All information contained in this email is confidential and not to be shared outside of the organization.
RWJUH COVID-19 Update
March 24, 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

Today’s update includes a brief summary of where RWJUH stands with the COVID-19 epidemic as well as an important call to action. 
 
Situational Overview

Our first COVID-19 patient was hospitalized on March 11, 2020. We are now in our third week of battling this pandemic and, as of last night, had 36 inpatients that were COVID-19 positive.   We also had 16 patients that are awaiting test results.

To respond to the COVID-19 challenge, RWJUH has developed a Surge Plan that calls for progressive co-horting of COVID-19 inpatients into discrete care units. Co-horting has a number of advantages including conservation of PPE and promoting a single standard of care competency. We just opened the third such COVID-19 unit in the MICU, which joins the South Building and Respiratory Care Unit as dedicated COVID-19 care units. We salute the staff on these three units and throughout the entire Hospital for their service in these unprecedented times.  

Included in the Surge Plan is the daily tracking of both PPE levels and critical equipment such as ventilators and ICU beds. The goal of continually monitoring PPE and equipment levels is to avoid shortages. With the support of Corporate Materials Management and the product sharing that is going on between/among the System hospitals; we are managing our supply chain effectively. No stockouts have occurred and none are anticipated. We thank everyone for helping us conserve valuable resources.  

There are a number of epidemiologic models that have been developed to predict the hypothetical progression of COVID-19. All of the models that we have seen show that the number of infected patients is expected to increase in the foreseeable future. One similarity in the modeling, which is consistent with CDC and NJDOH guidance, is that social distancing appears to be the most effective means of “flattening” the infection curve. Recent changes in our visitation policies and meeting formats are reflective of the critical importance of social distancing in defeating the pandemic. 

Call to Action – Blood & Platelets Supply

While social distancing is critical to curb the spread of COVID-19, an unintended consequence has been a severe drop in blood/platelet donations. The Centers for Disease Control, Food and Drug Administration and American Association of Blood Banks all warn of an unprecedented threat to our nation’s blood product supply if donors do not step up in the days and weeks ahead. 

I am asking today that you and your family members consider donating blood. Our Blood Donor Center, located on the 4 th floor of the Clinical Academic Building, has taken additional precautions to maintain safe donations. You will need to schedule an appointment so that we can stagger your visit and support social distancing. Blood Services is open Monday through Friday and Saturdays by appointment. Please call 732-235-8100 extensions 221, 248 or 222 or go online to rwjuhdonorclub.org to schedule an appointment to donate.

Thank you again for all of your extraordinary efforts.

CLICK HERE for today's daily update from the RWJBarnabas Health system offices.

#RWJUHSTRONG 
9 Tower

Send your #RWJUHSTRONG photos to [email protected] and we'll feature them in the daily emails and on the new screen in the Courtyard!
RWJUH COVID Situational Update
As of 12:00 PM, RWJUH had 36 COVID-positive patients in the hospital. Tests on additional patients and potential discharges of positive patients were pending. 12 patients were in ICU level of care.

RWJUH has had 60 COVID 19-positive tests to date.

SBMU , RCU and 4 West are cohorting COVID-positive med/surg patients (IMCs on 4 West).

MICU & CCU are cohorting COVID-positive ICU patients, with the former SICU-CORE space being prepared to take COVID-positive ICU patients, as well. (Non-COVID MICU patients have been reassigned to the former SICU-West space.)

As of 1:00 PM, the NJ Dept. of Health is reporting 3,675 COVID-positive patients in the state -- an increase of 846 from yesterday -- and 44 deaths . Of those, 147 positive patients are in Middlesex County, 158 are in Monmouth County, and 51 are in Somerset County.
New Masking Policy - Surgical Masks Available
A new masking policy is going into effect.

Clinicians may request a surgical mask from the first unit you round on each day .

Masks can be used on non-COVID units for an entire day and discarded when you leave the hospital. If the mask becomes wet or soiled , please discard and request a new mask.

For COVID-cohorted units , please follow PPE protocols when seeing patients.

CLICK HERE for the full policy.
Donations: iPads & iPhones
Thank you for all of the mask donation offers . We are coordinating with hospital leadership, Foundation leadership and the materials management team on each offer.

The hospital is also accepting donations of iPads and iPhones , which we can utilize in patient rooms to provide patients with easier connectivity to staff and physicians (via specialized apps), as well as their families and loved ones.

Please contact the RWJUH Medical Staff Office at [email protected] if you or someone you know would like to donate.
Now Seeking Volunteers!
As the number of COVID-positive patients (and clinicians) increases, we are working on plans to maintain our clinical staff to provide great care for our patients.

IF YOU WOULD BE INTERESTED IN VOLUNTEERING TO ROUND AND TAKE CALLS AT RWJUH (for COVID and/or non-COVID patients), please fill out the form below .
NOTE: We have not yet reached the level where we are calling on volunteers to begin rounding. This process is to allow us to build our contact lists, if the need to activate volunteers.
Additional New Updates
  • The triage tent outside the Emergency Department continues to work really well. ED leadership is evaluating expanding hours in the tent.

  • Updated guidance is available on the cleaning and reuse of goggles and face shields. CLICK HERE for details.

  • ALL donation offers -- including, but not limited to, masks, electronics (such as iPads/phones), food, money and volunteering -- must be approved by RWJUH leadership. Please email the Medical Staff Office at [email protected] and the RWJUH Command Center at [email protected] with all offers and donation-related questions.

  • 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.

  • The Courtyard doors right beside Starbucks, leading to/from the East Tower, are being closed and made swipe-access only. The doors nearest the East Tower elevators will no longer require a swipe.

  • New guidelines are in place for the handling of COVID-positive decedents. All expirations of COVID-positive patients must be reported to the Medical Examiner's office and the NJ DOH Communicable Disease alert statement must be included, with COVID-19 written in as the infectious agent. CLICK HERE for the full guidelines.

  • 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.
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.
Do NOT Send Patients To ED Unless
They Require Hospitalization
Please do NOT send patients to the RWJUH Emergency Department for COVID-19 testing unless they require hospitalization .

Due to a shortage of swabs and viral transport medium , RWJUH is currently unable to test everyone who comes into the Emergency Department.

As noted above, all tests require the approval of RWJUH Infection Prevention.

Outpatient testing facilities are now open in Bergen County , Monmouth County (beginning tomorrow), and Union County (beginning tomorrow, for Union County residents only). Morris County is also setting up a county-run testing facility for residents.
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.











#RWJUHSTRONG
Send us photos of you demonstrating the #RWJUHSTRONG attitude, and we'll share them on the new video screen in the Courtyard and on social media !
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.
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.
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. The State of NJ has mandated, and both CMS and ACS advise to cancel all elective procedures.

  • 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.

  • 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.

  • 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.
Additional Useful Resources