265 Church Street, 14th Floor
New Haven, CT 06510
Phone: 203-687-4422
Fax: 475-202-6844
PLEASE BE ADVISED OF THE IMPORTANT UPDATE BELOW


March 13, 2020
 


Re:        COVID-19 Update
__________________________________________________________________

Today's update contains a lot of information. Please click through on the links for details. I would also ask practice administrators to please forward it to your clinicians.
 
  • Confirmed cases continue to increase. I am again linking the most recent guidelines on PPE and infection control from the CDC from March 10th here.

  • Attached please find a clinical protocol for triaging adult patients with symptoms of fever, cough, and potential COVID-19 exposure. Patients should be triaged before coming into the office by phone.

This guideline was developed in collaboration with YNHH in an effort to provide consistent guidelines across the community. It is based upon best evidence/best practice information as of 3/13/2020 and is subject to change. The guideline does not address testing as test sites are not widely available; future iterations will include recommendations regarding testing.

This guideline is not a substitute for your clinical judgment. For example, there is a recommendation for empiric Tamiflu for phone triaged patients with flu-like illness. This recommendation may differ from your normal approach. The consensus is that there is sufficient benefit and little harm in prescribing Tamiflu, which ensures patients without access to flu swab testing can be treated. This pathway will also be used at YNHH emergency departments and their hotline for consistent application of the guideline. We are working for a similar pathway for pediatrics which I will disseminate as soon as possible. 
  • There are several potential HR issues related to the COVID- 19 pandemic. We have prepared detailed responses to several scenarios here along with a FAQ sheet.

  •  COVID- 19 may have a significant impact on the revenue of your practice due to decreased patient volume or staff absences. We have prepared a series of suggestions to help you prepare and manage a potential temporary drop in revenue, which you will find here. Any other ideas from the group on this topic would be appreciated and we will disseminate.

  • Lab capacity for testing is ramping up at multiple sites, including Quest, Labcorp, and local hospitals. National laboratories are expanding locations where testing is performed, which will increase capacity and lower turnaround. I am cautiously optimistic that capacity will increase at some point next week. There will still be a prioritization process that may slow return times for less acutely ill patients. Samples have successfully been collected in our offices and processed through Quest using normal lab pick-up. As of today Quest reports turnaround time of 3-4 days; this is not confirmed.

  • There are several testing sites already operational, although capacity is limited at this time. There are plans for multiple locations across the state, but the timeline for implementation is unknown.

  •  I will send out communications over the weekend as needed. Please know that the following individuals at CMG will be checking emails over the weekend: 
 

Please do not hesitate to reach out to us if needed. 


Please forward me any useful information you have, any corrections or updates to the above.

Be safe.


Best,


Joseph L. Quaranta, MD


Joseph L. Quaranta, MD
President, Community Medical Group