COVID-19 Daily Update

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DAILY UPDATES

Update for Saturday, March 14

Postponement of Elective and Non-Urgent Surgeries and Procedures

UW Medicine is postponing elective and non-urgent surgeries and procedures through March 31.  The move covers all UW Medicine healthcare facilities and will take effect Monday, March 16, for Harborview Medical Center, University of Washington Medical Center Montlake and Northwest campuses; and at Valley Medical Center on Wednesday, March 18.  Patients who have elective surgeries scheduled are being notified by UW Medicine. They will be rescheduled as the COVID-19 pandemic is controlled. That will enable UW Medicine providers and facilities to regain capacity and respond again to elective surgery needs.

Questions & Answers

Why is UW Medicine postponing elective and non-urgent surgeries and procedures?

UW Medicine is facing a rapidly increasing need to respond to the COVID-19 pandemic. We are seeing a significant increase in the number of COVID-19 patients at our hospitals, which is placing increasing pressure on our staff and demand on our supplies of personal protective equipment such as gowns, masks, and/or face shields. With new guidance from the U.S. Centers for Disease Control, specifically to Seattle-King, Pierce and Snohomish counties, UW leadership decided on the postponement.

What UW Medicine facilities are affected?

The postponement covers all UW healthcare hospitals.  All outpatient and ambulatory procedure centers will be postponing procedures that are deemed to be elective in nature until March 31.

What causes a surgery or procedure to be postponed?  

The decision is up to each patient’s doctor, based on two main factors. The first factor is that a surgery or procedure is elective and non-urgent. This means it can be rescheduled without significantly impacting the patient’s health outcome. The second is whether the surgery or procedure requires the use of personal protective equipment such as gowns, masks, and/or face shields. If a procedure involves both factors, it is eligible to be postponed.

What types of surgeries or procedures will continue to be performed as scheduled?

Emergent and urgent surgeries or procedures will continue to be performed. These are surgeries that should be done right away or within a four-week time period. Otherwise, delaying any further may negatively affect the patient’s health outcome or harm the patient.

How will our patients find out if their surgeries or procedures are being performed?

All patients whose surgeries are being postponed are being notified. Any patient with questions should call his or her doctor.

Update for Friday, March 13

Zoom Town Hall Video Link

Thanks to all of you who joined us for the UW Medicine Zoom Town Hall. 

We appreciate your engagement and participation. We realize that the space on Zoom filled quickly and are sharing this link to the recording of the Town Hall for those who couldn’t attend.  

During the meeting we discussed many topics including the clinical course of COVID-19, understanding risks to family and friends, issues around PPE, approaches to managing our work force and the rising need for childcare.

We will have another Town Hall next week with greater capacity and an opportunity to answer more questions. Thank you all.

 

Childcare Services and Prioritization

UW Medicine is able to offer a limited number of backup childcare services provided through Bright Horizons, KinderCare and limited spots at UW Medical Center – Northwest. In addition, we are working to make low-cost options available and will share those with you as soon as possible.

In the meantime, we will be prioritizing requests accordingly:

I. Unable to work without ​child care (No adult – teleworking or otherwise – or teenager at home to watch young children)

  1. Clinicians/technicians providing direct patient care related to COVID – doctors, physician assistants, advance registered nurse practitioners, nurses, pharmacists, RTs, MA/PCTs.
  2. Ancillary healthcare workers directly supporting COVID – EVS, PSS, Dietary, Supply Chain, Radiology Imaging Services.
  3. ​UW Medicine administration directly supporting COVID - entity and UW Medicine Emergency Operations Center staff.
  4. Healthcare workers providing direct patient care not involving COVID patients.
  5. UW Medicine employees not in above categories.

II. Tenuously able to work without childcare but challenging (adult or teenager at home)

  1. Clinicians/technicians providing direct patient care related to COVID – doctors, physician assistants, advance registered nurse practitioners, nurses, pharmacists, RTs, MA/PCTs.
  2. Ancillary healthcare workers directly supporting COVID – EVS, PSS, Dietary, Supply Chain, Radiology Imaging Services.
  3. UW Medicine administration directly supporting COVID - entity and UW Medicine Emergency Operations Center staff.
  4. Healthcare workers providing direct patient care not involving COVID patients.
  5. UW Medicine employees not in above categories.
  6. UW employees, not in UW Medicine.

To request a childcare slot at Bright Horizons, KinderCare or University of Washington Medical Center – Northwest, please e-mail your request to HR at medchildcare@uw.edu.

 

Zoom Town Hall

We invite all members of the UW Medicine community to a Zoom Town Hall to talk more about the evolving COVID-19 outbreak. We know that this is a time of uncertainty, stress and anxiety. Our goal is to answer questions and to listen to concerns. Please join us for our Zoom Town Hall on Friday, March 13, at 3 p.m. The event is organized by Trish Kritek, MD, EdM, Associate Dean – Faculty Affairs, and Timothy Dellit, MD, Chief Medical Officer – UW Medicine, President – UW Physicians.

The Zoom link is: https://uw-phi.zoom.us/s/320200321.

We realize that many of you will be caring for patients or have other commitments. We will record the discussion and post it on The Huddle afterwards. We will also have another Zoom Town Hall next week.

Thank you for all you are doing to take care of our patients and each other.

 

Clinical Trial Suspension

In response to the local SARS-CoV-2 outbreak, King County Public Health has declared a state of emergency and has issued recommendations to avoid visiting hospitals to the extent possible while keeping six feet away from patients. There is a potential for significant exposure of personnel performing clinical research to COVID-19 infection.

We are now experiencing an increasing influx of patients seeking care for suspected and/or confirmed COVID-19 and expect this to continue in the coming weeks. As part of this response and in accordance with UW Medicine and local public health recommendations, we are suspending all non-COVID-19 clinical study activity (see exception for studies that deliver immediate care below), including consenting, that requires presence of research personnel in UW Medicine intensive care units, and emergency departments effective immediately and extending until March 24, 2020.

This suspension includes all non-COVID-19 related waiver of consent and/or sample collection-only studies. Clinically obtained biospecimens will continue to be available through Northwest Biospecimen (sbowell@uw.edu). The duration of stoppage may be altered depending upon the evolving situation and updates will be posted to the UW Medicine Huddle. We are taking this action out of an abundance of caution to limit potential exposures to personnel as well as to avoid disruption to clinical personnel responding to patient needs.  

Ambulatory clinics are not included in this clinical research suspension, but each ambulatory clinic has the authority to determine whether studies in the clinic should continue as patient volume increases.  All patients with confirmed COVID-19 infection or requiring potentially aerosolizing procedures should be avoided unless the study is specific for patients with COVID-19.

If your study involves the delivery of immediate patient care that cannot be interrupted and you need access to the spaces above in order to deliver care, please coordinate with the appropriate clinic.  This includes randomized controlled trials in which access to patients randomized to the control arm are critical to the research objective.

For clinical studies focused on COVID-19, it is critical to avoid any adverse impact from research activity on inpatient acute care areas.  Please, if your study needs to take place in inpatient acute care areas, be respectful and supportive of clinic staff.  Make sure that your activity does not add to their burden or stress. 

For non-COVID-19 clinical trials, UW Medicine asks that study PI’s develop a COVID-19 mitigation plan for their individual study. Mitigation plans will be reviewed promptly to determine which studies are safe to resume as the suspension is lifted and should be submitted according to the primary area of study enrollment as follows:

You will be notified directly if enrollment for your study has been determined to be safe to resume.

If your study involves the delivery of immediate patient care that cannot be interrupted and you need access to the spaces above in order to deliver care, please coordinate with the appropriate clinic.  This includes randomized controlled trials in which access to patients randomized to the control arm are critical to the research objective.

We realize that this will have a negative impact on research studies recruiting subjects at UW Medicine Hospitals. We will be working diligently to resume all studies as soon as it is safe to do so. Please provide this notification to your funding partners who request justification for research stoppage.

Guidance for development of COVID-19 mitigation plans for studies enrolling in UW Medicine Hospitals.

The following items should be addressed in the mitigation plan:

1. All patients with confirmed COVID-19 infection or requiring potentially aerosolizing procedures should be avoided unless the study is specific for patients with COVID-19.

2. Decreasing potential exposure for nonclinical personnel at increased risk of severe illness from COVID-19.

People at higher risk include:

  • Over 60 years of age
  • With underlying health conditions including include heart disease, lung disease, or diabetes
  • With weakened immune systems
  • Who are pregnant
  • Caregivers of children with underlying health conditions

3. A protocol for noncontact screening for active symptoms of acute respiratory infection possibly related to COVID-19. This may be accomplished by speaking with care providers, chart review, screening surveys, or other options prior to approaching potential research subjects. Those subjects with active symptoms should be avoided.

  • UW Medicine definition of symptoms of acute respiratory infection are fever, new cough, new shortness of breath, myalgias, etc.

4. Reducing face-to-face contact with research subjects. For example, this may be accomplished by including barriers between research personnel and subjects, and or using technology (e.g. telephone, facetime, intercoms) to conduct interviews.

5. Address PPE training status for nonclinical research personnel who need to be within 6 feet of subjects. Address sources of PPE for research use. Address methods to reduce PPE usage by all personnel, including limiting requests for second blood draws and sample collections by clinical personnel.

Update for Thursday, March 12

COVID-19: Employee Communication

The past couple of days have truly been unprecedented, and we cannot express enough how honored and humbled we have been by the efforts shown by all of the staff at every level of the organization.

In an effort of support, we want to provide some updates in areas we know are top of mind:

Elective procedures and surgeries
Based on the impact this virus is having in our own facilities here in Seattle and based on actions from our local community and other healthcare partners, UW Medicine has decided to begin postponing elective procedures effective Monday, March 16 thru March 31. We will be evaluating this decision weekly with the hope of getting back to normal operations as soon as possible. Leadership will be reaching out to you about any exceptions to this policy. UWMC-Northwest has taken immediate action due to the large volume of COVID-19 patients that they are currently managing.

In preparation for postponing elective care, we are asking that each service who delivers elective care quickly huddle and determine which patients should be postponed. Please review what is truly elective and can wait. We must continue to provide urgent and emergent care to our patients and not cancel anything that will jeopardize the patients’ immediate health status. Please document all procedures that are being postponed, so that we can determine the impact. We will provide schedulers a script to use when informing patients. Please do not start this postponement process until Friday, March 13, in the morning when you receive the script.

Northwest Geropsychiatric Center
We wanted to let you know that the Geropsychiatric Center at UW Medical Center - Northwest has detected two positive coronavirus cases today. We have taken immediate action to move positive patients to an isolated area of the hospital for treatment and further monitoring. We have tested and are actively monitoring all remaining patients within the Geropsychiatric unit. If any of our patients demonstrate COVID-19 symptoms, they will be moved to an appropriate isolated area. Potentially exposed staff have been contacted by our Employee Health team and have been provided information on potential exposure and screening guidelines. We have notified the families of patients affected by this news.

Supplies
Responding to COVID-19 has placed and will continue to place unprecedented pressure on our supply of PPE and other critical equipment. To combat this challenge, we are taking extraordinary measures to conserve and extend supplies of critical equipment while maintaining staff and patient safety. We will continue to monitor and regulate equipment usage to ensure supplies for front-line staff are available. We will reduce staff interaction with affected patients, and we are limiting those who come into contact with affected patients. We will continue to work with our vendors and partners to acquire additional supplies as soon as possible. We have formally requested supplies from the National Stockpile.

We’re in this together
At the moment there are two clear knowns: 1) The next couple of days will continue to be unprecedented and will challenge each of us in unexpected ways. 2) UW Medicine is prepared for the challenge. We have the absolute best team in the country when it comes to infectious disease and operate with highest professionalism at every level of the organization.

Please stay safe and follow all safety protocols. When you are off shift, make sure you are resting and taking care of yourself and your family. We need everyone healthy and mentally focused on the path and tasks ahead.

 

New and Updated Clinical Protocols and Guidelines

As many of you know, we have been working hard at developing protocols, policies and recommendations for the care of known or suspected COVID-19 patients, the health of our community, and the safety and protection of our staff. I’d like to thank the many of you who have volunteered to provide expert guidance.

Following please find some important updates on our UW Medicine COVID-19 Website:

Clinical Protocols and Guidelines – NEW

Discontinuation of precautions for hospitalized patients with previous diagnosis of COVID-19:

  • Key new guidance on how to “clear” a patient, discontinue precautions and facilitate discharge.

Personal Protective Equipment (PPE) Donning and Doffing for Special Contact/Droplet:

  • Standardized methodology across UW Medicine for donning and doffing, a key component for keeping patients and staff safe.

Room cleaning for suspected and confirmed COVID-19 cases:

  • Key: For ambulatory settings, no downtime of room is required.
  • Treat cleaning per Droplet/Contact Precautions protocol (same as influenza).

ED Discharge instructions for patients with a viral syndrome:

  • Provides education and clarifies expectations for patients and families.

Ambulatory Alternate Care Delivery Options (ACDO) Workflow:

  • Provides alternatives to in-person appointments, including phone, telehealth video visit, eCare.

Practices to minimize aerosolizing procedures for patients on droplet precautions:

  • Tool to promote the judicious utilization of aerosolizing procedures which, in turn, will lead to less airborne isolation needs.

Conservation plan for respiratory supplies:

  • Provides staff with guidance on how to maximize conservation of disposable supplies in critical situations.

Clinical Protocols and Guidelines – UPDATED

  • Number of swabs and testing recommendations:
  • In an effort to conserve supplies, including swabs, Lab Medicine has asked us to just submit 1 swab in a single bag to test for both COVID-19 and flu, if clinically indicated.
  • UW Medicine Employee COVID-19 Testing Center will start sending only COVID-19 tests.
  • Outpatient clinics should limit testing to COVID-19 whenever possible. Flu/RSV should only be tested if it will substantively change clinical management. Use clinical judgement and empiric oseltamivir when clinically indicated.
  • Test for flu/RSV in inpatients/ED only when clinically indicated. Do not test for flu/RSV just because the patient is being tested for COVID-19.

Reminders

  • Hand hygiene and environmental cleaning are the keys to infection prevention.
  • Facemasks and other PPE must not be worn outside of direct patient care.
  • If you’re sick, please stay home and review the staff guidance posted on our UW Medicine COVID-19 Website.
  • If you have acute respiratory symptoms such as new cough, muscle aches, fever, new shortness of breath or sore throat, please fill out the survey if you would like an appointment in our UW Medicine Employee COVID-19 Testing Center located at UWMC – Northwest. The link to the survey has changed. Employee Health will contact you with details regarding time and location.
  • Please review telework and travel recommendations on our website.
  • We strongly recommend that you shave facial hair in order to obtain the correct seal needed for N95 masks. Accommodations will be made for those who have facial hair for religious or medical reasons.
  • Check out our new external facing website for us to share our protocols and recommendations with the whole world. Send any COVID-19 clinical protocols to Drs. Santiago Neme and John Lynch for review and posting. Please share this widely with your colleagues everywhere: https://covid-19.uwmedicine.org/.

 

UW Medicine Town Hall Announcement

Organized by Dr. Trish Kritek, MD, EdM, Associate Dean – Faculty Affairs

We invite all members of the UW Medicine community to a Zoom Town Hall to talk more about the evolving COVID-19 outbreak. We know that this is a time of uncertainty, stress and anxiety. Our goal is to answer questions and to listen to concerns. Please join us for our Zoom Town Hall on Friday, March 13 at 3:00 p.m. The zoom link is https://uw-phi.zoom.us/s/320200321.

We realize that many folks will be caring for patients or have other commitments. We will record the discussion and post it on The Huddle afterwards. We will also have a second Town Hall next week.

Update for Wednesday, March 11

Message Regarding Closure of Seattle Public Schools

For those of us with school-age children, today’s announcement regarding the two-week closure of Seattle Public Schools adds yet another layer of complexity to the growing impact of the COVID-19 outbreak in our community.

Human Resources is currently working to activate additional resources (e.g. services that connect those with childcare need to accredited resources; partnering with university programs that match accredited students with an interest in child development to families with need; contracting with local childcare services with excess capacity, etc.). We will share additional information as soon as possible. Short-term, we are asking that all staff with school-age children quickly review and activate their individual disaster contingency plans as they relate to childcare support. This may include turning to friends and family for additional help.

If you have any immediate questions or concerns, please contact your manager.

These are extraordinary circumstances for sure, and we are continually humbled by the exceptional efforts being made by the UW Medicine team. We play such a critical role in the care of the community, and our family, friends and neighbors rely on us to be here when in need.

Thank you for your flexibility and understanding.

UW Medicine Human Resources

 

Update for Tuesday, March 10

UW Medicine continues to develop and compile policies, protocols and other resources to ensure our community is better prepared for a long-term response to COVID-19. Today, we are sharing important information on our policies for asymptomatic staff who have not had any  unprotected exposure to a known or suspected COVID-19 case. You will also find a range of support options that are now available to address challenges at work and at home, including counseling, childcare and town halls. 

We recognize that our response to COVID-19 will be a marathon, and we will continue to share with you our plans to provide the best possible care for patients while protecting our employees and supporting the well-being of the UW Medicine community.

UW Medicine Work Policy for Staff Who Both Are Asymptomatic and Have Had No Known Unprotected Exposure to a Confirmed or Suspected COVID-19 Case – Message from UW Medicine Leadership

Our colleagues at Public Health Seattle & King County shared a message last week with the community with recommendations (not requirements), that people at higher risk of severe illness stay home and away from large groups of people as much as possible. People at higher risk include:

  • Over 60 years of age
  • With underlying health conditions (heart disease, lung disease or diabetes)
  • With weakened immune systems
  • Who are pregnant

Examples of settings that could be avoided include concert venues, conventions, sporting events and crowded social gatherings.  Public Health does not consider hospitals and clinics to be in those same categories as elective social events due to the use of additional measure such as personal protective equipment (PPE) to minimize risk of exposure.

The UW Medicine healthcare team is made up of individuals from many communities representing a range of abilities, skills, perspectives, and life stages. Some members of our team are working while pregnant; others work while facing illnesses or treatments that may make them immunocompromised as a result; others who are older than 60 years of age (there are over 2,000 people working in UW Medicine in this last category)

Based on what we know today about this novel infectious disease, COVID-19 does not appear to be associated with an increased risk for worse outcomes in pregnancy. Less is known about its impact in immunocompromised populations.  At the same time, we recognize that we are still learning about how this virus acts in many different populations.

UW Medicine Policy Statement:

  • Staff over the age of 60: UW Medicine Staff and faculty who are over the age of 60 should continue to work per their regular schedules.
  • Staff who are pregnant, immunocompromised or over the age of 60 with underlying health conditions (such as poorly controlled diabetes; heart, lung, kidney, or liver disease): UW Medicine Staff and faculty in this category should continue to work per their regular schedules. Individuals are invited to talk to their team leader or manager about any concerns. We understand the concerns with direct patient care of patients with known COVID-19 and suggest these individuals talk to their team leader or manager about this. If this is a difficult conversation, we are here to help navigate it.

All UW Medicine PPE policies, protocols, and recommendations for providing care for patients with infectious diseases are designed to protect all healthcare workers, regardless of their age, health or pregnancy status. If you are concerned about access or type of PPE that is being recommended for your work, please talk to your team leader or manager. We are also messaging the UW community to remain home with respiratory symptoms that don’t require medical attention. This should also decrease potential exposure to ill co-workers.

We recognize and emphasize the need for each of us to prioritize our own health and well-being so we can best care for ourselves, our families and community for the long haul.

Well-Being Update – Message from Drs. Anne Browning and Trish Kritek

Thank you all for the unprecedented collaboration and creativity you are showing as we develop ways to best support our patients, community and each other in the face of the COVID-19. 

Below are several ongoing efforts to provide support to our healthcare teams and their families during these challenging times. Many of the ideas come from folks taking care of patients with whom we have been talking over the last week. Thank you for your ongoing insights and recommendations. We know you are receiving a lot of communications.  Here are the quick takeaways with additional information below. We have also put these resources together on our faculty website.

Peer Support: We have ramped up our Peer Supporter network and will be able to offer virtual Peer Support session using zoom and other technologies. We know the stress, anxiety and exhaustion that comes with caring for folks during this time of uncertainty and knowing that we are all in this together. Please reach out through our Peer to Peer Program

In addition to our one-on-one Peer Support, we will be offering group Peer Support discussions via zoom. The format for these sessions will be open conversations with all comers moderated by several of our Peer Supporters. Our first Peer Support drop-in session will take place 4 to 5 p.m. on Tuesday March 10: https://gbhi.zoom.us/j/617972378; Meeting ID: 617 972 378.  All members of our healthcare teams are welcome to attend. 

We recognize that this is a challenging time for families as well. We will hold an additional Peer Support drop-in session via Zoom for partners and spouses Thursday from 10 to 11 a.m.: https://gbhi.zoom.us/j/798370879; Meeting ID: 798 370 879.  Our hope is that this will allow an opportunity to listen and answer questions from these essential members of our team.

Childcare: For many folks with children, a primary concern is the potential loss of childcare and day-time child supports as we anticipate more school closures in the coming weeks. We share your concern and realize that this will impact our workforce’s ability to perform clinical care and have downtime when away from work. We have a team from across the University of Washington compiling and expanding resources to best support parents and caregivers in our workforce. We will leverage creative ways to draw on the strengths of our broader community to support access to childcare in the eventuality of additional closures.  For now, we recommend that parents connect with other families in their schools and neighborhoods to set up shared care plans if possible.  Back up child care is available through the UW on a first come first serve basis: https://hr.uw.edu/child-care/backup-and-sick-child-care/. We will have a separate communication about additional options soon.

Acknowledging the Challenges: For providers and family members who would like immediate help, please contact our Faculty and Staff Assistance Program: Carelink which provides consultation and triage support.  Free counseling or a session with a Critical Incident Counselor is available within 24 hours. Call 866.598.3978 to set up in-person or over-the-phone counseling at a date and time that works for you. 

Sharing our experiences in healthcare, especially during intense, emotional or stressful times increases our connectedness and well-being. Hearing stories from others helps us know we are not alone and strengthens our community. The authenticity, compassion, creativity and bravery of our colleagues helps us access our own emotions and helps us carry on. 

If you are interested in sharing a short reflection (55 words or fewer) about how the COVID-19 outbreak has impacted you to understand, appreciate or process something about the impact, response, or practice of medicine and healthcare at this moment, please use our Catalyst submission form. We invite all members of the healthcare team to contribute across all professions and roles. Please feel free to share with a colleague. 

Town Halls: Lastly, we want to provide access to folks on the front lines to share their concerns and needs regarding their health and well-being with our leadership. We will host a well-being focused town hall on Friday, March 13. Please check your local medical center or practice location communications for updates on local town halls throughout the week. 

In a time of great challenge, it has been inspiring to witness the coming together of our community.  We have been in awe of the sacrifices and courage of our team members in the units supporting patients with COVID-19 as well as those who are caring for all the other patients in our system, those working with high risk patients and navigating their treatment in ongoing innovative ways, our community members working to build reliable testing for the virus as well as already working on a future vaccine, and our leaders who are tirelessly building the foundation we need to face the marathon ahead. We are grateful for our entire UW Medicine community.  Please feel free to reach out to any of us directly if you have questions, concerns and suggestions regarding how we can best support our community well-being. 

Anne Browning, Ph.D.
Assistant Dean for Well-Being,
UW School of Medicine
Founding Director, UW Resilience Lab
Affiliate Assistant Professor, UW College of Education

Patricia Kritek, MD, EdM
Associate Dean – Faculty Affairs
Professor - Division of Pulmonary,
Critical Care and Sleep Medicine
University of Washington School of Medicine

UW Medicine Communication for Community Partners: UW Medicine has implemented a policy for communication with Adult Family Homes, Long-Term Acute Care Hospitals and Skilled Nursing Facilities. See the Communication policy on our UW Medicine COVID-19 Website.

Situation Report: Public Health – Seattle & King County reported 74 new cases of COVID-19 on March 10, 2020, which brings the total number of reported King County cases to 190, including 22 deaths. The Washington State Department of Health reports 267 confirmed cases and 24 deaths in the state.

The CDC reports 647 cases of confirmed or presumed COVID-19 cases in the United States in 36 states (including the District of Columbia). Travel health notices have been issues for the following countries and territories: China, South Korea, Iran, Italy, Japan and Hong Kong. For the most current COVID-19 country list, please refer to our Current Outbreak List on our UW Medicine COVID-19 Website.

The World Health Organization reports a total of 113,702 confirmed cases globally. In China, 80,924 confirmed cases and 3,140 deaths have been reported.

 

 

Update for Monday, March 9

Over the weekend, the pace of our COVID-19 response at UW Medicine continued to quicken. Our colleagues around the country are looking to us for guidance and best practices.

This update covers the following topics:  

  • Employee Screening at UW Medical Center – Northwest
  • Revised SARS-CoV-2 Testing Criteria
  • Patient Screening at UW Neighborhood Clinics
  • Interfacility Transfers of Patients with COVID-19
  • Situation Report: Local, National and Global COVID-19 Cases

UW Medicine Employee Screening at UW Medical Center – Northwest:  The UW Medicine Employee COVID-19 testing center opened on Friday, March 6. To date, over 175 staff, faculty and trainees have requested testing and as of end-of-day Sunday, March 8, 94 have been tested for both flu and COVID-19.

Once at the testing center, employees stay in their cars and testing is completed by a nurse in a “drive through” process. Employees then receive their results and guidance on next steps within 24-48 hours. Employees who test positive for COVID-19 are notified immediately by our staff and given additional instructions on how to proceed, usually including home isolation unless their symptoms are worsening, and they require additional medical evaluation. For more information, please refer to our “FAQ for Staff with Respiratory Infections” and “Scenario-based Assessment and Triage of Staff Exposed to SARS-CoV-2” posted on our UW Medicine COVID19 Website. Most employees are testing negative for COVID-19, and we are still seeing a fair amount of influenza in our clinic.

Employee Screening at UW Medical Center -- Northwest
The COVID-19 screening center for UW Medicine employees is fully operational at UW Medical Center -- Northwest 

The testing center is currently open seven days a week by appointment only. We will continue to expand our capacity at this location, and we will be standing up additional locations in the city to improve access to our staff.

Reminder: Employees who have symptoms consistent with an acute respiratory infection (such as fever, new cough, and/or new shortness of breath) and want to be screened or tested, must fill out a brief survey and submit it to the screening team. You will be contacted by Employee Health with instructions on how to proceed for testing if clinically indicated. You cannot be screened and tested without first completing this process.

Revised SARS-CoV-2 Testing Criteria: We have revised our UW Medicine SARS-CoV-2 Testing Criteria to reflect our expanding testing capabilities for patients. Key changes include: 

  • For patients with mild-moderate symptoms of acute respiratory infection who do not require hospitalization and do not have any other known risk factors (listed under Special Populations), the recommendation to test is based on the provider’s clinical judgement.
  • Older adults (age ≥ 65 years) are now listed under Special Populations.
  • Examples of congregant facilities now include dorms, fraternities and sororities.
  • Added a recommendation to strongly consider testing for influenza/RSV when testing for COVID-19, as other respiratory viruses are currently circulating, and co-infections can occur.

Please review the UW Medicine SARS-CoV-2 Testing Criteria our UW Medicine COVID19 Website.

Patient Screening at UW Neighborhood Clinics: UW Medicine Neighborhood Clinics have expanded their capability for administering tests to screen for COVID-19. Patients with symptoms consistent with acute respiratory infection can now be tested at the primary care and urgent care clinics. We continue to advise patients to contact the clinic first to discuss their symptoms before arriving to help prevent the spread of disease.

Interfacility Transfers of Patients with COVID-19: UW Medicine has implemented a policy regarding the transfer of patients with COVID-19 from other facilities if those facilities are capable of delivering care to this group of patients. See Interfacility Transfers policy statement on our UW Medicine COVID19 Website.

Situation Report: Public Health – Seattle & King County reports 33 new cases of COVID-19 as of March 9, 2020, which brings the total number of reported King County cases to 116, including 20 deaths.

The CDC reports 423 cases of confirmed or presumed COVID-19 cases in the United States in 35 states (including the District of Columbia). Travel health notices have been issues for the following countries and territories: China, South Korea, Iran, Italy, Japan and Hong Kong. For the most current COVID-19 country list, please refer to our Current Outbreak List on our UW Medicine COVID19 Website.

The World Health Organization reports a total of 109,578 confirmed cases globally as of March 9, 2020. In China, 80,904 confirmed cases and 3,123 deaths have been reported.

 

Update Sunday, March 8

UW Medicine Work-Related Travel Restrictions

In late February, UW President Ana Mari Cauce announced international travel restrictions for the UW community, including staff, faculty and students, to help stem the spread of the SARs-CoV2 infection that causes COVID-19. These UW international travel restrictions remain in place.

UW Medicine faculty and staff are playing a critical role in the community effort to identify and care for patients, track and analyze the spread of disease, and establish protocols and procedures to protect our workforce and patients from exposure. Our clinical care, education and research activities are essential for the local community, and the UW Medicine work is also having a major global impact. We need to protect and preserve the UW Medicine workforce so that we can continue to provide the expertise necessary to address the challenges of the COVID-19 pandemic.

To protect and preserve our workforce, UW Medicine leadership has decided to restrict all work-related travel for UW Medicine employees, effective March 9, 2020 through April 3, 2020. Additionally, I encourage everyone to reconsider their personal travel plans to help contain this epidemic. We also recommend that visiting faculty and meetings be postponed, cancelled or held via teleconference. Please read the entire policy here.

I greatly appreciate the sacrifices you are making to respond to this global pandemic. UW Medicine faculty and staff have been local and global leaders throughout these tumultuous times and with your commitment we will lead the way through this crisis. Your current efforts are an extreme example of our mission to improve the health of the public, and I am deeply indebted to each of you.

Sincerely,

Paul Ramsey, MD
CEO, UW Medicine
Executive Vice President for Medical Affairs and
Dean of the School of Medicine,
University of Washington

 

UPDATE

UW Medicine Incident Command continues to develop policies and procedures to guide our COVID-19 work and how we interact with patients, families, our staff, and the public. Multiple daily briefings keep our teams across the system aligned as we work toward providing our frontline staff with the tools, supplies and infrastructure they need to adequately address this unprecedented epidemic in our community.

Updates:

We have received additional personal protective equipment (PPE) supplies and will be establishing a process for allocating those supplies to the areas of most critical need. This process will differ from how you typically make requests so that we can closely monitor inventory and best use those supplies. 

We have several updated policies and procedures that you need to review and implement. There are also other activities taking place around the system that will be of interest to you and your teams. 

  • UW Medicine Travel Restrictions for Faculty and Staff
  • Employee Screening at UW Medical Center – Northwest
  • Patient Screening at UW Medicine Neighborhood Clinics
  • Expanded Role for Telemedicine
  • UW Medicine Virology Lab
  • New Policy Statements and Protocols  
    • RN Phone Triage Process and Resources for Patient Calls
    • Nursing Protocol for Nasopharyngeal Collection for SARS-CoV-2 testing
    • Scenario-based Assessment and Triage of Staff Exposed to SARS-CoV-2
    • Telework and social distancing recommendations
    • Emergency Procedures for Patients with Known or Suspected COVID-19
  • Situation Report: Local, National and Global COVID-19 Cases

UW Medicine Travel Restrictions for Faculty and Staff: To protect and preserve our workforce, UW Medicine leadership has decided to restrict all work-related travel for UW Medicine employees, effective March 9, 2020 through April 3, 2020. Additionally, we encourage everyone to reconsider their personal travel plans to help contain this epidemic. We also recommend that visiting faculty and meetings be postponed, cancelled or held via teleconference. Please read the entire policy here.

Employee Screening at UW Medical Center – Northwest:  We successfully opened a drive-through clinic to screen and possibly test staff for SARS-CoV-2 on the UW Medical Center – Northwest campus. Over the first two days, we tested approximately 100 employees.

Employees who have symptoms consistent with an acute respiratory infection (such as fever, new cough, and/or new shortness of breath) and want to be screened or tested, must fill out a brief survey and submit it to the screening team. You will be contacted by Employee Health with instructions on how to proceed for testing if clinically indicated. Employees will be tested by appointment only. You cannot be screened and tested without first completing this process. 

Patient Screening at UW Medicine Neighborhood Clinics: UW Neighborhood Clinics and its Urgent Care centers have expanded their capability for administering the test to screen for COVID-19. Patients with symptoms consistent with acute respiratory infection can now be tested at the clinics. This weekend, our Urgent Care and Primary Care Clinics screened and tested approximately 25 patients.

Expanded Role for Telemedicine: UW Medicine had 105 Virtual Care visits on Friday, March 6, and 111 visits on Saturday, March 7, compared to a normal volume of about 10 per day. About 130 primary care doctors are able to do telemedicine visits and our goal is to have every primary care provider privileged and trained in the next 1-2 weeks with go-lives planned this week and next. In addition, 19 other specialties already offer telemedicine (such as Ob/Gyn, Burns, Psychiatry). Another goal is to rapidly implement telemedicine in clinics with particularly vulnerable populations, including Oncology, Cardiology, Rehab Medicine (ALS and other ventilated patients), and Transplant.

UW Medicine Virology Lab: Our partners in the UW Medicine Virology Lab are expanding and supporting screening efforts for not only UW Medicine but also the local and in some instances regional community as public health and providers ramp up SARS-CoV-2 testing. Please note that only a patient’s physician or healthcare provider can order the test based on the patient’s risk factors and symptoms, please refer to the recommended Testing Criteria on COVID19 Website.

New Policy Statements and Protocols:

  • RN Phone Triage Process and Resources for Patients Calling about COVID-19 

There are resources for nurses triaging patients with suspected COVID-19. This resource includes a decision tree and a list of resources. See RN Phone Triage on our COVID-19 Website.

  • Nursing Protocol for Nasopharyngeal Collection for SARS-CoV-2 testing

Collecting NP swabs is an important tool in the diagnosis of a variety of upper and lower respiratory tract infections including influenza, respiratory syncytial virus (RSV) and SARS-CoV-2 (virus that causes COVID-19). The quality of the specimen is critical as is the correct collection of the specimen. See Sample Collection for COVID-19 Testing Nasopharyngeal on our COVID-19 Website.

  • Scenario-based Assessment and Triage of Staff Exposed to SARS-CoV-2


The health and safety of our staff, patients, and community is our top priority. For a detailed summary of the UW Medicine Scenario-based Assessment and Triage of Staff Exposed to SARS-CoV-2, please review our COVID-19 Website.

  • UW Medicine COVID-19 Telework and Social Distancing Recommendation

UW Medicine is aligning with the University of Washington policy on telework and social distancing. For details, see the update for Friday, March 6, on The Huddle. 

  • Emergency Procedures for Patients with Known or Suspected COVID-19 

This document provides guidance for physicians and staff on assessment and proper PPE precautions for suspected and confirmed COVID-19 emergency room patients. For more information, see Emergent procedures for patients with known or suspected COVID-19 on our COVID-19 Website.

Situation Report: The Washington State Department of Health reports 71 confirmed cases in King County, including 15 deaths, as of March 7, 2020. Across the state, there are 102 confirmed cases and 16 deaths. These numbers continue to change daily.

The CDC will report new numbers for confirmed or presumed COVID-19 cases in the United States on Monday, March 9. Travel health notices have been issues for the following countries and territories: China, South Korea, Iran, Italy, Japan and Hong Kong. For the most current COVID-19 country list, please refer to our Current Outbreak List on our COVID-19 Website. 

The World Health Organization reports a total of 105,586 confirmed cases globally as of March 8, 2020. In China, 80,859 confirmed cases and 3,100 deaths have been reported.
 

Update for Saturday, March 7

The past week has been a challenging time for our health system and region. With increasing numbers of confirmed COVID-19 cases, our primary focus is the care of our patients and their families, protection our caregivers and staff, and partnership with Public Health in controlling SARS-CoV-2 transmission in our region.

Highlighted below is information about UW Medicine changes in procedures, University of Washington operational responses to COVID-19 and other helpful information for our workforce.

  • COVID-19 Policies and Protocols 
  • Social Distancing
  • Employee Testing
  • Protective Personal Equipment (PPE)
  • FAQ for Staff with Respiratory Infections 
  • Screening and Care Protocols for Immunocompromised Patients 
  • Screening and Care Protocols for Pregnant Patients
  • Zoom Meetings
  • Resources
  • Situation Report

 

COVID-19 Policies and Protocols: All employees have access to the most up-to-date COVID-19 clinical protocols, policies and procedures on the UW Medicine SharePoint site. You can use the COVID-19 shortcut on your desktop to reach this site. 

COVID-19 Icon

Social Distancing: We are recommending that people avoid large gatherings, if possible. At work, we encourage faculty and staff to consider cancelling or postponing large group meetings and other non-essential meetings. If you must meet in person, practice social distancing during your meeting to allow space between you and your colleagues (one empty chair between meeting participants).

Employee Testing: We have opened a COVID-19 employee screening service located on the UW Medical Center – Northwest campus. Employees who have symptoms consistent with an acute respiratory infection (such as fever, new cough, new shortness of breath) must fill out a brief survey and submit it to the screening team. You will be contacted by Employee Health with instructions on how to proceed for testing if clinically indicated. Employees will be tested by appointment only. Walk-ins are not allowed. 

Personal Protective Equipment (PPE): UW Medicine, has revised its recommendations for PPE when caring for suspected or confirmed COVID-19 patients. This decision was based on our evidenced-based understanding of SARS-CoV-2 (virus that causes COVID-19) and is in alignment with World Health Organization (WHO), Washington Department of Health (DOH), Washington State Hospital Association (WSHA), and other local health systems. Please refer to the revised PPE Recommendations Schematic and Detailed Summary and Rationale for PPE Recommendations on our COVID-19 Website.

FAQ for Staff with Respiratory Infections: Staff with acute respiratory symptoms (such as fever, new cough or shortness of breath) can be tested for COVID-19 in our new screening facility on the UW Medical Center – Northwest campus. Although screening is not mandatory, staff with symptoms are encouraged to fill out the survey that will be reviewed before an appointment is arranged. No walk-ins will be accepted. Managers will only be informed of the results of a positive test if you worked while you were ill so that your co-workers can be contacted and tested. For more information, please refer to the FAQ for UW Medicine Employees with Acute Respiratory Symptoms on our COVID-19 Website.

Screening and Care Protocols for Immunocompromised Patients: Testing for SARS-CoV-2 (COVID-19) is available and can be ordered in ORCA and Epic. Since other respiratory viruses, including influenza, are circulating in the community, we recommend that testing for SARS-CoV-2 be ordered in conjunction with Rapid Influenza/ RSV PCR or Extended Respiratory Viral panel PCR for patients presenting with respiratory symptoms in selected circumstances. See Immunocompromised Patients Protocol on our COVID-19 Website.

Screening and Care Protocols for Pregnant Patients: We have developed guidelines for phone and in-person screening for pregnant women as well as procedural changes for Labor and Delivery for both known and suspected COVID-19 patients. Additionally, we are restricting all visitors in the perinatal and newborn areas across UW Medicine. Mothers may have a single partner onsite who must remain on the unit. No children under 16 will be allowed. See Pregnant Patients Protocol on our COVID-19 Website.

Zoom Meetings: As an alternative to in-person meetings, UW Zoom Pro is now free to all current faculty, staff and students. Any member of the UW community in these categories may now schedule and host Zoom meetings of unlimited duration. For HIPAA compliance, UW Medicine employees should be sure to access Zoom by signing into the HIPAA UW Zoom option. 

Situation Report: The Washington State Department of Health reports 58 confirmed cases in King County, including 10 deaths, as of March 6, 2020. Across the state, there are 79 confirmed cases and 11 deaths. These numbers continue to change daily.

Nationally, the CDC reports that 164 people have been diagnosed with confirmed or presumed COVID-19 in 19 states. The CDC has issued travel health notices for the following countries and territories: China, South Korea, Iran, Italy, Japan and Hong Kong. For the most current COVID-19 country list, please refer to our Current Outbreak List on our COVID-19 Website. The World Health Organization reports a total of 101,927 confirmed cases globally as of March 7, 2020. In China, 80,813 confirmed cases and 3,073 deaths have been reported.

Update for Friday, March 6

Our Path Forward with COVID-19

UW Medicine Community,

The situation we are in with the COVID-19 outbreak is new to all of us and evolving every day. Please remember that we have the best minds in medicine working in our system, and they are working tirelessly to help us appropriately care for our staff and our patients. We recognize that this is a challenging and frightening situation, but we will get through this together! 

This situation requires everyone’s participation. Each of us must do our part by keeping ourselves informed and following the recommendations that are being produced daily by UW Medicine. 

We want to assure you that we have leaders at all levels of UW Medicine focused on keeping staff safe while we care for the patients who require our care. We will ensure that you have the necessary protection and equipment needed to care for our patients.

Please remain calm and focused on the information being provided so that you remain healthy and can perform the job for which you were trained.

We are extremely proud and humbled by the dedication and commitment by all members of our UW Medicine community.

Sincerely,

Lisa Brandenburg
President
UW Medicine Hospitals & Clinics

Tim Dellit, MD
Chief Medical Officer
UW Medicine & President, UWP

Cindy Hecker
Chief Executive Officer
UW Medical Center

Paul Hayes
Chief Executive Officer
Harborview Medical Center

Rich Roodman
Chief Executive Officer
Valley Medical Center

Debra Gussin
Executive Director
UW Neighborhood Clinics

Jeff Richey
Interim Executive Director
Airlift Northwest
 

UW Medicine Meeting Restrictions and Telecommuting Options:

Dear Colleagues,

The past week has been a challenging time for our faculty, staff, patients and the entire community as we see the rising numbers of individuals exposed to or infected with COVID-19. The response from our UW Medicine community has been courageous and inspiring. We are very grateful for your hard work and dedication.

To help protect our workforce and students, UW Medicine is recommending meeting restrictions and telecommunication options to minimize the possibility of infection. The University of Washington is also recommending limited in-person classroom instruction. Those recommendations are outlined below. There are additional messages pending that will help guide how we continue to provide quality care to our patients, exceptional training for our students and trainees, and how we protect our healthcare professionals, staff and students from possible exposure.

New information will be posted to The Huddle on a regular basis. You may also receive these messages via your entity's Infolines. Our goal is to reach as many people as possible with important information that is critical to all employees.

Thank you for all of your excellent work.

Sincerely,

Paul G. Ramsey, M.D.
CEO, UW Medicine
Executive Vice President for Medical Affairs and
Dean of the School of Medicine,
University of Washington

Lisa Brandenburg
President, UW Medicine Hospitals & Clinics
Vice President for Medical Affairs, University of Washington

Timothy H. Dellit, M.D.
Chief Medical Officer, UW Medicine
Vice President for Medical Affairs, University of Washington
President, UW Physicians

Meeting Restrictions and Telecommuting Options:

In an effort to slow the spread of novel coronavirus (COVID-19), UW Medicine is encouraging all faculty and staff to consider cancelling or postponing large group meetings and other non-essential meetings. We further encourage telecommute options for employees whose work can be performed from home. Additionally, the University of Washington is recommending that all classroom instruction be done remotely.

Telecommute: In accordance with Public Health-Seattle King County guidance, we encourage supervisors to provide telework options to employees or students whose job duties can be performed remotely without hampering operations. Supervisors have maximum flexibility to implement this through April 3, 2020. You can find telecommute resources here.

Meetings: All large group meetings and gatherings should be cancelled or conducted via teleconference whenever possible through April 3, 2020. Please work with your supervisors and use good judgment about which meetings are essential and limit the number of people present where possible. If your meeting is critical, please consider convening your meeting via Zoom.

UW-IT has made UW Zoom Pro free to all current faculty, staff and students. Any member of the UW community in these categories may now schedule and host Zoom meetings of unlimited duration. For HIPAA compliance, UW Medicine employees should be sure to access Zoom by signing into the HIPAA UW Zoom option.

If you must convene or attend a meeting in person, please use the following precautions:

• Stay home, and urge participants to stay home if they are sick; participants who are sick should also contact their care provider via phone or telehealth.

• Practice social distancing during your meeting; allow space between you and your colleagues (one empty chair between participants in the meeting).

• Practice good personal hygiene; wash your hands frequently and thoroughly, and don’t touch your face with unwashed hands.

Classroom Teaching: The University of Washington is recommending all in-person classroom instruction to take place remotely starting Monday, March 9, through March 20, 2020. For the remainder of the quarter, instructors are asked to conduct classes and/or exams remotely, as possible, until the quarter concludes on March 20. In some cases, when the nature of a class is not suited for remote delivery, other options, including submitting grades based on work conducted to this point, may be used. Faculty and graduate students will receive additional information in a follow-up message from Provost Mark Richards and Faculty Senate Chair Joseph Janes. The University’s goal is to make sure that students’ academic work is fairly recognized and that any disruption does not present a disadvantage to their future academic progress, including admission to their preferred major in the months or years to come.

Update for Thursday, March 5

COVID-19 Testing Clinic for UW Medicine employees

Dear UW Medicine Staff,

We are excited to announce the opening of a COVID-19 testing clinic for UW Medicine employees. The goals of this clinic are to support our employees while simultaneously keeping our clinics and hospitals safe for patients. While this clinic is currently located at UW Medical Center – Northwest, this is a shared resource across all UW Medicine entities. There is no cost for this screening.

Please note that our capacity for testing is LIMITED and there is NO role for testing asymptomatic staff at this time. Priority will be given to clinical staff with significant symptoms or direct exposure to known COVID-19 patients.

Who is eligible?

• Employees calling out sick because of fever (Temperature ≥ 101F), new uncontrolled cough or new shortness of breath.

What will we be testing?

• We will be testing nasal swabs for influenza/RSV and COVID-19.

Is testing mandatory?

• No.

• Regardless of testing, it is the UW Medicine expectation that employees who are ill remain home for at least 24 hours after their symptoms have resolved.

Is testing confidential?

• Your manager will be alerted to a pending test and your timeframe for returning to work once results have returned.

How long does testing take?

• Turnaround time for COVID-19 testing is evolving, and employees should be prepared to wait several days or more for test results in some circumstances.

• Testing for Flu/RSV is generally available same day.

• Employees with pending tests are expected to remain home.

I’m sick and meet the testing criteria above; how do I contact the clinic?

• Fill out the survey. The survey will ask for your employee identification number. It is on the back of you ID badge or you can find it in WorkDay.

• Employee Health will contact you for an appointment on the UW Medical Center – Northwest campus; they will tell you where to go.

• Please note, all testing is done by appointment only; no walk-ins will be accepted.

What if I test positive?

• Public Health will be notified about employees who test positive per infectious disease reporting guidelines.

• Depending on your symptoms and living situation, if you test positive for COVID-19, you will be asked to self–isolate for the duration of illness and until you test negative. It is possible that staff in communal living may be quarantined elsewhere by Public Health.

• Employees will be expected to follow current sick leave policy from their department and HR.

We realize this may be a stressful time for our staff and are committed to supporting the health of our UW Medicine community. If you have any questions, please contact Employee Health at your organization.

Sincerely,

UW Medicine Leadership

Update for Wednesday, March 4

Well-Being of our UW Medicine Community

Dear UW Medicine Healthcare Team,

Our teams have done an outstanding job of mobilizing to support the community and region as we prepare to face challenges associated with the spread and treatment of COVID-19.  We thank each of you for the work you do to care for our community members each and every day.  We also want to acknowledge the stress, fear, anxiety and other complex emotions that come with the work we do at the front lines of caring amidst an unknown, ambiguous and evolving landscape.

As part of our continued focus on well-being, we have our Peer Support Program in place with supporters ready to connect in-person or virtually with UW Medicine community members who want to talk through how they are feeling.

In the weeks to come, we will hold Peer Support drop-in sessions in person as well as virtually via Zoom to give you an opportunity to connect with others in our community.  We are also partnering with our Department of Psychiatry to offer additional resources for our healthcare team. For leaders within UW Medicine, we are available to help support you as you think of ways to take care of your team. 

To best open lines of communication across our UW Medicine community, we will be organizing a Zoom-based town hall in the near future to allow us to hear the needs and concerns of folks across our institution.   

We would like to echo UW President Ana Mari Cauce’s message, “Our common humanity calls on us now to offer support, empathy and understanding to those most affected by this virus. All of us, as individuals and as a community, are responsible for treating each other with kindness and empathy. We are best equipped to deal with any threat to health when we work together." Click here to connect with the UW’s broader supports and information about COVID-19.

We care about the health and well-being of each of you and together we can support the resilience of our community as we address the emerging health threats of COVID-19.  Please take good care of yourselves and one another during this time.  Know that if you find yourself struggling with the challenges of providing care or events in the community, we want you to reach out and connect with us and one another. 

With great appreciation for all that you do,

Timothy H. Dellit, MD
Chief Medical Officer, UW Medicine
President, UW Physicians

Lisa Brandenburg
President, UW Medicine Hospitals & Clinics

Trish Kritek, MD, EdM
Associate Dean for Faculty Affairs
UW School of Medicine

Anne Browning, PhD
Assistant Dean for Well Being
UW School of Medicine

 

Update for Tuesday, March 3

UW Medicine’s Incident Command announces the following COVID-19 updates.

Screening for COVID-19: We have developed protocols and guidelines for screening and testing for inpatients, outpatients, and staff, which have been distributed to all clinicians. These documents can be found at https://one.uwmedicine.org/coronavirus. All testing must be done at the request of a provider based on testing guidelines; patients should not self-present for testing. We are working to establish a special employee health clinic to test employees who have respiratory symptoms and have concerns about possible exposure to coronavirus. The location will be announced as soon as plans are finalized.

Telehealth: In order to continue to provide continuity of care and to prevent patients with mild respiratory viral disease from having to come to clinic or the ED, we are in the midst of a rapid rollout of telemedicine visits in all of UW Medicine primary care. We are also vetting specialty telemedicine programs for expedited rollout in partnership with UW Medical Center and Harborview Medical Center. In order to provide telemedicine services, the clinician must be privileged for telemedicine specifically.   We are quickly getting our primary care clinicians privileged as this is not part of core clinical privileges.

Personal Protective Equipment (PPE): Teams are conducting training refreshers on proper usage of respirators, surgical masks, eye protection, gowns and gloves with focus on proper doffing and avoidance of self-contamination to assure maximum safety for both patients and clinical staff. We continue to closely monitor our stock of N95 respirators, surgical masks and other supplies to ensure that we have the necessary items to allow us to safely treat all patients who might be admitted to our hospitals with suspected or confirmed COVID-19. Please be respectful to your colleagues and do not stockpile supplies for personal use.

Protecting Patients and Staff: We can protect ourselves and our patients by staying home if we have symptoms of a respiratory virus. In addition, please follow these common steps for disease prevention:

  • Wash hands often with soap and water for at least 20 seconds. If not available, use an alcohol-based hand sanitizer. See KOMO News story with Dr. Paul Pottinger, UW School of Medicine allergy and infectious disease specialist, on the proper techniques for hand washing.
  • Avoid touching your eyes, nose or mouth with unwashed hands.
  • Avoid contact with people who are sick.
  • Cover your mouth/nose with a tissue or sleeve when coughing or sneezing.

Human Resources: UW Medicine is working on establishing new leave policies for staff who are exposed and need to self-isolate.

Media: UW Medicine’s clinical experts have been in high demand by the local and national media for facts about COVID-19. Topics have included general questions about COVID-19 and risk factors for complications: primarily, people over 65 and people with underlying health conditions. Our experts are also emphasizing how important it is for people to call their healthcare provider before coming into a clinical setting with respiratory illness symptoms and how good health practices can help limit the spread of respiratory viruses including COVID-19.

Situation Report: Public Health – Seattle & King County announced on Tuesday seven additional confirmed cases of COVID-19 in King County residents, bringing the total of confirmed cases to 21, including eight deaths in King County and nine in Washington state.

Nationally, the CDC reports that 60 people have been diagnosed with confirmed or presumed COVID-19 in 12 states. The CDC has issued travel alerts for the following countries and territories: China, South Korea, Iran, Italy, Japan and Hong Kong. For the most current COVID-19 country list, please refer to our COVID-19 Website. The World Health Organization reports a total of 88,948 confirmed cases globally as of March 2, 2020. In China, 80,174 confirmed cases and 2,915 deaths have been reported.

Message from Dr. Paul Ramsey, CEO, UW Medicine

UW Medicine Communications Regarding COVID-19

Dear Colleagues,

I write to provide information regarding communications related to COVID-19. UW Medicine clinical leaders are working with CDC, state and county public health leaders and others to coordinate our clinical responses with the community. Our leadership team will be providing regular updates on The Huddle. Please see the link to yesterday’s update. Over the coming days and weeks, the UW Medicine Incident Command Team will be providing regular updates. The Huddle site will also include updated FAQs and links to key resources. I ask that you check Huddle on a daily basis to review new information.

Many individuals in UW Medicine have spent countless hours over the last few weeks to prepare for the possibility of a COVID-19 pandemic. We are fortunate to have the expert clinical and research leadership to contribute to the community response network. Effective communication will now be vital to support all members of the UW Medicine community as we strive to ensure that you and your friends and families have the best support possible to be safe and healthy. Please check The Huddle each day for information to guide your work and to support the health of our workforce.

Sincerely,

Paul G. Ramsey, M.D.
CEO, UW Medicine
University of Washington

Update for Monday, March 2

UW Medicine Incident Command Update 

Incident Command: UW Medicine’s Incident Command (IC) structure is fully operational today with the goal of ensuring consistency in our COVID-19 response and communications across the health system. Teams have been formed to focus on specific issues such as operations, infection prevention and control protocols, ambulatory care, education and training, logistics and human resources. Hospitals and clinics share their best practices with the IC to ensure continuity across the system. Especially important is communications. We want to present a unified message to our patients, providers and employees. This includes signage, web content, discharge instructions and other materials. Please do not re-invent the wheel. Experts have been identified across the system to develop policies, protocols and communication materials to help streamline processes. As needs arise in your areas of work, please contact your leadership who can access the IC and its experts who can help develop the materials and processes you need. Daily updates will be provided on The Huddle.

UW Medicine COVID-19 Test:  The UW Medicine Clinical Virology Laboratory in the Department of Laboratory Medicine is now offering a PCR-based test developed by Dr. Alex Greninger with presumptive positive tests subsequently being sent to the state public health lab and/or CDC for confirmatory testing. We are actively developing clinical testing guidelines to ensure appropriate use of this resource and avoid unnecessary testing.

Situation Report: Public Health – Seattle & King County announced today four additional confirmed cases of COVID-19 in King County residents, bringing the total of confirmed cases to 14. King County Executive Dow Constantine signed an Emergency Declaration, enabling county government to take extra steps to fight COVID-19. Among the first actions: purchasing a motel and setting up modular housing units on publicly-owned parking lots and other available land.

Nationally, 43 people have been diagnosed with confirmed or presumed COVID-19 in 10 states. The World Health Organization reports a total of 88,948 confirmed cases globally as of March 2, 2020. In China, 80,174 confirmed cases and 2,915 deaths have been reported. The CDC has issued travel alerts for the following countries and territories: China, South Korea, Iran, Italy, Japan and Hong Kong.

Coronavirus Disease 2019: Preparing for Potential Pandemic (Video): At the Leadership Development Institute on Feb. 28, Dr. Tim Dellit, chief medical officer and infectious disease specialist, provided information on the COVID-19 outbreak. He discussed how the current outbreak compares to other pandemics and how you can support UW Medicine’s systemwide preparations. Dr. Dellit also talked about the likelihood of widespread transmission in our community and stated his confidence that we have the expertise at UW Medicine to meet this challenge successfully. Watch video.

Update for Sunday, March 1

UW Medicine Activates COVID-19 Incident Command

Over the weekend, several new cases of Coronavirus Disease 2019 (COVID-19) were identified in King County – including a case at Valley Medical Center – as well as a death at a local hospital from COVID-19. Despite the increasing number of cases, the majority (roughly 80%) of the illnesses in the U.S. and around the world are mild and do not require hospital-level care. 

To further coordinate our communication, preparedness and response activities, UW Medicine formally activated a system-wide Incident Command structure on February 29.  

Over the last several weeks, the UW Medicine COVID-19 Response Team, led by Dr. John Lynch (Associate Medical Director, Harborview) and Adam Parcher (Associate Administrator, UW Medical Center Montlake & Northwest) has prepared the system for a possible COVID-19 pandemic. Due to increasing global spread and new local cases suggesting potential transmission in our community, UW Medicine leadership activated the Incident Command structure to further scale our response in anticipation of additional cases. 

Danica Little (UWMC Emergency Response Manager) has been appointed as the UW Medicine Emergency Response Director. In this role, she will partner with Dr. Lynch and Parcher to continue to build a system-wide structure to coordinate entity activities as well as coordinate with the Northwest Healthcare Response Network and city and county agencies. The many other critical members of the COVID-19 Response Team will be incorporated into the Incident Command structure going forward. Each hospital is also activating command centers to coordinate with the overall UW Medicine response and will distribute information internal to their operations.  We will also continue to partner with the Seattle Cancer Care Alliance and Seattle Children’s Hospital to further align our activities.
 
Formal situational reports will begin to be distributed beginning Monday, March 2, to keep everyone informed about the rapidly changing environment. 

Additional Exposures: It has been reported that several UW Medicine medical assistants may have come into contact with nursing students who had interactions with residents at the Life Care Center in Kirkland where two people have tested positive for COVID-19. We believe their risk for exposure to be low; however, we have asked the medical assistants to remain home out of an abundance of caution.

Feeling Ill with Flu-Like Symptoms? If you are feeling ill with flu-like symptoms, please do not come into work.  Call your primary care provider or urgent care clinic to discuss your symptoms before seeking treatment. Our goal is to minimize exposure to other staff and our patients.

Daily Updates: We are adding the latest information for patients and clinicians to our COVID-19 presence on UW Medicine’s public facing website. You will find daily updates for employees on The Huddle. 

Masks and Isolation Supplies: We are closely monitoring our N95 respirators, surgical masks, and other supplies to ensure that we have the necessary items to allow us to safely treat all patients who might be admitted to our hospitals with suspected or confirmed COVID-19. Please be respectful to your colleagues and do not stockpile supplies for personal use.

Pandemic Preparedness for You and Your Family: Planning and preparedness are essential in the event of a pandemic. As the number of cases of COVID-19 in the U.S. grows, we want to remind you that it is important to have conversations with your families about the potential for an outbreak and what that may look like for all involved. Please remember that as healthcare workers we are all essential staff and the community depends on us to provide care. 

It is important to consider the following questions before we encounter a public emergency: 

  • What are your childcare plans in the event of school and daycare closures?
  • Backup care for your pets? 
  • Communication strategies with family, friends and community? 
  • Backup transportation plans?

The following resources from Public Health – Seattle & King County and the CDC can help guide your preparations: 

National and Worldwide Situation Report 

  • The World Health Organization reports a total of 87,137 confirmed cases globally as of March 1, 2020. In China, 79,968 confirmed cases and 2,873 deaths have been reported. 
  • The CDC has issued travel alerts for the following countries and territories: China, South Korea, Iran, Italy, Japan and Hong Kong.
  • In the United States, 472 individuals have been screened and 22 have tested positive through public health surveillance systems since Jan. 21, 2020. An additional 47 people have tested positive after being repatriated to the U.S. on State Department chartered flights. 
Update for Tuesday, Feb. 25

Critical update: Screening/travel recommendations for clinics, emergency departments and inpatient units

On Monday, Feb. 24, 2020, the Centers for Disease Control and Prevention (CDC) increased the Travel Health Notice for South Korea to Warning Level 3 (Avoid Nonessential Travel). Mainland China remains at Warning Level 3.

Recommendations for people with fever and/or respiratory symptoms returning from South Korea and mainland China:

  • Ensure that all individuals with any respiratory symptoms are wearing a surgical mask.
  • Place the person in a private room. Please use an airborne infection isolation room (AIIR/negative pressure room) if available. If not, place the person in a room with the door closed.
  • All healthcare workers should follow prior recommendations to wear respiratory protection (N95, PAPR/CAPR or surgical mask if respirator not available), eye protection, an impermeable gown and gloves if they need to interact with the patient.
  • Contact your Infection Prevention & Control Team and Public Health immediately.

 

On Sunday, Feb. 23, the CDC updated their Travel Health Notices to include Italy, Iran and Japan. All three of these countries are now at Alert Level 2 (Practice Enhanced Precautions) indicating sustained community spread of SARS-CoV-2 (the virus that causes COVID-19).

Travel recommendations for Italy, Iran and Japan

  • Older adults and those with chronic medical illnesses should consider postponing nonessential travel.

Screening recommendations for Italy, Iran and Japan

  • Healthcare providers should obtain a detailed travel history for patients with fever or acute respiratory symptoms.
  • For patients with these symptoms who were in Italy, Iran, or Japan and had onset of illness within two weeks of leaving, consider novel coronavirus infection and notify your Infection Prevention & Control Team and your local health department immediately.

Worldwide status report

  • The World Health Organization reports a total of 79,331 confirmed cases globally as of Feb. 24, 2020. In China, 77,262 confirmed cases and 2,595 deaths have been reported. According to China’s National Health Commission, 24,635 patients have been cured and discharged from hospitals as of Feb. 21, 2020.
  • South Korea has reported 833 confirmed cases with over 32,000 patients tested. Japan has reported 156 cases. Italy has reported 132 cases. New case reports and deaths have been observed in Iran and neighboring countries.
  • In the United States, 426 individuals have been screened and 14 have tested positive through public health surveillance systems since Jan. 21, 2020. An additional 39 people have tested positive after being repatriated to the U.S. on State Department chartered flights.

Local status report

  • No additional cases of COVID-19 have been identified in Washington state since the initial patient. Four patients from the Diamond Princess cruise ship with confirmed COVID-19 have been transferred from Travis Air Force Base in California to Providence Sacred Heart Medical Center in Spokane for treatment.
  • No patients with confirmed COVID-19 have been admitted to UW Medicine hospitals.

For more information

  • The University of Washington’s MetaCenter hosted an event on campus on “Coronavirus and Pandemic Disease Preparedness: What We Know and the Way Forward.” The event was recorded and is now available on YouTube.
  • Read the Seattle Times article on COVID-19 screening procedures at Sea-Tac Airport. Harborview Medical Center is named as one of four local hospitals designated to receive patients from the airport.

Questions: covid19@uw.edu

Update for Friday, Feb. 14

UW Medicine continues to maintain a high level of preparedness regarding the outbreak of the 2019 coronavirus, now known as COVID-19, in coordination with Public Health – Seattle & King County and the Washington State Department of Health. While the immediate risk of this virus to the American public is believed to be low at this time, we want to share with you key elements of our response to this emerging public health threat.

Worldwide status report

  • On February 11, 2020, the World Health Organization announced an official name for the disease that is causing the current outbreak of coronavirus disease, COVID-19.
  • To date there have been over 64,000 confirmed cases of COVID-19 globally with most of the cases occurring in mainland China. In the United States, 427 individuals have been screened, 15 have tested positive, 347 negative, and 66 tests still pending. Patients with this virus have reported mild to severe respiratory illness with symptoms of fever, cough and shortness of breath. CDC reports that 11 confirmed cases have been diagnosed in the United States. The first case diagnosed in the U.S., a man diagnosed in Washington state after traveling to Wuhan, China, has been released from the hospital.

 Local status report

  • Under the leadership of Dr. John Lynch, medical director of Harborview Medical Center’s Infection Prevention and Control (IPC) program, the UW Medicine COVID-19 Response Team includes infectious disease physicians, nursing and administrative leadership, IPC team members from all sites, communications, supply chain, facilities and leaders of other critical functions.
  • Daily team meetings ensure all entities are well prepared to screen patients who present at any of our entities, while ensuring the safety of our physicians, staff and other patients.
  • Dr. Tim Dellit, chief medical officer for UW Medicine, coordinates our response activities with University of Washington leadership, as part of a broader effort to prepare for potential COVID-19 exposures among UW faculty, staff and students.
  • Harborview Medical Center has been designated as the lead coordinating entity should patients need to be hospitalized or screened within our system.
  • Harborview’s Home Assessment Team (HAT), led by Vanessa Makarewicz, R.N., manager of the Harborview IPC team, provides COVID–19 screening and testing at individuals’ homes instead of in clinics and emergency rooms.
  • The UW Medicine Supply Chain team has increased stocks of personal protective equipment (PPE) needed to assess and care for patients with known or suspected COVID-19 infection. The team will also be introducing access controls to ensure that we have appropriate PPE for patients and staff when they are needed. 

Employee and patient safety

Prevent the spread of COVID-19 by following standard precautions for respiratory illnesses and closely adhering to screening and prevention criteria:

  • Practice good hand hygiene, cover your cough and stay home if you are ill.
  • If patients present with flu symptoms, offer them a mask and move them out of the general waiting area to protect other patients.
  • Continue to obtain a travel history on all patients presenting with respiratory symptoms, fever and/or a rash.
  • If you receive a call from a patient who has flu-like symptoms and has traveled to mainland China within the past 14 days of exhibiting symptoms, please contact the Infection Prevention & Control team or individual for your facility to coordinate appropriate care.
  • Patients with respiratory illness symptoms are being advised to call or use eCare to reach their providers before coming to a hospital or clinic. They can also call the Nurse Care Line, which has a recorded message to answer frequently asked questions and an option to consult with a nurse. The FAQs are posted on uwmedicine.org and updated as new information becomes available. The Nurse Care Line can be reached at 206.520.2285 or 1.855.520.2285.

 Patient care considerations

  • Note for faculty and staff who provide direct patient care: All laboratory testing for the COVID-19 virus is performed by the Centers for Disease Control and Prevention (CDC). None of the UW clinical labs test for this virus. If a UW clinical lab results report indicates that a patient has a coronavirus, this is one of the common human coronaviruses that cause colds, not the novel coronavirus. Please contact the ID consult service on-call or your facility’s Infection Prevention & Control team with any questions or concerns.

For more information