COVID-19 Update May 7, 2020

Do You Have a Story To Tell or a Photo To Share With Your MSSNY Colleagues? Send to Csouthard@MSSNY.org or Call 516-488-6100 Ext. 355!


COVID-19 Map – Johns Hopkins Coronavirus Resource Center


Gov. Cuomo’s Press Conference Thursday, May 7

GENERAL:
– Total hospitalizations down to ~8,600. Net change also down.
– Intubations are down.
– Number of new cases relatively flat (607). Gov says this has been a slow
downturn.
– Deaths since May 6: 231; 191 in hospitals; 40 in nursing homes.
– Top priority is protecting essential workers. Gov honors their courage and
efforts to take care of society.

TESTING:
– Have been “aggressively” testing essential workers: 25 downstate healthcare
facilities, over 27k employees.
– Found 12% of NYC healthcare workers tested positive (slightly lower
than general population, 19.9%).
– Shows that masks, gloves, and sanitizer have worked.

NOURISH NY:
– Gov said many farms have been particularly impacted by COVID-19, facing waste
and financial loss.
– Launched $25 million Nourish NY Initiative (funds 50 food banks). Wants to
continue this, urged philanthropies/foundations to help.
– Contact covidphilanthropies@exec.ny.gov
– 20,000 households will receive Nourish NY products within the next week.

REOPENING:
– Need to prioritize public health over the economy. No doubts that we will
reopen, Gov just wants to do so safely.
– Gov says leaders making decisions should be willing to participate in
anything they authorize.
– Reiterated that decisions must be made based on facts and data.

Q&A:
FINANCIAL ASSISTANCE:

– PAUSE to expire May 15, then will look at different regions to see where to
begin reopening. Economy will be starting at this point.
– Gov wants to ensure the most vulnerable and financially needy are protected.
He attributed moratorium on evictions, funding food banks, and more as relief
efforts. Hopes extension of moratorium can ease the anxieties of many.
– Gov is working on relief from the banks for landlords, as well as relief for
banks themselves. However, the state’s priority is protecting families from being evicted.
-Have overflow facilities across the state to take nursing home residents
that cannot be cared for.


Is Your Practice in Need of PPE? MSSNY Can Help!
Are you facing challenges obtaining needed PPE for your practice?

If you are a MSSNY member, please let us know if you would like MSSNY’s assistance in obtaining protective equipment, including N95 and KN95 masks.  MSSNY is working with vendors and the New York State Health Department to help physicians meet their PPE needs so that they can get back to treating patients.

Please be aware that some businesses promoting PPE availability have not been properly vetted, have provided substandard products and in some cases have not delivered on the ordered products.  Please contact mauster@mssny.org / pclancy@mssny.org / eskelly@mssny.org if you are a member and require MSSNY’s assistance.


New MSSNY Officers and Councilors Elected May 7, 2020
The Nominating Committee held a meeting on Thursday, January 30, 2020.  After careful consideration of the recommendations submitted by the district branches, county medical societies, the medical student, resident & fellow and young physicians sections, your Committee respectfully submits the following candidates for election on April 25 and 26:

Officers (Each for term of 2020-2021)

President                Bonnie L. Litvack, MD, Westchester
President-Elect        Joseph R. Sellers, MD, Schoharie
Vice-President         Parag H. Mehta, MD, Kings
Secretary                Frank G. Dowling, MD, Suffolk
Assistant Secretary Joshua M. Cohen, MD, New York
Treasurer                Mark J. Adams, MD, Monroe
Assistant Treasurer Howard H. Huang, MD, Jefferson
Speaker                  William R. Latreille, MD, FACP, AME, Franklin
Vice-Speaker          Maria A. Basile, MD, Suffolk

Councilors (Four for term 2020-2023)

First District            Adolph Meyer, MD, Kings
First District            David Jakubowicz, MD, Bronx
Fifth District            Barry Rabin, MD, Onondaga
Seventh District       Janine Fogarty, MD, Monroe

Councilor (One for unexpired term of Edward Bartels to 2021)

Eighth District          Mark Jajkowski, MD, Erie

Resident and Fellow Section Councilor (One-year term 2020-2021) – Raymond Lorenzoni, MD

Medical Student Section Councilor (One-year term 2020-2021) – Shireen Saxena, Monroe

Officers, Councilors and Trustees

Trustees (One Five-Year Term 2020-2025) – Thomas J. Madejski, MD, Orleans


Coronavirus Fear Prompting Avoidance of Healthcare, Poll Finds
Around 29 percent of U.S. adults said they have delayed or avoided seeking medical care due to concerns about contracting COVID-19, a new poll shows.

The poll, conducted by market research firm Morning Consult on behalf of the American College of Emergency Physicians between April 18 and April 20, surveyed a national sample of 2,201 U.S. adults.

Four survey findings:

  1. Sixty-three percent of respondents said they are “very” or at least “somewhat” concerned about wait times at healthcare facilities, and 59 percent expressed concern about receiving adequate care.
  2. Fifty-four percent of adults between 18 and 39 years of age said they have actively delayed or avoided seeking care due to COVID-19 concerns, compared to 59 percent of adults, ages 40 to 74 years.
  3. Around 80 percent of respondents said they are concerned about contracting COVID-19 from another patient or visitor if they need to go to an emergency room.
  4. Most respondents (73 percent) are concerned about overstressing the health care system when considering a trip to the emergency department. (Becker’s Hospital Review, Ap 29)

Look Out for COVID-19 Scams Directed at Physicians
Unfortunately, scammers are using the COVID-19 pandemic to try to steal your Medicare Number, personal information, and money. And they are using robocalls, social media posts, and emails to do it.

Remember, if anyone reaches out to get your Medicare Number or personal information in exchange for something, you can bet it is a scam.

·  Be on the lookout, so you can stop scams before they happen. Here are recent Coronavirus scams to watch for:

·  Robocalls offering you respiratory masks they will never send

·  Social media posts fraudulently seeking donations for non-existent charities, or claiming to give you stimulus funds if you enter your bank account information

·  Fake testing kits, cures, “immunity” pills, and offers for protective equipment

Remember this:

·  Medicare will never contact you for your Medicare Number or other personal information unless you have given them permission in advance.

·  Medicare will never call you to sell you anything.

·  Visit Medicare.gov/fraud for more information and tips on preventing Medicare scams and fraud.


Hackers Targeting Healthcare to Steal COVID-19 Info, U.S., U.K. Warn
Sophisticated hackers are targeting healthcare and medical research organizations to gain information about the novel coronavirus, according to U.S. and U.K. cybersecurity agencies.

The Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency and the U.K.’s National Cyber Security Centre in a joint alert issued Tuesday said they have found evidence that “(advanced persistent threat) actors are actively targeting organizations involved in both national and international COVID-19 responses.”

APT groups typically comprise hackers backed by a nation state. The CISA and the NCSC did not say whether the attacks they have identified were linked with specific countries.

Hospitals have already seen an uptick in cyber attacks trying to take advantage of the COVID-19 outbreak to spread malware. But the attacks warned of by the U.S. and U.K. cybersecurity agencies this week differ in that APT groups are frequently looking to steal intellectual property or sensitive data related to COVID-19 research.

Hackers affiliated with APT groups have looked to exploit healthcare organizations’ weak password practices, according to the agencies.

The CISA and the NCSC are investigating “large-scale password spraying campaigns” that have targeted healthcare entities in the U.S. and the U.K., as well as international healthcare organizations. In a password spraying campaign, a hacker will try to enter different commonly used passwords into many accounts to try to break into them.

“These attacks are successful because, for any given large set of users, there will likely be some with common passwords,” the alert reads.

Hackers have also been taking advantage of the shift to remote work by searching out vulnerabilities in virtual private network, better known as VPN, products.

The CISA and the NCSC warned that they are investigating multiple attacks against organizations involved in COVID-19 research, including against pharmaceutical companies, medical research organizations and universities. Those attacks may have been perpetrated to “steal sensitive research data and intellectual property for commercial and state benefit,” the agencies said.

To protect against cyberthreats, the CISA and the NCSC recommended organizations implement multi-factor authentication, update VPNs and set up security monitoring capabilities, among other mitigation tactics. (Modern Healthcare, May 6)


Q & A: What About Mild or Asymptomatic Cases of COVID-19?
Asymptomatic transmission has not only been confirmed in China, but recent modeling data found that mild or asymptomatic cases that went undetected (“undocumented”) accounted for 85% of total infections in the earliest stages of the outbreak. The study found these cases were less infectious on a per-contact basis, but because those individuals were not isolated, they infected more people in total.

The big unknown, however, is how common it may be for people to become infected but with symptoms too mild to seek treatment. Currently, detection is based on molecular testing, which is performed only on individuals who come into contact with the healthcare system. The prevalence of such mild or asymptomatic infections will not be known until an inexpensive serological test, detecting antibodies to the virus that signal previous exposure, is available for use with routine blood draws. Thus, the extent of exposure in the population may not be known for years.

How do you contract COVID-19?

Research points to droplet and fomite transmission, with recent data suggesting the virus can survive on surfaces such as plastic and stainless steel for up to several days. It can also survive in the air for a few hours, indicating it may also potentially be aerosol transmissible.

The virus may also be transmitted through the fecal-oral route, with research suggesting some patients develop gastrointestinal symptoms, and that the virus is shed through stool.

A small cohort study in China found the virus present in two patients’ tears, indicating it might be transmissible through eye secretions.

How infectious is the COVID-19 coronavirus?

Research from China found a similar viral load in symptomatic and asymptomatic patients, which may suggest patients can transmit the virus whether they have mild or severe disease.

Latest data from the World Health Organization estimated the “R0” as 2.0 to 2.5, meaning infected individuals transmit it to 2-2.5 others on average. By contrast, the R0 for measles is 12-18, while for seasonal influenza it is a little over 1.

How virulent is COVID-19?

According to JAMA, global mortality for COVID-19 is reported to be 4.7%, and about 1.7% of patients died in the first 141,000 cases in the U.S., though the authors emphasized this was not an accurate case-fatality rate due to the uncertain denominator.

CDC examined the first 4,200 U.S. cases, and found 508 (12%) of patients were hospitalized, and of those, 121 were known to be admitted to an intensive care unit, and 44 patients died. Similar to China, both hospitalization and mortality rates increased with increasing age, though this data indicated 20% of hospitalized patients and 12% of patients admitted to an ICU were ages 20-44. Nine patients ages 20-44 died, though in the entire group most deaths were among adults ages 65 and older.

Notably, however, mortality rates vary dramatically from one country to another, raising more questions about case-finding and record-keeping than there are answers.

What are the early symptoms of COVID-19?

In addition to fever, cough and shortness of breath, CDC now lists several other symptoms: chills, repeated shaking with chills, new loss of taste or smell, muscle aches, headache and sore throat.

Examining data from patients admitted in New York City, prior to respiratory symptoms, including about three-quarters presented with cough or fever, and almost 60% with shortness of breath. Gastrointestinal symptoms seem to be more common in U.S. patients, with about a quarter reporting diarrhea and 20% reporting vomiting.

It appears not all patients present with symptoms, with research out of Germany in February finding patients testing positive for COVID-19 despite being afebrile and otherwise normal-seeming.

How is COVID-19 diagnosed?

A patient is swabbed, then the sample is tested via reverse transcription polymerase chain reaction (RT-PCR) to determine presence of viral RNA.

The FDA recently authorized the first serology test to detect IgM and IgG antibodies under Emergency Use Authorization, for diagnosing COVID-19 infection in combination with other clinical and lab data.

What are the risk factors for more severe disease?

Reports from China indicate disease is much more severe in older patients, with the highest mortality rate among adults age 80 and older. Patients with other comorbidities are also the most at risk, with U.S. data finding hypertension and obesity were the most common chronic medical conditions among patients hospitalized with COVID-19, followed by chronic lung conditions, diabetes and cardiovascular disease.

Data out of New York City found obesity as a risk factor for mechanical ventilation. Patients requiring mechanical ventilation were also more likely to need vasopressors, and experienced other complications such as atrial arrhythmias and new renal replacement therapy.

What does severe disease look like?

JAMA detailed 21 patients from Washington state, 15 of whom needed mechanical ventilation. All 15 had acute respiratory distress syndrome, and eight developed severe ARDS by 72 hours. Vasopressors were used for 14 patients, though most patients did not present with evidence of shock, and seven patients developed cardiomyopathy. Mortality among this group was 67%, 24% remained critically ill and 9.5% were discharged from the ICU, as of March 17.

In New York City, a third of patients required intubation, and of these, 30% did not get supplemental oxygen, meaning they deteriorated quickly.

However, U.K. research indicated a lower proportion of COVID-19 patients in the critical care unit survived compared to patients with non-COVID-19 viral pneumonia (52.1% vs 77.8%, respectively).

How is the disease treated?

Treatment mainly consists of supportive care, according to CDC recommendations. The most common complications of severe disease include pneumonia, hypoxemic respiratory failure/ARDS, shock, multiorgan failure. Since pneumonia is common, IV antibiotic use has been widely reported, along with supplemental oxygen, with anecdotal reports of proning and ultimately, mechanical ventilation, including some patients who receive extra corporeal membrane oxygenation (ECMO).

Although corticosteroids were widely used in China, the CDC generally recommends against them except in patients with steroid-responsive comorbidities such as septic shock. “[P]atients with MERS-CoV or influenza who were given corticosteroids were more likely to have prolonged viral replication, receive mechanical ventilation, and have higher mortality,” whereas reports from China in COVID-19 were uncontrolled and observational, the CDC explained. Research indicates patients hospitalized with COVID-19 often develop blood clots, leading some international societies to call for patients to receive prophylactic anticoagulant treatment to prevent this complication.

What are the potential therapeutic options for treating the virus?

There are currently no approved therapies to treat COVID-19. The NIH released treatment guidelines, which noted both insufficient clinical data to recommend for or against use of both remedisivir and hydroxychloroquine and chloroquine. Specifically, the agency noted monitoring patients who receive HCQ for adverse effects, especially prolonged QTc interval. The FDA recently issued a warning about the heart risks of the drug. NIH also said there is insufficient clinical data to recommend use of convalescent plasma or hyperimmune globulin, as well as interleukin-6 inhibitors and interleukin-1 inhibitors. The agency recommended against the use of hydroxychloroquine plus azithromycin, lopinavir/ritonavir (Kaletra) or other HIV protease inhibitors, interferons and Janus kinase inhibitors.

What is the status of clinical trials for these potential therapies?

Remdesivir has been available for compassionate use. An interim analysis of a formal trial from the National Institute of Allergy and Infectious Diseases including data from U.S. patients found remdesivir met its primary endpoint in severe COVID-19 patients, significantly faster time to recovery versus controls, and trended towards a survival benefit. Manufacturer Gilead Sciences also reported topline results from a phase III trial comparing two dosing regimens in severe cases, but without a usual-care control group, showing a trend favoring a 5- versus 10-day treatment period.

Many hospitals have begun to use hydroxychloroquine or chloroquine, which is most commonly used to treat patients with malaria, as well as arthritis and systemic lupus erythematosus, although the supporting evidence is anecdotal at best. The FDA has issued an Emergency Use Authorization for hydroxychloroquine held in the National Strategic Stockpile, although that does not make COVID-19 an approved indication. Latest data from the U.S. found no difference in risk of ventilation the drug in male veterans with severe COVID-19.

A small case series in China found three of five patients treated with convalescent plasma were later discharged from the hospital, though questions about scaling this as a potential therapy remain. Some centers have also tried anti-cytokine agents such as tocilizumab (Actemra) but evidence of benefit over standard treatment remains scant. Controlled trials with tocilizumab are now underway, including one sponsored by drugmaker Genentech/Roche.

Sanofi and Regeneron announced a phase II/III trial for sarilumab (Kevzara), another anti-interleukin-6 agent, for patients with severe COVID-19.The Milken Institute has collated currently ongoing trials for COVID-19 interventions on its website.

What are the vaccine prospects?

Several companies and public health agencies have vaccines in development, including the National Institute of Allergy and Infectious Diseases. Phase I trials with vaccines are underway, with a timeline of 12-18 months for a vaccine to be ready for wide-scale deployment.

As of April 21, the Milken Institute counted 115 vaccine candidates in development, including six in phase I and five in phase I-II safety and efficacy studies in humans.

What is the prognosis for patients with COVID-19?

Older patients and those with other comorbidities are the most at risk, whereas the disease appears to be less severe among younger patients. U.S. data seems to indicate fewer children contract severe disease than adults, and hospitalization in this population is most common among infants and children with underlying conditions.

Research is starting to come from China that COVID-19 vertical transmission from mother to baby is possible, given several isolated case reports.

What are some potential complications of COVID-19?

Data from New York City indicated ST-segment elevation on the EKG was complex, and confirmed COVID-19 cases were complicated by ST-segment elevation, which could have indicated potential acute MI.

Neurologic complications have been reported, with limited case reports from Italy linking COVID-19 infection to Guillain-Barré syndrome. And in China, more than a third of confirmed COVID-19 cases had neurologic symptoms, such as acute cerebrovascular events, impaired consciousness and muscle injury, which were more common among patients who required mechanical ventilation.

What are the long-term sequelae of COVID-19?

It is unclear whether or how often COVID-19 survivors will experience persistent pulmonary or other problems, or for how long. Many patients have remained hospitalized with the illness for weeks outside of China, out of an abundance of caution and for public health reasons.

Researchers from China pointed to cardiovascular system abnormalities in nearly half of a small group of SARS patients in a 12-year follow-up cohort, as well as about two-thirds with high lipids and 60% with glucose metabolism problems. They suggested COVID-19 may also cause chronic damage to the cardiovascular system, as the virus has a similar structure to SARS. Last Updated May 07, 2020.


COVID-19 Info and Advice for All Physicians
COVID-19 presents new challenges for everyone. However, healthcare professionals are facing unique personal and professional challenges within the context of this rapidly shifting landscape.

Individuals may find themselves managing multiple new challenges at once. Some medical professions, such as anesthesiology, emergency medicine, or intensive care, incur greater risks for contamination as they perform intubation procedures on hospitalized COVID-19 patients.

Healthcare clinicians wearing full-body PPE in the hospital are faced with physical barriers to self-care during shifts: eating, drinking, and lavatory visits may be delayed or eliminated, leading to depletion in personal reserves.

Craig Spencer, MD, MPH, director of Global Health in Emergency Medicine and an ER physician at New York-Presbyterian/Columbia University Medical Center in New York City, is on the front lines of managing the COVID-19 patient surge. In a Washington Post op-ed and a Twitter thread, he wrote about his daily experience of navigating the compounding stressors of the patient surge; managing patient life support with limited ventilators; being unable to attend to personal needs during long shifts; and, to protect his family, vigilant decontamination before leaving work and again once he arrives home. Other healthcare clinicians report quarantining themselves in sections of the home to limit the risks of contaminating family members.

These new and daunting circumstances require careful attention to self-care, stress management, and wellness practices to best ensure continued health and performance in a time of great need.


COVID-19 Strategies for Coping and Wellness

1. Take stock. As routines drastically change, health choices may falter. Ask yourself how you are doing in regard to daily health behaviors: the quantity and quality of sleep, exercise, nutrition, and hydration.

2. Stabilize yourself with good health behaviors. After taking stock, choose one area for improvement and set a goal. Examples of concrete goals are maybe 30 minutes of daily exercise, limiting evening screen time in the hours before bed, and eating three servings of vegetables daily.

COVID-19 brings a high degree of uncertainty, and feelings of loss of control are common. Setting a self-care goal can help keep you grounded and focused on things you can control. Good self-care will ensure that your immune system is best supported and able to fight illness. Remember too that when you are well cared for yourself, you can be of best service to others.

3. Observe your stress level. Stress manifests mentally, emotionally, and physically. Observe the tension level in your muscles, the frequency and intensity of any difficult emotions, and potential physical effects such as headaches, upset stomach, or difficulty sleeping.

4. Identify your emotions. Anxiety, sadness, fear, anger, and frustration may all be common. Acknowledge these emotions as they arise. Often, they are temporary and observing them without judgment can allow them to dissipate quicker.

5. Employ stress reduction techniques. Stress activates the sympathetic nervous system and keeps you in a state of “high alert.” Even low-grade prolonged stress can have negative impacts on sleep, mood, blood pressure, cortisol — all of which reduce your tolerance to future stressors. Ongoing stress can also promote unhelpful choices, like using alcohol for stress relief, and further deplete sleep, mood, and energy. In this time of COVID-19, stress mitigation is key, and calming your nervous system is medicinal.

If you have a favorite stress reduction tool, ask yourself if you are using it frequently enough. If you do not have a favorite stress reduction tool, these are some good options to try:

·       Shine: Calm Anxiety & Stress offers a special toolkit for COVID-19 anxiety, with a free app that offers guided relaxation and meditations, daily motivational messages, and an “ask an expert” section

·       Headspace is a stress, meditation, relaxation, and sleep app, free with NPI provider number

·       The UCLA Mindful: Meditations for Well-Being app includes recorded mindfulness meditations of varying lengths and a weekly podcast

·       The Society for Health Psychology, a division of the American Psychological Association, offers a wide range of recommended wellness tools, including a sleep app and resources to address trauma

·       Calm Your Nervous System is a free, stream able, 20-minute guided relaxation audio file. Using headphones or earbuds allows background binaural technology to deepen your relaxation response

Use your favorite tool daily or as needed throughout the day to de-stress, interrupt any unhelpful thought patterns, and as a general wellness practice.

6. Have compassion for yourself and others. Recognize that everyone is doing their best in this time of crisis, including yourself. Remind yourself that everyone is navigating unchartered territory without a playbook. Anchor yourself and avoid reacting to the emotional instability of others. Use any of the calming tools listed above or another you may love.

7. Stay socially connected. Social connection is certainly different with “physical distancing” — and it may be more important than ever. Reach out to others by phone, email, text, or various social media platforms. Check in with older adults, anyone you know to be socially isolated, and daily friends and colleagues that you do not have contact with now due to quarantine or shelter-in-place orders.

8. Find personal space in isolation. Paradoxically, physical distancing is forcing people and families in close proximity for extended periods of time. During a stable time of emotional neutrality, discuss individual needs for personal space and develop a plan.

9. Set a timer and limit your access to the news. Reports of mounting disease and death counts can be distressing and anxiety-provoking. The volatility of the stock market and loss of investment and retirement income may represent a personal threat to security and trigger anxiety or despair. While staying informed is important, limiting news and screen time can support stress management and mental health. If you find yourself constantly scanning the news, consider containing your news-checking to twice daily and for a defined and brief period.

10. Gratitude and positivity. Daily, find a positive story in the news that illustrates resilience and positivity amidst challenge. Allow yourself to reflect on one personal gratitude each day.

Resources and Guidelines by Specialty

Below, the MedPage Today staff has compiled a list of COVID-19 resources for physicians and other healthcare professionals. We will be updating this list frequently to ensure it remains a collection of the latest guidelines, resources, and best practices in dealing with COVID-19 both personally and professionally. You can track the U.S. COVID-19 outbreak on a real time dashboard, by state and by county.

Anesthesiology
American Society of Anesthesiologists library

Cardiology
American College of Cardiology – ACC’s COVID-19 Hub
ASNC/SNMM – Guidance and Best Practices for Nuclear Cardiology Laboratories
European Society of Cardiology – COVID-19 and Cardiology
American Heart Association- COVID-19 Resources
Society for Cardiovascular Angiography and Interventions – Considerations for the Cath Lab Considerations for Cardiac Catheterization Laboratory Procedures During the COVID-19 Pandemic

Dermatology
American Academy of Dermatology

Emergency Medicine
American College of Emergency Physicians
American Academy of Emergency Medicine
American College of Surgeons – How to Set Up a Regional Medical Operations Center to Manage the COVID-19 Pandemic

Endocrinology
American Association of Clinical Endocrinologists – AACE Position Statement: Coronavirus (COVID-19) and People with Diabetes – The American Association of Clinical Endocrinologists’ (AACE) guidance on helping people with diabetes prepare for and prevent the spread of COVID-19. Some precautions for this high-risk population include staying home as much as possible, washing hands regularly, and stocking up on prescriptions. The guidance also advises people with diabetes to check with each individual states’ department of health website to see if he or she is able to purchase an additional 30-day supply of insulin or other diabetes medication.

ENT
American Academy of Otolaryngology-Head and Neck Surgery

Ethics
AMA Journal of Ethics – COVID-19 Ethics Resource Center

Gastroenterology
American Gastroenterological Association
American College of Gastroenterology
SAGES (gastroenterology surgeons)

General
Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic
American Medical Association – Guide to telemedicine
American Medical Association – CMS payment policies and flexibilities

Geriatrics
CDC – COVID-19 Guidance for Older Adults
American Geriatrics Society – information hub and article in Journal of the American Geriatrics Society

Health Policy
CDC – Evaluating and Testing For COVID-19
CDC – Healthcare Infection Control Guidance
CDC – Guidance for Emergency Medical Care Services
CDC – Healthcare Personnel with Potential Exposure Guidance
CDC – Inpatient Obstetric Care Guidance
AMA – COVID-19 Resource Center for Physicians – Includes a physician’s guide to COVID-19 along with information from JAMA and other resources.
AMA – COVID-19 FAQ – Addresses what to tell patients, how to manage PPE, and other practice issues.
National Institutes of Health – Coronavirus (COVID-19)
CDC – Clinician Outreach and Community Activity Call CDC: Contact Tracing Not Needed for HCPs Exposed to COVID-19

Hepatology
American Association for the Study of Liver Diseases

Infectious Disease
Infectious Diseases Society of America
American Society of Microbiology – Novel Coronavirus (COVID-19) resources
The Lancet – COVID-19 Resource Center
New England Journal of Medicine – Coronavirus (COVID-19)

Nephrology
National Kidney Foundation regarding dialysis
American Society of Nephrology regarding dialysis and hospitalized patients with kidney failure

Neurology
American Academy of Neurology- COVID-19 resources
National MS Society – Disease-Modifying Treatment Guidelines for COVID-19 – Recommendations of the National MS Society’s National Medical Advisory Committee
American Headache Society – Headache Clinic Workflows During the COVID-19 Pandemic – Telemedicine and precaution to treat patients
Movement Disorders Society – MDS Statement, References, and Resources for the COVID-19 Pandemic
American Epilepsy Society – COVID-19 Resources for Epilepsy Clinicians – Patient management, medications, and more

Nursing
American Association of Critical-Care Nurses – Resources
American Association of Critical-Care Nurses – Online course on pulmonary, ARDS, and ventilator resources
American Nursing Association
Oncology Nursing Society – Interim Guidance During the COVID-19 Pandemic

OB/GYN
American College for Obstetricians and Gynecologists: COVID-19 Guidelines
CDC – Considerations for Inpatient Obstetric Healthcare Settings
Society for Maternal-Fetal Medicine

Ophthalmology
American Academy of Ophthalmology – Important Coronavirus Updates for Ophthalmologists

Oncology
MedPage Today – COVID-19 Poses Special Challenges to Cancer Care – While having an unprecedented impact on all aspects of the nation’s healthcare system, the COVID-19 pandemic created unique circumstances and challenges for cancer care, according to authors of a review from the early U.S. epicenter in metropolitan Seattle. ASCO – ASCO recommendations
Oncology Nursing Society – COVID-19 Resource Page – Links for providers and patients, Nat’l Comprehensive Cancer Network – COVID-19 Resource Page – Links for providers of cancer care:
American Cancer Society Answers to Common Questions – Oriented toward patients, caregivers

Pathology
College of American Pathologists
American Society of Clinical Pathologists

Pain Management
ASIPP – Statement from ASIPP on COVID-19
American Association of Pain Management – Managing Pain and Related Symptoms during Coronavirus
ASRA – Recommendations on Chronic Pain Practice during the Pandemic
DEA – Coronavirus Guidance

Pediatrics
American Academy of Pediatrics – Management of Infants Born to Mothers with Suspected or Confirmed COVID-19

Primary Care
American Academy of Family Physicians
American College of Physicians

Psychiatry and Psychology
American Psychiatric Association: COVID-19 mental health impacts
Interagency Standing Committee: mental health and psychosocial aspects of COVID-19
The Lancet: The psychological impact of quarantine and how to reduce it
CDC: Mental Health and Coping During COVID-19

Public Health
CDC – Manage Anxiety & Stress

Pulmonology/Critical Care
CHEST
Society for Critical Care Medicine
American Thoracic Society

Radiology
American College of Radiology (ACR) on nuclear-med ventilation scans
ACR on CT scans
Society for Interventional Radiologists

Rheumatology
American College of Rheumatology – COVID-19 Resources
EULAR

Sleep
American Academy of Sleep Medicine – COVID-19: FAQs for Sleep Medicine

Surgery
American College of Surgeons (ACS) general information and directory
ACS: elective case triage
ACS: review committees for triage decision-making
SAGES (gastrointestinal surgeons)
American Association of Neurological Surgeons


 


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