NYT | Fear of Covid Leads Other Patients to Decline Critical Treatment

Psychologists say anxiety and uncertainty prompt irrational decisions — like turning down a transplant when an organ becomes available.

…In Newark, emergency medical services teams made 239 on-scene death pronouncements in April, a fourfold increase from April 2019. Fewer than half of those additional deaths could be attributed directly to Covid-19, said Dr. Shereef Elnahal, president and chief executive of Newark’s University Hospital…

From the New York Times►

The Hill | Coronavirus crisis squeezes ambulance operators

From May 19, 2020’s The Hill article by Reid Wilson

…The coronavirus crisis is putting an unexpected financial squeeze on ambulance operators, ratcheting up costs and tanking revenue even as they audibly remind people of the virus’s proliferation throughout the county…

Read the full article featuring interviews with many AAA members, including Bell Ambulance, Empress EMS, Great Falls Emergency Services, and REMSA!

JEMS | Paramedicine Strategic Planning

By Brian J Maguire, Dr.PH, MSA, EMT-P, Scot Phelps, JD, MPH, Paul Maniscalco, PhD(c), MPA, MS, EMT/P, LP, Daniel R. Gerard, MS, RN, Andy Gienapp, NRP, Kathleen A. Handal, MD and Barbara J. O’Neill, PhD, RN

… Many of the system deficiencies can be traced to three main factors. First, there is no single U.S. federal agency solely charged with supporting paramedicine operations. Second, no legislative mandate exists to engage in paramedicine operational research. Third, there is no paramedicine-specific financial support to advance core initiatives at the federal, state, tribal and local levels…

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John Hopkins | How to better protect EMS personnel from infectious disease?

Download PDF Report Emergency medical services systems and providers are on the front lines of the health response to large-scale disasters, including COVID. EMS professionals in the United States have provided medical care and transportation during pandemic influenzas, importations of Ebola, and other high-consequence pathogens, but none have had the widespread systemic effects of COVID….

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CDC: Guidance for Institutions of Higher Education

Read as a PDF Who is this guidance for? This interim guidance is intended for administrators of public and private institutions of higher education (IHE). IHE includes a diverse set of American colleges and universities: 2- or 4-year; public, private non-profit, or private for-profit; and comprehensive, research-focused, or special mission. IHE administrators (e.g., presidents, deans,…

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FEMA | Alternative Care Site Fact Sheet

To address immediate and projected needs from the coronavirus (COVID-19) pandemic, state, local, tribal, and territorial (SLTT) governments may, under certain conditions, be reimbursed through FEMA’s Public Assistance (PA) Program for costs associated with keeping Alternate Care Sites (ACS), including temporary and expanded medical facilities, minimally operational when COVID- 19 cases diminish and the facilities…

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NYT | Paramedics, Strained in the Hot Zone, Pull Back From CPR

From the New York Times on May 10, 2020

Around the country, in cities and counties in the grip of the pandemic, emergency medical technicians have had to do something they’re not used to: think of their own well-being before that of their patients. With so many paramedics falling ill, emergency units have changed their practices to limit exposure to the virus.

The most unsettling change, according to interviews with paramedics in a half-dozen of the most affected states, is the decision to suspend, or limit, resuscitation in cases when the odds of survival are near zero.

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Gowns | Merrow Forloh Reusable

AAA Professional Standards Committee Chair Bill Mergendahl has offered to coordinate a bulk order of Merrow Forloh reusable gowns.

Although each gown is pricey ($40/pp), they are made of extremely high-quality ripstop material and can be washed 100 times, making them comparable to a $0.40 disposable.  Additionally, they can be sprayed with standard outdoor gear water repellant and be good for another 100 washes.  One size fits all.

These gowns are American made in Fall River, Massachusetts, which avoids a number of the quality assurance problems many member organizations have experienced with imports.

The goal is to pull together a group order of 10,000 pieces for delivery in 3–4 weeks. Pro EMS will coordinate splitting the payments between providers.

Please see the attached brochure, then contact wmerg@proems.com if you would like to participate.

#MinutesMatter Campaign | Don’t Hesitate to Call 911


Reports across the country indicate that some members of the public hesitate to call 911 for medical assistance out of fear of COVID-19. Share our #MinutesMatter Facebook post or retweet our Tweet to help spread the word that time is of the essence when it comes to heart attack, stroke, or respiratory distress.

The American Ambulance Association has heard reports that some members of the community are hesitant to call 911 out of…

Posted by American Ambulance Association on Wednesday, April 22, 2020

CMS | Re-opening Facilities for Non-Emergent Healthcare: Phase I

CMS Issues Recommendations to Re-Open Health Care Systems in Areas with Low Incidence of COVID-19

Today, the Centers for Medicare & Medicaid Services issues new recommendations specifically targeted to communities that are in Phase 1 of the Guidelines for President Trump’s Opening Up America Again with low incidence or relatively low and stable incidence of COVID-19 cases. The recommendations update earlier guidance provided by CMS on limiting non-essential surgeries and medical procedures. The new CMS guidelines recommend a gradual transition and encourage health care providers to coordinate with local and state public health officials, and to review the availability of personal protective equipment (PPE) and other supplies, workforce availability, facility readiness, and testing capacity when making the decision to re-start or increase in-person care.

The new recommendations can be found here (PDF). 

The Guidelines for Opening Up America Again can be found here.

CMS | Nursing Home COVID-19 Transparency Effort

From the CMS.gov Newsroom

Trump Administration Announces New Nursing Homes COVID-19 Transparency Effort

 

     Agencies partner with nursing homes to keep nursing home residents safe

Today, under the leadership of President Trump, the Centers for Medicare & Medicaid Services (CMS) announced new regulatory requirements that will require nursing homes to inform residents, their families and representatives of COVID-19 cases in their facilities. In addition, as part of President Trump’s Opening Up America, CMS will now require nursing homes to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC).  This information must be reported in accordance with existing privacy regulations and statute. This measure augments longstanding requirements for reporting infectious disease to State and local health departments. Finally, CMS will also require nursing homes to fully cooperate with CDC surveillance efforts around COVID-19 spread.

CDC will be providing a reporting tool to nursing homes that will support Federal efforts to collect nationwide data to assist in COVID-19 surveillance and response. This joint effort is a result of the CMS-CDC Work Group on Nursing Home Safety. CMS plans to make the data publicly available.  This effort builds on recent recommendations from the American Health Care Association and Leading Age, two large nursing home industry associations, that nursing homes quickly report COVID-19 cases.

“Nursing homes have been ground zero for COVID-19. Today’s action supports CMS’ longstanding commitment to providing transparent and timely information to residents and their families,” said CMS Administrator Seema Verma. “Nursing home reporting to the CDC is a critical component of the go-forward national COVID-19 surveillance system and to efforts to reopen America.”

“Scientific data derived from solid surveillance is a key element of recommendations to protect Americans, particularly our most vulnerable, from the devastating impact of COVID-19,” said CDC Director Dr. Robert Redfield. “This coordinated effort with CMS will allow CDC to provide even more detailed information to state and local health departments about how COVID-19 is affecting nursing home residents in order to develop additional recommendations to keep them safe.”

This data sharing project is only the most recent in the Trump Administration’s rapid and aggressive response to the COVID-19 pandemic. On February 6, CMS took action to prepare the nation’s healthcare facilities for the COVID-19 threat. On March 4, CMS issued new guidance related to the screening of entrants into nursing homes, informed by CDC recommendations. On March 10, CMS issued guidance related to the use of personal protective equipment (PPE) usage and optimization. On March 13, CMS issued guidance for a nationwide restriction on nonessential medical staff and all visitors, except in compassionate care situations. Shortly after that announcement, President Trump declared a national emergency, enabling the agency to take even stronger action. CMS then announced a suspension of routine inspections, and an exclusive focus on situations in which residents are in immediate jeopardy for serious injury or death, and implemented a new inspection tool based on the latest guidance from CDC. Additionally, on April 2, CMS issued a call to action for nursing homes and state and local governments. It included guidance that reinforced infection control responsibilities and urged leaders to work closely with nursing homes in their communities to determine needs for COVID-19 testing and personal protective equipment. The recommendations also urged state and local officials to work with nursing homes to designate certain sites for COVID-19-positive or COVID-19-negative patients to avoid further transmissions. On April 15, CMS announced the agency will nearly double payment for certain lab tests that use high-throughput technologies to rapidly diagnose large numbers of COVID-19 cases. This announcement built upon a March 30 announcement that hospitals, laboratories, and other entities can perform tests for COVID-19 on people at home and in other community-based settings outside of the hospital – including nursing homes.

CDC continues to work closely with CMS, state and local health departments, and nursing homes to inform national infection prevention and control policies and strategies to further support nursing homes, residents and families of residents.  CDC built a long-term care toolkit to be distributed to all 50 states to help increase infection prevention and control preparedness in nursing homes and provide remote tools to further assist these important healthcare providers.

In addition, CDC rapidly sent teams of infection control experts to support state and local health departments during the first COVID-19 outbreak in a nursing home in the U.S. Teams were on the ground within 36 hours of the notification to assist with the implementation of measures to detect and contain additional infections in the community.  CDC continues to work closely with state and local health departments to assist long-term care facilities with COVID-19, with on the ground support provided to more than 30 jurisdictions and remote technical assistance from infection control experts across the U.S. with plans to provide additional support underway.

Today’s guidance is available here: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/upcoming-requirements-notification-confirmed-covid-19-or-covid-19-persons-under-investigation-among

This action, and earlier CMS and CDC actions in response to the COVID-19 disease, are part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit www.coronavirus.gov. For information specific to CMS, please visit the Current Emergencies Website.

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Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter CMS Administrator @SeemaCMS@CMSgov, and @CMSgovPress

NYT: Disposable N95 Masks Can Be Decontaminated

Disposable N95 Masks Can Be Decontaminated, Researchers Confirm The National Institutes of Health released research showing N95 masks can be used more than once using certain decontamination methods to prevent infection from the coronavirus, a claim that has been proven from previous research but never specifically for COVID-19. The researchers found that using vaporized hydrogen…

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