COVID 19: New and Updated Information and Resources
NJAASC has curated authoritative information and a list of resources for our Membership’s reference. We will continue to update this as more information becomes available.


PAST COVID E-BLAST HAVE BEEN ARCHIVED DUE TO SPACE RESTRAINTS AND TO KEEP THINGS CURRENT. 
TO VIEW PREVIOUS E-BLASTS, CLICK HERE

GOVERNOR EXTENDS PUBLIC HEALTH EMERGENCY- EO 109 STILL IN EFFECT – 5/7/20
As expected and properly, Governor Murphy extended for another 30 days the Public Health Emergency.   This is procedural, do not read into it!
 
EO 109 is still in effect and will be until he rescinds it or amends it. I have been receiving dozens of calls and e-mails about this!
It does not  mean that only emergency procedures can be performed for another 30 days-electives are coming per the Governor ‘sooner rather than later’.
 
 
As NJAASC has been communicating to everyone- electives are coming- sometime this month.
 
Stay the course.

FORMER GOVERNOR CHRISTIE WEIGHS IN ON RE-OPENING NEW JERSEY- 5/7/20

NEW JERSEY GRANTS EMERGENCY LICENSES FOR GRADUATES - 5/7/20
In an effort to shore up medical staff, NJ will begin to issue thousands of temporary licenses to recent graduates.   

VIEW A VIDEO OF PROPER DONNNG/DOFFING OF PPE- 5/7/20

BURN RATE CALCULATOR FOR PPE – 5/7/20
In an effort to conserve, and only use what you need, here is a calculator from CDC for PPE.

PPE – GUIDANCE ON MASKING, CLEANING AND USE- 5/6/20
As part of the series started yesterday, here are resources for masking.
It is important that all centers understand use, cleaning and conservation.
Part of opening for elective surgery hinges around PPE- the Governor is still a bit on edge regarding it. Thus it is important that we in the ASC community understand fully how to use it (do not use N95 for instance if not necessary for the case of for the health care provider), clean it if applicable and be judicious in using it period- conservation.
 
 
 
 

MASK CLEANING WITH STERRAD – 5/6/20
Here are instructions for N95 emergency masking cleaning with Sterrad

DISINFECTING YOUR ASC IN THE AGE OF COVID- WATCH OUT FOR PRODUCTS THAT DON’T PASS THE SNIFF TEST! – 5/6/20
With everything going on, we hear about products and such that promise everything but are just not what they say they are, or not appropriate for use in ASCs.
For instant disinfectants. I will not of course mention the product or company, but please see comments below from IC people, and resources to use.

This seems to be a spray-on product, but the facility still has to use an EPA approved disinfectant that kills HBV, HCV and HIV, which by the way will also kill Covid-19.  

The facility should be using an EPA, hospital-grade disinfectant, which the CDC recommends and says will kill Covid-19:  



This product is sprayed onto environmental surfaces, which still have to be cleaned and disinfected as per facility policy, and does nothing to control the source (which is the patients and healthcare workers respiratory tract).

WHEN WE START BACK UP- INSURANCE COVERAGE COULD BE AN ISSUE -5/6/20
While we are all preparing for elective surgeries to return, patient insurance coverage should be part of the equation. Some studies indicate that if unemployment continues to rise, a significant number of Americans will no longer be insured through their employer.


New Jersey could allow elective surgeries ‘sooner rather than later’ – 5/6/20
FYI- this also includes ASCs per conversation with Governor’s Office- the article below is generic press.
 
Gov. Phil Murphy said Tuesday that New Jersey hospitals may soon be able to resume elective surgeries, which would offer a major financial boost to medical centers that have been the hardest-hit by the coronavirus pandemic.

“That’s something that is, on the sequencing, that’s on the sooner rather than later side,” Murphy said during his daily coronavirus press briefing in Trenton. “We’re still not there yet.”

In March, Murphy signed an  executive order  suspending any elective surgery or invasive procedure that could be delayed without putting the patient’s health in “undue risk.”

The purpose of the order — which was in line with federal guidance and had already been adopted by some health systems — was designed to preserve health care resources as New Jersey entered the pandemic’s peak.

It also cut off hospitals from their most lucrative revenue source as they faced the greatest public health crisis of the last century.

As the worst days of the public health crisis faded, Pennsylvania last week gave hospitals the green light to move forward with elective surgeries, prompting some lawmakers to recommend Murphy also pull back his order.

Though hospitalization rates are improving, New Jersey hospitals are still admitting hundreds of confirmed or suspected Covid-19 patients each day.

More than 5,300 patients were receiving treatment for the coronavirus in New Jersey hospitals as of Monday night. Of those, 1,534 were in critical or intensive care and 1,169 required ventilators.

“We have avoided the worst of it by a lot,” Murphy said, noting that earlier projections had around 36,000 residents requiring hospitalizations. That said, “There’s not some magic date” when economic activity — which presumably includes elective surgeries — can resume.

“We’re trying to make every decision based on the science, the data, the facts,” he said. “But we’ve got to do it right.”

WITH PPE-IT’S NO LONGER BUSINESS AS USUAL- 5/5/20
I wanted to begin the conversation about how we will need to function when electives come back- and they will. There will be changes, and we need to adapt to what will be the new normal.
In speaking with and listening to the Governor’s Office, DOH and others, PPE is a large part of that discussion- as it should be.
NJAASC will begin a series of articles and instruction for ASCs, centering on correct use, conservation, re-use and repurposing and if applicable cleaning of PPE.
 
While the supply chain has improved, it is not nearly back to normal. Some could make the argument that opening up for electives only exacerbates an already tenuous PPE situation.
No matter the argument, there is still PPE ‘rationing’ going on from suppliers, with ASCs (correctly by the way) receiving less of an allotment than hospitals. Taking that and the formation of a regional governor’s purchasing group formed for the purpose of stockpiling against future outbreak into consideration, the situation is not likely to change.
 
So what can ASCs do?
 
First and foremost would be conservation. We have to learn to use only what we need and re-purpose if possible and safely.
We also have to completely understand what specific PPE is appropriate for health care providers depending upon the patient circumstance. 
 
To that end, please refer to the CDC document below, which was referenced by NJDOH in a previous COVID e-blast: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html

QUESTION FROM GOVERNOR MURPHY’S COVID UPDATE TODAY- 5/5/20
In his daily Covid updates, the Governor always takes questions from the press at the end of the program.
Today he was asked about elective surgery, when would they resume.
His exact quote was: ‘Sooner rather than later’.
It is coming!

JOINT COMMISSION ON MANAGING COVID IN AMBULATORY ENVIRONMENT -5/5/20

AGA ISSUES GUIDANCE - 5/5/20
American Gastroenterological Association released guidelines on consultative management of COVID patients.

DRUG SHORTAGES AND COVID - 5/5/20
With resuming electives on the horizon, the FDA has issued a shortage list of over one hundred drugs.

LEAPFROG SAFETY GRADES- APPROPRIATE AT THIS TIME? – 5/4/20
Leapfrog put out its hospital safety grades, though some believe it is inappropriate during the COVID crisis, and unfair.
 
NJAASC met with the Leapfrog representatives in New Jersey the other month and expressed our extreme displeasure with their ASC roll out. We told them that in all good conscience we could not recommend that New Jersey ASCs participate until Leapfrog actually listens to the ASC community, and realizes that we are not hospitals!

HEALTH CARE COVERAGE AND COVID- 5/4/20
There is a growing concern that millions may lose health care coverage due to the crisis and people losing their jobs.

Questions? Contact Jeff Shanton at  jshanton@jssurgctr.com