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Last Updated  12/14/2020

COVID-19: After the Crisis

On Dec. 11 the FDA issued an Emergency Use Authorization (EUA) for the first COVID-19 Vaccine.  Updated COVID -19 Vaccine information is now available here.

A common, core component of the guidance and roadmap is COVID-19 testing capability and capacity to accommodate the needs of both the healthcare workforce and patients to make sure all feel safe during in-person healthcare visits. CMS cautions any decision to resume procedures is at the discretion of local and state authorities. The guidance recommends routine COVID-19 screening for staff, accompanied by testing and quarantine as appropriate. A facility that decides to reopen procedures should also create areas to reduce the risk and exposure to COVID-19. Any patient who is coming in for a procedure must also be screened for potential symptoms of COVID-19. “When adequate testing capability is established, patients should be screened by laboratory testing before care, and staff working in these facilities should be regularly screened by laboratory test as well,” according to the guidance. For COVID-19, there are two types of tests available:
  • Diagnostic – are you currently infected with SARS-CoV-2, the virus that causes COVID-19
  • Serologic (“antibody test”) – you have had a recent SARS-CoV-2 infection
CDC – Overview of testing for SARS-CoV-2 (COVID-19) opens in a new tab (updated Oct. 21) provides comprehensive recommendations on testing for COVID-19. CDC – Interim Guidance on Testing Healthcare Personnel for SARS-CoV-2 opens in a new tab (updated July 17). CDC – Domestic Travel During the COVID-19 Pandemic opens in a new tab (updated Dec. 2). The CDC recommends against non-essential travel in the U.S. “The safest thing to do is to stay home.” While testing does not eliminate all risk, it can help make travel safer. The CDC’s recommendations for travel-related quarantine now include two acceptable periods: 10 days without a test if the person in quarantine has no symptoms and 7 days with a negative test if the individual has no symptoms. In both instances, the CDC urges people to continue to monitor their symptoms for the full 14 days following exposure. CDC – SARS-CoV-2 Testing Strategy: Considerations for Non-Healthcare Workplaces opens in a new tab  (updated Oct. 21). These considerations are meant to supplement, not replace, any federal, state, local, territorial or tribal health and safety laws, rules and regulations with which workplaces must comply. FDA – Emergency Use Authorization (EUA) – COVID-19 resources opens in a new tab (content current as of Aug. 3). Lists current and terminated EUAs for diagnostic and therapeutic medical devices used to diagnose and respond to the COVID-19 public health emergency, including both PPE and in vitro diagnostics. FDA – FAQs on Testing for SARS-CoV-2 opens in a new tab (current as of Nov. 16).

Contact tracing is a well-established public health technique used to slow down the spread of infectious outbreaks, such as COVID-19. Specially trained individuals provide support to patients with known or suspected infection to help them recall everyone they have had close contact with during the time they may have been infectious. Contacts are informed they may have been exposed and are armed with education, information and support to understand their level of risk of developing COVID-19 and how to quarantine and self-monitor for symptoms. Timeliness is critical to successful contact tracing.

Many U.S. hospitals and health systems heeded guidance from the Centers for Medicare & Medicaid Services (CMS) (March 18) and others to pause on any non-emergent/non-urgent surgeries and procedures as a strategy to preserve PPE and other finite resources, including healthcare workforce, early in the pandemic.

On June 8, CMS issued updated recommendations opens in a new tab for re-opening facilities to provide non-emergent, non-COVID-19 healthcare services. The safe resumption of care is of utmost importance. The guidance applies only to Phase II areas, those with no evidence of rebound or surge.

In April, CMS provided guidance opens in a new tab for facilities to begin to resume performing deferred procedures, such as elective surgeries. Elective surgeries are considered those procedures that are preplanned by both the patient and the physician that are advantageous to the patient but are not urgent or emergent. The American College of Surgeons, American Society of Anesthesiologists, Association of periOperative Registered Nurses and American Hospital Association also issued a joint statement opens in a new tab and have shared their roadmap to operationalizing resumption of surgeries.

The following information, resources and tools are provided to support organizations to thoughtfully and practically re-engage and scale up to resume normal, safe, full-service surgery and procedural services.

Three critical operational considerations are:

  1. Adequate, appropriate PPE opens in a new tab for healthcare workers; patients and visitors should wear cloth face coverings. Such coverings are not PPE, but do serve an important function of “source control” opens in a new tab
  2. Appropriate staffing, including preserving surge capacity
  3. Testing capabilities and capacity; CMS recommends viral testing for SARS-CoV-2, the virus that causes COVID-19, for hospitalized patients and those imminently undergoing a procedure or surgery
Premier Healthcare Alliance:

In the past three most memorable pandemics, 1918’s Spanish flu, 1968’s Hong Kong flu and 2009’s H1N1 flu, the second wave was consistently deadlier than the first. We are now dealing with the first wave of COVID-19, and there is no reason to expect this pandemic will behave differently. Organizations must prepare for surge and wave 2 now, even as you recover from wave 1. CDC’s COVID-19 Surge opens in a new tab tool is invaluable in planning.

Premier hosted a webinar opens in a new tab on May 5 to introduce our real-time technology solution opens in a new tab for evaluating the incidence and trends in COVID-19.

For more information and resources to support surge preparedness, click hereopens in a new tab.

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