East Bay COVID-19 Update: March 31, 2020

As of March 31, there are 313 confirmed cases of COVID-19 in Alameda County and 7 deaths (including City of Berkeley information). As of March 31, there are 212 confirmed cases of COVID-19 in Contra Costa County and 3 deaths. Please check www.accma.org/COVID-19 for the latest updates. 
Shelter in Place Order Extension

On March 31, Alameda County and Contra Costa County joined five neighboring health jurisdictions to extend the jointly issued Shelter in Place Order through May 3, 2020, to reduce the spread of COVID-19.

While the prior Shelter Order has been effective in slowing the rate of transmission of COVID-19 (“flattening the curve”), it is not enough. Given the continued increase in cases—more than eightfold since the Order was first issued on March 15th—the Bay Area Health Officers have determined that stricter social distancing is needed for a longer period of time.

The goal remains to slow the rate of spread, prevent deaths, and stop the health care system from becoming overwhelmed. This Order is in effect until 11:59 PM on May 3, 2020, alongside the open-ended Stay at Home Order issued by Governor Newsom on March 19th; where more restrictive, our local order prevails.

Review the full Alameda County order here . Review the full Contra Costa order here .
ACCMA Recruiting Physician Volunteers

The Alameda-Contra Costa Medical Association (ACCMA) is helping to coordinate our local response to the COVID-19 emergency. As part of the effort, ACCMA is mobilizing physicians who may now be working a reduced schedule, who are recently retired, part-time, engaged in non-critical research or teaching, or otherwise available. If you are available and willing to volunteer, please complete the 3-minute survey . ACCMA is coordinating with County health officials to share information about physicians who would like to volunteer. Thank you!
CMS Sweeping Regulatory Changes

On March 30, 2020, at President Trump’s direction, the Centers for Medicare & Medicaid Services (CMS) issued an unprecedented array of temporary regulatory waivers and new rules to equip the American healthcare system with maximum flexibility to respond to the 2019 Novel Coronavirus (COVID-19) pandemic. These temporary changes will apply immediately across the entire U.S. healthcare system for the duration of the emergency declaration. These changes intend to allow hospitals and health systems to deliver services at other locations to make room for COVID-19 patients needing acute care in their main facility, to expand the healthcare workforce by removing pre-existing barriers, to temporarily postpone paperwork requirements so healthcare facilities can focus on patient care, and to promote telehealth services.

To view some of the actions CMS is taking during the COVID -19 pandemic, please click here .
Governor Newsom Announces California Health Corps

Governor Gavin Newsom recently announced the opening of additional health care sites to treat people affected by COVID-19. In order to ensure adequate staff for health care sites throughout California, Gov. Newsom is calling on healthcare providers, behavioral health professionals, and health care administrators to register for the California Health Corps .

California is calling for:
  • Physicians (MD, DO), including medical students
  • Pharmacists
  • Dentists
  • Nurse practitioners
  • Physician assistants
  • Nurses (RN, LVN, CNA), including nursing students
  • Behavioral health professionals (psychiatrist, psychologist, psychiatric nurse practitioner, LCSW, LMFT, LPCC)
  • Respiratory therapists
  • Paramedics
  • Medical assistants
  • Emergency medical technicians
Members of the California Health Corps will be paid for their services and will be given malpractice insurance coverage. Locations will vary, but Cal Health Corps will try to match your geographical preferences.

To be eligible for COVID-19 emergency medical staffing roles, you must:

  • Be 18 years of age or over
  • Be eligible to work in the United States
  • Have a valid driver’s license or passport, and a social security card
  • Have a valid California License for clinical practice (if you are a MD, DO, etc.) 
  • OR are a medical student or nursing student 
  • Have no negative licensure/certification actions (for licensed/certified professionals)

To sign up, visit covid19.ca.gov/healthcorps/.
Governor Newsom Relaxes Scope Requirements

On Monday, March 30, Gov. Gavin Newsom released an executive order in order to ease the path for health care professionals to practice in an expanded capacity in preparation for a surge in COVID-19 patients. The order, which is in effect through June 30, 2020, gives the California Department of Consumer Affairs (DCA) the authority to temporarily loosen restrictions on staff-to-patient ratios at medical facilities and scope of practice rules for nurse practitioners and physician assistants. The state will temporarily give hospitals the authority to lift the cap on the number of nurse practitioners (NPs) who can serve under a supervising physician. Current law allows for no more than 4 NPs to serve under the supervision of any individual physician.

The DCA will execute five waivers that have already been vetted by DCA and its respective licensing boards. The five waivers already approved are:

  1. Waiver of any CME or examination requirements for the renewal of licenses that expire from March 31, 2020, through June 30, 2020, and allow up to six months after the state of emergency declaration is lifted for licensees to make up these requirements. This applies to physicians as well as other licensees who are due for renewal during this window.
  2. Reinstatement of inactive/retired licenses (who have been retired or inactive for five years or less) without the CME or other requirements and an abbreviated license application to bring these practitioners into the workforce quickly.
  3. Allow nursing students to use their time working during this crisis to count towards their clinical hours, as clinical rotations through their educational institutions have been suspended through this crisis.
  4. Remove the current ratios in place for physicians supervising nurse practitioners and physician assistants. Physicians can now supervise the number of NPs or PAs they can competently and confidently supervise without a statutory ratio in place.
  5. Allowing residents who complete their first year of residency by June 2020 to become fully licensed without meeting the new 36 month residency requirement. 

For more information, click here . For the Alameda County EMS update concerning the executive order, click here .
ACCMA Letter to East Bay Mayors

On Sunday, March 29, the ACCMA drafted a letter to the Mayors of cities in Alameda and Contra Costa Counties regarding mobile and remote COVID-19 testing. The ACCMA understands that there is a high level of interest among East Bay cities, fire departments, and other organizations to increase availability of mobile COVID-19 testing sites in our community. Accordingly, the ACCMA urges local cities, fire departments, community-based organizations, and others to incorporate a set of standards in any efforts to develop mobile test sites in our community, including:

  • Ensuring that testing is completed by licensed entities;
  • That all testing sites follow proper protocols to prevent further COVID-19 transmission;
  • That testing sites transmit all test results, both positive and negative, to appropriate public health officials; and
  • That testing sites have protocols in place for ensuring proper care coordination is occurring for each individual tested.

Review the full memo here .
AMA and CMA Frequently Asked Questions

Both the American Medical Association and the California Medical Association have created FAQ sections on their websites with the most frequently asked questions from physicians regarding the COVID-19 outbreak.
The AMA has categorized their FAQs by:
  • Patient-Physician Relationship
  • Clinical
  • Practice Management
  • Ethical
The CMA has categorized their FAQs by:
  • Personnel
  • Financial
  • Telehealth
  • Testing
  • Prescribing
  • Miscellaneous
If you have any additional questions that are not currently listed, please contact communications@cmadocs.org.
Upcoming Webinars
Leading with Compassion: Supporting Healthcare Workers in a Crisis (presented by Schwartz Center for Compassionate Healthcare)
Tuesday, April 7 | 10:00 - 11:00 AM | FREE
Join Richard Westphal, PhD and Patricia Watson, PhD as they discuss specific strategies health care leaders and managers can use to address the five essential human needs that support recovery from adversity and stress. They’ll also explain how to use the Stress First Aid framework for conducting a stress and coping assessment. Following their presentation, Schwartz Center Chief Medical Officer Beth Lown, MD, will moderate a brief Q&A session. To register for this webinar please click here

Please contact ACCMA at 510-654-5383 or accma@accma.org with any questions or concerns you have. Although we may not currently have an immediate answer to all questions, we want to know the information and resources that you need to continue to provide care for our community during this difficult time.  
This information will also be posted online at  www.accma.org/COVID-19 and will be updated frequently. Please check the ACCMA website regularly for updates.