Sent to all dialysis facility leadership in New York State with valid email addresses in CROWNWeb
Updated Resources: COVID-19
Six cases confirmed in Westchester and New York City

As of March 4, 2020, Six individuals have been diagnosed with COVID-19 in New York State ( link to briefing ) . Given the continuing spread of the virus around the globe it is expected that NY will see additional people infected with COVID-19.


Weekly Joint DOH/DOHMH
COVID-19 Healthcare Provider Call

New York State Department of Health and the New York City Department of Health and Mental Hygiene for a Healthcare Provider COVID-19 Weekly Call on:

Thursday, March 5, 2020, from 1PM - 2PM. 
 
For audio, please call 844-512-2950. 


NEW Resources:

March 4, 2020

NYC DOHMH Alert #3 :

New York City Resident Diagnosed with 2019 Novel Coronavirus (COVID-19) Infection;
NYC Health Department Now Performing COVID-19 Testing;
Clarification of New CDC Testing Criteria
 
• The 2019 novel coronavirus disease (COVID-19) outbreak continues to expand worldwide, with community transmission on several continents.
• Two people in New York City (NYC) have been diagnosed with COVID-19.
• The NYC Public Health Laboratory is now able to perform COVID-19 testing.
• Providers wanting to request COVID-19 testing should be familiar with the Centers for Disease Control and Prevention’s (CDC) updated testing criteria for Persons Under Investigation (PUI) for COVID-19. (See Table below)
• Prepare to prevent and minimize the spread of COVID-19. Develop plans and protocols to:
--Promptly identify, isolate, and evaluate persons with possible COVID-19
--Notify the NYC Health Department if patients meet CDC PUI testing criteria
--Once approved, collect clinical specimens for diagnostic testing for COVID-19
  
As of March 3, 2020, two individuals have been diagnosed with COVID-19 in New York City. It is expected that given the continuing spread of the virus around the globe, with time additional persons infected with COVID-19 will be identified in NYC.
 
This announcement comes along with notification that the NYC Health Department is now able to perform COVID-19 testing at its Public Health Laboratory using a real-time reverse transcription polymerase chain reaction (rRT-PCR) molecular assay. This expands the capacity for COVID-19 testing available for NYC patients while decreasing the time for test results to become available. See the Provider Management Checklist ( https://www1.nyc.gov/assets/doh/downloads/pdf/imm/2019-ncov-provider-checklist.pdf ) for details on evaluation of an individual with possible COVID-19. Visit this page ( https://www1.nyc.gov/site/doh/providers/reporting-and-services/public-health-lab.page#forms ) for more information on specimen collection and ordering tests.

Providers also should be aware of recent updates to the CDC criteria for a person under investigation (PUI) for COVID-19, which were published in a CDC Health Advisory ( https://emergency.cdc.gov/han/2020/HAN00428.asp ) distributed on February 28, 2020 (see Table below). Prior to these changes, CDC COVID-19 PUI criteria were based entirely on a combination of clinical and epidemiologic features. A new category of PUI was introduced with the following criteria:
• patients without identified sources of exposure AND
• fever with severe acute lower respiratory illness (e.g., pneumonia, ARDS [acute respiratory distress syndrome] requiring hospitalization and without an alternative explanatory diagnosis (e.g., influenza).
 
This new CDC COVID-19 PUI criterion for severe acute lower respiratory disease allows COVID-19 testing for patients in whom there is a high index of clinical suspicion. For patients with severe acute lower respiratory disease who do not have an identified epidemiologic risk factor for COVID-19, clinicians should perform routine evaluation, including testing for common causes of community-acquired pneumonia, before notifying the NYC Health Department of the case and requesting testing for COVID-19, unless there is a high index of clinical suspicion for COVID-19. If COVID-19 is on the differential diagnosis, please implement appropriate infection control precautions ( https://www.cdc.gov/coronavirus/2019-ncov/infection-control/index.html ) until discussing with a NYC Health Department clinician.
 
For severe lower respiratory illness in hospitalized patients with no identified epidemiologic risk, clinical features that may increase suspicion of COVID-19 include:

• acute respiratory distress syndrome
• infiltrative process on chest x-ray (e.g., bilateral infiltrates consistent with viral pneumonitis).
• bilateral ground-glass opacities on chest computerized tomography
• unexplained lymphopenia or thrombocytopenia
 
If the clinical and radiologic presentation are equivocal, the following epidemiologic exposures within the 14 days preceding symptom onset should increase suspicion for COVID-19: close contact with an ill traveler who was in an affected country, or being a healthcare provider who may have had exposure to an unrecognized case of COVID-19.
 
The NYC Health Department asks that all healthcare providers report all patients with suspected COVID-19 and especially those in whom testing, in their clinical judgment, is likely to yield a COVID-19 diagnosis. To discuss any patient with a NYC Health Department clinician, call the Provider Access Line (PAL) at 866-692-3641.
 
The outbreak of COVID-19 is a rapidly evolving situation. We encourage NYC health care providers and institutions to take advantage of the COVID-19 resources available on the NYC Health Department provider webpage ( https://www1.nyc.gov/site/doh/providers/health-topics/novel-respiratory-viruses.page ), including patient management and clinical laboratory guidance, information for healthcare facilities, and office posters in multiple languages, and those on the CDC website ( https://www.cdc.gov/coronavirus/2019-nCoV/index.html ). We encourage you to review your plans and take steps now ( https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/index.html ) to prepare for a community outbreak of COVID-19.


New York State
Health Commerce System
(NYSHCS)
New York State dialysis providers should be receiving updates from the DOH via the  Health Commerce System . If your facility does not already have an active HC account (for NYPORTS) please see this website for instructions on creating an account: https://www.health.ny.gov/prevention/immunization/information_system/providers/hpn_account_instructions.htm