June 25, 2020

Dear Colleagues,   UNC Children’s has been very busy this week. The hospital has been full and surgeries are at pre-COVID levels. Please remember to call the Children’s administrator on call for any issues including bed capacity problems. We have now admitted 18 children with acute COVID or MIS-C. The multidisciplinary approach to caring for these children has really advanced our understanding of the disease and its management. We are also slowly opening our Chapel Hill outpatient clinic (please see ambulatory updates below).

UNC COVID Updates

Ambulatory Care The Chapel Hill Clinic has opened with severely limited space, no ability to utilize the waiting room, limits of a total of 10 people (MD, NP, specialty RN, Resident, Fellow) for all services utilizing the clinic each day and limited staff due to deployments and COVID exposure.  For those service utilizing this space, please adhere to the 50% template policy.  Adding onto your clinic outside of your template will impact the clinic spaces available for other services.  Add On slots are now available at the Chapel Hill location. We have a total of 16 slots per day for emergent/urgent patients. This is defined as patients who need to be seen within 48 hours but do not need Emergency Department evaluation. Once these slot are full, patients will need to either be seen the next day or in the ED. Please provide as much information as possible in the Follow Up section of EPIC after the clinic visit. The schedulers are unable to efficiently schedule patients if these instructions are not provided.  Please contact Ryan Haushalter at Ryan.Haushalter@unchealth.unc.edu with questions.

Your COVID-19 Questions & Answers Responses from Tom Belhorn Q: I read that studies show antibody to COVID-19 might be gone a few months after infection. Does that mean everyone can get infected again in a few months? How does that impact testing and precautions?   A: The article published in Nature Medicine last week about immunologic assessment in asymptomatic SARS-CoV-2 infections has again focused discussions on duration of immunity after infection. First of all – we need more data. The authors did demonstrate in their smaller population more rapid decrease of antibody especially compared with the original SARS and MERS-CoV. Even if this finding is verified by others, one must remember immunity does not always equate with circulating levels of antibody (lower levels can be protective, there is immunity via T cell responses, etc.). But this data, when clarified, will impact all management decisions where duration of immunity is important – decisions on timing of re-testing, needed precautions, vaccine studies, et al. Again, more data is needed and no changes in management protocols are needed at this time. Stay tuned…

Wellness and Diversity

UNC Walks for Healthcare Equity UNC Health sponsored walks for healthcare equity in support of Black Lives Matter activism Tuesday at UNC Medical Center in Chapel Hill and UNC REX Hospital in Raleigh. Several hundred employees gathered to demonstrate their stand against racism and in support of Black Lives Matter. Each event began with words from senior hospital leaders and a moment of silence.

The UNC Health sponsored walk for healthcare equity on Tuesday was amazing! I hope some of you were able to participate. Finally, our interns started on Wednesday so you may be seeing lots of new faces!   Gratefully,

sddavis@med.unc.edu 919-417-3130 (cell)