COVID Briefing Minutes 3.25-3.27

We're closing out the week and we look forward to seeing you at the briefings and the town hall next week! Thanks for all your hard work and care for each other during this time!


"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

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- 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."

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