RWJUH COVID-19 Update
March 18, 2020
TO: All Members of the RWJUH Family
FROM: John J. Gantner, President and CEO, Robert Wood Johnson University Hospital
RE: RWJUH COVID-19 Update

This will be my 8th COVID-19 Daily Briefing. The Leadership Team continues to refine the Action Plan related to the safe handling and treatment of COVID-19 patients. As that Action Plan becomes hard-wired into the organization, there is less new material to share.

That being said, I am pleased to report that the ED Tent, complete with Robotic testing capability, became operational this afternoon. We have also developed surge capacity and labor contingency plans to address the increased volume that we anticipate in the coming days.  

I do want to take this opportunity to share my observations of RWJUH’s response to this national crisis. Our entire Team has displayed exceptional professionalism and confidence in dealing with the uncertainties and challenges of this pandemic. Attitudes remain compassionate and selfless. I could not be more proud of what has been accomplished. Nobody does it better than you. 

CLICK HERE for the latest Daily Briefing Report that is sent out from the RWJBH corporate offices. The briefing contains additional up-to-date information regarding the impact of COVID-19.

For more information or if you have any questions about COVID-19: e-mail [email protected] .
 
Again on behalf of our Leadership Team, thank you for your support, hard work and commitment to serving our patients and community during this challenging time. 
RWJUH COVID Situational Update
As of 12:00 PM, RWJUH had 6 COVID-positive patients in the hospital. Tests on additional patients and potential discharges of positive patients were pending. At least five COVID 19-positive inpatient have recovered and been discharged.

RWJUH has had 15 COVID 19-positive tests to date.

As of 1:00 PM, the NJ Dept. of Health is reporting 427 COVID-positive patients in the state -- an increase of 162 from yesterday. Of those, 40 positive patients are in Middlesex County, 32 are in Monmouth County, and 16 are in Somerset County. A total of 18 counties in NJ have at least 1 positive patient.

CLICK HERE for the NJ DOH's county-by-county tracking page.
Are You Under Quarantine?
If you are presently under quarantine , please contact the Medical Staff Office at [email protected] or (732) 937-8767 .

Providers under quarantine should contact RWJUH Corporate Care/Employee Health for clearance to return to work. You may also need clearance from your employer.

Please provide documentation to the Medical Staff Office of your clearance to return to work.
COVID-19 Testing Guidance
--Reminder: NEW Phone Number For COVID-19 Testing Approval--

RWJUH is continuing to conduct a LIMITED number of COVID-19 tests in-house.


ALL REQUESTS FOR COVID-19 TESTING MUST GO THROUGH INFECTION PREVENTION .


The NEW phone number for testing approval is 732-947-9620 . NOTE: This is a new phone number, opened yesterday. PLEASE DO NOT SHARE THIS NUMBER WITH ANYONE OUTSIDE OF RWJUH.

DO NOT CALL THE COVID-19 HOSPITALIST TEAM SEEKING ASSISTANCE IN GETTING TESTING APPROVED . The Hospitalist team is focused on caring for these patients and does not influence testing decisions.

For Infection Prevention questions, please use extensions 2480 / 4482 / 7552 / 4474 during regular business hours. The public may call 1-800-222-1222 for any COVID-19 questions.

Guidance on COVID-19 Testing For Patients Not Requiring Admission--

At the current time, due to a shortage in swabs and viral transport medium, RWJUH is only taking swabs from patients who need to be admitted to the hospital .

The State of NJ is finalizing plans for drive-thru testing facilities, starting with Bergen and Monmouth Counties. It is expected these facilities will process approximately 2,000 people per day.

Additionally, in the interest of conserving viral transport medium for patients requiring COVID-19 testing, please do not order any Respiratory Virus Panels (RVPs) until further notice .

--Guidelines For Other Testing For COVID 19-Positive Patients--

Please be thoughtful in your ordering of tests for COVID 19-positive patients. If a test is not absolutely necessary, consider the potential exposure risk for other staff members involved in completing the testing.
Scientific Reviews
These links are provided solely for your consideration. The RWJUH Medical Staff Office is not providing these as recommendations for care of patients.








We're All In This Together
The nursing and support staff at RWJUH are doing exceptional work under these trying circumstances. They are here to help, but they face the same worries and concerns that we all do.

These are extraordinary times. You are doing extraordinary work. Please keep doing so, as we all work towards the same basic goals: provide the best possible care for our patients, while trying to keep them -- and ourselves -- safe .
Do NOT Enter SBMU
In addition to being a closed service, SBMU is a closed unit for the protection of our patients and providers.

Please do not enter SBMU unless asked or consulted by the COVID-19 Hospitalist team.

This is both for your protection - limiting your risk of exposure to the virus - and in the interest of high quality patient care , keeping the patients treatment limited to teams that are trained and gaining expertise in COVID-19.
Blood Shortages
We have received notices from our blood suppliers regarding the tremendous strain COVID-19 has placed on blood supply . Recommendations from RWJBH’s Blood Management Program are as follows:

  • Strict adherence to the recommended transfusions triggers for RBCs:

  • 7g/dL for stable, non-bleeding patients (focus on entire clinical picture, symptoms not just a numbers)

  • 8g/dL for patient with cardiovascular disease

  • Single unit transfusion – RBCs and platelets (MUST reassess before ordering a second unit)

  • Surgical cases – anticipated blood loss ≥500cc implement cell saver with the requirement to spin down everything collected in reservoir and give back to the patient in order to reduce the need for banked blood

  • Minimize serial lab draws – focus on draws that are necessary (keep the blood in the patient)

  • ICU/CTICU and CCU – ensure utilization of VAMP (Venous Arterial blood Management Protection) systems to re-infuse excess blood not needed when drawing blood sample for testing

--Blood Donations Accepted-- 

Your help to encourage healthy people to donate blood and platelets is requested at this time. Our RWJUH Blood Services staff is working very hard to continue to provide services throughout this unprecedented time. Our goal is to maintain a safe and adequate supply for our patients in need!

Please have interested and potential donors access our appointment portal at rwjuhdonorclub.org or call 732-235-8100 x221 .
Updated N95/All Mask Information
--FIT Testing Restrictions--

FIT testing remains limited to areas that will be treating COVID-19 patients and PUIs. When testing is opened up to a wider group, we will let you know.

--Proper Use of Masks (Which Sometimes Means NOT Wearing A Mask) Are Important To Preventing Infection Spread--

Proper use of masks includes :

  • Put the mask on when you're donning PPE to enter a room, and fully remove it while doffing after exiting;

  • Do NOT leave a mask dangling around your neck;

  • You do NOT need to wear a mask while walking on floors or around our campus. As we are carefully monitoring mask supply, unnecessary use of masks not only depletes supplies, but spreads fear.
Daily Video Briefings
Every morning, a video briefing by Dr. Jim Salwitz will be released, providing an update on COVID-19 activity at RWJUH and the implementation of the hospital's action plan.

BOOKMARK THIS PAGE and check daily for updates. New briefings will be posted at approximately 10:00 AM.

Have questions? Email [email protected] and please CC Chris Hoenig and we will try to ensure they are also included in our daily Video Briefings.
Additional Updates
  • Please ensure your ID is visible at all times. RWJUH continues to evaluate campus entrance points to ensure the safety of our patients, clinicians and staff.

  • Visitor guidelines have been updated to allow post-op patients 1 short visit by 1 person following the procedure;

  • Leaders at Bristol-Myers Squibb Children's Hospital continue finalizing plans to cohort all pediatric patients with respiratory illness, including COVID 19-positive patients and PUIs;

  • The tents outside of the Emergency Department are now open. They are wired for telehealth, limiting clinician exposure to potential COVID-19 patients. These spaces are NOT for testing & treatment -- they will be used to triage patients arriving in our ED, protecting the health of both our patients and caregivers;

  • There are no special laundry handling guidelines for COVID-19 -- standard washing and use of disinfectants on surfaces will kill the virus. While you may choose to not wear your white coat, standard precautions will help prevent the spread of the virus;

  • The new digital screen in the Courtyard is now live and includes information on COVID-19;

  • As we continue our efforts to restrict the number of people entering our facilities, a temporary ban is being put in place on flower deliveries to patients;

  • The Federal government announced today that CMS will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the country. Beneficiaries will be able to receive telehealth services in any healthcare facility, including a physician’s office, hospital, nursing home or rural health clinic, as well as from their homes. Medicare beneficiaries will be able to receive various services through telehealth including common office visits, mental health counseling, and preventive health screenings. CMS is waiving certain HIPAA requirements for telehealth services during this Public Health Emergency, allowing the use of platforms like Facetime on cellphones.
Additional Useful Resources