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The Outbreak Prevention and Infection Control (OPIC) team's mission is to provide support to healthcare and congregate care facilities as you mitigate and manage risks due to communicable diseases and emergencies. We do this by promoting high levels of readiness, ensuring effective responses, and providing training and educational opportunities. Our monthly newsletters include: news and guidance updates, community status updates, available trainings and other educational opportunities.
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Guidance Updates
- Bookmark this overview of all active COVID-19 AFLs, and all expired AFLs.
- Order of the State Public Health Officer - Adult Care Facilities and Direct Care Worker Vaccine Requirement is no longer active. Meaning, CMS will no longer require HCP to have the primary series of COVID-19 vaccines.
- PIN 23-12-ASC, effective July 1, 2023, the Infection Control regulations are permanently adopted of the California Code of Regulations (CCR), Title 22, Division 6, Infection Control regulations for Adult and Senior Care licensees
- Chapter 2, Social Rehabilitation Facilities (SRF), Section 81095.5
- Chapter 3, Adult Day Programs (ADP), Section 82095.5
- Chapter 6, Adult Residential Facilities (ARF), Section 85095.5
- Chapter 8, Residential Care Facilities for the Elderly (RCFE), Section 87470
- Chapter 8.5, Residential Care Facilities for the Chronically Ill (RCFCI), Section 87895.5
- PIN 23-13-ASC provides information on the end of the vaccination and booster requirement for all workers in Adult and Senior Care (ASC) facilities and the end of the masking requirement in ASC facilities. This PIN also provides the latest guidance to ASC licensees on screening, testing, isolation and quarantine, visitation, and infection control requirements.
- SARS-CoV-2, Influenza Virus and RSV Result Reporting
- Report results electronically to the CalREDIE system within 24 hrs.
- Facilities certified under CLIA to perform non-waived testing must report:
- All laboratory-based SARS-CoV-2 and influenza virus Nucleic Acid Amplification Tests (NAAT) results, including positive and non-positive (negative, indeterminate, etc.) and are requested to report all RSV NAAT results, including positive and non-positive (negative, indeterminate, etc.).
- All SARS-CoV-2 and influenza virus non-NAAT diagnostic testing (e.g., high throughput antigen testing) results, including positive and nonpositive results of and are requested to report RSV non-NAAT diagnostic testing results, including positive and non-positive (negative, indeterminate, etc.).
- Facilities conducting testing with a CLIA Certificate of Waiver (e.g., skilled nursing facilities, schools):
- Reporting of positive and non-positive results for SARS-CoV-2, influenza virus, and RSV is not required.
Please reach out to calrediehelp@cdph.ca.gov with any questions.
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Multi-Drug Resistant Organisms (MDROs) News, Resources, and Trainings
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Marin Updates
Here is a link to the current list of approved and permitted private ambulance providers authorized to perform ambulance transports here in Marin County. NorCal Ambulance is the only provider with an ambulance base here in Marin; however, the other providers are in adjoining counties and often have ambulances in Marin throughout the day.
Public Health Advisory
Marin County Public Health issued this advisory to healthcare providers regarding the increasing availability and use of hemp products that cause intoxication and adverse effects, especially in youth.
Public Health Surveillance Dashboards
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Upcoming Trainings and Opportunities
Great opportunity! NHICS Training & TTX. Open to all sites.
Please join us on Zoom for our rescheduled NHICS Tabletop Exercise & Training
Thursday, June 29th 1:00-2:30pm!
The County of Marin’s Public Health Preparedness’s department is excited to partner with Ray Boudewyn from Prevent and Prepare, LLC for our Nursing Home Incident Command System’s (NHICS) training! It would be most beneficial if you have more than 1 person attend this training from your facility for the Tabletop Exercise.
To register for the training, please email: LTCFReport@marincounty.org to receive the zoom meeting invitation and link.
Facility Evacuation: Lessons Learned
Training held May 4, 2023: RECORDING
Virtual Infection Prevention Train the Trainer Workshops, by CDPH
Trainings are repeated four times per week for each workshop topic to accommodate schedules. Choose one day/time per workshop topic to attend.
Certified Nursing Assistant IPC Curriculum
Multiple offerings: July 17-21
Register HERE
EVS IPC Curriculum for EVS Managers
Multiple Offerings: August 21-15
Register HERE
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NEWS
Medical Redeterminations
Continuous coverage and enrollment in Medi-Cal is ending, along with the end of the Public Health Emergency. That means, anyone enrolled in Medi-Cal will be receiving a redetermination packet, and that will need to be completed. If their paperwork is not completed, the person will lose their Medi-Cal. Please help beneficiaries report contact information changes, so they receive paperwork at the right address. Call Center: 877-410-8817 and BenefitsCal.com.
MORE evidence that routine vaccine is particularly important for our elderly; this report describes durability of protection for bivalent COVID-19 vaccination among immunocompromised adults: Estimates of Bivalent mRNA Vaccine Durability in Preventing COVID-19–Associated Hospitalization and Critical Illness Among Adults with and Without Immunocompromising Conditions
Improving Communication From Hospital to Skilled Nursing Facility Through Standardized Hand-Off: A Quality Improvement Project
The U.S. Food and Drug Administration (FDA) approved naloxone hydrochloride nasal spray (Narcan) for over the counter (OTC) nonprescription use. This action allows the life-saving medication to reverse an opioid overdose to be sold directly to consumers. For the specific provisions that must be followed by licensees and staff at adult or senior care facilities, please see PIN 19-20-ASC – The California Overdose Treatment Act.
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re now widely available. Marin Public Health and the 
Scarlett and Rizzo, the COVID-sniffing dogs familiar to Marin’s long term care facilities, are gaining national attention. Their effectiveness in school-based screening was described 
The California MAT (Medication Assisted Treatment) Expansion Project is offering free 
While we have finally seen the end of a long winter of atmospheric rivers, Marin Public Health is now preparing for the wildfire season, which includes 
se, Marin County Public Health is also going back to the basics. You can still stay up to date with 
Anyone who wants protection from MPX infection may receive the MPX vaccine. There is no shortage of MPX vaccines now. Anyone at risk of getting MPX can now receive the JYNNEOS vaccine to prevent infection. Healthcare providers can now offer the intradermal or subcutaneous regimen based on patient preference. Due to stigma related to vaccine administration, patient preference of vaccine route should be a consideration. For a detailed list of priority groups for vaccination and a list of providers offering MPX vaccines, please visit the 
Learn more about the 
arks website
February has been a dynamic month in the worlds of communicable disease prevention and control and public health emergency preparedness. In Marin County, we have valued community assets that increase our resilience. We have Neighborhood Response Groups (NRGs), Community Emergency Response Teams (CERT), the Marin Medical Reserve Corps (MMRC), Marin County Voluntary Organizations Active in Disaster (VOAD), Disaster Councils, among others -- whose members have invested significant amounts of time and energy to increasing our community's readiness for emergencies and disasters. With wild fire season around the corner, we should follow their lead by visiting 
While pesticide intoxications are rare, they are potentially fatal and may represent ongoing risk to the community. Under California law, any known or suspected pesticide-related illness or injury must be reported within 24 hours. Timely reporting on your part allows the 
One clear theme of the past few months -- with a late end to wildfire season and evacuation shelters, extended power shut-offs, and emerging infectious diseases --- is the need to remain ready and able to respond to crises as a community. These challenges reveal our mutual interdependence as a healthcare system and we're grateful for your ongoing engagement as we build even stronger capacity.
endix to the County's 
Flu Update
that describe the clinical features of measles, including diagnosis, treatment and infection control measures. This year, there have been 5 measles outbreaks in California, 4 of which were linked to international travel. Providers should make sure patients have measles protection before international travel.
a poster to help remind clinicians about how to administer PEP. The poster can be downloaded 
Marin Recognizes Overdose Awareness Day
Public Health Program Spotlight: STD Prevention and Control
Message from the Deputy Public Health Officer
Due to an expected shortage of APLISOL, the Centers for Disease Control and Prevention (CDC) is 
orld Health Organization (WHO) declared the current Ebola outbreak in the Democratic Republic of the Congo a 
The Rabies Control Program is one of Marin County's mandated communicable disease prevention and control programs. Annually, 10-12% of captured bats in Marin County test positive for rabies. Most human rabies cases in the United States have been caused by bat bites that were unrecognized or undetected due to bats' extremely fine teeth. Human rabies can be prevented by providing rabies pre-exposure prophylaxis (if indicated), prompt local treatment of bite wounds, and/or appropriate rabies post-exposure prophylaxis. Marin County Public Health works closely with 
Last month, we informed readers about the risk of extended power outages (3 - 5 days) due to the launch of PG&E's 
Public Safety Power Outages
Preparing for Measles in Marin
is an exception. Thanks to 
California State Board of Pharmacy, Marin County Health and Human Services, and RxSafe Marin are hosting a free Continuing Education forum for pharmacists on July 20th, 
Public Health Program Spotlight: Community Epidemiology
Marin County Whole Person Care pilot program
Opioid overdose remains a leading cause of accidental death in Marin. The 
ars old may benefit from daily aspirin. On the other hand, it is no longer recommended to start or continue aspirin for primary prevention. Aspirin is still recommended at any age for clinical ASCVD. As guidelines change, healthy eating and active living remain the mainstay for cardiovascular and diabetes prevention.
Marin's response to the opioid epidemic was highlighted at the RxDrug Abuse and Heroin Summit in Atlanta last week. The 
to the WIC Program. For more information, please call 415-473-4029 or email: 
Second Wave in Seasonal Flu
updated. Direct any questions to Marin County HHS Communicable Disease Prevention and Control unit at 415-474-4163.
t Marin city to take action against the harms of vaping and flavored tobacco, joining Corte Madera, Larkspur and Sausalito. This follows the lead of the County Board of Supervisors' 2018 vote to prohibit the sale of all flavored vaping and tobacco products in unincorporated areas of Marin. This response is being mirrored in Sacramento, where
Many low-income Marin residents are food insecure and experience higher rates of preventable cardiovascular disease. The Marin City Health and Wellness Center food pharmacy program offers low-income patients the fresh taste and nutritional benefits of produce direct from local farms. Clinic patients who screen positive for food insecurity are given a prescription for free produce at the weekly Rollin' Root mobile market, provided by the Agriculture Institute of Marin and supported by Marin HHS. Other sites that offer affordable local produce through Rollin' Root are available 
o measles. While recent measles outbreaks in other states have sparked concern, Californians are not at significant risk for measles unless they travel to Clark County. While providers should consider measles in patients with fever and a descending rash, measles is unlikely in the absence of contact with a confirmed case of measles or a history of travel or exposure to travelers. The California Department of Public Health (CDPH) has issued 
Association (WFA) for celebrating the diverse cultures of our county. The Global Stage showcased community performers' artistic interpretations and expressions of the "All for One & Fun for All!" theme. The fair also hosted an International Festival of Short Film and Video, culinary contests, including a Recetas Latinas Contest for Latino foods, and an Out at the Fair day for Marin County's LGBTQ+ community.
ergency shelter beds. After a decade, the Rotating Emergency Shelter Team (REST), which provided 60 additional winter emergency shelter beds, ended in April 2018. This season, HHS developed a Severe Weather Emergency Shelter (SWES) plan to open emergency shelter beds when cold-weather conditions increase the risk of hypothermia-related morbidity and mortality for residents who are unsheltered. This winter season, we have activated the SWES plan four times and provided seven nights of shelter at the Health & Wellness Campus. 
018, there has been an outbreak of pertussis (aka whooping cough) in Marin County. Outbreaks commonly occur every 3 to 5 years. Compared to 44 cases of pertussis in 2017, Marin County had 249 reported cases in 2018. As of January 2019, there were 18 confirmed cases of pertussis in Marin County. Visit Marin HHS' 
essments and services to low-income children and youth in California. In 2016, the CHDP adopted the American Academy of Pediatrics' (AAP) 
Training our "First" First Responders
Limiting Local Antimicrobial Resistance 
reporting
Public Charge
Congenital Syphilis
Marin Passes Flavored Tobacco Ban 
Wildfire Smoke Response 