March 10, 2020
Dear CMG Providers,
I wanted to provide an update regarding the COVID-19 outbreak.
I will be direct and to the point about the information, I have available and update as often as possible. The situation is changing rapidly, and any updates may become quickly outdated. I have directly reached out to the Department of Public Health on your behalf and still await guidance on many of these issues. Unfortunately, many of the answers to essential questions remain unknown.
A few key points to summarize:
- Although the CDC has unrestricted testing criteria, testing remains available on a limited basis at this time in Connecticut and restricted to hospital-based settings at this time. The timeline for broadened test availability is unknown.
- Patients suspected of exposure or symptoms, after telephone or video triage, are being recommended to shelter in place unless clinical situation rises to the need for ER evaluation or admission. If patients do need to be seen, they need to be evaluated in a location with the resources to provide appropriate precautions. At this time, the emergency department remains the only option. Most patients will not need to be physically evaluated and can be reliably triaged remotely.
- It is not recommended to send patients to the ER just for testing at this time.
- If a patient's clinical situation warrants ER evaluation or hospitalization, call the emergency department before the patient's arrival.
- There are several plans in development to establish regional outpatient testing centers where patients with suspected Covid-19 can go for testing. However, these are not currently available, and there is still insufficient testing capacity available. The timeline for implementation of these is unknown.
- Personal protective equipment is in very short supply across the extended delivery system. Hospital facilities are rationing PPE at this time. Most ambulatory office settings face shortages at this time, whether independent or health system based. We have no easy solution at this time. The timeline for the resolution of this issue is unknown.
- Yale-New Haven has set up a hotline for patients and clinicians at 203-688-1700. The recommendation is that we provide initial triage before having patients call the hotline to prevent overwhelming current capacity.
- Many of you have expressed interest in implementing telehealth. We are doing everything we can to expedite this process with our vendor. However, the implementation is not usually done under such exigent circumstances, and we are assessing our capability for rapid deployment.
If you have discovered resources that you found helpful, please let me know, and we will disseminate it to everyone.
I know these are challenging times for us all personally and professionally. However, it is times like these when our patients need us most. Please be safe.
Joseph L. Quaranta, MD
Joseph L. Quaranta, MD
President, Community Medical Group