NCMS Morning Rounds 3-16-20

What will this week bring?

Your NCMS Morning Rounds for sure!

  March 16, 2020

THANK YOU to our physician and PA members and all the health care professionals who are tirelessly caring for the public’s health during this stressful time.

Keeping up with Covid-19

Remember: The most timely and credible information is available at the
NC Department of Health and Human Services Covid-19 website
Centers for Disease Control and Prevention website
• The NCMS homepage also has a list of useful links and resources to help in your response to the pandemic.
• For immediate questions/concerns from members of the public, please call 866-462-3821.
• For non-urgent health care provider questions, please email ncresponse@nc.dhhs.gov.
• For urgent provider or local health department questions, please call 919-733-3419 (available 24/7). Please do NOT give this number to patients and members of the public.

Last Friday’s Forum Answered Some of Your Pressing Questions

Last Friday, NC DHHS and NC AHEC offered its first call-in Forum for health care professionals to answer questions you have about response to Covid-19. Below are some of the broad categories of questions with links to the latest information posted on the NCDHHS and CDC webpages.

Another call-in Forum is slated for this Friday, March 20 from 12:30 to 1:30 p.m. Please submit your questions by 5 p.m. on Wednesday to questionsCOVID19forum@gmail.com.

Access the forum through your computer at https://zoom.us/j/705979628. Or you can dial-in for audio-only, by calling 1-646-558-8656 and entering the conference ID: 705979628#.

During last Friday’s Forum, NCDHHS Medical Epidemiologist Erica Wilson, MD, MPH, answered questions and offered resource links in the following areas:

Who to test for Covid-19:
While we’re in cold and flu season, Dr. Wilson stressed it is important to distinguish the broad range of Covid-19 symptoms from a cold or flu. At this point, a person who is asymptomatic, should not be tested, she said.

As of Friday, the state lab and LabCorp were performing tests for Covid-19. For testing through the state lab, prior approval by your local health department or the state epidemiologist on call is necessary. Testing through LabCorp does not require prior approval.

Symptom criteria for testing:
• Fever OR signs/symptoms of lower respiratory illness (e.g., cough, shortness of breath) in any person, including healthcare workers, who has had close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset.
• Fever AND signs/symptoms of lower respiratory illness (e.g., cough, shortness of breath) AND negative influenza test (rapid or PCR) and no other more likely diagnosis.

Here is the latest NCDHHS guidance on testing, specimen collection and shipping.

Here is LabCorp’s guidance document.

Dr. Wilson said that NCDHHS is working to compile a comprehensive list of clinics, public health departments and hospitals throughout the state that are equipped to offer testing.

She also said that as of Friday afternoon, the turnaround time for test results from LabCorp was three to four days. The state lab turnaround time depends on volume of test orders.

Once a person has been tested, Person Under Investigation (PUI) protocols are initiated, in which the person is isolated pending the test results. Learn more about these protocols.

Dr. Wilson also stressed that this is a reportable condition.

Personal Protective Equipment
Dr. Wilson directed health care providers to the Centers for Disease Control and Prevention (CDC) website for the latest on personal protective equipment (PPE) requirements. Someone is at risk of infection if they are within six feet of a person who is infected with the virus for at least 10 minutes and/or come in contact with any respiratory secretions from that person.

She urged clinics that do not have adequate PPE to find another location in the community where people may be seen or tested. NCDHHS is currently compiling a list of facilities in each county that can accommodate patients being sent to them. Ultimately, the individual practice will have to make the decision on seeing patients who may need to be tested, she said.

If you have questions about PPE, she encouraged you to send them to ncresponse@dhhs.nc.gov

Other information from the Forum
In answer to other questions during the Forum, Dr. Wilson said that the specifics for Covid-19 as far as viral shedding and spread are still not known.

When asked if the warmer spring and summer weather would perhaps mitigate the spread of the virus, she only commented: “We’ll see.”

What’s happening at the AMA Regarding Covid-19

At this time, the AMA’s Annual Meeting scheduled for June 6 to 10 in Chicago is still set to take place, although AMA leadership is monitoring the Covid-19 situation and will let delegates and others know if there is a change in plans.

The AMA also is maintaining a Covid-19 Resource Center for Physicians. Access that information.

NCMS Legislative Update

Last week was relatively quiet on the local election front, however, there is one piece of news to report: NCMS member Kristin Baker, MD, a psychiatrist from Concord who comfortably won the Republican primary race in 82nd district for the NC House of Representatives, has been appointed by GOP officials to fill the unexpired portion of Rep. Linda Johnson (R-Cabarrus), who died last month. In November, Dr. Baker will face Aimy Steele, who won the Democratic primary in the district. Congratulations once again, Dr. Baker!

The NCMS is emailing daily updates and information for physicians and PAs on response to the Covid-19 pandemic from the NC Department of Health and Human Services (NCDHHS) and the Centers for Disease Control and Prevention (CDC). These are the primary sources for the latest and most credible information. You can also access this information on our website homepage, www.ncmedsoc.org.

As reported earlier in your NCMS Morning Rounds, the Joint Legislative Oversight Committees on Health and Human Services and Medicaid met last Tuesday to discuss a wide variety of issues including the state’s response to Covid-19. For a full summary of the committees’ discussion and links to the meeting documents, visit our Legislative blog.

On Thursday legislative leaders announced that due to Covid-19 legislative meetings are being postponed until April 1 at the earliest.

“The work of the people does not stop or end during a crisis, and the General Assembly will remain operational throughout this period,” Senate leader Phil Berger (R-Caswell) said in an emailed statement Thursday. “The formal beginning of the short session is scheduled for April 28, and that remains unchanged.”

House Speaker Tim Moore (R-Cleveland) stated, “North Carolina is well-prepared financially to support all recommended prevention and relief efforts to keep our people safe from harm. Lawmakers stand ready to approve robust policy and budgetary action to support frontline health care professionals as may become necessary.”

Don’t Forget Your Sunday Survey # 3 – Public Health

If you haven’t already, please take just a minute to complete this week’s NCMS Sunday Survey, which was emailed yesterday afternoon and focuses on public health issues. The quick one-question survey asks you to prioritize public health issues you’d like to see the NCMS advocate for at the General Assembly.

The NCMS Legislative Cabinet will use these surveys, including any comments you have, as they decide our legislative priorities for the coming legislative session.
Take the survey.

In the News

Why Providers and Insurers are Pushing Back on CMS’ New Interoperability Rules, The Advisory Board Forum, 3-12-20

Learning Opportunity

The NC Medical Group Management Association’s (NCMGMA) Annual Conference is still on for May 13-15. Registration is open for the conference, which will be held at the Grande Dunes Marriott in Myrtle Beach. The two keynote sessions focus on the patient experience led by the world-renowned Ritz-Carlton Leadership Center. Learn more and register.

 
 

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