Comprehensive Coronavirus Daily Briefing Minutes

Hi Everyone,


Here are all the meeting minutes since day 1. It's interesting to look back, but a few things have come up that referenced older briefings. I thought it would be nice to make one comprehensive post. If this comprehensive post is beneficial, let me know, and I can do this monthly.


Warmly,

Diane


Daily Briefing

Meeting format

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

2.Updates on action items:

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

4. Good news, positive experiences in last 24 hours

3/3/2020

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

2. Updates on action items:

- Website updates – in progress with Thelamedia, should be complete today

- Zoom agreement - to be signed this morning so training plan needed, also need decision on use for patients

- Registration log, is it now in place? Will be implemented this week

- Mask supply status? Still only have N-95s. Need to try and find other sources. Still pending a surgical mask order that was made a few weeks ago.

- Communication status? Patients, Students/Faculty/Staff General email sent, website coming, will print and post materials as appropriate, use hubspot to send info to those patients with whom we have contact info

3. Any new issues (e.g. Known traveling or potential exposures, unavailable supplies, etc)

Cancellation of Wellness Hour on website, Jean can notify as well as people call in

· We will do a check on expiration dates on Gels and replace accordingly

· Yesterday a practitioner who had been to California and had visible cold/flu symptoms. We will create a communication for customers exhibiting signs or symptoms of flu or cold

· Will establish multiple means of training after finalization of agreement with Zoom

· Student Clinics - when treating patients, students should follow regular infection prevention, wash hands properly or gel prior to visiting a patient and after. Registration will be gate keepers but students should discuss any concerns with supervisors

· Ask Zoom about downloading videos when instructors are using from their private computers.

· Agreed we will set up Classroom E1 and E2 for classes when students must work remotely because of possible coronavirus exposure. Faculty must discuss this need with Dr. Hamilton so class relocations can occur if needed. IF we get to an advanced Phase III of our plan, faculty will be able to use Zoom from home and have classes remotely.

3/4/2020

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

Question whether we should cancel our regular attendance at SXSW and other health or speaking events. We all agreed to err on the conservative side and excuse ourselves of large events like SXSW this year. Faculty or staff invited to speak at community events will determine if they feel they can safely present. If they decide to cancel they have our support.

2. Updates on action items:

Website updates – as of early yesterday the AOMA website landing page prominently displays AOMA response to coronavirus covid 19. Our response plan, a letter from Mary, and CDC best practices for handwashing and gel can be easily accessed.

Other-

- Alert media – Michael will send out via alertmedia information on where all of us can access updates on our plan.

- An Extra issue of student newsletter devoted to coronavirus response will be distributed

- Student will who must stay home or need to disclose travel should notify their advisor

- Zoom agreement – is finalized. We are awaiting the licenses we will receive for individual faculty members so they may use to assist students who must work remotely

- Registration log for clinic patients - is it now in place? Log is being finalized. Stephanee with work with Robert and Diane.

- Mask supply status? Surgical masks ordered months ago still not here but we found another source and will get those in a few days. We do have supply of N95 masks but will be kept secured and distributed as needed through Stephanee Owenby.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures, unavailable supplies, etc)

8 students have either traveled, have traveling visitors, and others who plan to travel. A private list is being developed so that we may track this. Students should be notifying their advisors if they plan to travel. We are developing a plan for doctoral week and will share as soon as that is available.

We ask all faculty to remind students to help us by please wiping down tables after each class. Also, containers of wipes have been disappearing. These are not to be removed!!! Taking these from the school for personal use puts others at risk and is theft. These products are getting more difficult to obtain so it is critical those we have remain in place and not moved except by our AOMA facilities staff.

A plan is being developed for any needed testing or make up exams for students

3/5/2020

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

Checking on process for anyone who may be at risk because of travel not wanting to isolate

or self-quarantine

2. Updates on action items:

- Zoom should be officially available to us as an institution. We must develop a training plan.

- We will make a decision on how to handle exams for students unable to be in class because of the infection prevention actions

- Investigation platforms to do online exam and cost Examsoft is an option, Diane is willing to do this for faculty but needs to know NOW. Robert will touch base with Ashley to determine how many students and exams.

- Immune sensitive students must be considered

- Time to write new policies in this new environment. Suggested we develop a generic to apply to all emergency situations like the current one we are experiencing.

- In Phase II says practitioners should mask with treating patients but we are faced with the inability to increase our supply on masks because of shortages nationally and internationally. We must remind practitioners that they we need them to consider carefully if a mask is absolutely necessary. It is critical that all other prevention measures are taken, washing hands or using gel properly immediately before seeing a patient and immediately after is first line of protection. Supplies, like masks are getting difficult to obtain so we must use what we have strategically.

- The question of how we should properly dispose of Personal Protective Equipment (PPE) like masks. Stephanee will check with Stericycle and update us.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures, unavailable supplies, etc)

Students with diagnosed compromised immune systems are welcome to isolate. Advisors are points of contact. We are asked to make sure student website emphasizes use of student advisors for updates, questions, etc.

3/6/2020

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

Although APH department is not requesting that people other than those who have traveled from either China or other countries identified for high risk, they are advising individuals that a given organization’s directive and/or policy should be honored. AOMA Administration has agreed to take a conservative stance and are requesting anyone who has traveled by plane or cruise ship recently should quarantine for 14 days. For students we will support them to ensure they get what is needed to continue studies and meet timelines for graduation. Students should work with their academic advisors.

2. Updates on action items:

4 Cases of rubbing alcohol so 48 bottles.

Ordered additional bags for wall dispensers for sanitizers

3. Communication status? Any new issues (e.g. Known traveling or potential exposures, unavailable supplies, etc)

PPC (People’s Community Clinic) had been doing acupuncture in a large community room, this room will become a triage room. Acupuncture will continue but will be in an alternative solution for a location. They are essentially working at our Phase II. Billy Zachary will share our plan with them. Our plan has also been shared with other TCM schools and CCAOM who are wanting to develop their own.

Students have many questions. One student concerned about another student who went to visit a family ill in a nursing home in San Antonio. Robert will be in touch with the student in question.

We will take the issue of how to work with staff members who want to quarantine because of a compromised Immune system to Cabinet on Monday.

What if schools close how will we handle staff with school age children? We’ll also bring this to Cabinet on Monday.

SXSW is a concern but we still don’t know how the City will handle, several major exhibitors have already pulled out and there has been a petition with thousands of signatures presented to the City, so there is a possibility it will be cancelled. We can’t keep staff or students from attending public events on private time so we just have to continue to watch for any signs of illness and handle appropriately.

3/9/2020

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

-Have to submit a change form to ACAOM to avoid the fee for distance education, we need the state of emergency statement from City of Austin

-Dr. Luo wants us to begin work on Clinic risks, especially the VA, will be discussed at Cabinet

- Have been in contact of doctoral students who may have to fly. Faculty have been notified.

2. Updates on action items:

- Zoom meeting today at 11 to determine what if any limitations we will have as we use Zoom as a tool to provide support for continued education during this time of coronavirus response.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures, unavailable supplies, etc)

- CVS does get shipments on Wednesdays so everyone

- In two weeks we should be getting a shipment of masks (surgical)

- 7 containers of wipes, 2 large bottles of hand gel, 9 cans of Lysol spray

- Minutes of Daily Briefing will be placed in Student website to ensure students have access

3/10/20220

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

DSHS meeting update:

- 12 cases in Texas confirmed or presumed positive

- Wide community spread likely

- We must develop mitigation plans. Dr. Hellerstadt (State Health Commissioner) stated that organizations have complete latitude to make the decicions on mitigation plans regarding how to stay safe. We certainly must use CDS as baseline and not do anything below those recommendations but we can all do more if we desire.

- Most important is to consider vulnerable populations (those 65 or older, heart patients, immune compromised patients), prepare for community spread but be mindful that PPE (personal protective equipment like masks) is in shortage so use wisely and strategically.

Work closely with your local public health department.

It was reported that Dell Consultant from India was diagnosed as positive on return to India. He had visited Austin and New York and exposed multiple individuals.

2. Updates on action items:

- Exams for students - Lesley and Phil have drafted communications for faculty and asked for input. This communication includes suggestions to faculty on how to handle courses, exams, etc.

- Zoom license distribution began last evening, Admins have been identified to support Zoom users, classroom trial run will occur this morning, suggesting downloading app to phones as this will be an easy way to use, especially for students

- Robert sent an algorithm for better screening of Clinic patients that will be copied and distributed.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures, unavailable supplies, etc)

- Victor shared questions from students. Ask that we clarify when to mask up when treating patients. Students should consult with their supervisors. The screening of patients should occur at registration. Using the algorithm created by Robert, if patient is in “yellow” category we should mask. We will clarify at today’s 4pm meeting with DSHS when and who should mask (patient vs. provider).

Will print color copies of the algorithm for our Clinics! Make 10 color copies with date of most current version so we can keep track of updated versions.

3/11/2020

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

- From Department of Health Services 4pm meeting last evening:

· In US cases have increased 200 in last two days

· Austin is suggesting cancellation of any event with 2500 or more

· It is recommended we begin to practice spread of 6-7 feet as the virus is spread via droplets. Cleaning surfaces is critically important right now.

· There are still only 7 labs in Texas able to test one in El Paso, Tarrant County, Houston, Lubbock, San Antonio, and the State Health and Human Services department lab in Austin. Private labs like Quest and Lab Corp should begin testing today or tomorrow. Capacity at each lab is still just 10-25 tests per day, but this should improve with the next two weeks.

- Harvard will move all classes to on-line, also other universities are doing the same

- Westlake HS student just returned from a high risk area and is self-quarantined, all of AISD and Eanes are cancelling all international travel

- It was reported that one Austin hospital has all staff all using masks, goggles, PPE, but their outpatient clinics are not doing the same. Important to remember that hospital settings are much more vulnerable than outpatient settings and thus use of PPE will be different, especially in light of PPE supply shortages.

2. Updates on action items:

- Clinic receptionists now using the new screening algorithm, the algorithm is dynamic and will be updated as needed, they are dated to ensure we are using the most current version.

- We are updating our response plan to include use of masks

3. Communication status? Any new issues (e.g. Known traveling or potential exposures, unavailable supplies, etc)

When testing Zoom, can see the faces of those zooming in, students showing up that are not on our list. If folks are seeing each other will those quarantined feel privacy is invaded? This is very temporary fix. We have to report what we are doing to ACAOM. All we are doing is precautionary.

Diane has put together 3 page of FAQs that will be distributed.

Zoom is for self-quarantining or to avoid travel by plane

Otherwise Zoom is working well for us

Need one point person can go to for Zoom, we will determine.

Robert reported that Seton McCarthy has changed processes because masks are becoming very limited.

3/12/2020

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

· Cases are increasing in the US, it is anticipated community spread will soon begin to greatly increase in Texas

· If someone is ill and presents without a medical home they should be referred to a local Emergency department

· Because of low capacity for testing at this time only symptomatic patients are being tested

· Highly recommend using social separation 3-6 feet distance or in clinic registration or triage situations but up some barrier like plexiglass or glass

· Anyone with respiratory issues should mask

· As of our President’s announcement last night as of this Friday US will prevent entry from European countries (for 30 days) into US with UK being the exception and US citizens screened from reentry.

· MBA has cancelled all games

· NCAA will have games but limited attendance, no fans

· WHO announced this as Pandemic

2. Updates on action items:

- Updates on algorithm to be made on Tuesday, stores will also receive a similar algorithm

- We need to plan for social separation as a school

3. Communication status? Any new issues (e.g. Known traveling or potential exposures, unavailable supplies, etc)

- Having a few more students who are ill and self-quarantining, others considering their travel plans

- Notice to ACOM re: our use of Zoom during this time of emergency

- We were able to get a small amount of hand gel at CVS; they get deliveries on Wednesday so check at your local CVS if you can. Deliveries are in morning and they unload about 11am. They warn it goes fast.

- All cams installed in all classroom, currently goes through internet so if we can load on our computers in the classroom, would be helpful. Many faculty members want the camera in a different position, so we are determining how to best accomplish this.

3/13/2020

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

- This morning it was announced that two cases of the virus are presumed confirmed for Austin, the two individuals tested positive by local health authorities but still need testing by CDC.

- From DSHS call last evening:

-25 cases (not included the 2 new in Austin) in Harris, Tarrant, Montgomery, Dallas, Ft. Bend and now Travis counties.

-Nationally 1, 215 cases, an increase of 277 since yesterday, 1099 from community spread

-Testing still a challenge but commercial labs, hospitals and other local health agency labs are coming on board

-Recommended mitigation strategies include: stay home if sick, stack up on everyday essentials, wash hands, actively practice social separation, disinfect all common use surfaces each day, for schools determine short term and long-term closures, for workplaces review leave policies, implement social distancing, limit travel, consider health checks

- Recent non-peer reviewed study to be published in New England Journal of Medicine showed survivability of the virus 2-3 days on stainless steel and plastic surfaces. But study had very specific conditions 65% humidity, 70 degrees F temp.

- CDC will be issuing lab guidance, Nasal pharyngeal swabs will be used for testing. Oral pharyngeal will no longer be required.

- Question about emergency responders transporting affected patients. Paramedics in full PPE would still quarantine 14 days. Emergency vehicle would return to service after full disinfectant cleaning.

- Question about reusable masks that APD is using. These can safely be used as long as the manufacturers instructions for cleaning are followed.

- Question about defining large gatherings. There is no definition, joking said “two’s company , three’s a crowd”. Ability to keep social separation would be a guideline. Suggest putting up signage, put hand washing stations or gel stations, but all factors must be considered for each gathering.

- Question regarding someone refusing quarantine. Contact local health authorities in these cases.

- School closures have been individual school decision there is no standard at this time.

- Phil has info from other TCM schools, PCOM will shift all didactic cases to on-line will go into effect Monday. Clinics are remaining open. AOMA’s President’s Cabinet will discuss what other action AOMA should take as the situation evolves for Austin.

- Question: Should we be requiring staff to quarantine if been traveling, it is up to the given institution, self- monitoring for 14 days is also an option

- Other questions can be sent to dshs.texas.gov

- Public Health Department’s mission is to slow transmission, protect people at high risk and protect the healthcare systems

- Call Center at DSHS will be open 24/7

2. Updates on action items:

- We did approval from ACAOM through April 21. All will be forwarded to SASCOC, this will cover THEB.

- Clinic Screening update meeting will occur on Tuesday, Dr. Shen and Dr. Jing will attend

3. Communication status? Any new issues (e.g. Known traveling or potential exposures, unavailable supplies, etc.)

- Tracking students, tracking for staff is needed as well, will mimic what we are doing for students. Reminder to be cautious of privacy!

- Will set up Zoom today to use for the Daily Briefing moving forward. We should be able to set up a means by which multiple folks can call in, if not, will simply send a zoom invite to all those who have regularly been participating.

- AOMA community clinics have not changed at this time. The affiliates will be the ones to make the decision at this time. We will let the affiliate Clinics drive these decisions.

3/16/2020

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

- Gov. Abbot declared State Disaster, this allows Texas to now receive supplies from the national stockpile and will facilitate the ability to do telemedicine

- As reported this am, there are 6 confirmed cases in Austin

- As of Friday 1,264 cases nationally, 36 deaths. In Texas 62 cases, counties impacted now include Harris, Ft. Bend, Montgomery, Dallas, Tarrant, Bell, Collin, Gregg, Smith and now Travis

- Suggesting individuals not stockpile supplies, stores will shorten hours to shelve new inventory. Primary goal is to stop spread and this is everyone’s responsibility. Do all the things that have been advised, avoid unnecessary travel, wash hands and gel often and properly, avoid touching eyes, nose or mouth, clean common use surfaces before and after use, practice social distancing

- For more information see www.dshs.texas.gov/coronavirus

- Testing capacity still limited but improving as commercial labs begin testing. At this time only those with symptoms, especially in high risk category, or who have symptoms and traveled within 14 days. Primary symptoms are fever, dry cough and lower respiratory issues.

- Public Health priority for testing include: Healthcare professionals so they may continue to care for others, those with no risk factors but are symptomatic, those in high risk categories, those who are ill and hospitalized for no reason

- If a patient doesn’t meet the criteria above a physician could still order testing can order through one of commercial labs now offering testing

- Current community mitigation is staged, Stage I – make emergency plans to work from home if possible, Stage II – social distancing, Stage III, extensive teleworking

- CDC is still recommending repeat testing, positive patients will have two negative swab tests before released/cleared from quarantine. BUT criteria is continuously changing.

- Decisions for distribution of supplies from the national stockpile will be made by local health authorities

- For suggestions like UV lighting us CDC guidelines (there are no specific guidelines for this with CDC, it is not listed as a mitigation or prevention strategy)

- A new phone number will be mailed for the DSHS daily 4pm meeting. The current conference bridge will not work on 3/16.

- PCC student/patient issue, Billy Z. will report back

- N. Store will close today due to staffing

- Community Clinics, we will move to thermometer screenings prior to visits to stores and clinics. Processes must be worked through.

2. Updates on action items:

- For our own clinics N or S, if we find supervisors sick they must go home

- Supervisor shifts will be reviewed and gaps filled as we are able to do so, some clinic may have to be cancelled and rescheduled

3. Communication status? Any new issues (e.g. Known traveling or potential exposures, unavailable supplies, etc.)

- We must follow the guidelines of our local health authorities who are following CDC closely

3/17/2020

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

- Other cities like Dallas have closed restaurants and bars. Food establishments are being allowed to do drive through or carry out. Austin may be making decision regarding this today.

- If we are able to join the State and Local Health authority daily meetings today, we’ll have updates tomorrow. The number has changed, and we did not get notification yet on the new number.

2.Updates on action items:

- Dr. Song will lead a team to develop a plan to offer herbal medicine services virtually.

3.Communication status? Any new issues (e.g. Known traveling or potential exposures, unavailable supplies,etc.)

- Please see correction in minutes of 3/16 regarding national vs. Texas stats for number of Covid 19 cases.

- All students were notified of transition to complete distance learning for at least 2weeks, a few are stating they did not know and missed class or are calling in to say they are ill and not coming to campus. Lesley will work with Dr. Jing to ensure all students know we only have remote classes at this time.

3/18/2020

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

- US confirmed cases 4,226 75 deaths

- Texas 64 confirmed cases 2 deaths

Most of these are travel related but community spread appears to be involved as well.

656 tested in Texas by Public Health Labs, 70 pending results

- Advise is that best community mitigation and most critical is social distancing, discouraging any travel, stay home as much as possible, avoid any congregating of groups of people.

- If ill with fever, respiratory issues stay at home and isolate, even if symptoms are mild. Everyone with symptoms should call ahead if they plan to go to a hospital or physicians office to allow the office or hospital to plan and remain safe.

- Two articles now published on the survivability of the virus, latest New England of Medicine Journal and Journal of Hospital Infections (this article refers to other viruses so New England Journal is probably best info at this time)

- Best community mitigation is social distancing, avoid travel, avoid group gatherings

- If ill even with mild symptoms stay at home and isolate. Everyone with symptoms should call ahead to a hospital or physician’s office to allow prep and maximum safety for healthcare workers

- Most testing being done in Texas by Public health labs we are still minimum 3 weeks out before testing capacity is increased dramatically

- There is a number for PPE supplies 1 888 info fda but trauma centers and high volume hospitals will be first priority

2.Updates on action items:

- We currently have enough cleaning supplies and toilet paper as we should with no onsite classes. There are supplies on shelves of the stores as they replenish their stock, but we are reminded not to hoard so that everyone has access to needed supplies

- There are conversations with ACAOM to develop some creative solutions for students to receive remaining hours for graduation. More to come on this.

- We have received a shipment of 200 surgical masks. Dr. Jing will also be receiving a donation of both surgical and N-95 masks.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

- Diane made a video with Mary inviting students to a Zoom meeting, much like a Townhall so questions can be asked and answered. It was suggested this be scheduled for either F, M, or Tuesday 12:45-1:45

3/19/2020

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

- US 7038, increase of 2812 since yesterday 97 deaths

54 States and Territories are impacted

83 cases, Increase of 19 since yesterday TX 2 deaths

Community spread appears to be increasing

- Testing in our state is increasing almost 700 tested in public health labs so far 1210 in commercial labs

- # of confirmed cases will continue to rise We must act now, the next few weeks are critical to prevent spread but will take all of us complying and doing as has been advised

Older adults and those with underlying conditions are most at risk, they must stay home and avoid unnecessary outings

- Strategic National stockpile, will go to areas where needed most, healthcare and first responders

- Avoid face to face meetings, keep groups to less than 10 and include social distancing

Mitigating the spread is everyone’s responsibility, cover cough and sneezing, clean commonly used surfaces, always use social distancing

Community mitigation

- Social distancing is critical with more suspected community transmission (not related to travel or contact with a known case). Can impact pace of spread if we don’t follow social distancing. We are learning from other communities that social distancing works.

Stay out of crowded places, avoid group gathering, and stay 6 feet apart are PROVEN to work!

- Focusing on social distancing because easy to implement and effective so we are all asked to comply.

If you need to venture out of your home keep 6 feet away from others.

Those sick should stay at home and isolate from any well individuals even if mildly ill (most will not need tested) 80% will fall into the mild category. DSHS Website has info on self-care and how long to wait before going back to school or work. Our hospitals/healthcare system will be overwhelmed so mild symptoms should stay home.

If in a high-risk category you should contact your doctor if you have a fever, or respiratory condition. Ask you doctor to help with decision of next steps for yourself.

- Cancel non-urgent elective surgical procedures.

- People really need to be watching health after doing any travel even domestic. It is recommended they isolate for 14 days on return home.

- Lab capacity now up to 150 tests per day in Austin and across the state

CDC has released new guidance on PPE, find on DSHS website Strategies for optimizing your supply of PPE. Will help us get through this time of shortage of PPE, help us to prioritize and extend use!

- It is advised the steroids not be used for treatment of COVID 19

2.Updates on action items:

- Pilot for On-line testing for herbal services going went well we will do next iteration of pilot and prepare to launch soon

- Our academic leaders have developed opportunities per ACAOM guidance on how to provide students hours for didactic and clinical practicum with acupuncture and herbs. Some students may continue into break week to get more hours. This starts Friday with 3 different supervisors. Special thanks to Dr. Shen who has made himself very available, also Dr. Fan and Dr. Song helping on Fridays. As Pro Clinic begins offering Traditional Chinese Medicine telemedicine students will have the opportunity to observe.

- With only one staff member in herbal dispensaries currently, Lesley is helping a few hours each day. Phil will also begin coming to learn so he may help as well. Our thanks to Dr. Lesley and Dr. Phil!

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

What needs to be added to the update on the website updates?

- Info Chinese herbal telemedicine once we are ready to fully launch including message that if patient doesn’t reach clinic staff leave a message and we’ll get back to you. Stephanee and Lesley will work on appropriate verbiage.

- Dr. Jing has information on how China is treating patients with the virus. The file is large but we will determine how to best post this.

3/20/2020

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

- US 10,442 increase of 3404 cases in 24 hours, 150 deaths

- TX 143 increase of 60 cases in 24 hours, 3 deaths

- Governor Abbott declared State mandates including:

1. Every person in Texas must avoid social gatherings that have more than 10 people.

2. People should avoid eating and drinking at bars, restaurants and food courts or visiting gyms. There will be no dining at bars or restaurant dining rooms since they will be closed. Restaurants can still offer take-out options.

3. People shall not visit nursing homes, retiring centers or long-term care facilities unless they're providing critical care assistance.

4. All Texas schools must close temporarily. This does not mean that education stops. Superintendents will continue to work with the Texas Education Agency to continue online or additional educational options.

For offices and workplaces that remain open, employees are encouraged to practice good hygiene and work from home if possible, the governor said.

- Texas Health Commissioner, John Hellerstadt declared TX a Public Health disaster

Mitigaton

-Texas’ large rise day after day in large partly due to community spread

- Trying to flatten the curve with social distancing, this is critical!

- If any mild symptoms stay at home! Call ahead if you plan to go to hospital or physician’s

Office

- Online self checker from CDC will be on line later today, it provides info on how to take

care of yourself at home and isolate from others. Check on CDC website.

- CDC’s Severe outcomes among patients with CV19 severity of disease by age group Shows that 80% of the deaths are with older adults(65 and older), highest % among 85 and older. In US 49M in this risk age group.

- Regarding ibuprofen conflict. WHO does not recommend against the use of ibuprofen. There appears to be no evidence that Ibuprofen is harmful for respiratory infections. Jury is still out though so discuss with your doctor.

- CDC has also come out with guidance for optimizing use of PPE, on CDC website see Strategies for optimizing PPE

- CDC is also recommending that hospitals and surgical centers try to cancel non urgent surgeries to save PPE

- CDC also has information on “How to prepare your practice for CV19” , there are FAQ’s for healthcare providers

- Public number for coronavirus questions is 211, will triage calls and being used as call center entry point

- With community spread all EMS should consider responding to any respiratory illness

- Regarding national stockpile of PPE, there is selected distribution of PPE to those areas most critical for life saving activities.

2.Updates on action items:

- Pilots for herbal medicine services going well. Should be able to do a full launch soon.

- We received a wonderful letter regarding our first pilot. Patient so thankful to be able to get herbs during this time of health crisis. Letter very much thanked Russ for his assistance and Dr. Song and AOMA for offering this service.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

- We’ve updated the website to include videos and other materials for virtual community wellness.

- For supervisors and others, who “critically” need remote login for T:Drive access let Stephanee know by end of day today!

- Victor shared question from students regarding whether AOMA can support the community effort by providing testing for COVID 19. At this time we are not equipped to provide testing, all is being done by public health or commercial laboratories. Opportunities are developing for AOMA to provide support to our community in particular our healthcare providers and first responders. We’ll be working with Rachelle Lambert and her work nationally for emergency response. She is creating a template based on this work in Colorado and will work with us to help spread here in Texas in the coming few weeks.

3/23/2020

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

- CDC- US now has 15219, 201 deaths all 50 states DC and 3 US territories

- In Texas death total has risen to 5 . It will take all of us to protect our community

- 194 cases an increase of 61 from yesterday(Thursday)

- 34 Tx counties with confirmed ( 7 more counties)

o https://dshs.texas.gov/news/updates.shtm#coronavirus

- More people being tested 1168 in Texas by public health labs – 4109 by commercial labs

- Expecting many more cases – every person shall avoid public gatherings – no restaurants except for delivery or carry out, no bars, stores are now required to enforce social distancing

- Do not visit nursing homes, schools are closed, pharmacy and banks are still acceptable, but most are not allowing walk-in only drive through

- Continue strategies to slow the spread of the disease. This is everyone’s responsibility, stay home when sick, clean surfaces, etc.

- 211 can refer callers to COVID-19

- Gratitude to the healthcare workers and grocery staff

Community Mitigation:

-Continue to ask that we stay at home – only go to grocery store, pharmacy and cancel anything with more than 10 people. We aim to flatten the curve we are dealing with prolonging the disease due to community spread.

- There is one new published article JAMA characteristics and outcomes of 21 patients in Washington state

o Describes clinical presentations of critical cases of COVID 19. They showed co-morbidities. 60% had other diseases (mentioned chronic kidney disease)

o Overall 50% of those admitted to the ICU died. Of note, when they looked at those about 15% had another viral infection

- Lab update

o Increasing capacity at Austin public health labs. Positive test from any lab is now confirmed as COVID positive. No need for additional verification.

- Question: Pets allowed in nursing homes? – no restrictions on pets – CDC urge pets not to be around people with COVID 19.

- Day care and sick children – COVID? No separate guidance for discontinuing isolation (found on website and CDC) but protocols will be developed, right now check CDC

- If child is not tested and have symptoms? – still recommendations that presumes COVID and so kids or anyone with symptoms at this point – fever and respiratory symptoms isolation at least within 72 hours right away after fever – quarantine for at least 14 days.

Coronavirus@dhs.texas.gov

- One of the areas that will fall under crisis PPE strategies – if we don’t have any – then perhaps using cloth masks –

o No specifications on how they should be made or out of what material

o Not considered PPE as they have not been tested

o – In crisis situation with PPE – if we do continue to see shortages that can’t be improved there will be federal guidelines on how to use them, including development and design.

o We might get to that point and hopefully have more information

- Elective surgeries are there any plans or mandates for health facilities? Nothing at the moment it is a dynamic situation and PPE is just not available. Demand currently exceeds the supply.

-

2.Updates on action items:

- Saturday worked well, but will require 2 with volume of voicemail

- Huge kudos to Ralf’s innovation that is allow us to safely dispense herbal prescriptions!

There is a clear demand for herbs and all we can do to provide will help our patients and help AOMA’s business as well. I was impressed with the number of voicemails at the N. Clinic on Friday, so very grateful to Dr. Song, Stephanee, Russ, Lesley and all involved in helping us get Dr. Song’s plan executed.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

- We have an AOMA community member experiencing flu like symptoms. We will explore necessary steps.

- Two of our students also experiencing some symptoms. One found out that at least one friend they shared time with has tested positive. One student is not eligible for testing. All are quarantining. Reminder to us all that we MUST do all the things that have been advised, social distancing, vigilant handwashing, stay at home if you can, etc.

3/24/2020

Resent calendar appointment for Daily Briefing, set for 1 hour but will hold to 30 minutes.

Big news City of Austin will go to shelter in place announcement will be made today.

What sheltering in place will mean in Dallas County

  • Anyone residing in Dallas County must stay in their home, apartment or hotel or motel room.

  • They may leave if they work at an essential job or need to run an essential errand, such as going to the grocery store or doctor’s office.

  • All gatherings — public or private — outside a household are banned regardless of size.

  • Outside exercise is permitted. So is walking pets. But you must walk, run or bike 6 feet away from other people.

  • What is an essential job? Broadly, health care work is considered essential, as are government jobs that provide for the health, safety and welfare of the public, such as first responders. People who work in construction, public transportation, utilities (water, sewer, gas, electric, sanitation, internet, telecommunications, etc.) are also considered essential, as well as food service providers, such as grocery stores and restaurants that prepare food only for delivery or carry-out.

  • Residents are prohibited from attending religious services. They may be broadcast, but only 10 staff members are allowed on-site during the taping.

  • Weddings are prohibited. Funerals are allowed, but social distancing of 6 feet is required.

  • All elective surgeries, dental work and doctor visits are prohibited. These could include chiropractors and some physical therapy. People should consult with their health care providers.

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

-One report 33k, John Hopkins reports41K, know that data will vary depending on timing and other factors. The trend is important, cases increase by 18K since Friday. Over 400 deaths, which means it doubled over the weekend.

-Up to 8 deaths in TX as of yesterday this number may have increased in last 24 hours

-352 confirmed cases in TX but could be different depending on source

-Community Spread is a fact

-46 counties reporting confirmed cases increase of 12 since Friday

-1175 by TX public health labs 8480 from TX commercial labs

-Please continue using prevention measures

-Gov. Abbott is allowing temp permits to advanced nursing student, and easing other requirements to build nursing capacity at this time, retired nurses and physicians are being asked to reactivate their licenses

-Bed capacity is becoming very limited; beds are being prioritized for only life-threatening situations

- Allowing Pharmacists to conduct consultations via telephone

- Employers who remain open must ensure employees use strict infection prevention measures or work from home. Basic hygiene and social distancing are most important

Our collective actions are needed

Mitigation

- Trying to flatten the curve trying by doing things in our communities that will prevent spread.

- Big issues are huge demand for ventilators and dwindling supply with so many people needing ventilators at the same time, also if too many healthcare workers get sick that would overwhelm our healthcare system. So much effort to keep our healthcare workers safe. Interventions may have to be maintained for several months. Need all of us to understand rationale of the strategies and use them. Social distancing, health screenings (temp or symptoms before allowed to enter work, limit all travel), stay at home as much as possible all are necessary strategies. Stay home if you are sick should avoid going out at all. If mildly ill stay at home and take care of yourself there. At home care is provided on dshs website, including when you discontinue isolation.

- Trying to increase lab capacity in TX. Currently public labs testing in Austin, Tyler, Paris, Houston, Lubbock, Harlingen, and Corpus Christi

- CDC just came out with new guidance over the weekend included on dshs website. Includes talking to children about the pandemic, how to keep them safe, therapeutic options for CV19, how to disinfect your facility, guidance for retirement communities, jail and correctional facilities coming soon.

- FDA website has good info on PPE.

- CDC COCA phone calls directed at clinicians for care of patients. Underlying med conditions and people at risk Tues 1pm central, Wed 1-2 Optimization strategies on PPE. Search CDC COCA on Google.

DSHS public media campaign #Stay home Texas, will be an attempt to keep reminding us to stay safe

2.Updates on action items:

- Herbal dispensaries are staying busy especially with orders to mail.

- Limitation on shipping such as with E-fong. Some items ordered have been received

- Make up clinic schedule, Lesley is putting schedule together focus is on students who should graduate this term or in Spring 20.. Determining how faculty to discuss their cases and to provide this effectively via Zoom

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

- Dr. Song will organize a series of panel discussions that can include other providers from PCC or UT School of Pharmacy. Will discuss how TCM has played a role in the prevention and treatment of CV19 in China and the value of integrative approaches in combating this virus. These discussions may provide some make up opportunities for our students.

- Website will be updated as soon as verbiage to use on herbal telehealth is received.

- We will keep AOMA in distance learning mode and staff working at home through Sunday April 12th as approved by President’s Cabinet yesterday. Today’s Shelter in Place directive for the City of Austin, Travis and Williamson counties may require us to extend even more.

- CCAOM townhall at 5:30 CST today.

3/25/2020

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

- 44183 confirmed in US confirmed deaths 544

- 715 cases in TX increase of over 300 cases since yesterday but represents new methodology rather than increase, now 11 deaths

- 19 counties are reporting confirmed cases

- More than 11k lab results so far

- Goal is to reduce rate of spread

- Trying to increase hospital and healthcare capacity including providing sufficient PPE

www.dshs.texas.gov/coronavirus

Hashtag #Stay at home Texas

-Same mitigation strategies are emphasized especially staying at home as much as possible

-See self- checker at dshs website

-DSHS is developing signage for clinics and printable instruction sheet for in home care for those exposed or confirmed

-Travel update Level III (widespread ongoing transmission with restrictions on entry to the US) China, Iran most European counties, United Kingdom and Ireland

Countries with widespread ongoing transmission without restrictions on entry to the US but CDC recommends that travelers avoid all nonessential travel to the following: Australia, Brazil, Canada, Chile, Ecuador, India, Indonesia, Japan, Israel, Malaysia, Pakistan, Philippines, Qatar, Romania, Saudi Arabia, Singapore, South Africa, South Korea, Thailand, Turkey.

-Opinion piece in JAMA, Fatality Rate in Italy compared to China. Fatality in Italy higher than China. Demographics in Italy differ, older population so may explain in part, how CV19 are identified in Italy and different testing may also be contributing.

- continue to try and increase lab capacity

- COCA (Clinical Outreach and Communication Activity calls are rescheduled. March 25th Optimization of PPE When: Wednesday, March 25, 2020, 2 p.m. to 3 p.m. (Eastern Time) Webinar Link: https://www.zoomgov.com/j/1605586706external icon

Dial In: US: +1 669 254 5252 or +1 646 828 7666

International numbersexternal icon

iPhone one-tap: US: +16692545252,,1605586706# or +16468287666,,1605586706#

Webinar ID: 160 558 670

March 27th targeted on clinicians and decisions they need to make underlined medical conditions When: Friday, March 27, 2020, 2 p.m. to 3 p.m. (Eastern Time)

- Lesley setting up a dropbox for important documents especially related to manual updates, she is checking with others who may need documents available but secured so the dropbox could also be used

-

- 2.Updates on action items:

- LogMeIn will soon be available as an alternative to VPN for those employees needing to work from home. Stephanee is coordinating this will be contacting folks about spyware need on home/personal computers.

- Today both herbal dispensaries will be open all day.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

- Yesterday Lesley sent communication to all students and faculty and to doctoral students We will know better by end of next week whether we will continue everything

- Store employees asking about when back to work.

3/26/2020

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

- cases continue to grow

- 54, 553 cases 737 deaths (one report this morning is stating over 1,000 cases deaths)

- TX 974 case, 12 deaths

-Over 13K tests completed to date

- Exec order from Gov. Abbott to obtain timely info on testing and hospital bed capacity daily submission to dshs, if using CV19 approve tests must report daily all negative and positive tests

- Continuing to reinforce that we all practice the mitigation strategies. These make a difference.

- US in accelerating stage cases increasing rapidly. TX is anticipated to see the same kind of increases other states are seeing soon because of known community spread. Social distancing is critical. The more people who follow the instruction the more chance of controlling the spread.

- New surveillance system being rolled out by CDC to better track CV19 specifically in US. Will be rolled out on it’s website over the next week. Will help us have better visibility of hotspots around the US.

-One new therapeutic option posted on FDA website; investigational treatment being explored with convalescent plasma taken from people who have already recovered from the disease. Will only use on specific severe cases only accepting patients with severe or life-threatening cases. Not for prevention only treatment. More info on FDA’s website for providers wanting to use on a given patient. From FDA website: A licensed physician must request the Emergency IND(emergency investigational new drug) (eIND) and obtain the COVID-19 convalescent plasma from a blood center. FDA does not provide COVID-19 convalescent plasma for eINDs.

COVID-19 convalescent plasma must only be collected from recovered individuals if they are eligible to donate blood (21 CFR 630.10, 21 CFR 630.15). Required testing must be performed (21 CFR 610.40) and the donation must be found suitable (21 CFR 630.30).

-Lab’s still increasing capacity but new equipment coming soon may allow other labs to offer the testing,

- Many health depts have question of who is responsible for enforcement of the executive or local order contact your jurisdictional authority do not call the health department

- PPE is key in keeping healthcare system going. Very concentrated effort by State officials to get needed PPE.

- With community spread we are no longer monitoring individuals traveling from other countries we aren’t doing that any more so we are asked NOT to call first responders or health agencies for monitoring lists.

- Hays county now going into Shelter place

- Shelter in place document is in our dropbox

-Letter will be provided for all staff and faculty to carry to validate that our work is within compliance as “essential” under the City’s Shelter in place order.

2.Updates on action items:

- Ralf yet again had a great innovative idea and piloted at the south herbal store yesterday. A container of disinfecting wipes is secured at the store entrance. A sign telling patient to take a wipe to clean the door handle on entry and exit. This will free our staff from having to do this between each patient. At least in south Austin disinfectant wipes are very available and Ralf has a good stock. We will take a supply to the N. Clinic.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

-Supervisor meeting yesterday, Phil shared how to use breakout rooms on Zoom. There will be opportunities for students to get make ups during break week. Four to Five Supervisors can work at the same time with breakout, potentially we could handle 50-60 students in any 4-hour shift. This will be a huge help. Announcement will go out to students tomorrow.

- Will have developed a list of needed licenses and plan will plan accordingly but Zoom has some capabilities that appear to allow us to work with our current allocation of 20 licenses.

- Clinic legal forms for supervisors will be distributed by Lesley

- Tally sheets are cumulative so no need to send in after each class. Each page is unique for a student, normally students complete, and supervisors sign off. Supervisors will have to put in all information during this time of distance learning. Lesley suggests that students all keep their video on as proof they are always in the room. Phil is doing random checks during the class to validate attendance. Both good methods!

3/27/2020

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

From CDC:


-Texas 1,396 cases reported 18 deaths, 119 reported cases in Travis county, continuing to increase

-21,424 total tests, 2,680 Public labs, 18,744 private labs

- CDC has PPE calculator which can help us plan and optimize PPE, look under PPE Burn rate in CCD website

-FDA working to determine how anesthesia machines can be used as ventilators as shortages of ventilators increase

-CDC and local health agencies also looking for alternatives for caring for victims of the virus as hospital capacity continues to dwindle

-We can ease the healthcare system but will take all of us reducing contact with others by 90%

-Virtual mask making service, we may be able to create zoom parties to support this important effort and homemade masks are being encouraged as a last resort option.

2.Updates on action items:

-Wipes are available for the N. Clinic. We will get these over by next week.

- US mail is still being delivered, we are reviewing and distributing or contacting others to get approval to open something that looks important and time sensitive.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

-Still awaiting word on our involvement with the emergency response from Rachel Lambert, but should hear something next week

-Students and make up clinics: ACAOM announced some tight restrictions with virtual hours with a 10% rule. For observation hours of 150 only 15 hours (10%) allowed. Of 700 hours of internship only 70 allowed. Break week clinics with multiple supervisors to accommodate a fairly high volume by end of next week, students can earn up to 40 hours when moving into the Spring. If we must do virtual clinics, considering all factors, we could come to a halt on students’ ability to get hours. There is a movement to create a collaboration approach where all schools would pool our waiver forms and approach ACAOM collectively, to help with this issue. Much strong criticism of ACAOM’s decision. ACAOM is not showing the flexibility that is needed for students to progress at this difficult time. We do understand the need for the hands-on portion of the education, so this is a difficult balancing act. Moving toward a more collaborative approach rather than a competitive one among TCM schools will be healthy for the profession overall.

- Moved forward to acquire more Zoom licenses that will be needed to accommodate all faculty into the next couple of terms. We need to prioritize classroom faculty with the Zoom licenses. Zoom is graciously going to issue 5 more free basic licenses for a limited time. We must also relook at who really needs a license, as one user can manage another but causes limitation for the individual that lends their Zoom access.

-Will need to coordinate for the doctoral students, students do better with weekly or bi-weekly check ins with faculty

-Must start our self-study. Our collective experiences through our COVID 19 response will be important to capture as we have done a tremendous amount of institutional effectiveness planning during this time, including a distance learning platform and work from home through Zoom. Any work we have been doing that is allowing us to continue to provide learning or to continue operating as a business that has and will come up should be documented for IEP purposes. Diane and Phil will work on a template for all of us to use, so we are consistent in how we capture this information for the self-study.

- We decided yesterday to cancel the 2020 SW Symposium. Brian is posting this in all the appropriate places and work is being done to contact all speakers and to refund those who either paid for attendance or sponsorship.

- Graduation plans continue but we are developing contingency plans until we know what we must do considering the COVID 19 crisis.

3/30/2020

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

2,552 cases reported and 34 deaths

Greater than 25K tests

- Trying to prevent deaths and a surge in cases that could overwhelm our healthcare system.

- Spread is accelerating so must not let up on our preventive measures

- 59 countries having a level III travel warning

- Since no vaccines or medicines available we are relying on our mitigation strategies

-Shared case of nursing home that had a very rapid spread despite preventive measures in place so may have been a resident who was a symptomatic

-Not enough evidence to tell people not to take NSAIDS if concerned take Tylenol If you are taking at your doctors’ direction don’t stop until speaking to your doctor. There is no clear answer from experts. Some experts say the NASAIDS may make you more infectable but no clear evidence yet.

- It was announced that Sheltering in place is extended to April 30th across the nation. Lesley will send information out regarding how this will impact

2.Updates on action items:

-Containers for Wipes left at S. Store for N. Store/Clinic. Stephanee picked those up.

- At this time no set hours at each of the store, S is working approximately 1-6 M-F , 10-1 on Sat

N Store is dependent on staffing and the availability of Dr. Song or Stephanee.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

- For employees please see notice on Families First Coronavirus Response Act sent on Friday also posted. Lots of questions and not clear answers regarding the Act. One question is regarding school closures related to COVID 19. Many legal experts are providing guidance to employers on how to interpret the act. As we know more, we will share. All employers though are required to communicate the existence of the Act to all employees before April 1 when the Act goes into effect.

- On student website there’s a new bar that students can go to learn about everyday offerings at lunch. Some great ways to stay connected.

- Question regarding Student clinics. There can be no real patients at this time because of Shelter in Place so faculty will pull from clinical files. Will be more case review.

- Question regarding employees who may be asking about returning to work. Alisha, Stephanee and Mary to meet to discuss Clinic staff, but is also an organizational wide issue. Linda and Mary will be meeting to discuss how we can manage work organizationally moving forward.

-Relaxing of EPA standards at this time, may be industrial

3/31/20

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

-US now has over 140,000 Increase of over 55,000 cases over the weekend We are in acceleration phase

-TX 2877 confirmed 1146 increase over the weekend 38 increase of 15 since Friday

-Working to expand IP hospital capacity and alternative places

- Texas Goals.

Expand hospital bed capacity

Develop alternative treatment/care sites

Acquire needed supplies and equipment to support healthcare and testing

Protect the most vulnerable

Prevent spread

Ensure visibility of data related to the spread of the virus

Support local government

-CDC did recommend limited domestic travel

-Since no approved vaccines or treatments must rely on mitigation strategies

-FDA issued EUA many ways for decontamination of masks that will allow use up to 20 times. Also more flexibility to sell packaged foods

2.Updates on action items:

- 5 licenses were granted to us by Zoom at no additional cost. Lesley is feeling that faculty will most likely need to have licenses go through at least until the end of May

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

- There were social media posts related to Herbal medicine use specifically for coronavirus treatment. The implication of these claims for AOMA was not understood. This has been removed from AOMA social media sites. It is important we remember that in US remedies/treatments must be vetted by the FDA regardless of use elsewhere in the world.

- Need to update on closure dates when those decisions are made. AOMA has not decided to continue closures through end of April but most likely will. We align our decisions with those of our local government. Since the Federal government has extended social distancing guidelines through April 30th, Academics is using that timeline as a guide. The Spring term will remain on-line.

- Dr Song is developing an interprofessional panel discussion to discuss integrative approaches to patient care including COVID 19. She is starting with a few pilots with small groups before opening these up to larger more public groups. The goal is to eventually offer these to the community at large.

- N and S clinics are still operating for herbal consults. Patients can call and let us know they are interested in herbal consultation and they will be scheduled.

- Although homemade masks are not considered by CDC to be official PPE the CDC does advise if there are no other options there is no harm is using them. As Dr. Phil expressed there is no evidence that they are effective but also no evidence that they are not. It was shared that many of the homemade masks are including an additional layer of filtering protection that is ironed into the cloth mask. So, the homemade masks are creatively being made to add more protection.

4/1/20

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

- Texas Executive Orders & Public Health Disaster Declaration

On March 31, 2020, Gov. Abbott issued an Executive Order implementing Essential Services and Activities Protocols. The protocols renew the Governor's directive to avoid eating or drinking inside at bars, restaurants, and food courts, although use of drive-thru, pickup, and delivery for food is highly encouraged. The order prohibits visiting gyms or massage establishments, and expands to include tattoo studios, piercing studios, and cosmetology salons. It also extends social distancing measures to April 30, 2020, and schools will remain closed to in-person classroom attendance through May 4, 2020.

On March 30 and March 26, Gov. Abbott issued several self-quarantine edicts for travelers returning from certain locations within the United States. For complete details on which returning travelers are subject to these self-quarantine orders, see our Information for Travelers page. Instructions for self-quarantined travelers can be found on the CDC COVID‑19 Traveler Information Card.

-WHO reports Worldwide 783,360 confirmed cases, 37,203 confirmed deaths

-CDC reports US greater than 163,000 cases reported, more than 1700 deaths

-DSHS reports TX 3,266 cases reported 41 deaths, 206 cases in Travis county, 122 of 254 Texas counties reporting cases

-

-

2.Updates on action items:

-US mail is still being delivered and one of us will be checking and distributing. We will contact those that need to know about a given piece of mail as needed.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

- Looking at probably through end of April for continuation of classes on-line, may need to extend at least through May 1st because school district will be closed through May 4.

- Will determine who needs Zoom licenses, some non-faculty licenses will have to be given up to accommodate faculty needs.

- We need to update our signature lines about being closed through 30th of March. Best to have a generic statement with no date. Example: AOMA is complying with state and local authorities regarding COVID 19 response. Our campus, clinic and store closures will remain in effect accordingly. We will provide notice when operations are back to normal schedules. Herbal Dispensary and Virtual Herbal Consults are available which can be scheduled through the traditional patient scheduling process for consults or by calling our Herbal dispensaries North and South for herbal prescriptions.

4/2/20

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

- US 186,101 cases reported, 3,603 deaths

- TX 3997 cases reported 58 deaths, Travis county 244 cases 3 deaths

- No new information just strong emphasis on continuing to do all the recommended mitigation strategies most importantly the physical distancing

- Head line in newspaper states, if you have symptoms “assume you are infected” because testing can take up to two weeks.

- Problems with phone lines. The outgoing message was changed and apparently routed all calls routed to North Clinic. Stephanee is working with Reliant to get all corrected.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

-We may still need additional Zoom licenses for faculty but will continue to determine how we might reassign existing licenses.

- Lesley will send email to faculty and others about the updated message to public regarding closure dates for AOMA.

- Question regarding class for Herbal dispensary; will those have to be made up specifically? Answer is yes, will have to be made up but time for making up these types of classes will be extended. The pedagogy of Herbal Dispensary is not suited to the virtual platform.

- ASA will have a meeting today to catch up and to get any student concerns addressed. Meeting at 12:45 today. Dr. Hamilton and Dr. Garrison are happy to attend if needed.

4/3/20

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

-US 213,144 cases, 4,512 deaths, almost a fourth of the deaths in NY

TX 4,669 cases reported 70 deaths almost 51,000 total tests, 305 cases in Travis county , 3 deaths

-As of yesterday, 44 UT students tested positive who took a Spring break trip to Mexico. We are urged to adhere to advise of authorities regarding travel and physical separation, etc. especially as it is clear you can be non-symptomatic and spread the virus.

- It is definitely aerosolized everyone being advised to mask if going out at all

- YMCA Townlake has confirmed an employee has tested positive, members will be notified

2.Updates on action items:

- Staff is burning Sage in the store before starting the day, Sage can clear the air, helpful with molds and viruses

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

- Consider Posting our OTC herb sheet on the website. Ashley can add some buttons to the store page if we want to sell more things on MIVA. Great idea but to make sure we don’t forget something important before we implement, Alishia will quickly bring together and lead a small team to include Finance.

4. Good news or positive experience in past 24 hours -

-AOMA’s request for waiver was approved by ACAOM and ACAOM increased approved observation hours from 15 to 50, internship hours remain at 70 but this means students can get a many as 120 hours. Great news for those who are up for graduation soon.

4/6/20

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

-US Total cases: 304,826 Total deaths: 7,616

-TX 91 6,812 plus cases upward trend 127 deaths

- Locally, cases are rising in Austin, with hot spot in West University area most attributed to the Spring Break trip to Mexico by several students

-Several HEB employees have tested positive, I image employees of other grocers will also come up positive

-Mayor Adler recommending all of mask or use some type of covering for face when out in public because of clear evidence that there are so many asymptomatic carriers

-DSHS Goals remain as stated before. Save lives, reduce spread, protect our vulnerable populations

- Real focus on increasing hospital capacity private and public sectors are working together to increase bed capacity. Press conference held today

- We only have non pharmaceutical interventions, so we must focus on mitigation strategies

-Washington state study March 5-9 supports how effective physical distancing is in the prevention of the virus.

-Fit testing for N-95 respirator filters out at least 95% of airborne particles but must be well fitting to your face OSHA requires an initial and annual fit testing. Meant to ensure healthcare workers have protection, OSHA has released requirement of annual fit testing but does require the initial. CDC blog has information, the blog is linked onto the DSHS website under PPE. If you need N95 level of protection you need to choose the respirator that fits you best. Look at training videos, should fit over nose and chin and snug all around your face you don’t want any gaps. Conduct a user field check each time the mask is worn. Test on inhale and exhale to demonstrate good seal.

- There is a State Team appointed by the Governor dedicated to getting more PPE for Texas

- One news reports stated there will be up to 20K beds that can be devoted to Texas

-US attorney general says this will be the highest peak week of the virus in US

-UK has surpassed Italy with number of cases

- It was reported that news media stated Medical Personnel /doctors have been approved to give to patients hydroxychloroquine. The following is from the FDA as this is what is called an EUA or Emergency use authorization and is being used for only certain COVID19 patients and those patients must be given fact sheets that include known risks.

The U.S. Food and Drug Administration today announced the following actions taken in its ongoing response effort to the COVID-19 pandemic:

  • On March 28, 2020, the FDA issued an Emergency Use Authorization (EUA) to allow hydroxychloroquine sulfate and chloroquine phosphate products donated to the Strategic National Stockpile(SNS) to be distributed and used for certain hospitalized patients with COVID-19. These drugs will be distributed from the SNS to states for doctors to prescribe to adolescent and adult patients hospitalized with COVID-19, as appropriate, when a clinical trial is not available or feasible. The EUA requires that fact sheets that provide important information about using chloroquine phosphate and hydroxychloroquine sulfate in treating COVID-19 be made available to health care providers and patients, including the known risks and drug interactions. The SNS, managed by ASPR, will work with the Federal Emergency Management Agency (FEMA) to ship donated doses to states.

- DSHS officials state that hydroxychloroquine is not recommended by FDA to be used prophylactically.

2.Updates on action items:

- No updates today

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

-Natalie now has access to take any kind of payment remotely

- Getting OTC herbs on website, meeting being planned, and finance will be included

Alisha organizing the meeting

4. Good news or positive experience in past 24 hours -

- Michael shared that when biking it is great to see neighbors he never sees walking and although physically distancing they are happily staying social, friendly and safely making the best of the situation.

4/7/20

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

-DSHS/APD Meeting shifting to MWF

-US Total cases: 330,891 Total deaths: 8,910

-TX 7,276 cases, 140 deaths

- See FDA opinion on use of hydroxchloroqine in minutes for 4/6/20.

-CV19 in animals, confirmed case in a tiger here in US, the tiger was ill, now other tigers in same zoo are ill. Animals apparently contracted COVID 19 from a caretaker. It is advised that pets should not stay with sick humans.

-CDC is advising that maintaining 6-feet social distancing remains important to slowing the spread of the virus.  CDC is additionally advising the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.  Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure. Kids under the age of 2, those with difficulty breathing, people who cannot manage a face covering should not wear.

-AISD is recommending that all schools get off Zoom and start using Microsoft, concern for security issues. Related to this Zoom CEO is hosting a webinar every Wed at noon to share with Zoom users info on security put in place. Lesley reminded all faculty to always password protect your courses.

-It was reported that unfortunately a large supply of PPE from the national stockpile sent to different states were old and no longer usable.

-Diane reported that Dr. Song shared information that Anti-viral tissues are a bit denser and could be used as a fairly effective face covering. Tissues may be available at local stores and are also available on-line. It was also mentioned that using a blue shop towel will also make good cloth mask.

- CCAOM is going to have a meeting tomorrow (Wednesday) about distance education for clinic and Thurs meeting about ACAOM regulations

2.Updates on action items:

None at this time

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

unavailable supplies, etc.)

-Governor has proclaimed this is national public health week. Please recognize how important these professionals are to all of us.

- Estella reported she has posted a Financial Aid link on the website regarding student loan debt relief, it is located on FA page

-Brian would like to get a message out on AOMA social medial regarding our telehealth offerings. Stephanee will draft the message to be reviewed by Mary and Lesley before distributing.

4. Good news or positive experience in past 24 hours –

- Consider placing a white ribbon on a tree in honor of our frontline health care workers caring for COVID 19 patients

- Diane is organizing a lip sink video to thank our frontline healthcare professionals, she asked for volunteers and got many! A great idea!

4/8/20

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

-US 374,329 case 12,064 deaths

-TX 8,262cases 154 deaths

-Non-essential workers should be using face covers as in essential work environments like groceries stores and continuing the other mitigation strategies

2.Updates on action items:

-Local trail and Park closures Thurs evening through Monday morning. State parks are also closing over the Easter weekend as a mitigation effort.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures,

-Food for student’s local collaborative

4. Good news or positive experience in past 24 hours –

-Blue bonnets are beautifully in bloom right now, Mary has 16 baby blue bonnets in her yard, she is mothering very carefully.

-Break week clinic attendance is very high, and these virtual offerings appear to be well appreciated!!

-First Summer 2021 application!

4/9/20

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

-US 395,011 cases, 12,754 deaths, over 100K of these cases are in NY

-TX more than 9,353 cases deaths 177 Travis county has 554 cases

-CDC now recommending a face covering for everyone in public places, will not necessarily protect but will help to prevent any spread from wearer

- DSHS shared example in Louisiana where Individual with mild symptoms who did not seek medical assistance, attended a funeral, shared a meal, hugged others, etc, resulted in 16 cases with transmission within non-household contact, 3 ended up dying. This was before social distancing was in place in this community. Social distancing now in place and it has made a difference in the community’s ability to control spread.

-KXAN provided a news piece on which neighborhoods are at greatest risk for the virus and East Austin appears to have highest risk

2.Updates on action items:

-Robert will send information on Clinic Theatre II for the past term out to students. Lesley will remind all students that all classes are on Zoom except Herbal Dispensary. Faculty to set up each course and clinic and put the meeting in hyperlinks then email students to go to the hyperlink to get into the class. One click in URL will provide the hyperlink, password is already in the URL

-Zoom meeting with Zoom CEO to was reassuring about security taken. Numerous steps have been taken to correct. Highly recommended we all use automated meeting id and use passwords. Autogenerating is much more secure than allowing individual id and passwords to be reused. Tracking is now gone for privacy purposes; some features will come and go to make them more secure. No new features will be added for at least 3 months because focus is security.

-CCAOM meeting very collaborative very collegial the angst against ACAOM is much softened because there is now a greater understanding of the restrictions ACAOM has with their own accreditors.

- Lesley will poll each supervisor regarding how virtual clinics are going but anecdotally all seems to be going well. Dr. Wu has over 250 cases that can be used.

- Letter from SACSCOC provided update on Temporary Emergency Relocation of Instruction (on-line teaching). “Because of the coronavirus outbreak presents an unusual challenge to estimating the date instruction will resume at the original location, notification are by default accepted for 120 day maximum”. The original waiver was 90 days. Should there be a need to extend beyond 120 days AOMA will need to submit a request for approval for temporary emergency relocation.

- A Food Support plan was developed to assist students, staff and faculty who may find themselves needing food assistance. ASA has agreed to manage this effort, but we are all pleased to be able to provide this type of support in a safe manner.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

Nothing additional to those items mentioned above in #2.

4. Good news or positive experience in past 24 hours

Lesley’s Gardening processing kitchen almost ready!

4/10/20

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

-US 492,416 cases 18,559 deaths

-TX 12,561 cases, 254 deaths, Travis County 690 cases

- We are encouraged to wear facial covering when in public as a means of controlling virus spread

- Link to Japanese study on value of masking due to micro droplets staying in air for long periods of time in unventilated rooms https://vimeo.com/402577241?ref=em-share

2.Updates on action items:

- Food support program has begun with food bags distributed at our south herbal dispensary and north clinic. ASA will be sending out details on how to obtain a bag for anyone in need.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

- Supervisor meeting this weekend

4. Good news or positive experience in past 24 hours

- Happy wishes to everyone for the Easter weekend!

4/13/20

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

-US 525,704 cases, deaths 20,486

-TX 13, 484 cases, 271 deaths, 744 cases in Travis County

2.Updates on action items:

- We have 5-6 bags of groceries that have been donated as part of student and staff support during this time. ASA will provide information on the process for delivery and pick up of the bags.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

-Diane posts the Daily Briefing minutes in the student website at aomastudents.com

-Brian is suggesting planning for Summer orientation on-line. He and Diane will meet to develop a plan in the event we must continue virtual work through the Summer.

- Don’t forget Daily Briefing will now be held M, W and F starting this week

4. Good news or positive experience in past 24 hours

-Dr. Jing hosted a wonderful supervisor meeting yesterday. Faculty shared best practices. It was a very engaging and interactive session and spoke volumes about how outstanding our Faculty are at AOMA. They have done an amazing job ensuring students continue their education but also

supporting this significant shift in learning (and teaching) and considering the emotional support needed at this time.

4/15/20

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

-US 576,005 confirmed cases, 22,252 deaths

-TX 14,624 cases 318 deaths 2,580 recovered cases

-Austin 900 cases 14 deaths

-Austin everyone is to mask when in any public places

People should be prepared for coronavirus face-covering mandates issued Monday to last well beyond their current May 8 expiration date, said Dr. Mark Escott, interim health authority for Austin and Travis County.

The penalty for not wearing a facial mask in public is a $1,000 fine and up to 180 days in jail. Children 10 or younger are not required to wear face mask, but that is largely a component of statutes for prosecuting minors and not an encouragement.

Adler and Eckhardt said they both hope the community widely embraces face masks. Neither have plans to send law enforcement out to start ticketing people for not wearing masks.

Everyone over the age of ten must wear a face covering over their nose and mouth when in a public building, using public transportation or ride shares, pumping gas and while outside when six feet of physical distancing cannot be consistently maintained. A face covering is not required when eating, riding in a personal vehicle, alone in a separate single space, or in the presence of other members of your residence. Additionally, a face covering is not required when wearing one poses a greater mental or physical health, safety or security risk such as anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the cover without assistance.  

- Buda had first loss

2.Updates on action items:

- We had our first student who was able to take advantage of our food support! We thank Michael for helping facilitate that!

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

-Questions from student body: Will there be a China Trip in 2021? It is impossible at this time to answer. There are still too many unknown/uncertainty with the Coronavirus (timing for a vaccine, will there be a resurgence of the virus, etc.) Things for prepping aren’t even available at this time. We have to ensure safety before a decision can be made.

- To keep spirits up ASA will host a drinks and pajama social for students, Friday April 24, 7pm BEST PJs contest included

4. Good news or positive experience in past 24 hours

Please take time to congratulate Dr. Luo who has completed his Masters in Public Health from John Hopkins. He is just pending delivering his Capstone project results. We are all very proud of him and this wonderful accomplishment!

4/17/20

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

-US 632,548 cases 31,071 deaths

-TX 16,455cases 393 deaths, 977 cases in Travis county

-Under guidance issued by the local health authority today, March 20, everyone is asked to monitor their health frequently and anyone feeling any symptoms – however mild – is asked to check their temperature twice daily.

If an individual finds their temperature is 99.6 F or higher they should self-quarantine, by staying home and avoiding close physical contact with family members and roommates. Individuals who test positive for COVID-19 also need to self-quarantine until they are well to reduce the risk of community spread. 

- Governor Abbot is to announce today a staged plan to get Texas back to some level of normalcy that will allow many to get back to work

2.Updates on action items:

-Please be sure and only put non-perishable items in the donation food bags. Some perishable items like bread were noted in one bag

-Our donation of personal protection masks arranged by Dr. Jing with the Austin Asian Association arrived. As agreed AOMA is keeping the surgical masks and a donation of the N95 masks will be made to the husband of student Robin Banyasz. Her husband is an Emergency Physician leading the COVID19 response for Baylor Scott and White hospitals. Robin was very touched by this kindness and arrangements are being made for pick up today.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

- None currently

4. Good news or positive experience in past 24 hours

- Diane was able to assemble a new swing set for her son Logan, despite some challenging tools

provided with the set 😊 Logan is happily enjoying his swing

-Brian is happy that driving lessons for his daughter have been accident free so far 😊 With quieter roads right now it is a good time to learn to drive in Austin

4/20/20

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

US 720,630 confirmed cases, almost a 59K increase since Friday, 37,202 deaths

TX 18,923 cases, 477 deaths, 1,092 cases in Travis county, Harris county (Houston area) has largest number of cases in Texas greater than 4600

-Modeling is being used to determine whether we have experienced our peak with the virus.

-We have better data now to help us assess how effective social distancing

-We are still getting new cases but appears to be stabilizing but need more days before taking specific action. Like a hurricane that we know is going to hit but don’t know how hard it will hit and the damage that will occur

-HHSC has great guidance on long term and assisted living facilities on their website

-SPICE Response, surveillance(testing), protection(PPE), isolation(quarantine), communication, evaluation of plans and policies

- Friday, Governor Abbott did release a plan to re-open the state, in phases. Starting this week, restrictions on surgeries, state parks, and retail will be loosened. Abbott says the plan will be guided by data and medical professionals. Parks are reopening today; masks must be worn and physical distancing is still required. Retail establishments will open (conditionally) on Friday.

DSHS guidance on how to re-open safely for both employees and customers

COVID-19: Guidance for Employers, Employees, and Customers of Reopened Retail Services

This guidance is based on the best information currently available and will be updated when appropriate. Please visit dshs.texas.gov/coronavirus and cdc.gov/coronavirus for updates. This guidance is intended for employers, employees, and customers of retail businesses reopening under the Governor’s Executive Order issued on April 17, 2020. This guidance does not apply to businesses considered essential. This guidance is based on recommendations from the Centers for Disease Control and Prevention (CDC).

I am an Employee of a retail business re-opening. What should I do to keep myself and our customers safe?

• All employees must be trained on environmental cleaning and disinfection, hand hygiene, and respiratory etiquette.

• All employees must be screened before coming into the business for new or worsening cough; shortness of breath; sore throat; loss of taste or smell; feeling feverish or a measured temperature greater than or equal to 100.0 degrees Fahrenheit; or known close contact with a person who is lab-confirmed to have COVID-19. Any employee who meets any of these criteria should be sent home.

• Upon entering the business, employees must wash or sanitize hands.

• All employees must wear face coverings.

• Employees must maintain at least 6 feet separation from one another.

I am a Customer. How do I purchase and obtain goods from a retail store that has just re-opened?

• Customers may purchase items from a retail location for pickup, delivery by mail, or delivery to the customer’s doorstep, but may not enter the premises.

• Retail to-go: o All payments should be done over the phone or internet if possible, and contact should be minimized if remote payment is not available.

o Purchased items should be delivered by the employee to the backseat or trunk of the customer’s vehicle whenever possible to minimize physical contact with the customer.

o Employees must wash or sanitize their hands after each interaction with a customer, and whenever possible, must disinfect any item that came into contact with the customer.

• Retail delivery to customer’s doorstep: o All payments should be done over the phone or internet if possible, and contact should be minimized if remote payment is not available.

o Purchased items should be delivered by an employee or third-party carrier and delivered to the customer’s doorstep. The employee or third-party carrier may not enter the customer’s house or business.

• Retail delivery by mail: o All payments must be done over the phone or internet.

o Purchased items should be delivered by mail without customer contact.

• The customer should wash or sanitize their hands after the transaction.

2.Updates on action items:

None currently.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

Lesley reminded us that Gov. Abbott also stated that schools will remain closed through the end of the school year which is normally around Memorial Day. AOMA’s schedule is different and we need to be mindful of that and the implications. Also, we need to follow up with ACAOM.

4. Good news or positive experience in past 24 hours

- Kudos to Ralf and Michael who are doing some wonderful work that is not easy to do when people are on campus. Thank you Ralf and Michael!!!

4/22/20

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

-US 776,093 confirmed cases, 41,758 deaths

-Texas 20,196 confirmed cases, 517 deaths, in Travis County 1,233 confirmed cases 17deaths

- First at-home COVID19 testing kit is authorized by the FDA. The commercial lab LabCorp makes

the test kit and they are prioritizing healthcare workers and first responders at this time. With this test, people who are eligible can swab their nose to collect a fluid sample, but they will still need to send it to a lab for testing. Self-sampling sidesteps the need for a clinician to perform the test, reducing their exposure to symptomatic patients. It also frees up more personal protective equipment, which is in short supply. The test costs $119.

-One hospital department (Maternity) did a mini study and started testing all patients coming into their unit. They found 80% of their healthy pregnant patients were asymptomatic carriers of the COVID19 virus.

2.Updates on action items:

-No internet at AOMA this morning from 8 until approximately 9am. HCTG our IT contractor is upgrading our system’s firewall.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

- None at this time

4. Good news or positive experience in past 24 hours

- Good faculty meeting yesterday, well attended, discussed future of on-line education at AOMA and compared vendors to make best decision for a Learning Management System (LMS)for AOMA.

-All materials for ACAOM self- study have been sent out to the team leads to launch this week! If you are invited to be on a team please make yourself available. We have a short 6 week period to get this completed.

4/24/20

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

-US 828,441 confirmed cases 46,379 deaths

-TX 21,944 confirmed cases 561 deaths, Travis county 1,263 confirmed cases

- Stores like Walmart will update their response in beginning of May, by having one-way isles to encourage physical distancing

2.Updates on action items:

- 22 students have already applied for student relief grants

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

-Students still concerned they are running out of clinical hours. They should continue to attend on-line clinics and they should talk to their advisors. Advisors will look at individual records to see what can be applied. Students need to consistently check with Advisors: Lesley, Reagan, Robert and Phil are the Advisors. Please note: Ashely is not an advisor!

-Store leaders also getting questions from students on herbal dispensary. Students must wait until we open campus, experience in herbal dispensaries must be hands on, can’t be done on-line.

-Phil had great faculty meeting to review acupuncture curriculum and how to improve student success

-AOMA food back only has only 1 bag, please donate if you can

4. Good news or positive experience in past 24 hours

-Austin hotels have had special lighting to show support to the ATX community, hearts and words like hope are displayed.

-Today is National Arbor day, pigs in a blanket day, silence day, forgetful mommy day, world meningitis day, and Armenian genocide day

-Wildflower Center is extending membership because of the time closed, also State Park passes have been extended. State Park opens for day passes but no camping and you must go online and reserve

4/27/20

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

-US This morning it was announced that we now have over 1million confirmed cases in the US, more than 52,000 deaths

-TX 24,631 confirmed cases, 648 deaths Travis county has 1.396 confirmed cases

- Although our cases are still low in Texas compared to other states like NY, we know our testing has been limited so as we open things back up we must still be very careful.

-FDA warning on hydroxychloroquine outside the hospital setting, serious heart rhythm problems. increase use of prescriptions of these drugs so remind physicians to be cautious with this. Still in clinical trials. Abnormal heart rhythms, Pulmonary Embolism, clotting issues and other risks increase when hydroxychloroquine is taken with some other meds. Anyone with cardiac and kidney problems are also at risk. Not intended for outpatient environment at this time only in hospitals.

DSHS has added new information on its , website including:

-Consideration for Pharmacies during a pandemic

-Coronavirus and traveling in US

-Living in close quarters and caring for a COVID patient

- Article about Putting Genie back in the Bottle

-CDC video about properly putting on and taking off PPE

2.Updates on action items:

- Students asking about reopening of Clinics. We are following the guidance of national, state and local authorities. Gov. Abbott will give a statement today so that may provide more information. Students also asking if campus will be closed the entire academic year. The answer is we don’t believe so and the plan is to reopen clinics in the Summer but again all is dependent on decisions that are outside of the schools control. We will keep everyone notified as things change and we have a better idea of when we will be able to reopen. We appreciate everyone’s patience.

- Thanks to everyone for bringing in more food bags, there is clearly a strong need so all donations are very much appreciated.

-Students also asking about whether testing for COVID will be available to them when school reopens. This will depend on what is available in the community. Testing continues to be prioritized for those providing direct care to COVID patients and first responders. The home testing may be available more readily soon but again at this time is prioritized for those healthcare workers directly treating COVID patients and first responders.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

-Webinar from AOBTA today at 1:30 CST. Robert to send link to everyone who is able to attend.

4. Good news or positive experience in past 24 hours

- Lesley’s garden seeing few bugs so far this year!

- Mary’s friend who is in her 40’s is steadily recovering from a very serious stroke, she has been hospitalized since early March. She was very ill before the stroke and apparently there have been many COVID patients who have stroked in this age group, so there is now the thinking that COVID may have caused this stroke as there has been no other known reason for the stroke.

4/29/20

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

US 981,246 confirmed cases 55,258 deaths, it had been reported Monday that US had crossed the million mark with cases and although close CDC numbers don’t indicated we are there yet

TX 26,171 confirmed cases 690 deaths

-Gov. Abbott held a press conference yesterday to announce an executive order to begin re-opening businesses in Texas the staged plan loosens some of the restrictions related to COVID19. Stage I includes:

“Reopened services” shall consist of the following to the extent they are not already “essential services:”

  1. Retail services that may be provided through pickup, delivery by mail, or delivery to the customer’s doorstep. 

  2. Starting at 12:01 a.m. on Friday, May 1, 2020:

  3. In-store retail services, for retail establishments that operate at up to 25 percent of the total listed occupancy of the retail establishment.

  4. Dine-in restaurant services, for restaurants that operate at up to 25 percent of the total listed occupancy of the restaurant; provided, however, that (a) this applies only to restaurants that have less than 51 percent of their gross receipts from the sale of alcoholic beverages and are therefore not required to post the 51 percent sign required by Texas law as determined by the Texas Alcoholic Beverage Commission, and (b) valet services are prohibited except for vehicles with placards or plates for disabled parking.

  5. Movie theaters that operate at up to 25 percent of the total listed occupancy of any individual theater for any screening.

  6. Shopping malls that operate at up to 25 percent of the total listed occupancy of the shopping mall; provided, however, that within shopping malls, the food-court dining areas, play areas, and interactive displays and settings must remain closed.

  7. Museums and libraries that operate at up to 25 percent of the total listed occupancy; provided, however, that (a) local public museums and local public libraries may so operate only if permitted by the local government, and (b) any components of museums or libraries that have interactive functions or exhibits, including child play areas, must remain closed.

  8. For Texas counties that have filed with DSHS, and are in compliance with, the requisite attestation form promulgated by DSHS regarding five or fewer cases of COVID-19, those in-store retail services, dine-in restaurant services, movie theaters, shopping malls, and museums and libraries, as otherwise defined and limited above, may operate at up to 50 percent (as opposed to 25 percent) of the total listed occupancy.

  9. Services provided by an individual working alone in an office.

  10. Golf course operations.

  11. Local government operations, including county and municipal governmental operations relating to permitting, recordation, and document-filing services, as determined by the local government.

  12. Such additional services as may be enumerated by future executive orders or proclamations by the governor.

Higher Ed to continue teaching remotely but teachers can come to campus to hold remote class, if needed.

The conditions and limitations set forth above for reopened services shall not apply to essential services.  Notwithstanding anything herein to the contrary, the governor may by proclamation identify any county or counties in which reopened services are thereafter prohibited, in the governor’s sole discretion, based on the governor’s determination in consultation with medical professionals that only essential services should be permitted in the county, including based on factors such as an increase in the transmission of COVID-19 or in the amount of COVID-19-related hospitalizations or fatalities.

-Not yet verified but the order may also allow all licensed healthcare professionals can continue work.

- From CDC: People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness.

Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms or combinations of symptoms may have COVID-19:

· Cough

· Shortness of breath or difficulty breathing, breathing pain

Or at least two of these symptoms:

· Fever

· Chills

· Repeated shaking with chills

· Muscle pain

· Headache

· Sore throat

· New loss of taste or smell

· Or heightened sense of taste or smell

· New onset of confusion

· Bluish lips or face

- Lots of news coverage regarding COVID19 and Stroke risk for individuals in their 30’s and 40”s

- CDC trouble breathing pain in chest new confusion bluish lips or face

- Other MDs reporting very unusual patient experiences or clinical observations related to

COVID 19

2.Updates on action items:

- We are overflowing with food bags currently, thanks for all donations

- Netflix show about COVID19 for those interested

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

- AOMA experienced a campus break-in on Monday night. This appeared to be more vandalism as nothing of value was taken but three doors were damaged including Library entry off the courtyard, the door between the library and faculty lounge and B1. APD came and did finger printing. It is thought this is may have been retaliatory related to a homeless individual who was asked to leave our campus during the day on Monday who was angry when confronted by AOMA facility team. Also, it was discovered Monday that over the weekend the “black” box at building C was broken into. Incident reports have been completed for both incidents.

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

None today

4. Good news, positive experiences in last 24 hours

-Still no bugs in the garden Lesley please let us know how you are keeping the bugs out of your garden

-Violet’s panel discussion slated for May 7 (Integrative approach to a public health crisis like a pandemic) now has 41 registered to attend. Brian will get it on AOMA calendar and other locations to ensure AOMA community has information on the session.

- Tomorrow (April 30) there will be a faculty development opportunity, 6-8pm. Topic is how to write good quality multichoice questions that are in compliance with NCAAOM.

Today is national guide dog day, dance day, zipper day and world wish and stop food waste day!

5/1/20

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

-US 1,031,659 confirmed cases 60,057 deaths

-TX 28,087 confirmed cases 782 deaths Travis County 1,591 confirmed cases

-Texas.gov, Texans helping Texans shares key information like testing isolation of infected people, quarantining all exposed for 14 days, Texas can go on www.texas.gov to find out dshs health trace application can be used. It is imperative we all stay safe as things reopen. Goal is to keep Texans safe as we reopen. We must keep up the mitigation efforts and social distancing is key! Prevention measures must be re-emphasized, personal hygiene, using face coverings, stay home if sick and not go out at all if you are feeling sick. Those at risk should limit contact with others. We are relying on each other to do the right things to stay safe.

- Expect 6 decontamination systems in Texas including one in Austin. These units will enable decontamination of items like N95 masks. Shipping to and from the decontamination unit is being organized through local Hospital Preparedness Programs.

- New NIH study with Remdesivir an anti-viral for COVID19 Designed trial with results in 4 months and was compared to a placebo 31% faster recovery (Remdeivir is given via IV) studied in over 60 locations mortality rate also better Remdesivir, developed by Gilead Sciences Inc., is an investigational broad-spectrum antiviral treatment. It was previously tested in humans with Ebola virus disease and has shown promise in animal models for treating Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), which are caused by other coronaviruses.

- CDC reopening guidance for employers also info for employers with vulnerable employees

- Conferences, Live events, etc. don’t appear to be in Gov.’s report. Still limitation of congregation of 10 or less unless falls under 25% or less

2.Updates on action items:

- We have an overabundance of Food bags, so no donations needed at this time

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

Testing availability

-None currently

4. Good news, positive experiences in last 24 hours

-Doors that were damaged in break-in will be repaired in next 8-9 days.

-Diane and others are find favorite writing pens 😊

-Today is National chocolate parfait day, no pants day, loyalty day, mother goose day and, this has been declared National Senior month. It is also May day!

-Good conversation with a couple of other schools for possible distance learning clinical collaboration. Will Zoom into Dr. Shen’s clinic today and may pilot as early as a week from today with the Won Institute. The Maryland School is also interested.

-Consider one of the many meditation groups that are attempting to do massive virtual group mediation as a means of positively impacting the pandemic. You can find these on line.

5/4/20

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

US 1,122,486 confirmed cases 65,735 deaths

TX 31,548confirmed cases 867 deaths 1,714Travis County

On Monday, April 27, 2020, Governor Greg Abbott announced the first phase of the plan to Open Texas while minimizing the spread of COVID-19. Under Phase I, certain services and activities are allowed to open with limited occupancy, and DSHS released minimum standard health protocols for businesses and individuals.

The Governor also announced statewide testing and contact tracing initiatives to identify and test Texans who contract COVID-19 and mitigate further spread of the virus.

Additionally, the Governor announced a process for rural counties with five or fewer laboratory confirmed cases of COVID-19 to, on an individualized basis, increase occupancy limits for certain businesses if the county judge certifies and affirms to DSHS that certain requirements have been met.

The Governor's announcement is accompanied by Texans Helping Texans: The Governor's Report to Open Texas. This detailed report, available on the Governor’s Strike Force to Open Texas website, helps Texans understand Phase I by outlining the new protocols, guidance, and recommendations.

- As many organizations People’s Community Clinic will continue work via telehealth for at least another month

2.Updates on action items:

- Meeting with Dr. Shen and Dr. Jeffres, on writing good quality multiple choice questions was very well received!

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

Testing availability

4. Good news, positive experiences in last 24 hours

- Collaborative work with UT School of Pharmacy was showcased with other great work through UT’s Interprofessional collaboration group. We’ve been given permission to place the poster presentation on AOMA’s Blog and other social media.

-Lesley has beautiful cactus blossoming that she captured for her virtual background, the cactus only bloom for a day!

-All faculty timesheets are in, thanks everyone!

-More Sign ups for panel discussion on May 7 Integrative Approach to a Pandemic. Some faculty are not seeing the email. Brian will send to AOMA-all and to AOMA-faculty emails. Some may get it twice but in this way, they should receive it.

5/6/20

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

US 1,171,510 confirmed cases 68,279 deaths

TX 33,369 confirmed cases 906 deaths Travis Co. 1,816 confirmed cases 53 deaths

-In Travis county the highest number of cases are among the age groups 20-59 with highest in the 40-49, the highest number of deaths in Travis county are among the 80+ age group, second highest is with the 65-69 followed by 50-59

-There is currently no evidence that COVID-19 is being spread through the mail. Similarly, there is currently no evidence to support transmission of COVID-19 associated with imported goods and there have not been any cases of COVID-19 in the United States associated with imported goods. However, individuals should follow everyday actions to help prevent the spread of any respiratory virus, including COVID-19. After collecting mail from a post office or home mailbox, wash your hands with soap and water for at least 20 seconds or use a hand sanitizer with at least 60% alcohol.

2.Updates on action items:

-Gov. Abbott opening hair salons and barber shops, with restrictions, on Friday

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

- None currently

4. Good news, positive experiences in last 24 hours

-Over 100 signed up for tomorrow’s Panel Discussion, 5-7 topic is an Integrative approach to a pandemic like COVID19.

-Ralf and Michael continue to do some great work to keep our south Campus looking good. Ralf has done an awesome job with floors in the classrooms!! Thank you Ralf!!

-NCCAOM Townhall 7pm CST this week topic is going back to work, so timely topic for us as we plan re-openings for AOMA

-NCCAOM is allowing students to take boards prior to graduation, internal AOMA requirements are still required but can start process for boards before graduation. This is approved through Fall 2020 at this time. There will though be a Fall forum that will discuss this topic.

-Today is: National no diet day, beverage day, tourist appreciation day, no homework day, wishbone day, National Nurses Day, Great American Grump out day!

5/8/20

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

US 1,219,066 confirmed cases 73, 297deaths

TX 35,390 confirmed cases 973 deaths Travis county 1,946 confirmed cases 57 deaths

2.Updates on action items:

-Austin Public Health is now offering free COVID – 19 testing This is drive through testing. Go to -Austin Public Health website

-We are still relying on non-pharmaceutical measures to contain this virus so we must continue to be hyper vigilant with things like personal hygiene and physical distancing

-County Judge in Bastrop may have had COVID as early as February

-More cars are driving very fast out on the roads be careful out there

-It is suggested we consider taking a pulse Ox reading as well as temp for screenings as we open Clinics

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

-One of our students received the Trudy McAlister Award we will try and organize recognition at one of our Daily Briefings next week to publicly announce.

4. Good news, positive experiences in last 24 hours

-Wishing all moms a very happy mother’s day this Sunday!

-Polished floors in E building so good time for photos or videos of our campus

-Medical Legal specialist from PCC will be speaking to students Thursday 2pm People’s Zoom Clinic

-National Coconut Cream Pie, Military Spouse, Coke vs Pepsi, Provider Appreciation, Blueberry Pie Day!!!

5/11/20

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

-US 1,300,696 confirmed cases, 78,771 deaths

-TX 38,869 confirmed cases, 1,088 deaths Travis county has 2,095 confirmed cases 60 deaths

-With loosening of some of the restrictions it was evident this weekend folks are taking risks, many gathering with large numbers of people who were unmasked were observed. As our Public Health authorities are advising, with the loosened restrictions we MUST continue to be vigilant to contain the spread of the coronavirus and COVID19. Let’s all keep each other safe!

2. Updates on action items:

- We will arrange for our student who received the Trudy McAlister AOM Scholarship to join us at a Daily Briefing this week so we can formally announce and recognize this achievement publicly

-Article on inflammatory condition in children that may be COVID 19 related

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

- Jean Green leaving us to return to the Texas Workforce Commission to work full-time. She came to us after retiring from TWC having worked for them 25 years. She will continue through this week doing some project work from home. We’ll begin to transition that project work to others as appropriate. We will miss Jean’s beautiful presence but wish her well.

-Question: Will summer semester be extended? We will move three summer classes to fall to allow students to do more clinics in the summer assuming that COVID19 will resurge in late fall, Ethics & Legal, Bio treatment of disease I and Bio treatment of disease II are the classes to be moved. Summer term On-line on line registration will occur next week for didactic courses, Clinic registration will be on-line in three weeks

- We are in progress of putting together our plans for reopening of our Clinics, Herbal Pharmacies and Stores and the Campus (which includes non-clinical operations). We’ll share these as soon as they are ready. PLEASE REMERBER all plans are fluid as so much is changing at the community level that will impact any planning. We very much appreciate everyone’s patience as we continue to move through these uncertain times.

4. Good news, positive experiences in last 24 hours

-Today is Eat all you want day, Accounting Day, World Ego Awareness Day, Twilight Zone Day, Nurses Week, Hospital Week, Cerebral Palsy, Lupus and Ehlers-Danlos syndrome awareness week, Asian Pacific Heritage Month, Military Appreciation Month, and Pediatric Stroke Awareness Month.

-AOMA has entered into agreements for the following:

1. Learning Management System (LMS)– this will provide us the capability to do on-line learning into the future. Still will have to go through the accreditation process which takes about 6 months, but this is an important Strategic priority for AOMA’s growth. We selected a system called D2L/Brightspace which is offering much greater level of support and training as well as creative design that the competing LMS vendors. We think D2L will be a good long-term partner.

Much thanks to Lesley and Phil for all the work to compare the top vendors and help us make the best decision for the school.

2. Electronic Medical Record System (EMR) – we have agreed to partner with a vendor out of San Antonio called BisVine. Our connection with this vendor was through American Acupuncture Council (AAC) who is our liability insurance carrier. They have endorsed this vendor and asked AOMA and two other schools to consider a partnership to help the vendor further develop their system to be one ideal for TCM schools. After many meetings and much dialogue, we have agreed to enter into a partnership with BisVine. It will be many months before we fully implement the system we will have to do much paper chart transition, practitioner and staff training, testing of the system, etc., but we are excited about this wonderful opportunity. The EMR is another strategic imperative for AOMA’s growth.

5/13/20

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

-US 1,342,594 confirmed cases 80,820 deaths

-TX 41,048 confirmed cases 1,133 deaths Travis county 2,171 confirmed cases

- Researchers are learning more about the Novel Coronavirus associated with COVID19, like other coronavirus it attaches to human cell ACE receptors especially to nose and arteries. The attachment to arteries accounts for reports of related blood clots and strokes in younger adults.

-YouTube MedCram is reported to be a good source for accurate information about the virus.

2.Updates on action items:

None today

3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

- Billy Zachary’s Zoom Clinical on will include the attorney from People’s Community Clinic. The link to participate is Thur 1:45 Zoom Link

https://us02web.zoom.us/j/525238213?pwd=Ync1UnRPTzQ1R3lseEVsaG5mZDV6UT09

4. Good news, positive experiences in last 24 hours

- Lots of good rain yesterday, 2 inches in most places

-Thunderbird’s flight path today will include Oakhill and very close to AOMA south. 2:45-3:15 is expected flight timeframe.

5/15/20

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

-US 1,384,930 confirmed cases 83,947 deaths

-TX 43,851 confirmed cases 1,216 deaths Travis county 2, 288 confirmed cases 72 deaths

Trends of cases and Fatalities in Travis County


-Gov. Abbott renewed state-wide Covid 19 disaster declaration for all Texas counties. This provides the state a number of resources to effectively serve the State as we continue to mitigate the spread of the virus.

- Statewide 47% of deaths are nursing homes and assisted living facilities, APH is now lifting or easing non-essential travel for people not at-risk low risk individual are

2.Updates on action items:

- We are checking US mail but if you are expecting something important that needs timely action, let me know and we’ll be on the lookout for it.

- Stores waiting for envelopes, we’ll be on the lookout for them

- More bags of food needed for our food pantry

-K-95 masks not same quality as N-95 DSHS discourages use for healthcare providers providing direct care unless nothing else available

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3. Communication status? Any new issues (e.g. Known traveling or potential exposures)

- Pilots will soon begin for Clinic re-opening, Dr. Jing is leading this effort. Re-openings will not occur until sufficient piloting is complete to ensure highest level of safety

- July 12th will be the AOMA virtual graduation ceremony, communication will be going out immediately

4. Good news, positive experiences in last 24 hours

- Great sightings of the Thunderbirds as they flew over our south campus on Wednesday afternoon! Interesting note, the lead pilot is a woman!

-Lesley has zucchini growing!

-Billy’s basil doing well!

-Today is National Chocolate Chip day, Pizza Party Day !

-2nd Collaborative Clinic is today with WON Institute, also working with Maryland School as well!

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