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PAST COVID E-BLAST HAVE BEEN ARCHIVED DUE TO SPACE RESTRAINTS AND TO KEEP THINGS CURRENT.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

AMBULATORY ASSESSMENT LEGISLATION -5/29/20
Here is the draft of the legislation-A4201 . It is co-sponsored by Assemblymen Greenwald and Conaway. It will be introduced during the next quorum call.
 
As I stated yesterday, it is asking for a nine month postponement for the June 15 th  installment. I doubt that will happen, the Governor will probably not go for that. I would expect it to get negotiated down to 90-120 days, which hopefully would be palatable to the Governor.  

NJAASC MEMBER VENDOR PHARMACY ANNOUNCES TESTING AVAILABLE AT THEIR LOCATION - 5/29/20
NJAASC vendor member Devines Pharmacy has announced that they will be doing COVID testing at their Edison location. Learn more .

PLEASE RESPOND- COMPLETE THE NJAASC TESTING ISSUES DATA TOOL- 5/29/20
We sent out a data collection/reporting tool this AM to all centers.
Please fill it out and return.
 
This is extremely important, as we need a lot of hard data to be able to use to show the Department that in our opinion testing is not working the way it should, or they expected.
                             https://conta.cc/2XfDAQ0

PPP Update: Loan Review Procedures - 5/29/20
The Small Business Administration (SBA) recently issued a regulation titled  “SBA Loan Review Procedures and Related Borrower and Lender Responsibilities”  under the Paycheck Protection Program (PPP). Here are the key takeaways:
  • For loans the SBA reviews, it may review borrower eligibility, loan amounts and use of the proceeds, and the loan forgiveness amount.
  • The SBA may conduct its review up to six years after the date the loan is forgiven or repaid in full.
  • The borrower’s failure to respond to the SBA’s inquiry during an audit may result in the determination that the borrower was ineligible for a PPP loan or loan amount, or for loan forgiveness.
  • If the SBA determines that the borrower is ineligible for the PPP loan, it will direct the lender to deny the loan forgiveness application. If the SBA determines that the borrower is ineligible for the loan amount or loan forgiveness amount claimed by the borrower, the SBA will direct the lender to deny the loan forgiveness application in whole or in part, and may seek repayment of the outstanding loan balance and other remedies.
  • The SBA will issue a regulation providing an appeal of the SBA’s determination that the borrower is ineligible for a PPP loan or ineligible for the loan amount or forgiveness amount.

AMBULATORY ASSESSMENT NEWS – 5/28/20
A bill is expected to be introduced today in both Houses regarding the ACF.

No introductions are reported until after the session is gaveled to an end, so as of now cannot say for certain, but all indications are that this should occur.

The bill reportedly would postpone for 9 months the assessment.

Now before everyone gets excited, I doubt very much considering his recent record, the Governor would sign off on something like that. There would have to be negotiation between the legislature and Governor’s Office for him to sign a bill like this.

I realistically would expect the postponement to be in the neighborhood of 2-3 months, in particular for the June 15 th  quarterly due. That is what I proposed to Senator Sarlo and Assemblyman Greenwald in correspondence, and what I testified to before the Senate Select Committee. I made it very clear that we need immediate relief, in particular for the June 15 th  installment.

Stay tuned for more information tomorrow.

PLEASE BE CAREFUL WITH YOUR TESTING – 5/28/20
I know that everyone is looking for a light at the end of the testing tunnel for electives, but please do not just jump in and use anyone or anything.
New Jersey has rules and regulations, including out of state labs with you mailing to them.
Today I had them investigate a particular test and as I suspected, they could not recommend it.
The test was FDA approved, but for patients with COVID symptoms, not for our use- pre-op screening of asymptomatic patients. 
I would suggest that you contact the Department before you jump in.
Melanie Rinaldi
Manger, NJ CLIA Program
Clinical Lab Evaluator

PRIVATE TESTING SITES – 5/28/20
While the COVID portal has information on community based and the like testing, they do not for private sites.
We have questioned this, and so have some legislators who are trying to help us.
 
Here is the response from the Governor’s Office to one legislator’s query:
 
We are exploring options to broaden information to include private testing site data, and hope to have an update on the COVID-19 portal in the coming days.

ICAR UPDATE -5/28/20
Information on damaged/degraded head straps on stockpiled NIOSH-approved Filtering Facepiece Respirator (FFRs)
 
The National Institute for Occupational Safety and Health (NIOSH) is aware that many different NIOSH-approved filtering facepiece respirator (FFR) models were stockpiled for prolonged times and are now distributed for use during the COVID-19 response. These FFRs are made using different materials (e.g., filtering media and strap material), which may age or degrade over time and become damaged. Generally, FFRs are not designed for long-term storage, and many models may have shelf lives designated by the NIOSH approval holder. The shelf life information is generally found on the packaging or the approval holder’s website.
NIOSH has received multiple inquiries concerning the identification and replacement of damaged straps on large caches of NIOSH-approved N95 FFRs that have since passed their designated shelf life. Users should perform a visual inspection of each respirator prior to donning per the user instructions. Additional questions and concerns related to the condition of the respirator should be directed to the approval holder.
For more information, see the  NIOSH conformity assessment notice 2020-1028 , dated May 2020.
 
Possible cases of recurrent COVID-19
China and South Korea have reported possible cases of recurrent SARS­ CoV-2 RNA detection, both with or without symptoms, among patients who have recovered from COVID-19; whether these cases represent re-infection versus intermittent viral RNA shedding is still to be determined. The extent to which such cases are occurring in the United States is currently unknown.

In order to learn more about clinician-suspected cases of reinfection, the Centers for Disease Control & Prevention (CDC) are requesting information from any clinician who may have identified a confirmed COVID-19 patient with clinical recovery for approximately 1O days after symptom onset or diagnosis (if asymptomatic), and subsequently had any of the following:
 
·      Two documented negative PCR results followed by a positive result
·      Recurrence of symptoms with a positive PCR result
·      Positive PCR results for ≥30 days after recovery (without any recurrence of symptoms)

If so, please use the attached link to enter a case description:  https://ein.idsociety.org/surveys/survey/125/

Additional questions should be directed to the Emerging Infections Network at  ein@uiowa.edu

OSHA Guidance for Employers
 
The latest  COVID-19 OSHA Alerts  provide recommended practices for protecting workers at  nursing home and long-term care facilities retail pharmacies , and  rideshare , taxi and car services .

Please monitor CDC and NJDOH COVID-19: Information for Healthcare Professionals  https://www.nj.gov/health/cd/topics/covid2019_healthcare.shtml  for additional information 

Melody Lee, MS
Infectious and Zoonotic Disease Program | Communicable Disease Service
Division of Epidemiology, Environmental, and Occupational Health | New Jersey Department of Health
Phone 609-913-5065 |Email  melody.lee@doh.nj.gov  | ICAR Email  CDS.ICAR@doh.nj.gov

Questions? Contact Jeff Shanton at  jshanton@jssurgctr.com