County of Marin Health and Human Services

MCPH OPIC Newsletter #7 October

MCPH OPIC Newsletter #7 October
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OPIC Monthly Newsletter

Issue 7                                                                    October 12, 2023

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.

Guidance Updates

Marin County Public Health Order
Marin County, alongside other Bay Area counties, instituted a health order that requires patients, staff and visitors to wear a mask in hospitals and skilled nursing facilities for the fall and winter virus season, November 1, 2023 through March 31, 2024.

The intent of the order is to protect individuals in these high-risk healthcare settings and limit the spread of seasonal respiratory viruses including RSV, influenza, and COVID-19. It will apply to all individuals within the facility while they are in patient care areas. Children under age 6 and those with a valid medical reason are exempt.

Marin County Public Health Advisory
Local Spike in Fentanyl Use and Overdoses
During the week preceding September 17, 2023, the concentration of norfentanyl, a marker of fentanyl use, doubled in Marin wastewater compared to the previous week. The following week, Emergency Medical Services responded to eight suspected opioid overdoses, double the usual weekly rate. This pattern could signify increased availability and intentional use of fentanyl or increased levels of fentanyl contamination in other substances.


All Facilities Letters (AFLs) from CDPH

COVID-19 Treatment Resources for Skilled Nursing Facilites

AFL 23-29 Coronavirus Disease 2019 (COVID-19) Treatment Resources for Skilled Nursing Facilities (SNFs)  provides guidance recommending that all SNF residents with symptomatic COVID-19 be evaluated by a prescribing clinician to be considered for COVID-19 therapeutics. This AFL also provides information regarding available guidance and resources and recommends SNFs provide information on appropriate therapeutics to their healthcare personnel (HCP) who have symptomatic COVID-19. 

Legal Requirement to submit immunization data

AFL 23-26 New Legal Requirement to Submit Immunization Data is now available. This AFL notifies SNFs and ICFs of the chaptering of AB 1797 (Chapter 582, Statutes of 2022) requiring all California healthcare providers to report vaccine administration information to a California Immunization Registry (CAIR or Healthy Futures/RIDE).SNFs and ICFs must ensure that they enter every vaccine administered, along with patient’s race and ethnicity, into the immunization registry to support access to immunization data needed for the Centers of Medicare and Medicaid Services (CMS) reporting.

If you have any questions about this AFL, please contact the CAIR Help Desk via email at or phone at 800-578-7889. or your Local CAIR Representative

View AFLs at the All Facilities Letter webpage.  


PINs from CDSS

Influenza and RSV Vaccination Recommendations 

The best way to prevent flu and its potentially serious complications is by getting a yearly flu vaccine.  CDC recommends flu vaccination for everyone 6 months and older.  Flu vaccination is especially important for people 65 years and older because they are at higher risk of developing serious flu complications. 

New CDC RSV Vaccination Recommendations

RSV infections can cause severe illness in older adults, including pneumonia, as well as worsening of underlying medical conditions like asthma, other chronic lung disease or congestive heart failure.  Adults at highest risk for severe RSV infection include:

  • Older adults
  • Adults living in long-term care facilities

The CDC recommends use of new RSV vaccines from GSK and Pfizer for people 60 years and older based on discussions with their healthcare provider about whether RSV vaccination is right for them.  These new vaccines are available now.
Expired COVID-19 Test Kit Guidance

Marin Public Health recommends that you suspend use of test kits that are beyond their extension date.  

Please dispose of all test kits that are beyond the FDA Extension date. 
At this time, County Public Health has limited supply of test kits.  While we work with CDPH to secure additional, non-expired test kits, please work with your vendors to purchase additional test kits, as needed for your facility/agency, to ensure CalOSHA / CDPH / CDSS compliance.

Marin Updates 

Marin County Public Health dashboards share local data and public health priorities to engage and educate the community we serve. Explore information on Reportable Communicable Diseases, COVID-19, InfluenzaLife Expectancy by Community, Non fatal and Fatal Overdoses, Hepatitis C, and the COVID-19 Community Assessment.

Multi-Drug Resistant Organisms (MDROs) News, Resources, and Trainings
Marin County Public Health is maintaining our focus on the threat of Multi-Drug Resistant Organisms. 
If your facility would like to receive an onsite training on MDROs and Enhanced Standard Precautions, please email your request to


Stay tuned for upcoming educational opportunities and news.

Upcoming Trainings

CDPH HAI IP Training for SNFs
The California Department of Public Health (CDPH) Healthcare Associated Infections (HAI) Program's Infection Prevention (IP) Training for Skilled Nursing Facilities (SNF) Online Course is back.  

The course provides practical guidance for implementing an infection prevention program in a skilled nursing facility (SNF) using evidence-based guidelines for preventing serious healthcare-associated infections (HAIs) including central line associated bloodstream infections (CLABSI), Clostridioides difficile infection (CDI), and catheter-associated urinary tract infections (CAUTI). 


California Department of Public Health/HAI Program approved by the California Board of Registered Nursing, Provider # 17280, for 18 contact hours. Register via the link below:

Infection Prevention (IP) Training for Skilled Nursing Facilities (SNF) Online Course Landing webpage:  

Virtual Long-Term Care IP Essentials Training
October 18–20, 2023
Managing infection prevention and control (IPC) in long-term care settings presents a unique set of challenges and issues. This training provides the foundation of the role of the infection preventionist (IP) and the practice of being an effective IP in a long-term care setting, including creating and managing successful IPC programs and mitigating risk at your facility. This training also covers CMS required topics. Learn more and register today!

Virtual LTC-CIP Certification Preparation Course
November 13–15, 2023
The LTC-CIP Certification provides a standardized measure of the basic knowledge, skills, and abilities expected of professionals working in the field. Successful long-term care infection prevention certification indicates competence in the practice of infection prevention and control within a long-term care setting. This comprehensive workshop includes guidance and support from a certified instructor(s) and access to the APIC Learning System for LTC-CIP. Space is limited, enroll today!

California Association of Long Term Medicine (CALTCM)
Infection Preventionist Orientation Program on demand training

This “on-demand” program is specifically targeted to infection preventionist nurses, however all who have a leadership role in infection prevention in a long term care setting will benefit. Infection Preventionists, Directors of Nursing, Assistant Directors of Nursing, Directors of Staff Development and more will have the opportunity to learn directly from an important leader in the field of infection prevention in long term care setting, Dolly Greene, RN, BSN, CIC. The CALTCM Infection Preventionist Orientation Program provides all the foundational information an Infection Preventionist needs to get started in their role through four (4) training modules.

  • Module 1 – Infection Preventionist Duties and Outcome Surveillance (1:08 min)
  • Module 2 – Process Surveillance and Antibiotic Stewardship (45 min)
  • Module 3 – Occupational Health & Immunization Program (43 min)
  • Module 4 – Infection Preventionist Resources and Tools (25 min)


Infectious Disease toolkits

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Marin County Public Health's Monthly Updates for LTCFs provide updates regarding guidance, surveillance updates, and professional training opportunities. Please contact

Next MCPH Monthly meeting is: Tuesday, October 24, 2:00-3:00 PM

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