenstein said.


https://www.businessinsider.com/coronavirus-booster-shots-after-initial-vaccination-2020-11







What to Expect after Getting a COVID-19 Vaccine

COVID-19 vaccination will help protect you from getting COVID-19. You may have some side effects, which are normal signs that your body is building protection. These side effects may affect your ability to do daily activities, but they should go away in a few days.

 Common side effectsOn the arm where you got the shot:PainSwelling Throughout the rest of your body:FeverChillsTirednessHeadache Helpful tips
If you have pain or discomfort, talk to your doctor about taking an over-the-counter medicine, such as ibuprofen or acetaminophen.
 To reduce pain and discomfort where you got the shot:Apply a clean, cool, wet washcloth over the area.Use or exercise your arm. To reduce discomfort from fever:Drink plenty of fluids.Dress lightly. When to call the doctorIn most cases, discomfort from fever or pain is normal. Contact your doctor or healthcare provider:If the redness or tenderness where you got the shot increases after 24 hoursIf your side effects are worrying you or do not seem to be going away after a few days RememberSide effects may feel like flu and even affect your ability to do daily activities, but they should go away in a few days.With most COVID-19 vaccines, you will need 2 shots in order for them to work. Get the second shot even if you have side effects after the first shot, unless a vaccination provider or your doctor tells you not to get a second shot.It takes time for your body to build protection after any vaccination. COVID-19 vaccines that require 2 shots may not protect you until a week or two after your second shot.
It’s important for everyone to continue using all the tools available to help stop this pandemic as we learn more about how COVID-19 vaccines work in real-world conditions. Cover your mouth and nose with a mask when around others, stay at least 6 feet away from others, avoid crowds, and wash your hands often.
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html
 

Here are the sample Invoices:

 
*** Above payment in the future would only be the Occupational Health Physician Clearance and Secure Backup of the Medical Questionnaire   The manual is only a one time fee,  and MSDS will keep it updated for the office.  The trained fit tester would be taking the RPP Fit Test per Staff out of the Equation.  However, we would always be available to help again if the need arose.**



  WINNER OF THE WEEK 


Winner of the week
 
Instead of the “Question of the week”; MSDS will be adding:
*Questions and concerns from our clients  
*Literature of Potential scam/spam
*Updates from the Board of Dentistry
*New Regulations from Federal or State
*And Grammar/Spelling Errors.  

  
      Weekly winners will receive a $10.00 gift card to Starbucks!
 

                               Names are drawn by the app below.     
             https://miniwebtool.com/random-name-picker/

                                  

 Organizing your computer for MSDS:Make a folder on your desktop named MSDS.Double click the folder.Create Folders for each category. OSHA-BBP, OSHA Safety Classes, HIPAA, Medical Emergency, BLS-CPR, etc.In each folder, for example, HIPAA:You’ll have the Business Associate Agreement, Patient Consent Form, Office’s Privacy Practice, etc.    We love our ClientsMSDS911ADDITIONAL SERVICES OSHA-BBP Exposure Control Plan.Mandatory by Federal OSHA-BBPRequired to be PersonalizedReviewed Annually by all office staff involved in OPIM. (Other Potentially Infectious Materials)This manual is also called: The OSHA manual, The Exposure Control Plan or The Bloodborne Pathogen manual.  

If you want MSDS to help you with your Personalized manual.  The cost for non clients is $450.00.  Cost for Clients is $250.00 this gives you not only a personalized manual in binder form, but also in PDF which is the format the Inspectors will want you to have.  Best to know that we will not have you answer incorrectly vs. you writing your own manual and the manual is incorrect.  MSDS can boast that our manual has never been given anything less than an A+ from an OSHA inspector.  

MSDS
Linda L. Cannon
Director of Safety Compliance

Phone: 1-757-718-1515
Toll Free: 1-800-483-0223

Email: [email protected]

www.MSDSSafety.com

MSDS' best practices website is not a standard or regulation, and it creates no legal obligations, nor does it change any existing OSHA or other government standard or regulation. The guide is advisory in nature, informational in content, and is intended to assist employers in providing a safe and healthful workplace.