Coronavirus Information Session Monday, March 2, 4:00 pm Program Title: Coronavirus Information Session Attendee Dial In Number: 866-342-8588 or 203-518-9865 Passcode/ID: 92489 1
Agenda Start Time Topic Presenter 3:45 p.m. Line opens for callers 4:00 p.m. Introduction Bob Garrett 4:05 p.m. Virus Update Dr. Jerry Zuckerman 4:20 p.m. CDI Research and Support Dr. David Perlin Mark Stauder 4:25 p.m. Operational Response Dr. Dan Varga Bob Glenning 4:40 p.m. Communications Response Dorie Klissas 4:45 p.m. Participant Q&A 5:00 p.m. Event concludes 2
Introduction Bob Garrett 3
Virus Update Jerry Zuckerman 4
Coronavirus • Enveloped non-segmented positive-sense RNA viruses • Distributed broadly among humans, other mammals, birds • Human coronaviruses: o hCOV-229E, OC43, NL63, HKU1 o Mild upper respiratory tract illnesses o Part of the rapid respiratory panel test 5
Zoonotic Coronavirus Outbreaks Severe acute respiratory syndrome Middle East respiratory syndrome (SARS-CoV) (MERS-CoV) 2002-03 Guangdong Province, China • Outbreaks 2012 -> present • • 8100 confirmed cases; 774 deaths As of 11/2019: 2494 confirmed o cases, 858 deaths • Animal reservoir: Palm Civets • Natural host: Bats Epicenter Saudi Arabia o • Mortality rate 10% • Animal reservoir: Dromedary Camels • Limited chains of human transmission • Mortality rate 37% 6
COVID-19 (SARS-CoV-2) Timeline 12/31/19 27 cases viral pneumonia in Wuhan, China reported to WHO 2/19/20 3/1/20 Outbreak in Totals South Korean 88,000 Cases religious sect 1/30/20 3,000 Deaths 1/7/20 Public Health Emergency novel of International Concern 2/20- coronavirus 2/21/20 identified Cases (SARS-CoV-2) reported in Iran and Italy https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases 7
COVID-19 Timeline 8
COVID-19 R 0 and Mortality Rate Est. R 0 – Basic Reproduction Number https://www.nytimes.com/interactive/2020/world/asia/china-coronavirus-contain.html 9 Accessed 2/3/20
COVID-19: Clinical Course Patterns • Mild illness with upper respiratory tract presenting symptoms (81%) • Non-life-threatening pneumonia (14%) • Severe pneumonia with acute respiratory distress syndrome (ARDS) (5%) o Onset around day 7 of illness o Rapid deterioration 10
Emerging Infectious Diseases SARs MERs Pandemic Ebola COVID-19 2002 2012 H1N1 2019 2014 2020 Human Sustained Limited Sustained Limited Sustained Transmission Transmission Respiratory Respiratory Respiratory Body Fluids Respiratory Symptom Abrupt Abrupt Insidious Abrupt Insidious Onset Infectivity Symptom Symptom Before symptom Symptom Before symptom onset onset onset onset onset Immunity None None Partial None None U.S. Cases 27 2 60.8 million 11 ???? U.S. Deaths 0 0 12,500 2 ???? 11
CDI Research and Support Dr. David Perlin 12
Why Coronavirus Diagnostics Matter • Clinical characteristics (e.g. acute upper or lower respiratory tract distress) are non-specific • A confirmatory diagnosis better supports clinical management and better clinical outcome • Specific diagnostics are needed to track virus within the healthcare setting and the community 13
How are Coronaviruses Detected? • Molecular diagnostics are used to detect RNA sequences specific to COVID-19. • The tests are rapid and sensitive, and can provide real-time information within hours. What if a Patient’s Sample Tests Positive? The Lab/Infection Control will contact the State Health Department and • the CDC, and the sample will be confirmed by a national/local CDC- designated reference laboratory. • The patient will be managed as a positive case, unless further testing proves negative. 14
COVID-19 Molecular Detection Assay Break open virus and isolate Convert RNA RNA to DNA Virus particles Amplify DNA Detect COVI-19 specific sequences Real-time quantitative detection 15
Operational Response Mark Stauder 16
Operational & Preparedness Response Steering Committee - Chair, Mark Stauder • Incident Command Structure – Development of Clinical and Operational Subcommittees with Task Forces led by Subject Matter Experts • Network Command Center – Open 24/7 as of 3/2/20 • Operational Preparedness Subcommittees • Co-chairs: Dr. Siddiqui and K. Haber • Clinical Access and Care Delivery Subcommittee • Co-chairs: Dr. Varga, Theresa Brodrick, Dr. Zuckerman 17
COVID-19 Committee Structure Operations Subcommittee Chair Clinical Access & Delivery Subcommittee Chairs • Dr. Daniel Varga, Theresa Brodrick & Dr. Jerry • Deeba Siddiqui & Ken Haber Zuckerman Task Forces Include: Task Forces Include: Emergency Management – Ken Haber Infection Control – Jerry Zuckerman Materials Management – Mike Goolsby Diagnostics – David Perlin Pharmaceuticals – Rich Epstein Communications – Jim Blazar Occupational Health/HR – Landa Poiani IT/EPIC – Dr. Lauren Koniaris Darocki & Mark Coleman Laboratory – Sean Fitzgerald Communications – Jim Blazar Pandemic Plan – Ken Haber Ambulatory Practices – Christine Devine 18
NJ DOH & NJHA: Partners for COVID-19 Response Structure: 3 Centers in Tandem 1. Regional Operations & Intelligence Center: ROIC - New Jersey State Command Center which will be activated at the Governor’s direction 1a. State Emergency Operations Center: SEOC - Subcommittee of the ROIC - Actively monitoring potential pandemic and the impact to New Jersey residents - Assessing Surge Capabilities across the State 2. New Jersey Hospital Association: NJHA currently activated - Emergency Management Division of NJHA is the primary call center for any preparedness-related questions - Act as a conduit to the Assistant Commissioner of Health at the NJDOH - Information gathering from WHO and CDC - Coordination with OSHA - Monitoring of Supply Chain Issues 3. Local Public Health Departments - Primary contact for patient screening, surveillance, and testing 19
Preparedness Activities Emergency Management • Incident Command Structure established 2/1/20; Command Center 3/2/20 • Task Forces mobilized • Facility Surge Plans: Space, Staffing, Supplies, 7 Tents & 3 Trailers secured • Telemedicine & Home Monitoring solutions will be activated • Negative Pressure Room Inventory • Ability to scale up at Pascack Valley Medical Center; 41 medical-surgical beds and 9 critical care beds Infection Prevention • Screening protocols – EPIC and paper • Isolation protocols – EPIC - ED, Inpatient, Ambulatory • Education/in-services (Donning/Doffing, etc.) Materials management • Inventory of personal protective equipment, respiratory equipment, and disinfectants 153,000 N95 respirators on hand o • Procurement and conservation of supplies – pandemic supplies • Pharmaceuticals – antivirals secured • Clinical equipment and evaluation – i.e. 200 IV pumps secured 20
Preparedness Activities Diagnostics • Diagnostic Lab Assay to be implemented this week in collaboration with Center for Discovery and Innovation Occupational Health/HR • Management of HMH TMs returning from China -> 14 day leave and active symptomatic monitoring • Fit testing strategy Tele-work strategy • Ambulatory Practices • Identify, Isolate, and Transfer (Home or ED) Workflows created • Supplies inventory Communication • Daily situation updates across the Network • Communication Strategy, Trees & Emergency Notification • Intranet site established with protocols, links, FAQs 21
Preparedness Activities Develop Network Surge Management Strategy • Access • Care Delivery • Alternate Care Sites: Tents, MSED Units Deploy MSED Units 22
Purchasing and Other Preparedness Activities Bob Glenning 23
Communications Response Dorie Klissas 24
Internal Communications Timely, consistent communications issued since January 24. COVID-19 Resource Center is updated daily and available through the HMH internet homepage and intranets. Leaders receive daily updates for their Safety Huddles from Infection Prevention & Control. Leveraging existing communication vehicles to provide regular updates to team members. 25
Urgent Updates All team member communications sent when updates are pertinent. Communications tree created. Email inbox created for team member questions and concerns. 26
Patient Communications 27
Media Coverage 28
Participant Q&A 29
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