Latest Updates:Due to the rapidly changing information available on COVID-19, this page is updated frequently. The latest updates include:
- Long-Term Care Facilities” links to content within the page (updated 3/27/2020)
- Coronavirus “Self-Checker” links to content within the page (updated 3/23/2020)
- Pregnancy And COVID-19 links to content within the page (updated 3/23/2020)
- Advisor Live® webinar: COVID-19: Implications for Clinicians links to content within the page (updated 3/20/2020)
COVID-19 (formerly 2019-nCoV)
- Coronaviruses are common around the world and cause a range of illnesses in humans, from the common cold to SARS and MERS. Viruses of this family also cause disease in animals. CDC confirmed person-to-person transmission in the U.S on Jan. 30. opens in a new tab On Feb. 26, they confirmed a possible instance of community-spread opens in a new tab of the virus that causes COVID-19.
- Complete CDC information and recommendations to date are available here opens in a new tab . The situation is unfolding dynamically; guidance will evolve.
- NEW: CDC Coronavirus “Self-Checker”. opens in a new tab The purpose of the Coronavirus Self-Checker is to help you make decisions about seeking appropriate medical care. This system does not replace the judgment of healthcare professionals or the performance of any clinical assessment.
- The WHO COVID-19 opens in a new tab outbreak website contains excellent videos on topics, such as, proper use, removal and disposal of PPE, and infographics for download. It also houses up-to-date facts and global statistics on the disease.
- The U.S. Environmental Protection Agency (EPA) released a list of EPA-registered disinfectants that are qualified for use against COVID-19 opens in a new tab on March 5. The SARS-CoV-2, is a coronavirus that causes COVID-19. Coronaviruses are enveloped viruses, meaning they are one of the easiest types of viruses to kill with the appropriate disinfectant product. Follow manufacturer’s direction for use of the product; pay close attention to the contact time (how long product must remain on the surface). Disinfect high touch surface areas frequently.
- The Centers for Medicare and Medicaid Services (CMS) just released a memoon CMS website opens in a new tab stating, effective immediately, that all hospital inspections will focus solely on infection prevention and control procedures. This is a call to action for HCWs to ensure they are actively implementing comprehensive infection prevention and control practices. CMS provided a checklist PDF opens in a new tab to guide facilities how to prepare for potential inspection.
Recommendations for Healthcare Providers
CDC – Clinician Outreach and Communication Activity (COCA) COVID-19 calls/webinars. opens in a new tab Recent topics include: Updates for Infection Prevention and Control; Long Term Care Facilities; and Caring for Children and Pregnant Women.
Protection of healthcare workers is a priority. This revised interim guidance prioritizes the use of N-95 respirators and other respiratory protection devices during high-risk procedures while still protecting healthcare personnel with facemasks and eye protection during other routine patient care activities in the setting of temporary respirator shortages.
In a March 10 memo issued to State Survey Agencies, CMS is expanding the allowable types of facemasks healthcare workers may use in situations involving COVID-19 and other respiratory infection. CMS also alerted state surveyors they are not required – on a temporary basis – to validate the date of a facility’s last annual test of the fit of N95 masks worn by workers in Medicare- and Medicaid-certified facilities. CMS took this step to minimize the discarded masks associated with such testing. Only annual fit testing validation is being waived.
CMS – Current Emergencies Website: COVID-19 opens in a new tab opens in a new tab This site includes clinical/technical, coding/billing and survey/certification guidance. Recent updates:
- Guidance to hospitals with emergency departments (EDs) on patient screening, treatment and transfer requirements opens in a new tab to prevent the spread of infectious disease and illness, including COVID-19, and remain in compliance with Emergency Medical Treatment and Labor Act (EMTALA) requirements. CMS has issued a frequently asked questions and answers on EMTALA opens in a new tab.
- Protecting patients, residents and healthcare workers in home health agencies opens in a new tab and dialysis facilities. opens in a new tab
- At present, there is no vaccine or specific treatment for COVID-19 infection; care is supportive. CDC’s current interim recommendations are available here. opens in a new tab
- Given the evolving nature of COVID-19 in the U.S., CDC now recommends clinicians use best judgment to make testing decisions. Priority for testing includes hospitalized patients with lower respiratory illness symptoms and fever; older adults; those with underlying co-morbidities/pre-existing conditions; and HCWs with symptoms.
- Symptomatic patients should wear a surgical mask and be placed in a single occupancy room; the ideal location is an airborne infection isolation room.
- Healthcare workers should adhere to standard precautions, contact precautions and use eye protection, e.g., goggles or face shield. CDC does not recommend the general public wear surgical face masks; masks are needed for those who are infected or suspected of being infected.
- CDC has provided updated strategies to optimize the supply of N95 respirators opens in a new tab on Feb. 29, in brief:
- Know your current N95 inventory.
- Understand your N95 utilization rate.
- Ensure compliance with robust policies and procedures for appropriate use, proper fit testing and demonstrated competencies in putting on and taking off (sometimes referred to as “donning and doffing”) respirators and other PPE.
- CDC and FDA opens in a new tab took actions to increase access to respirators, i.e., N95s for HCWs on March 2.
- CDC updated its interim guidance for risk assessment and public health management of HCWs with potential COVID-19 exposure opens in a new tab on March 4.
- If you are sick, stay home; do not go to work. Reach out to your employer for guidance on options and resources.
- As always, hand hygiene and cough etiquette (cover the cough – not with your hand) are invaluable prevention tactics.
- For the Americans, in general, be prepared for the possibility of a COVID-19 outbreak in your community. Take measures to reduce the spread of COVID-19. CDC has made resources, guidance and communication materials available for individuals and communities, opens in a new tab including nonpharmaceutical interventions (NPIs).
Long-Term Care Facilities (LTCFs)
- CDC’s Clinician Outreach and Communication (COCA) webinar: Coronavirus Disease 2019 (COVID-19) Update and Information for Long-term Care Facilities (March 17, 2020) opens in a new tab
- CDC’s Morbidity and Mortality Weekly Report (MMWR) COVID-19 in a Long-Term Care Facility — King County, Washington, February 27–March 9, 2020 opens in a new tab
- Guidance for Retirement Communities and Independent Living opens in a new tab. Plan, prepare and respond to coronavirus disease 2019
- CMS Announces New Measures to Protect Nursing Home Residents from COVID-19 opens in a new tab (March 13, 2020):
- Restricting all visitors, effective immediately, with exceptions for compassionate care, such as end-of-life situations.
- Restricting all volunteers and nonessential healthcare personnel and other personnel (i.e., barbers).
- Cancelling all group activities and communal dining.
- Implementing active screening of residents and health care personnel for fever and respiratory symptoms.
- COVID-19 – Long Term Care Facilities Guidance opens in a new tab
- IDPH Long Term Care COVID-19 Guidance
- Visitor Restriction Guidance
- Checklist for Long Term Care Facilities opens in a new tab
- Sample Long Term Care Facility Letter
- Employee Monitoring Tool opens in a new tab
- Coronavirus Resources opens in a new tab: Practical information and resources for providers; friends and family; and residents and patients.
- AMDA Update on COVID-19 site opens in a new tab, includes guidance, resources and tools.
Pregnancy and COVID-19
- American College of Obstetricians and Gynecologists (ACOG) – Novel Coronavirus 2019 (COVID-19) opens in a new tab
- ACOG and the Society for Maternal-Fetal Medicine – Algorithm opens in a new tab to aid practitioners in assessing and managing pregnant women with suspected or confirmed COVID-19
- CDC – Interim Considerations for Infection Prevention and Control of Coronavirus Disease 2019 (COVID-19) in Inpatient Obstetric Healthcare Settings opens in a new tab
- CDC – Pregnancy and Breastfeeding opens in a new tab – Currently, it is not known if pregnant women have a greater chance of getting sick from COVID-19 than the general public nor whether they are more likely to have serious illness as a result. Pregnant women should do the same things as the general public to avoid infection.
- Cover your cough (using your elbow is a good technique)
- Avoid people who are sick
- Clean your hands often using soap and water or alcohol-based hand sanitizer
- Society for Maternal-Fetal Medicine (SMFM) – COVID-19 resources opens in a new tab
Surge: Capacity and Capabilities
Surge capacity, meaning a facility’s or healthcare systems’ ability to handle a sudden increase in volume or demand, is fundamental to disaster preparedness. Surge capability is focused on meeting specialized needs, i.e., need for ICU care or specific care need, such as, isolation. Preparation is key.
- ASPR – Enhancing Medical Surge Capacity (April, 27, 2018) opens in a new tab
- ASPR – Hospital Preparedness Program (HPP): Hospital Surge Evaluation Tool opens in a new tab
- CDC – Steps Healthcare Facilities Can Take Now to Prepare for Coronavirus Disease 2019 (COVID-19) opens in a new tab
- HHS – Medical Surge Capacity Handbook opens in a new tab
- Wisconsin Department of Health Services – Guidelines for Managing Hospital Surge Capacity opens in a new tab. Wisconsin Healthcare Emergency Preparedness Program. Expert Panel on Medical Surge Capacity. (Rev. March 2015)
Communities also have a key role to play as active participants in planning for and responding to local health care crises, such as COVID-19.
Laboratory Specimen Collection, Testing and Reporting
- CDC updated its interim guidelines opens in a new tab for clinical lab specimens of Persons Under Investigation (PUIs) opens in a new tab and lab biosafety on Feb. 14. Providers should contact their local/state health department immediately to notify them of patients with fever and lower respiratory illness who live in or have traveled to an area with sustained transmission OR who have been in close contact (within six feet for at least 10 minutes) with a confirmed COVID-19 patient.
- Organizations with Premier® Clinical Surveillance technology and services opens in a new tab, powered by TheraDoc®, can deploy real-time alerts or set population flags to identify and track patients with suspected or confirmed illness, giving Infection Preventionists back precious time they need to stem the spread of COVID-19.
- CDC’s diagnostic test has been authorized by the FDA under the Emergency Use Authorization (EUA) opens in a new tab and the International Reagent Resources (IRR) has begun to distribute the test to requesting, certified labs, predominately local and state public health departments.
- CDC released official diagnosis coding guidance for encounters and deaths related to COVID-19 opens in a new tab on Feb.20. Information and guidance will likely be updates as new clinical information about COVID-19 becomes available.
Premier COVID-19 Response and Resources
Premier healthcare alliance: Disaster Preparedness and Response Resources opens in a new tab are available to help guide
the Premier membership in its preparation and potential response activities for emergencies, disasters and disruptions, such as hurricanes and outbreaks. Members will find preparation checklists, proposed disaster playbooks, monthly tips, supplier, regulatory and support offerings and real-time updates during and immediately following a disaster (member login required).
- NEW: Advisor Live® webinar: COVID-19: Implications for Clinicians
- The World Health Organization has deemed COVID-19 a global pandemic, which has raised fears and confirmed what many clinicians have suspected – we need to be prepared now!
- On March 18, Premier provided a live webinar designed specifically for clinicians and infection preventionists, who are the front lines in managing and mitigating the current crisis. This webinar provided the latest updates on the impact COVID-19 in the U.S. and arms the viewer with specific strategies and tactics supporting early identification and mitigation of the clinical risks associated with COVID-19. Listen to the recording and download the presentation on-demand here opens in a new tab.
- Topics covered included:
- Review of key points of knowledge needed for healthcare professionals and support staff.
- Discussion of the most updated guidelines and guidance for prevention and control of COVID-19.
- Overview of supply chain updates.
- Advisor Live webinar: Executive Briefing: State of Supply Chain and COVID-19 (Feb.19, 2020): This webinar provides an update on the impact of this disease in the U.S., covers specifics on the risks to our supply chain of PPE products, including N95 respirators, and makes recommendations for limiting risk for our nation’s healthcare systems and their patient populations. View the recording on-demand opens in a new tab at your convenience.
- Supply Chain:Premier members are encouraged to work with their supply chain to ensure adequate inventory of needed PPE, i.e., N95 respirators, masks and other supplies (Member login required). A recent survey of Premier members found 86 percent are concerned about are PPE shortages due to coronavirus.
Regulatory Flexibilities Available to Address COVID-19 opens in a new tabTo help you keep abreast of the daily announcements coming from HHS, Premier’s Public Affairs office has compiled a comprehensive resource on the regulatory flexibilities granted by HHS to date. They will continue to update this resource as new developments unfold. (Member login required opens in a new tab) The current public health emergency due to COVID-19 has exposed a blind spot in the U.S. supply chain; America’s patients are vulnerable to shortages of critical, life-saving drugs. Premier applauds the representatives who introduced the Preventing Drug Shortages Act. Read Premier’s statement here opens in a new tab.
- Premier Safety Institute