COVID-19

University of Washington COVID-19 Resources At Your Fingertips

University of Washington School of Medicine has compiled valuable up-to-date resources in response to COVID-19.

Resources include:
– COVID-19 treatment guidelines and algorithms
– PPE Guidelines

– Critical care training for non-critical care trained providers

Look below for specific resources that are available, or go directly to their resources by clicking HERE

Contacts To Know

WY Public Health Emergency Line

For providers with urgent patient care or public health concerns

WY Public Health Non-Urgent Questions

For non-urgent questions and concerns. Use COVID-19 email

WDH Infectious Disease

Wyoming Department of Health Infectious Disease and Epidemiology Unit

WY State Lab

Wyoming Public Health Lab Director Cari Sloma

Important Information

DONATIONS

State Homeland Security - Taskforce on Logistics has centralized all donation offers in order to best use these generous resources. Please direct all emails related to donating supplies and equipment to uc.logs@wyo.gov

EDUCATION

For information about an upcoming Tuesday Provider Connect Zoom, a recording from a past session or other webinars and learning opportunities, you can find it on the COVID-19 education page.

RESOURCES AND LINKS

Below is a repository of resources, links and supporting documents to support COVID-19 response across Wyoming. 

Current Research and Protocols

Therapeutics

Articles and tables referencing and reviewing all of the recent, past, and ongoing research involving hydroxychloroquine/chloroquine, remdesivir, tocalizumab, azithromycin, and others.

FDA: Issues Emergency Use Authorization for Potential COVID-19 Treatment (5/1/20)
NIH: Clinical Trial Shows Remdesivir Accelerates Recovery from Advanced COVID-19 (4/29/20)
Medscape: Coronavirus Disease 2019 Treatment and Management
Oxford Academic: COVID-19 Treatment: A Review of Early and Emerging Options (3/23/20)
ASHP: Assessment of Evidence for COVID-19 Related Treatments: (3/27/20)
UW School of Medicine: UW ID Treatment Guidelines for SARS-CoV2 (Item 8)
CDC: Therapeutic Options for patients with COVID-19
FLARE: Fast Literature Assessment and Review
Massachusetts General Hospital: COVID-19 Treatment Guidance

Hydroxychloroquine/chloroquine

International Journal of Infectious Diseases: Treatments with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19 (8/1/2020) 
FDA: Cautions Against use of hydroxychloroquine outside of hospital setting (4/24/20)
Gautret et al: Hydroxychloroquine and azithromycin as a treatment of COVID-19 (3/17/20)
American College of Cardiology: Ventricular Arrhythmia Risk Due to Hydroxychloroquine-Azithromycin Treatment For COVID-19 (3/29/20)
FDA: EUA for use of hydroxychloroquine and chloroquine (3/28/20)

Care Protocols and Guidelines

University of Washington – School of Medicine COVID-19 Resource Center

Resource Center includes information on the following and more:

  • Patient Care protocols and Algorithms
  • Policy Statements
  • Patient Care Protocols

Surviving Sepsis Campaign (SSC): Guidelines on the Management of Critically Ill Adults with COVID-19

Centers for Disease Control and Prevention (CDC): Information Repository for Healthcare Professionals

CDC: Clinical Care Guidance (Updated 3/7/20)

CDC: Ending Isolation for persons with COVID-19 – Interim Guidance

CMS: Guidelines to limit all non-essential planned surgeries and procedures (3/18/20)

CMS: General Provider Telehealth and Telemedicine Tool Kit (3/24/20)

American Academy of Family Physicians (AAFP) Checklist to Prepare Physician Offices for COVID-19 (3/12/20)

Wyoming Department of Health (WDH): COVID-19 Information for Healthcare Providers

WDH: COVID-19 Healthcare Licensing and Surveys Guidance (Includes guidance for infection control and prevention in nursing homes, hospitals, and more.)

PulmCCM (in partner with MedPage Today) Mechanical Ventilation in ARDS: Overview

AMA: Physician’s Guide to COVID-19

JAMA: Comprehensive overview of the coronavirus by the JAMA Network – including epidemiology, infection control and prevention recommendations – available for free on its JNN Learning website.

WMC: COVID-19 Respiratory Protection Plan Summary

Natrona County: Patient Screening Algorithm (3/27/20)

Personal Protective Equipment (PPE) & Supplies

University of Washington – School of Medicine PPE Policy Statements

Wyoming Medical Center Protocols and Guidance

Consolidated Sterilizer Systems (CSS): COVID-19 Face mask Disinfection and Sterilization for Viruses (updated regularly) 

CDC: Decontamination and Reuse of Filtering Facepiece Respirators
CDC: Strategies to Optomize the Supply of PPE and Equipment
CDC: Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease (COVID-19)
CDC: Coronavirus Disease 2019 (COVID-19) PPE Situation Summary Updated (3/21/20)
CDC: Healthcare Supply of Personal Protective Equipment (3/12/20)
CDC: Checklist for Healthcare Facilities: Strategies for Optomizing the Supply of N95 Respirators during the COVID-19 Response

CMS: COVID-19 Response News Alert: CMS Issues Key Protective Mask Guidance for Healthcare Workers (3/10/20)

U.S. Food and Drug Administration (FDA) Coronavirus Disease 2019 (COVID-19) Guidance

JAMA: Conserving Supply of Personal Protective Equipment – A Call for Ideas (3/20/20)

Emory University School of Medicine: Conservation – COVID-19 ACE/DICE Printiable PDFs

The New Yorker: Keeping the Coronavirus From Infecting Healthcare Workers (3/21/20)

Federal Action Toward PPE and Testing Supply

American Hospital Association, American Medical Association, and American Nursing Association Defense Letter (3/21/20)

AMA Advocacy toward emergency steps needed to boost production of PPE for COVID-19

Joint letter to request swift actions be taken to tackle PPE supply issues (3/18/20)

Telehealth

Telehealth will continue to play a key role in helping Wyoming care for patients in response to COVID-19. Use the links below to learn more.

General Guidance and Tools

American Medical Association (AMA) quick guide to telemedicine practice

Wyoming Telehealth Network (WyTN) 

Advisory Booard: 3 ways to ramp up telehealth to deal with COVID-19 (3/20/20)

Advisory Board: Tips to make telework work – for your team.

Billing and Reimbursement

MDedge: Emergency Rule – Docs can bill for telehealth and COVID-19 tests. Here’s how a commentary (3/20/20)

COVID-19 – Telemedicine Information published by WMS (3/18/20)

Blue Cross Blue Shield of Wyoming Telemedicine Operations Update (3/17/20)

Blue Cross Blue Shield of Wyoming Telemedicine Matrix (4/3/20)

UnitedHealthcare Provider Telehealth Policy Update (3/19/20)

CIGNA COVID-19 Interim Billing Guidance for COVID-19 (3/17/20)

TriWest Healthcare Alliance Telehealth Guidance (3/19/20)

Health and Human Services

Notification of Enforcement Discretion for telehealth remote communications during the COVID-19 nationwide public health emergency (3/17/20)

  • OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency

Medicare

CMS.gov: Press Release: President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 (3/17/20)

CMS.gov: Coverage and Payment Related to COVID-19 – Medicare

CMS.gov: Frequently Asked Questions to Assist Medicare Providers – COVID-19 FAQs

CMS.gov: COVID-19: New ICD-10-CM Code and Interim Coding Guidance

Foley: Telehealth: 5 Key Takeaways from the Coronavirus Spending Bill

Medicaid

Medicaid.gov: Coronavirus Disease 2019 (COVID-19)

Child Abuse/Neglect and Mental Health

During these unprecedented times we are all acutely aware of the far reaching and varied impacts of COVID-19. Stresses are heightened on a wide range of fronts: uncertainty, financial, loss of loved ones, fear, changed patterns, dynamic shifts at home, scarcity, and isolation. We know that stressors combined with limited or finite coping skills can lead to a perfect storm that ultimately can result in elevated levels of child abuse. In addition to the heightened stress that families are likely to be experiencing during this time, we also know that children are more isolated than usual, with very few if any outside outlets or safety nets (i.e. public health nurses, schools, church, coaches, etc). The AAP has recommended, when possible, to continue to bring children 2 and under in for their well child checks. The highest risk age for mortality from physical child abuse is infants under the age of 1. This vulnerable population of infants, is also the age of infants that the AAP and CDC are still recommending, when possible, to come in for their well child checks to keep up to date on their immunizations. So, let’s use that as an opportunity to discuss prevention (crying issues, safety plans to put infants down if getting frustrated, screening Mom’s for postpartum depression (Edinburgh postnatal depression scale), and trying to get Mom’s who screen high on the EPDS in for telehealth mental health appointments). Seeing the 2 year olds, gives us an opportunity to review normal toddler behavior (temper tantrums, boundary testing, potty training) that can be triggers/stressors under regular circumstances for families and opens the door to discuss appropriate discipline techniques and reiterate that spanking is not recommended by the AAP.  We can also ask about other children in the home and how families are coping with them.  Toddlers/pre-school aged children can pose frustrations and have trying behaviors for families. We can emphasize to families the importance of “time outs” for parents as well as for children, the importance of remaining as calm as possible, distraction and redirection.  

Additionally, during our well child checks, let’s commit ourselves to good, thorough naked exams on our patients (open hands, look at ears [not just TMs], check frenulums) and stay particularly attuned to TEN4 bruising or bruising in patterns.   Remember TEN 4 – bruising to torso, ears, neck 4 years and under and ANY bruising 4 months or younger is highly specific for concerns for physical abuse. If you see these findings consult a child abuse expert and get the appropriate evaluation by age for the infant (which depending on age of the child will include a minimum of blood work, head CT, and  a skeletal survey).  If possible, take pictures of your findings. Remember that we are all mandated reporters, so if you have a concern report it to your local DFS office.

*** Also remember the important caveat in Wyoming that DFS does NOT take protective custody.  That task lies with Law Enforcement and Medical personnel.***

 If your office is unable to do well child checks at this time, consider compiling a list of previously identified high risk families (including socially at risk, our medically complex kids or kids that are in foster care or kinship care placements) and have your staff reach out and touch base on how they are doing and offer resource assistance as needed. Let families know about telehealth options. ~ Bird Gilmartin, MD, FAAP, AAP Executive Committee Council on Child Abuse and Neglect

Full Text of the WY-AAP Chapter Statement, by Bird Gilmartin, MD, FAAP (4/14/20)

Child Abuse & Neglect – Resources for Providers

American Academy of Pediatrics (AAP): Abusive Head Trauma in Infants and Children (April 2020)
AAP: Child Abuse Review Materials – now free of charge
The Chronicle of Social Change: Coronavirus and What Child Welfare Systems Need to Think About (3/11/20)
AAP: Trauma Toolbox for Primary Care

Child Abuse & Neglect – Resources for Parents and Families

Healthychildren.org

Policies and Communication: Federal Gov't., CDC, WHO, CMS

Presidential Orders & Resources

White House 15 Days To Slow the Spread Guidance (3/16/20)

New joint website from the CDC, White House and HHS www.coronavirus.gov

COVID-19 Advocacy Efforts

AMA COVID-19 Federal Advocacy Progress Report

Financial Relief and Economic Stimulus Packages

AMA ACP AAFP ACS MGMA Adovcacy Letter (3/20/20)

Requested $100 billion for front line health care workers to preserve practices (3/16/20)

Bennet, Barrasso Release Rural Hospital and Provider Plan to Bring Relief to Health Care System Amid Coronavirus Pandemic

Centers for Disease Control and Prevention (CDC) Guidance

CDC: Travel recommendations

CDC: Information for schools and childcare facilities

CDC: Guidance for higher education

CDC: Guidance information for businesses and employers

Centers for Medicare and Medicaid Services (CMS)

CMS: Annnounces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs (3/22/20)

Physician Board Certification

American Board of Medical Specialties (ABMS): Board Certification Guidance and Information Related to COVID-19

Other General Information and Resources:

CDC: Coronavirus (COVID-19)

CMS.gov: CMS Guidance to Providers about COVID-19

Medicaid.gov: Coronavirus Disease 2019 (COVID-19)

Stay
Connected

We know that there’s power in staying connected and learning from each other. There are a myriad of national resources, but sometimes it’s even more helpful to just connect within the state.

WMS can help. Join us monthly over the noon hour to share stories &learned experiences, ask for help and rely on our community.

WMS is looking at varying opportunities for education and connection. One of those is a future partnership with The Doctors Company to bring you important content about reopening, mitigating risk and learning about liability concerns. Stay tuned for more information coming soon!


(Must not be a member to join. Everyone is welcome)

 

Wyoming Needs Your Help

During these trying times, WMS is asking physicians to consider answering a future call to provide their time, energy, and skill to help Wyoming help our patients. COVID-19 is putting a tremendous strain on all physicians, especially those on the front lines, and the state is positioned to see unprecedented surge in patient care needs.

WMS is working with the State Board of Medicine to identify physicians who would be willing to help care for patients if the time came that our state might need you. Please consider submitting your name below to be added to a database of providers that we may need to call in if the situation worsens.

Wyoming is strong, our providers are strong, and sometimes strong means asking for help. Thank you for considering volunteering in this difficult time.

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