Sent to all dialysis facility leadership and disaster contacts in NY State with valid email addresses in CROWNWeb, and all Emergency partners and stakeholders in the Network Service Area.
Providing Dialysis Care During the COVID-19 Pandemic

Today, Friday, March 20, 2020, Governor Cuomo announced a " PAUSE " (10-Point P olicy that A ssures U niform S afety for E veryone) for New York State, and the City of New York issued a Health Alert #8 (excerpt below) that will impact healthcare in the upcoming weeks.

Network staff are working with Local, State and federal partners to assist in overcoming barriers to providing treatment. Please report any issues that you are having to the Network via email esrdnetwork2@ipro.us , and if your patients or staff have been impacted by COVID-19, please report your facility status (link below).

We are happy to report that there have been 2 COVID-19 recoveries reported today. One dialysis patient has recovered, and one staff member.
NYC HAN Advisory #8
Excerpt below (full text link )

2020 Advisory #8
COVID-19 Update for New York City
 
  • Outpatient testing must not be encouraged, promoted or advertised.
  • Persons with COVID-like illness not requiring hospitalization should be instructed to stay home. It is safer for the patients and health care workers and testing does not currently change clinical management or recommendations about staying home.
  • Hospital systems may create alternate testing venues to offload their emergency departments.
  • This minimizes risk of transmission to others, especially healthcare workers (HCWs)
  • There is a national shortage of personal protective equipment (PPE), collection swabs, and viral transport media supplies and it is critical that laboratory testing be prioritized for hospitalized patients
  • There is no reason to test asymptomatic persons or mild-to-moderately ill persons who are not hospitalized, including HCW or first responders
  • Testing may play a more significant role after the pandemic has peaked
  • PRESERVE PPE for HCWs providing medically necessary care for hospitalized patients
  • Like other jurisdictions with general community transmission of COVID-19, New York City (NYC) is facing a critical shortage of PPE
  • PPE stockpile supplies in NYC are extremely limited and must be released based on strict criteria to preserve healthcare functions
  • Refer to NYC Health Department and CDC guidance on crisis strategies for preserving PPE
  • Be aware of new Occupational Safety and Health Administration (OSHA) approved measures to preserve PPE supply
  • There is no reliable data that use of NSAIDS or ACE inhibiters for patients with COVID-19 like illness is harmful
  • Instructions for how to volunteer for NYC Medical Reserve Corps are included in this HAN
MANDATORY REPORTING

It is very important that your facility report any COVID-19 Impact on your facility (Including staff shortages, need to alter treatments, any Persons Under Investigation (PUI) or Confirmed COVID-19 Positive, as we report to CMS daily.

If you have any patients or staff that are being tested (PUI) or that are unable to access the dialysis facility due to voluntary 14 day isolation, or confirmed COVID-19. Please submit this brief online reporting form:
https://redcap.ipro.org/surveys/?s=XAJLFDJPT8
PPE Conservation Guidance

On Thursday, March 19, 2020, New York State has over 4,000 Active COVID-19 (+) positive patients. The COVID-19 virus has impacted the dialysis community and 18 ESRD patients have now tested positive for COVID-19, 28 ESRD Patients are under investigation (PUI) and multiple staff members are in voluntary 14 -day isolation and 9 staff members are awaiting test outcomes.  

COVID-19 has created a strain on resources, which includes Personal Protective Equipment (PPE) Shortages. In following the Centers for Disease Control and Prevention (CDC) I nterim Additional Guidance for Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed COVID-19 in Outpatient Hemodialysis Facilities , Please continue to conserve personal protective equipment (PPE) per guidelines:

  • CDC: Strategies for Optimizing the Supply of PPE including sections on eye protection, isolation gowns, facemasks, and N95 respirators link
  • NYCDOHMH Strategies for the Conservation of Respiratory PPE link
  • FDA : Surgical Mask and Gown Conservation Strategies - Letter to Healthcare Providers link

These shortages are being addressed daily on a National level, and we will share any future updates.
Disposition of Non-Hospitalized Patients with COVID-19

This CDC Guidance provides various protocols for allowing patients to discontinue home isolation. at  https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html ,
Return to Work Criteria for Health Care Personnel with Confirmed or Suspected COVID-19

Guidance includes including sections on Return to Work Practices and Work Restrictions, and Crisis Strategies to Mitigate Staffing Shortages. at https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/hcp-return-work.html
New York State
Health Commerce System
(NYSHCS)
New York State dialysis providers should be receiving updates from the DOH via the  Health Commerce System . If your facility does not already have an active HC account (for NYPORTS) please see this website for instructions on creating an account: https://www.health.ny.gov/prevention/immunization/information_system/providers/hpn_account_instructions.htm