Thank you for joining Wellpath for the COVID-19 Partner Webinar on Thursday, July 16, 2020. Click here to access the presentation slides. Here are some other quick links to resources mentioned on the webinar: NY Times – Coronavirus in the US: Latest Map and Case Count Tracking the COVID-19 Response Updated (July 14, 2020) Interim Guidance on Management of Coronavirus…
- Updated Interim Guidance on Management of Coronavirus Disease 2019 (COVID-19) in Correctional and Detention Facilities >>
- Tracking The COVID-19 Response
- FAQs for Correctional and Detention Facilities from the CDC >>
- Framework for Healthcare Systems Providing Non-COVID-19 Clinical Care During the COVID-19 Pandemic >>
- Back To Normal: Considerations for Returning Jails to Pre-COVID-19 Operations >>
- CDC Morbidity and Mortality Weekly Reports (MMWR) >>
- World Health Organization COVID-19 Q&A >>
- Strategies to Optimize the Supply of PPE >>
- NCCHC COVID-19: What You Need to Know in Corrections >>
- OSHA COVID-19 Website >>
- Coronavirus Government Response Resource Center >> (Federal Contractors)
- Real-time updates from Johns Hopkins University >>
- NIH Director’s Blog >>
MESSAGE FROM THE CEO
A Message from Jorge Dominicis, CEO of Wellpath
Thank you for visiting the Wellpath COVID-19/Coronavirus Resource Center. We created this site to give you the information you need to navigate the uncertain and ongoing Coronavirus Disease 2019 (COVID-19) pandemic. The management of correctional facilities and hospitals is difficult in the best of times. The rapid spread of COVID-19 has added a new layer of challenges for all of us who devote our lives to providing healthcare to vulnerable incarcerated men, women, and juveniles. We hope you will find some answers here.
But a webpage alone will not solve your problems. It will be the partnership of dedicated professionals from your administration and the Wellpath clinical and leadership teams to cut through the noise and better understand how COVID-19 affects your facilities. In that spirit, I urge you to stay in close contact with your Wellpath Health Services Administrator (HSA) and/or Regional Operations Leaders. They are your liaison to all of us at Wellpath. Together we are doing everything we can to address your challenges with creativity and professionalism.
Wellpath will continue working closely with you to serve the healthcare needs of our patient populations. Our challenges will continue to be unique, as the nature of COVID-19 reveals itself daily. None of us has the luxury of waiting for answers. We must all respond to the known and unknown with precision, professionalism, and best practices with the best information we have.
We are updating this site as information from credible sources emerge, and I will continue sending Coronavirus email updates as needed. If you have valuable information to share with your colleagues in other locations, let us help you spread it. Please help us keep the lines of communication open. Please be assured that you are our priority.
To hope and healing,
Chief Executive Officer, Wellpath
PREPAREDNESS & ACTION PLANNING
Today’s COVID-19 environment is unique in many ways, but it is a healthcare challenge our team is meeting head-on. Wellpath is tracking the evolving state of the pandemic and continually deploying initiatives and recommendations by the government, the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). We are also working closely with local health departments on this emerging, rapidly evolving public health threat.
Wellpath understands how critical our role is for keeping staff and patients safe. Our primary focus during this time is to:
- Prevent the spread of the disease
- Cohort patients as one group for each day’s intake
- Promptly identify and isolate patients with possible COVID
- Care for patients with confirmed or suspected COVID-19
- Initiate COVID-19 emergency procedures in the event of an escalating outbreak
- Monitor and manage potential staff exposures
- Communicate effectively within the facility and local public health authorities
To that end, we have taken the following key actions:
Wellpath COVID-19/Coronavirus Executive Task Force
We have formed an executive-led COVID-19 Task Force, comprising multi-disciplinary site leaders from across the organization. The Task Force meets multiple times a week to ensure our sites have the information and resources they need to manage the situation.
Emergency Preparedness Checklist
Our COVID-19 Emergency Preparedness Checklist has been implemented at all our sites. It includes staffing contingency plans, ongoing monitoring, reporting and tracking of potential and confirmed cases, medical supply management, and supplemental intake screening procedures.
Wellpath Clinical Leader Calls
Our Associate Chief Clinical Officer leads large conference calls with our clinical and operations leaders to share information, provide guidance, and field questions. Key participants include clinical, nursing, procurement and human resources professionals.
KEEPING OUR STAFF INFORMED
Wellpath keeps our clinical team informed as information becomes available on key areas including:
- Developments in test specimen collection
- Developments on PPE use and reuse
- Guidance on maximizing PPE orders
- How to decrease risk if respirators are no longer available
- COVID-19 testing procedures
- COVID-19 intake screening instructions
- How COVID-19 might impact patient suicide risk
IMPORTANT TOPICS FOR DISCUSSION & CONSIDERATION
To keep you updated, below is an overview of what we are finding to be the most commonly discussed topics. If you would like any additional information about these topics please contact your Wellpath HSA.
- IN-PERSON VISITATION: Most of you have already suspended in-person visitation. To the extent that you have not, Wellpath strongly encourages each facility to consider eliminating in-person visitation, as well as “weekender,” and work release programs. Video visitation, if available, is an effective substitute during this time of social distancing.
- COMPASSIONATE RELEASE: Many of our partners across the country have begun evaluating compassionate release as a way to make room for quarantine and isolation areas within facilities. To aid these evaluations, Wellpath can help by recommending clinically appropriate candidates for compassionate release. We recognize that these decisions are yours, and are based on many factors, including appropriateness for release and adequate outside access to housing, medical care and other social support systems.
- TELEHEALTH: Wellpath currently has 2,100 credentialed staff, including Physicians, Nurse Practitioners, Physicians Assistants, Psychologists, and Mental Health Clinicians. In addition to credentialed providers, we have more than 6,000 nurses. To increase social distancing for high-risk staff and slow the spread of the virus, we are expanding our use of telehealth. Wellpath currently conducts more than 100,000 telehealth encounters each year. We expect that number to increase dramatically. Earlier this month, the U.S Department of Health and Human Services (HHS) announced, effective immediately, that it will exercise its enforcement discretion and will waive potential penalties for HIPAA violations against healthcare providers who use everyday communications technologies, such as Zoom, FaceTime or Skype, during the declared nationwide public health emergency in response to the worldwide pandemic. This applies to widely available communications apps, such as FaceTime or Skype, when used in good faith for any telehealth treatment or diagnostic purpose, regardless of whether the telehealth service is directly related to COVID-19.
- MEDICATION SUPPLY: The nationwide medication supply chain has adequate reserves and monitoring is in place with a focus on limiting the stockpiling of medication. The (CDC) position statement has reassured us that it is safe to ship boxes of medications. Wellpath Recovery Solutions Pharmacies, as well as our correctional pharmacy partners have been actively monitoring their pharmacy inventories to prevent medication shortages. We have continued to work with our medical staff , providing pandemic guidelines for prescribing. We have discussed Essential Medication guidelines with our medical staff that focus on ensuring the availability of scheduled medication for the treatment of chronic illnesses. Medical staff have been encouraged to review the use of “as needed”/intermittent medications for non-chronic conditions on patient profiles looking for opportunities to decrease polypharmacy and the patient’s overall pill burden. As part of our contingency planning, we have evaluated the medication administration process as it is a nursing resource intensive activity, with exposure risks to patients and staff.
- MEDICATION SUPPLY (continued): We have developed tools for assistance in creating a facility specific Keep on Person (KOP)/Assisted Self-Medication Program should nursing resources become critical. The focus of the guidelines are to decrease patient and nursing exposures, preserve nursing resources, while maintaining a safe medication use system that promotes compliance.
- ELECTIVE MEDICAL, DENTAL and OFFSITE PROCEDURES: In keeping with the government’s March 18, 2020 announcement, Wellpath has postponed all elective medical and dental procedures. Additionally, we are reviewing requests for offsite specialty care so that, where appropriate, we can convert some requests to onsite care, virtual visits from providers, and specialty electronic consults. We will temporarily defer other non-urgent offsite requests where appropriate.
- WORKING TOGETHER TO STOP THE SPREAD: Together we care for large numbers of people in close quarters, and we are doing all that we can to keep our patients and employees healthy. This includes taking aggressive actions to prevent the coronavirus from entering, reminding our staff members to sanitize common areas multiple times a day, practicing proper hand hygiene, and staying home if they are not feeling well.
- PERSONAL PROTECTIVE EQUIPMENT (PPE): Our staff uses Personal Protective Equipment (PPE) based on CDC criteria and best practices when available/possible.
- MASKING: Wellpath’s suggested masking guidance, until further guidance is provided and until further notice, is as follows:
- All new intakes should be issued surgical masks and quarantined for 14-days before moving to general population.
- All corrections staff and Wellpath staff should wear masks in all situations where others are present.
- All patients at high-risk of adverse outcomes from COVID-19 should wear N-95 or KN-95 respirators.
- All inmates/detainees should wear masks in all situations where others are present.
- CONTINGENCY PLANNING: Wellpath has developed facility-specific contingency plans in the event we experience Covid-19 related staffing shortages and other challenges. Most of our partner facilities have developed similar plans to deal with staffing shortages and the need to quarantine or otherwise manage infected inmates. To help us better manage this together, we would suggest that our local teams share and discuss these plans to ensure alignment of resources. We also ask that our team provide the combined plan to Wellpath leadership. If we identify gaps, we will address them before the situation requires action.
THE BASICS ABOUT COVID-19/CORONAVIRUS
What is COVID-19?
Coronaviruses are a family of viruses that can cause respiratory illness in people. COVID-19 is one of seven types of known human coronaviruses. It is believed to be spread person-to-person through respiratory droplets produced when an infected person coughs or sneezes.
What are the symptoms?
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 may have COVID-19:
- Fever or chills
- Shortness of breath or difficulty breathing
- Muscle or body aches
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
This list does not include all possible symptoms.
Symptoms also may be severe and lead to death. The following symptoms require immediate attention:
- Trouble breathing
- Persistent pain or pressure in the chest
- New confusion
- Inability to wake or stay awake
- Bluish lips or face
Those at higher risk for severe illness from COVID-19 include those who:
- Are 65+ years and older
- Live in a nursing home or long-term care facility
- Have chronic lung disease or moderate to severe asthma
- Have serious heart conditions
- Are immunocompromised (Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications)
- Have severe obesity (body mass index [BMI] of 40 or higher)
- Have diabetes
- Have chronic kidney disease undergoing dialysis
- Have liver disease
Pregnant patients should be monitored for severe viral illness.
Please visit this link for more information about high-risk individuals.
Should I get tested?
Most people have mild illness and can recover at home. Please follow local directives to determine if testing is medically indicated.
How do we treat it?
There is no vaccine to prevent COVID-19. The best treatment is to PREVENT EXPOSURE. How do we prevent it?
Wear a facemask
- Cover your mouth and nose with a cloth face cover or mask when in public settings and when around people who do not live in your household, especially when other social distancing measures are difficult to maintain
- The face covering/mask is not a substitute for social distancing
- The face covering/mask is meant to protect other people in case you are infected
- You could spread COVID-19 to others even if you do not feel sick
Keep your hands clean
- Wash hands with soap and water for 20 seconds after being in a public place or after blowing your nose, coughing or sneezing; properly dispose tissues
- Use a hand sanitizer with at least 60% alcohol
- Avoid touching the eyes, nose, and mouth
- Wear a facemask
TIP: As a timer while washing hands or using hand sanitizer, hum the “Happy Birthday” song from beginning to end twice.
Avoid contact with others – at least 6 feet distance
- Wear a facemask
- Close contact generally does not include brief interactions, such as walking past a person, according to OSHA.
- Use Personal Protective Equipment appropriate to the task
Clean and disinfect frequently touched surfaces daily
- Use EPA-registered disinfectants >>
- Use gloves if handling dirty laundry, including towels, from an infected person. Discard gloves after each use.
- Exercise hand hygiene >>
- CDC guidance on how to clean and disinfect properly >>