On Thursday afternoon, two officials from the CDC spoke to DOs about the federal response to the novel coronavirus disease (COVID-19) during a webinar. They also provided practice guidance and answered DOs’ questions. Here are the highlights.
CDC helpline for clinicians:
Clinicians with COVID-19 questions can call the CDC COVID-19 clinician call center at 770-488-7100. The helpline is staffed by clinicians 24/7.
Personal protective equipment (PPE):
The Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response (ASPR) manages the strategic national stockpile of PPE, and they are currently working to distribute as much PPE as they have, said Susanna Visser, MS, DrPH, CDC associate director for policy in the division of vector-borne diseases.
They are experiencing a shortage in equipment currently, but they are working every supply chain avenue available to them to obtain more PPE and distribute it to states, where it will then be distributed to hospitals and state and local public health authorities and others, she noted.
The Federal Emergency Management Agency (FEMA) stepped in last week to help with PPE distribution, a development that will help the government distribute PPE more quickly, Dr. Visser noted. FEMA also has a coordinated donation mailbox and sales website for those who have PPE and are trying to contribute it.
The CDC has detailed strategies for optimizing a limited supply of PPE here.
COVID-19 testing criteria and availability:
The U.S. currently does not have enough tests to allow for on-demand testing, said Elliot Raizes, MD, CDC medical officer.
“The decision has been made at the national level to prioritize testing people with moderate and severe symptoms as well as health care workers and people at higher risk for adverse outcomes, such as people with comorbidities and those over 65,” Dr. Raizes said.
However, some areas have a greater availability of tests and different guidelines for testing, so physicians should familiarize themselves with the local guidelines in their area, he notes.
Guidance for physician practices:
For physicians with ambulatory practices, the CDC is recommending the following to reduce community spread of the disease and reduce the risk of health care professionals contracting the disease.
- Consider postponing all elective procedures and elective appointments, such as well appointments, to conserve resources and PPE.
- Use a phone script to determine if patients have mild to moderate disease that can be monitored and treated at home. When making this call, consider the patients’ risk for an adverse outcome from COVID-19. Check in with these patients regularly, advise them on steps to take to avoid transmitting the disease to their family/roommates, and set criteria for when they should go to the hospital.
- Post signs at your clinic asking patients to immediately notify staff if they have symptoms of COVID-19. Some clinics have chosen to display signs on their doors, lock their doors and screen patients before they enter the clinic.
- Optimize your supply of PPE by following CDC guidelines.
- Monitor the safety and health of your staff. Having liberal policies for sick leave will ensure that staff don’t feel that they have to come to work when they have COVID-19.
- When possible, use telemedicine. (Note: An AOA COVID-19 telehealth guide is available here.)
- Consider volunteering to treat patients who need urgent care for non-COVID-19 illnesses and conditions to help relieve local hospitals.
Medications and COVID-19:
Although a research group has hypothesized that ACE inhibitors, such as those used for high blood pressure, may increase the severity of COVID-19 infection or the risk of contracting it, there is currently no data demonstrating adverse outcomes in patients that can be attributed to ACE inhibitors, said Dr. Raizes.
The medical community has also raised concerns about nonsteroidal anti-inflammatory drugs potentially causing more severe disease in COVID-19 patients. “At this time, there is no evidence to support changing the use of NSAIDs due to risk of COVID-19,” Dr. Raizes said, noting that goverment agencies around the world are continuing to monitor the situation for new information.
As far as treatment is concerned, while numerous clinical trials are underway, as of now there is no proven treatment for COVID-19 nor proven pharmaceutical interventions for prevention of COVID-19, Dr. Raizes said.