3/19/2020 COVID-19 Update

OccMedCIC, LLC learned the following updates by attending a call hosted by the Massachusetts Medical Society on Tuesday, March 17, at 4 p.m. with Dr. Monica Bharel, DPH Commissioner; Dr. Lawrence Madoff, Medical Director of the DPH Bureau of Infectious Disease and Laboratory Sciences; and Dr. Catherine Brown, State Epidemiologist.

  • 218 positives to date…20 over last 24 hours (as of 3/17/2020 4pm)
  • Moved from containment to Mitigate phase
  • 7 counties with community spread
  • Goal of social distancing “flatten curve” so healthcare won’t be overwhelmed
  • State labs can now test 400 patients a day
  • Test all healthcare workers with symptoms as priority to reserve manpower
  • Those hospitalized
  • Suspect living in congregate
  • Commercial lab/hospital approved
  • Covid19 is a mandatory reporting disease (labs send to DPH)
  • Touched on limitations in supply of PPE; Mass trying to access national supply…shortage lead to halting elective cases and emphasis on telehealth
  • Emphasis on diverting 80% of mild case away from ED in favor of telehealth, self-care.
  • Drive through testing via Labcor kits per one hospital after telehealth visit…limited now by supply of N95.  Regional coalition
  • CDC liberalized to allow mask (most spread from droplet nuclei) except high risk.  Eye gear and gloves.  “real driver” is droplet nuclei.  Infection from Surfaces is feasible (two day survival on plastic; frequent hand sanitizer or wash). Droplet Particles do not hang in air for long (example elevator previously used); aerosol not thought to be a factor
  • 617-983-6800 mass.gov/covid19 Epi number
  • Period of isolation if not tested? Per State Epidemiologist (Catherine Brown “aligning with those with positive Covid19 test”.  States:  72 hours fever free, improvement in respiratory symptoms, and at least 7 days since onset symptoms.  [not blanket 14 days; this is new and I have not seen this in written form yet]
  • Question about telehealth, e.g., Baker’s statements is for “any condition” not just Covid19 related specifically. Some disparity noted, i.e., Medicare not covering telephone only visits
  • Question regarding RTW:  “Yes, 72 hours after fever, cough doesn’t have to go away but there should be an improvement”.
  • What if, Med Assistant becomes positive, what about other staff?  If she was not symptomatic while working, then no need for other staff to quarantine.
  • Question testing asymptomatic spouse of individual with positive Covid 19 test? Test designed to assess those with symptoms.
  • Contact tracing…within 6 feet for 10-15 minutes when someone symptomatic.
  • UMass setting up testing facility, others going up around state
  • Mild to moderate illness? presume Covid19, isolate 7 days or until 3 days after fever + symptoms improved.

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