COVID-19 Information for Healthcare Providers

 

Kentucky COVID19 physician only hotline: 1-888-404-1539

Kentucky COVID-19 website

Kentucky COVID19 hotline for general public: 1-800-722-5725

 

Updated March 21, 2020

Table of Contents


RESOURCES:

 

Information for Medical Staff of COVID-19 Patients

How do we reduce risk for ourselves and staff while performing appropriate medical care? This must be your number one priority.  Providers with COVID-19 cannot care for patients.

CDC has extensive recommendations on how to protect yourself, your staff, and other patients during this Pandemic.  Please familiarize yourself with this guidance and implement these important strategies:
https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html

CDC has issued recommendations for optimizing PPE supply. There are steps that MUST BE TAKEN NOW to ensure PPE is available when it is needed for all staff and first responders: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html

To request additional PPE, click HERE for information and instructions.

 

Reduce face-to-face HCP encounters with patients:

  • Use a telephone triage to identify individuals with COVID-19 symptoms.
  • Whenever possible, triage by phone:
  • For those who need emergent care, refer to ER as you normal would.  Notify the ER that the patient is coming so that they are prepared to accept them
  • For mild symptoms, instruct your patient to self-quarantine and limit interaction with others, including family  members.  Family members should self-monitor for symptoms.
  • CDC has guidance for these patients: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html
  • If in-person evaluation is necessary, or an individual with symptoms arrives in your location, immediately place them in a mask and isolate them in a room. If an Airborne Infection Isolation Room is available, it is preferred.  Check with your employer to see if they have a preferred location for evaluation and sample collection.
  • Cohort patients and HCP and / or facilities
  • Limit number of staff / providers that interact with suspected COVID-19 patients
  • Exclude HCP not essential for patient care from entering care area
  • Reduce the number of patients going to outpatient settings
  • Excluding visitors to patients with confirmed or suspected COVID-19

Does my patient need to be tested for COVID 19?
Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Most patients with confirmed COVID-19 have developed fever1 and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing).

Here is a fact sheet to help patients who self-isolate at home.

When can my patient return to the community?
Clcik HERE for criteria on releasing a patient from isolation.


Healthcare Supply of Personal Protective Equipment (PPE)

LMPHW COVID-19 Unified Command Prioritization for Distribution of  PPE

LMPHW PPE Request Form for Healthcare Providers
 

Conservation of N95 Respirators (PDF)
Resources for Clinics and Healthcare Facilities
Release of Stockpiled N95 Filtering Facepiece Respirators Beyond the Manufacturer-Designated Shelf Life: Considerations for the COVID-19 Response

New Mental and Behavioral Health Resources
This moment is a stressful one for many of us with so many changes taking place so rapidly; however, as the Governor continues to reiterate—we will get through this together.

Social distancing can be particularly tough for individuals with Substance Use Disorder, but thankfully we have many organizations who have stepped up to offer virtual options for individuals to connect to their community and continue on whatever healing pathway they have chosen. 

 

Resources for Healthcare Facilities

Reducing the Risks for Bringing COVID19 Home: Tips for Asymptomatic Healthcare Workers

Healthcare Professional Preparedness Checklist for Transport and Arrival of Patients with Confirmed or Possible COVID-19
Coronavirus Disease 2019 (COVID-19) Hospital Preparedness Assessment Tool
Coronavirus Disease 2019 (COVID-19) Update—What Clinicians Need to Know to Prepare for COVID-19 in the United States [webinar held March 5, 2020 14:00 EST].
ASPR’s COVID-19 Healthcare Planning Checklist
Mass General Hospital Center for Disaster Medicine’s SARS-CoV-2 (COVID-19) Toolkit
Resources for Healthcare Facilities [Categorical Page]
Steps Healthcare Facilities Can Take Now to Prepare for Coronavirus Disease 2019 (COVID-19)
Interim Guidance for Healthcare Facilities: Preparing for Community Transmission of COVID-19 in the United States
Healthcare Professionals: Frequently Asked Questions and Answers for COVID-19
Clinical management and infection control of SARS: Lessons learned [Journal Article; 2013]
The Lancet’s COVID-19 Resource Center [Journal Articles for health workers and researchers]
CMS’ Information for Healthcare Facilities Concerning 2019 Novel Coronavirus Illness (2019-nCoV)
American Chemistry Council’s Novel Coronavirus Fighting Products List

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EMS GuidanceNovel Coronavirus (2019-nCoV) Update for Kentucky EMS Providers [slidedeck; compiled 2/7/2020]

ASPR’s EMS Infectious Disease Playbook
What EMS And 911 Need to Know About COVID-19 [Recorded Webinar]
Maryland Dept. of Health’s Emerging Infectious Diseases Videos for Prehospital Providers

Long-Term Care (LTC)-Specific Guidance
Post Acute Care Guidance (3/29/30)

Guidance for Long-term Care Facilities in response to COVID-19

Strategies to Prevent the Spread of COVID-19 in Long-Term Care Facilities (LTCF)

CMS’ Information for Healthcare Facilities Concerning 2019 Novel Coronavirus Illness (2019-nCoV)

Public Health Guidance
Interim Guidance: Public Health Communicators Get Your Community Ready for Coronavirus Disease 2019 (COVID-19)
Get Your Mass Gatherings or Large Community Events Ready for Coronavirus Disease 2019

Law Enforcement Guidance
What Law Enforcement Personnel Need to Know about Coronavirus Disease 2019 (COVID-19)

Laboratory-related Pages
Information for Laboratories [Categorical Page]
FAQ for Diagnostic Tools and Virus
Research Use Only Real-Time RT-PCR Protocol for Identification of 2019-nCoV
Research Use Only 2019-Novel Coronavirus (2019-nCoV) Real-time RT-PCR Primer and Probe Information

Planning Templates/Resources
Alabama Health Department’s Hospital Template for Serious Infectious Disease Procedures
CA EMS Authority’s Hospital Incident Command System – Incident Planning Guides (Infectious Disease)

Exercise Resources
NETEC’s Special Pathogen [Airborne] Tabletop Exercise (TTX) Template
NYC Health’s Infectious Disease 'Mystery Patient Drills' (TTX w/o functional elements)


Provider resources for Mental Health with COVID-19 (SUD/psychiatric resources):

Opioid Treatment Guidelines for Providers
SAMHSA Guidance for Outpatient Treatment Facilities
DEA “practice of telemedicine” exemption 

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Telemedicine Guidance

On January 31, 2020, the Secretary of the Department of Health and Human Services issues a public health emergency (HHS Public Health Emergency Declaration).

Question: Can telemedicine now be used under the conditions outlined in Title 21, United States Code (U.S.C.), Section 802(54)(D)?

Answer: Yes

While a prescription for a controlled substance issued by means of the Internet (including telemedicine) must generally be predicated on an in-person medical evaluation (21 U.S.C. 829(e)), the Controlled Substances Act contains certain exceptions to this requirement. One such exception occurs when the Secretary of Health and Human Services has declared a public health emergency under 42 U.S.C. 247d (section 319 of the Public Health Service Act), as set forth in 21 U.S.C. 802(54)(D). Secretary Azar declared such a public health emergency with regard to COVID-19 on January 31, 2020. (https://www.hhs.gov/about/news/2020/01/31/secretary-azar-declares-public...). For as long as the Secretary’s designation of a public health emergency remains in effect, DEA-registered practitioners may issue prescriptions for controlled substances to patients for whom they have not conducted an in-person medical evaluation, provided all of the following conditions are met:

The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice
The telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system. 
The practitioner is acting in accordance with applicable Federal and State law.

Provided the practitioner satisfies the above requirements, the practitioner may issue the prescription using any of the methods of prescribing currently available and in the manner set forth in the DEA regulations. Thus, the practitioner may issue a prescription either electronically (for schedules II-V) or by calling in an emergency schedule II prescription to the pharmacy, or by calling in a schedule III-V prescription to the pharmacy.

Important note: If the prescribing practitioner has previously conducted an in-person medical evaluation of the patient, the practitioner may issue a prescription for a controlled substance after having communicated with the patient via telemedicine, or any other means, regardless of whether a public health emergency has been declared by the Secretary of Health and Human Services, so long as the prescription is issued for a legitimate medical purpose and the practitioner is acting in the usual course of his/her professional practice. In addition, for the prescription to be valid, the practitioner must comply with any applicable State laws.

ASAM Guidance 
American Psychiatric Association:  “A conservative recommendation to support compliance with the act is to conduct an in-person exam at least once every 24 months.” 
CMS guidance for providers

LMDC Inmates and possible COVID-19 testing process

Please review the CDC Criteria for testing: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html
Complete a PUI Case Report Form:https://chfs.ky.gov/agencies/dph/covid19/casereportinginstructionsandform.pdf

Email the form via encrypted email to IMTReporting@louisvilleky.gov

CDC specimen collection guidelines, including infection prevention recommendation during collection: https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html

 

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