Physician-in-Chief's Message
April 13, 2020
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Dear Colleagues,
I hope many of you were able to connect with your family this weekend.
Please note that outbreaks at local nursing homes over the past week have reminded everyone that a surge could still be in front of us. However, we still have not had a child admitted to UNC Children’s test positive for COVID. This is very good news! I do think we can continue to feel cautiously optimistic that the policy and social changes implemented are making a difference, but future challenges in provision of healthcare could still be ahead of us. I have the utmost confidence in the team leading our COVID response for the medical center and in the work we are doing in Children’s.
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General Information
Currently there are 4 COVID-19 positive adult patients with 2 PUIs in the MICU with 6 additional COVID-19 positive adult patients and 6 PUIs elsewhere within in UNC Medical Center. There have been no positive pediatric patients anywhere in the UNC system.
PPE Update
We have an adequate supply of ear loop masks, provided we continue to use them for multiple days. We will not re-process these (earloop) masks because they have cellulose which degrades. However, all n95 are being reprocessed if not visibly damaged or soiled
Laboratory Update
We are running about 300 tests/day (between 2 assays) with about 10 days reagents on hand with more on order. There is work on the quick 45 min assay. They are validating the test this week, we will receive 300 more tests for receipt tomorrow – they will prioritize this quick test to ED patients and inpatient PUIs.
Non-Clinical Mask Distribution
We are expecting a significant number of masks for on-campus/non-clinical work (e.g., research, administrative) in the next day or two. Details will be shared by your Division Administrator when we know more specifics - please coordinate with them for distribution.
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Ambulatory Care
- Please continue to switch patients to VIDEO visits as the default visit type.
- In Specialty clinic, we are working to operationalize the video clinic visit process that will hopefully make these visits more efficient for providers by using clinic staff and nurses to help with some of the usual clinic responsibilities like triage and reviewing medications, problems etc. More to come on this.
- Remember that other participants can be brought into video calls using one of the methods in the attached tip sheet. It can be used for interpreters, residents to bring in attendings, scribes, or other staff at any time during the visit.
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Your COVID-19 Questions & Answers
Response from Tom Belhorn
Q:
A friend gave me several homemade cloth masks to wear at work in case there was a shortage. I was told I can not wear them at work. Why?
A:
As you know, there are a variety of types of masks. They all differ in the ability to prevent infections. The surgical masks we use at UNCH are effective in preventing disease from infectious respiratory droplets. We are now wearing these at work in the hospital or clinics. If there is greater risk of aerosolized pathogens during suctioning, testing procedures, etc. in caring for a probable or known COVID-19 patient, we take the extra precaution of wearing an N95 mask (and face shield or goggles). Now we have all been advised to wear masks out in public areas, especially when there is a higher likelihood of coming in close contact with others (for e.g. grocery, pharmacy). Cloth masks are often being used for this. The main purpose of these masks is to prevent others from being infected in case you are contagious. Some masks may be effective in preventing you from being infected, but as they are more variable, their use is not allowed while working in the hospital. And remember – it is still recommended to keep the appropriate physical distancing, even while wearing the masks!
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UNC Children's Wellness Initiative
If you have not responded to the
Buddy Survey please do so as soon as possible so we can get folks paired up. I want to stress
this buddy system is for EVERYONE in the department - staff, residents, fellow, faculty - so please sign up so we can help one another through these difficult times.
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Opportunities to Make a Difference
COVID-19 Plasma Donation
UNC is part of an effort to obtain
plasma from individuals who have recovered from COVID-19. Scientists and doctors are working hard to make treatment available which will not be possible without generous donors.
If you, or someone you know, has recovered from COVID-19, please consider registering to possibly donate plasma through the
National COVID-19 Convalescent Plasma Project (www.ccpp19.org)
.
HERO Invites Healthcare Workers to Fight COVID-19 Together
HERO Registry participants could have the opportunity to participate in future research studies to improve our understanding of COVID-19 and beyond, generating evidence to help keep healthcare workers safe and healthy. The first study, the HERO-HCQ Trial, will invite 15,000 healthcare workers from the registry to evaluate whether hydroxychloroquine can prevent COVID-19 infections.
heroesresearch.org
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Division Meeting Follow-Ups
There were several common questions asked during the meetings with the Divisions last week. Here are responses to a couple:
Q:
Are Pediatric Nurse Practitioners allowed to see adult patients? Are they covered by malpractice insurance if they are deployed to see adults?
A:
As we understand it now, Nurse Practitioners are to stay within the limits of their license - for PNPs, that means only seeing patients only up to 18 years of age. At this point, the NC Board of Nursing has not relaxed any rules; however, PNPs could still be deployed outside their traditional roles in a true emergency. They are covered by UNC malpractice insurance for anything they are asked to do as part of their work - including caring for adults in the case of emergency deployment.
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Q:
Since many our of physicians have recently been credentialed at Rex for consulting purposes, should they be included in completing the Rex deployment plan?
A:
There is currently no indication that pediatric physicians working primarily at the UNC Medical Center will need to be a part of the Rex deployment plan.
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A kind message of support from a UNC Football coach...
Carolina Football (@tarheelfootball) on Instagram: "A message from special teams coordinator and outside linebackers coach Jovan Dewitt...."
Read more
www.instagram.com
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Challenging times like this have really highlighted the incredible healthcare teams at UNC and our mission of serving the people of North Carolina. It is a true privilege to work with each of you every day.
Thank you for all you are doing.
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