Briefing Minutes 7.22

7/22/20

1. Any CDC, local health department, CCAOM or other agency updates?

US   3,818,139confirmed cases(more than 57K new cases in 24 hours)       140,630 deaths(473 new in 24 hours)

TX   341,739 confirmed cases     4,151 deaths               Travis county 17,791 confirmed cases   209 deaths

- Gov. Abbott will  monitor two key metrics to justify any reopening – positive rate and hospitalizations

- Some goods – Austin area is on a downward trend according to Dr. Escott Interim Medical Director for APH. He says that we must continue to dig deep to continue to take protective measures. San Antonio is currently on an up tick in cases.  We are still in Stage 4 in Austin, but hospitals are “teetering on the brink of being over-stressed. He recommended a staged rollout plan of in-person learning for our public schools.

We were honored this morning with  Janet Pichette, Chief Epidemiologist and Assistant Director of the Austin Public Health Department

She answered many questions:

- N95 masks: recommended when there is high risk for patient to produce aerosol by directly coughing, sneezing, etc. without a mask, for example a dentist or a patient that has an endotracheal tube. For our purposes surgical mask with eye covering in form of googles, protective glasses or face shields is safe. The key is having good barriers from the patient.

- What about AC ?  The risk of AC has been debated and is not confirmed, it’s a balance, high temperatures cause other health issues and have to be considered so indoor with AC is preferable. AC filtration is important. AOMA’s infrared and added bipolar ionization is ideal. Vast majority of droplets are large and fall downward, there may be smaller droplets and thus it is so important to disinfect properly. Janet will send us what is recommended for disinfecting  options to disinfecting wipes, she knows wipes are getting very hard to come by.

What we have set up through hallway in Building B is ideal as there is safe distancing and a wide area so no one has to touch a wall or other surfaces and direction is one way.

- How long is quarantine after showing of symptoms? -  14 days

- How long after testing? If tested positive individual would be isolated (no contact with anyone) 10 days, then 3 days fever free and symptoms improving. If the individual was in “ close” contact with others the contacts must quarantine for 14 days.

If one Tests positive and is asymptomatic clock starts on day of test,  cannot return for 10 days

Janet has a calculator for return to work or school, minimum 10 days and at least 1 day fever free and resolution of your symptoms. We will get the calculator when it has final approval by Health Department leadership. Typically resolution of respiratory symptoms are most important and would override other symptoms.

Olfactory symptomology is mostly loss of sense of taste and smell so metallic taste is not a common symptom but Austin Public Health is seeing so many varied symptoms this complicates things

Student or employee with symptoms but negative test- we must assume they are infectious for something and send them home. Should not return until resolution of fever for 24 hours without taking any medications for fever and not showing any other symptoms

What to do when someone in a classroom with others  is diagnosed with COVID? Do an assessment of the exposure risk. Distancing puts a classroom at medium risk, so we must monitor and  consider 14 day quarantine for all who were in the classroom. 

Test based strategy is NOT recommended, instead use with time based strategy.

If test is used should be RNA PCR nasopharyngeal which is gold standard. Anyone with any symptomology needs to be sent home. Anyone with symptoms must not come to campus, stay home!

Janet commended us on the plans AOMA has put in place. Few organizations have tested their plans as we have done and she held this out as best practice. Encouraged us to share with other schools.

WE All THANKED Janet and the Austin Public Health team for all they are doing for all of us. They are working tirelessly 80-100 hours a week to help get this COVID situation under control.

2.Updates on any action items:

Student Clinics and use of virtual supervisors:

-Important for students in clinic to mute their devices when not actively taking to supervisors to reduce background noise

-Students must write up reflections following a case so request that interns use initials when discussing the case. All in agreement.

- Also NO facial acupuncture, under no circumstances should we be removing a patient’s mask for needle insertion

- Supervisors should also mute their devices

- In South Clinic there is no space for filing the chart so please place the charts in  the metal bins for the receptionists

Zoom setting with tablet can we set an outlet so we can Ask

3. Communication for our AOMA community? Any new issues?

- More information will be forth coming but we are finalizing plans for re-keying all of our exterior doors. Old keys will be handed in and new ones distributed. The goal is to absolutely distribute the smallest number of keys possible and ensure campus safety. For some the change may be a bit inconvenient, but safety trumps convenience so we hope everyone will support the plan. But, much more to come before change is implemented. 

- ALL STAFF AND FACULTY MUST ALSO UNDERGO DAILY SCREENING.A system has been set up for self-screening in building D. Everyone should enter on the North side (facing Western Trails) and exit into the courtyard. Physical Distancing must be maintained (most will be alone in the building) The access code will be emailed in case someone doesn’t have it. Please wristband yourself so we know you’ve screened and please clean off the thermometer before and after use with a wipe. We have also set up some specific processes for staff screening in our south store and for Pro Clinic North. All this in an effort to keep us all safe. Thanks for your support and cooperation with these important safety measures!!

4. Good news, positive experiences in last 24 hours

Today is Hammock Day!

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