Medical Staff Initial Communication

The message below was sent to Medical Staff on March 13:

Good evening,

This message is being sent on behalf of the Kettering Health Network Incident Command Team.

COVID-19 is the disease caused by the novel coronavirus SARS CoV-2. While this epidemic started in China, it has now spread in a worldwide distribution and the World Health Organization has declared this a pandemic. The United States is in a relatively early phase of the epidemic, and case numbers are expected to increase as testing becomes more widely available. 

This Kettering Health Network update is for providers in the inpatient and outpatient settings.

General information

  • Fever, cough, and shortness of breath are the most common symptoms though mild symptoms and asymptomatic cases occur.
  • Approximately 5% of patients develop severe disease with hypoxemia and respiratory failure–advanced age and chronic medical conditions are the main risk factors.
  • Children do not seem to get infected at high rates, and they typically have mild disease.
  • The Emergency Department will not be testing patients who are released.
  • Patients with mild symptoms should self-isolate. Rapid flu testing can be done if indicated.
  • Severely ill patients should be sent to the Emergency Department–call ahead to warn Emergency Department staff if there is a concern for C OVID-19.
  • Testing can be sent to LabCorp or possibly the Ohio Department of Health. Turn-around time for LabCorp is estimated at 3-4 days.

Guidance for outpatient practices

  • Patients who are concerned that they may have come in contact with someone with COVID-19 should call their local health department for instructions on self-isolation at home and what to do if they develop any fever or respiratory symptoms.
  • Antibiotics are not indicated; symptomatic treatment can be provided as with any viral respiratory infection.

Guidance for hospitalized patients

  • Admitted patients will be assigned a negative pressure room with airborne and contact isolation.  Infection Prevention and Control should be consulted. 
  • Patient visitors will be limited based on GDAHA guidance.
  • A group of Kettering Health Network critical care, infectious disease, and hospitalist physicians are working with senior leaders developing clinical protocols and addressing issues such as surge capacity.

Who should be tested

Clinicians should use their judgment and CDC guidelines to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing). Decisions regarding who to test can be made in consultation with Infection Prevention and Control and the local Health Department.

Priorities for testing may include:

  • Hospitalized patients who have signs and symptoms compatible with COVID-19 in order to inform decisions related to infection control.
  • Other symptomatic individuals such as older adults and individuals with chronic medical conditions and/or an immunocompromised state that may put them at higher risk for poor outcomes (e.g., diabetes, heart disease, receiving immunosuppressive medications, chronic lung disease, chronic kidney disease).
  • Any persons including health care personnel who within 14 days of symptom onset had close contact with a suspect or laboratory-confirmed COVID-19 patient, or who have a history of travel from affected geographic areas within 14 days of their symptom onset.

There are epidemiologic factors that may also help guide decisions about COVID-19 testing. Documented COVID-19 infections in a jurisdiction and known community transmission may contribute to an epidemiologic risk assessment to inform testing decisions. Clinicians are strongly encouraged to test for other causes of respiratory illness (e.g., influenza).

Surgery and other procedures

  • There are no restrictions on surgery or other procedures at any facility. 
  • We are working on a contingency plan for elective procedures should it be needed.
  • Communications to patients and families will restrict surgery visitors to one.
  • Vendors are being restricted and asked to limit their presence in the procedural areas unless it has been approved by the surgeon and the director.
  • We are also limiting residents, medical students, and nursing students. We want to support their learning but also want to be sensitive to potential limited supplies.
  • While we are limiting access to surgical masks, we have an adequate supply.
  • Our Pre-admission Testing staff are assessing patients to determine risk factors and referring them back to your offices.

A Kettering Health Network Incident Command Team is having twice daily calls to address all pertinent issues regarding this epidemic and is in close contact with local public health, GDAHA and ODH Officials. Employees who have traveled or are concerned about possible exposure should contact Employee Health for instructions

If you have additional questions, please utilize the following resources:

  • If your question related to network policies or protocols and is not addressed via the resources on the intranet page, please submit questions via the myHR portal or call the hotline at 1-844-235-4647.
  • For general COVID-19 questions, the Ohio Department of Health has set up a hotline to answer questions. Please feel free to call 1-833-427-5634. The CDC has also set up a dedicated website for ongoing COVID-19 information: https://www.cdc.gov/coronavirus/2019-ncov/index.html

March 19, 2020

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