Waco COVID-19 Update 3/14/20

Fellow Physician Colleagues,

As the response to COVID-19 continues to affect us all, we have an even greater responsibility to our patients in order to provide them accurate information and guidance during this pandemic.  There have been multiple task forces and guidelines produced nationally and on the state level.  The McLennan County Medical Society will continue to help you in distributing local response measures that affect us here in Waco should you encounter any patients with symptoms or questions about COVID-19.  Please continue to follow CDC recommendations and any hospital issued recommendations for those employees of the hospitals.

Situation Update as of 3/14/20

  • Worldwide Cases – 155,371 confirmed cases.  5,802 deaths. China, Italy, Iran and South Korea have the highest confirmed cases. US ranks 8th worldwide in total cases.
  • US Cases – 2,572 confirmed cases. 51 deaths. New York, Washington, California, and Massachusetts have the highest confirmed cases. Texas ranks 10th nationally in total cases.
  • Texas Cases – 51 confirmed cases. 0 deaths. Harris County, Fort Bend County and Dallas County have the highest confirmed cases. Bell county is the closest county currently with a confirmed case.
  • McLennan County does not have a confirmed case currently.

*Note for case counts – We are reporting case counts from the CDC website. Due to increasing testing capacity at State and local labs around the country, the count may be lower than the numbers reported by media.

COVID-19 continues to be more harmful to individuals over 65 years old compared to younger individuals.  Those with underlying health problems make them more susceptible to complications from pneumonia.

  • Risk factors – diabetes, heart disease, lung disease, immunosuppression, renal and liver disease, pregnancy, blood disorders

Per the DSHS, a recent report found that the virus can live for 2-3 days on stainless steel and plastic and in the air for up to 3 hours following aerosolization.

Local Update
Plans are in the works for 2 “drive through” testing locations in the community for specific patients and will likely be implemented early next week.  Once locations and openings are confirmed, we will send out further information.

Specific clinics and locations for patients suspected to be positive will also be opening next week. Further information is pending.

Greater Waco schools have delayed re-opening until March 20 and March 27 tentatively.  Keep in mind that this may affect your staff availability in the coming weeks.

Weekly meetings are occurring with members from both hospitals, the Family Health Center, city leadership, the health department, the medical society and Dr. Verner our local health authority and ID specialist

An iPhone app will be released early next week for patients to receive local tele-consultation and guidance for further testing. More information to come.

Both hospitals are prepared to provide care for any patients who ultimately test positive.

Community mitigation strategies have been pushed to employers, schools and others to help slow the transmission of the virus.  https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf

Stockpiling has been occurring throughout the nation with several local stores sold out of specific goods.  HEB has implemented adjusted hours to allow time for restocking.

COVID-19 Testing

Testing availability has improved drastically with testing done at all state labs and within Central Texas early next week.  Turnaround on testing (nasopharyngeal swab) has improved to 6 hours once the sample is received while some testing facilities are still reporting 48 hour turnaround time.

No testing can be done for asymptomatic patients at this time.

Texas can perform 273 tests per day with next week the ability to test 500 or more.

Influenza activity continues to be elevated.

What do I do if I have concern a patient may be infected?
If you work at a BS&W Hillcrest or Ascension Providence facility, follow the protocols designated by your hospital.
If independent, follow “Screening Questions” in previous email or on CDC website, contact the health department at 750-5450 or 750-5472 and/or contact local EMS.

COVID-19 Treatment
There is no specific antiviral treatment recommended for COVID-19 infection. People infected with COVID-19 should receive supportive care to help relieve symptoms.

COVID-19 Prevention
Utilize standard airborne, contact and eye protection (gown, gloves, and N-95 respirator or surgical mask (when N-95 not available), goggles or face shield)

  • Assess and triage these patients with acute respiratory symptoms and risk factors for COVID-19 to minimize chances of exposure, including placing a facemask on the patient and isolating them in an Airborne Infection Isolation Room (AIIR), if available
  • Use Standard PrecautionsContact Precautions, and Airborne Precautionsand eye protection when caring for patients with confirmed or possible COVID-19
  • Perform hand hygiene with alcohol-based hand rub before and after all patient contact, contact with potentially infectious material, and before putting on and upon removal of PPE, including gloves. Use soap and water if hands are visibly soiled
  • Practice how to properly don, use, and doffin a manner to prevent self-contamination

See the CDC website for more information:
https://www.cdc.gov/coronavirus/2019-nCoV/summary.html
https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html
https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html

 

Again, this is a consolidation of physician specific information from the Waco-McLennan County Public Health District, CDC, BS&W Hillcrest, Ascension Providence and DSHS communications.  We advise following the guidelines distributed from your hospital system if applicable. More information and updates will follow as the situation continues to evolve.

 

William McCunniff, MD, MBA

McLennan County Medical Society

President

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