All information contained in this email is confidential and not to be shared outside of the organization.
RWJUH COVID-19 Update
March 21, 2020
#RWJUHSTRONG
The RWJUH ED night shift is #RWJUHSTRONG !
RWJUH COVID Situational Update
As of 12:00 PM, RWJUH had 17 COVID-positive patients in the hospital. Tests on additional patients and potential discharges of positive patients were pending. At least eight COVID 19-positive inpatient have recovered and been discharged.

RWJUH has had 35 COVID 19-positive tests to date.

As of 1:00 PM, the NJ Dept. of Health is reporting 1,327 COVID-positive patients in the state -- an increase of 442 from yesterday. Of those, 116 positive patients are in Middlesex County, 92 are in Monmouth County, and 34 are in Somerset County. A total of 20 counties in NJ have at least 1 positive patient -- Salem County is the only county not reporting a positive patient.

--New State DOH COVID-19 Website--

The State of NJ, along with the NJ Dept. of Health, has launched a new website for all information about COVID-19: https://covid19.nj.gov/
REMINDER: Call For IP Approval BEFORE
Ordering COVID-19 Testing
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 Tuesday. 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 are previously approved to be tested .

Additionally, in the interest of conserving swabs and viral transport medium for patients requiring COVID-19 testing, please do not order any Respiratory Virus Panels (RVPs) until further notice .
New PPE Guidelines
As with many emerging pathogens, the science of COVID-19 is always evolving. The latest research has led to new guidelines from the CDC and WHO on PPE requirements , which have been adopted by RWJUH , RWJBarnabas Health , and many large hospital systems state- and nationwide.

For many situations, droplet precautions + eye protection are now the rule.

For assessment or routine treatment of all suspected or positive COVID-19 patients the following equipment should be :

  • Surgical/face mask

  • Face shield/goggles

  • Gown

  • Gloves

N95 Respirators/Masks should be used with the following :

  • During Intubation for presumptive or known cases of COVID-19. All other cases should be intubated utilizing a surgical/face mask.

  • During aerosol generating procedures (i.e.: sputum induction and open suctioning

  • When collecting oropharyngeal or nasopharyngeal specimens on suspected COVID-19 patients

  • When assessing patients in the outdoor tent treatment area

CLICK HERE for the full updated PPE/Isolation guidance.
Additional New Updates
  • If you are concerned you may have been exposed to a COVID-19 positive patient, either in the community or in the hospital, please self-monitor your symptoms, including checking your temperature twice a day. Report any symptoms/temperature over 100.4 to RWJUH Corporate Care/Employee Health.

  • ALL transfers into RWJUH must be reviewed and approved by the Service Chief. Any patients that have tested positive for, or suspected of having COVID-19 must be approved by the Chief Medical Officer or his designee.

  • ALL coordination with government officials must be handled through hospital leadership. If you have questions or suggestions for state leaders, please email Dr. Salwitz and he will coordinate with RWJUH leadership.

  • Additionally, all members of the Medical Staff are expected to protect confidential information, including the information contained in this email. DO NOT SHARE with the press or on social media. Given the volatility of the current environment, especially on social media, you should always use caution in what you post. If you are approached by the media for interviews, please reach out to the RWJUH Medical Staff Office to aid in clearing with the hospital Public Affairs team any hospital information that can be shared.

  • Several policy updates will be coming in the next few days. These include guidelines for the disposition of decedents that are COVID-19 positive, and Labor & Delivery and NICU visitation restrictions. In the meantime, you will see increased screening and precautions for L&D staff, patients and significant others/support persons.

  • The RWJUH Cafeteria has converted to prepackaged foods only. Policies for Food & Nutrition are continuing to be reviewed. The Safari Cafe outside the BMSCH lobby will be closed until further notice.

  • An RWJBH employee/internal stakeholder hotline has been opened to answer all COVID-19 related questions. The hotline -- 1 (833) 579-0862 -- is manned 24/7 by clinical professionals. CLICK HERE for more details on that and more in the latest RWJBH System Update.

  • NJ's first drive-thru testing facility opened today in Bergen County, and quickly reached capacity. A drive-thru testing facility at the PNC Bank Arts Center in Monmouth County is currently scheduled to open on Monday.

  • As part of RWJUH's continuing efforts to support the Surge Plan, the Dept. of Pathology will not be performing elective, family-driven autopsies. Clinician-requested autopsies on non-COVID patients will still be considered. Any COVID-related deaths must be referred to the Office of the Medical Examiner. CLICK HERE for details.

  • Additionally, the IP team continues to assess guidance regarding quarantining during this time. The latest guidance/policy change keeps RWJBH employees at work after an exposure as long as there is no evidence of even mild symptoms. Exposed staff will wear a surgical mask for 14 days. As of now, a return to work may be allowed after 7 days of improving respiratory symptoms IF the COVID-positive patient is afebrile for 72 hours, without the need for medication. CLICK HERE to read the RWJBH Return to Work Policy.
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.








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.
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.
Daily Video Briefings
Every weekday 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.
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 .

Starting next week, RWJUH is partnering with the Embrace Kids Foundation to turn their New Brunswick facility into a donation center. CLICK HERE for more details.
Additional Information
  • The RWJUH OR has cancelled 330+ elective procedures to date. We are permitting only essential procedures to ensure the hospital has adequate resources for this COVID-19 outbreak. CMS and ACS both advise to cancel all elective procedures.

  • 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.

  • 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;

  • 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