ECHO Session: Update on COVID- 19 in NM & Social Isolation … · 2020-03-19 · 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 •

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

ECHO Session: Update on COVID-19 in NM & Social Isolation Precautions to slow risk of

transmission

Secretaries Kathy Kunkel (Dept. of Health) &

David Scrase, MD (Human Services Dept.)

March 19, 2020


COVID-19 at a Glance: Global

Total confirmed new cases, last 24

hours (as of 3/18/20)

Region Cases Deaths

Western Pacific 289 23

Europe 8506 428

Southeast Asia 124 2

Eastern

Mediterranean

330 3

Americas 2,234 18

Africa 42 1

Global 11,525 475

2

Source: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200317-sitrep-

57-covid-19.pdf?sfvrsn=a26922f2_4

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200317-sitrep-57-covid-19.pdf?sfvrsn=a26922f2_4


COVID-19 at a Glance: US

• Total cases: 4,226

• Total deaths: 75

• Cases in all 50 states and DC

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COVID-19 at a Glance: NM

• Cases as of 3/18: 28

• Bernalillo County

• Sandoval County

• Santa Fe County

• Socorro County

• Taos County

• Bookmark DOH COVID-19 website: https://cv.nmhealth.org/

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https://cv.nmhealth.org/


Flattening the Curve NM Style

• In 1918, Gunnison, CO was one of only a handful of communities worldwide that survived the Spanish Flu epidemic without a single case.

• Flattening the curve of the pandemic is key to ensuring health and safety of New Mexicans.

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StateFirst Date

Case

Public Health

Emergency

Declaration Date

Interval between

First Case and

Declaration (Days)

Washington 1/21/20 2/29/20 39

California 1/26/20 3/4/20 38

Massachusetts 2/1/20 3/10/20 38

Georgia 3/2/20 3/16/20 14

New York 3/1/20 3/7/20 6

Colorado 3/5/20 3/10/20 5

Louisiana 3/9/20 3/11/20 2

Florida 3/1/20 3/1/20 0

Michigan 3/10/20 3/10/20 0

New Mexico 3/11/20 3/11/20 0

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Flattening the Curve NM Style• Governor Lujan Grisham has

taken decisive actions, including:• Declaring health emergency.• Limiting large public gatherings.• Recommending self-isolation for

two weeks after out of state travel and/or COVID-19 exposure.

• Directing large numbers of state employees to work from home.

• Temporarily closing public schools.

• Issuing an order to nursing facilities to prohibit almost all visitors.

• State is preparing for possibility of community spread.

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• Aggressive and evidence-based social distancing interventions slow the spread of the virus in a manner that will NOT overwhelm our healthcare system.

• Mortality rates are much higher when people do not have access to an effective healthcare system.

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Flattening the Curve NM StyleSocial distancing includes:

• Encouraging people to stay at

home;

• Avoiding mass gatherings (10+);

• Closing schools, libraries,

museums, and eateries;

• Limiting public transportation; and,

• Quarantining individuals with mild

and asymptomatic COVID-19

infection.

The goal is to prevent people with

asymptomatic infections from

spreading the disease.

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A baseline simulation with case isolation only (red); a simulation with social

distancing in place throughout the epidemic, flattening the curve (green), and

a simulation with more effective social distancing in place for a limited period

only, typically followed by a resurgent epidemic when social distancing is

halted (blue). These are not quantitative predictions but robust qualitative

illustrations for a range of model choices. Source:

https://www.thelancet.com/journals/lancet/article/PIIS0140-

6736(20)30567-5/fulltext

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30567-5/fulltext



We believe NM is one of the safest places to weather COVID-19, because we are ahead of the curve. How you can help:

1. Keep your distance. 2. Buy local. 3. Make an appointment to donate

blood. 4. Help elders. Email ALTSD-

[email protected] with subject: READY TO HELP.

5. Check on vulnerable acquaintances.

6. Buy only what you need; don’t hoard.

7. Donate supplies to shelters. 8. Donate to foodbanks. 9. Practice self care.

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Source:

https://twitter.com/opsargentina/status/123963884919166

1569?s=20

http://bloodbanker.com/banks/state.php?state=NM

mailto:[email protected]

https://www.shelterlistings.org/state/new_mexico.html

https://food-banks.org/new_mexico-programs.html


Questions and Comments


ECHO Session: How to obtain necessary COVID-

19 testing for your patient

Secretaries Kathy Kunkel (Dept. of Health) &

David Scrase, MD (Human Services Dept.)

March 19, 2020


Clinician COVID-19 Information• Clinician information is

available at https://cv.nmhealth.org/clinicians/.

• Guidance re: clinical care, infection control, and PPE.

• Facilities seeking PPE should call 505-231-5506, requesting PPE and/or COVID-19 testing kits.

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https://cv.nmhealth.org/clinicians/


COVID-19: Testing per capita


COVID-19 Testing

CountryPopulation (millions)

Number of Tests

Tests per Million

First Case Date

As of Date

US 329 7,695 23 1/21/20 3/11/20

Japan 127 8411 66 1/20/20 3/4/20

UK 67.8 23,513 347 1/31/20 3/8/20

Netherlands 17.1 6,000 350 2/27/20 3/7/20

Israel 8.6 3,451 401 2/21/20 3/8/20

Taiwan 23.8 14,635 615 1/21/20 3/10/20

New Mexico 2.1 1720 618 3/11/20 3/17/20

Italy 60.5 49,937 826 1/31/20 3/8/20

Guangdong, China 113.5 320,000 2820 1/19/20 2/28/20

South Korea 51.3 189,236 3692 1/20/20 3/8/20

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Testing Symptomatic Patients: 4 Steps

1. Perform risk evaluation (COVID-19 contact, travel history, medical history)

2. Conduct clinical evaluation re: testing

3. Acquire sample via nasopharyngeal swab;

4. Conduct COVID-19 testing in reference lab

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Source: https://www.youtube.com/watch?v=ar2Grm_t8X8

https://www.youtube.com/watch?v=ar2Grm_t8X8


COVID-19 Testing Criteria Special Populations

• Older adults (age ≥ 65 years),

• Immunocompromised individuals

(e.g. cancer, solid organ transplant,

immunosuppressive drugs, chronic

lung disease, hemodialysis,

advanced HIV)

• Pregnant people

• People who are homeless or live in

congregant settings (e.g. dorms,

shelters, corrections, skilled nursing

facilities, adult family homes).

• CDC Level 3 Travel Advisories:

Europe, China, South Korea, Iran

• US Community Transmission: CA,

Chicago, New York City, Seattle

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COVID-19 Testing Sites in NM

• EDs and urgent care facilities, including referral-only and open-to-all sites

• Drive-thru sites (commercial and DOH)

• Laboratories (DOH and commercial)

• Will be updated on DOH COVID-19 website, https://cv.nmhealth.org/

Sites to open by ~7 days

Sites currently open

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https://cv.nmhealth.org/


COVID-19 Testing: EDs, Urgent Care & Laboratories

Emergency Departments & Urgent Care Centers

• When possible, patients should make initial contact by telephone before arrival.

• Signs posted outside entrance with phone number to call for assistance

• Initial screening and assessment done through the window of the patient’s car

• If more thorough evaluation and treatment is indicated, patient is moved to isolation room

• Can be referred by Primary Care Providers and by self -referral

• COVID-19 testing is obtained only as clinically indicated after assessment

Laboratories

DOH State Lab

• 500-600 tests/day

• Receive overflow from Tricore and vice versa

• Turn around time 1-3 days

Tricore (increased capacity in near future)

• 300 tests/day; turn around time 1-3 days

• Serves UNMH, Presbyterian, Lovelace, others

Quest

• 3,000 tests/day nationwide, 10,000

tests/day by end of week

• Serves IHS and clinical sites in S. NM

• Turn around time 1-2 days

LabCorp

• One test site in North Carolina

• Turn around test 3-4 days

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COVID-19 Testing: Drive-Thru Sites

Referral Only Sites

• Christus St. Vincent’s (Entrada

Contenta, Santa Fe)

• Sample collection by clinician

referral

• No on-site assessment

• Española Presbyterian Hospital

• COVID-19 testing upon referral

• Add’l screening at test site

even with referral

Open to all Sites

• Patients screened before testing with medical questionnaire and on-site assessment (e.g. symptoms/signs of significant upper respiratory infection)

• COVID-19 test collection as indicated by clinical assessment

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COVID-19 Testing: Drive-Thru Sites

Commercial

• Lovelace (ABQ) • Closed, but will reopen• 760/day capacity on one day• DOH collaboration in future

• Presbyterian (ABQ)• Online registration; provider • Referral by Provider• Additional screening onsite

• San Juan Regional (Farmington)

• Christus St. Vincent Medical Center (Santa Fe)

• Holy Cross (Taos)

• Gallup Indian Medical Center

DOH Public Health Offices

• Referral from M.D. or DOH needed;

screening via questionnaire

• Available in Roswell, Las Cruces

(partnership with Burrell College),

Socorro, Las Vegas

• Open daily with regular hours

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COVID-19 Case Study (Fictitious)

Alex (retail worker)

• Alex interacted with a customer, who recently traveled out of the country and was sick and coughing. Customer returned to the store 2 days later.

• Alex started feeling symptoms 2 days later, followed by chills, and lung pains. Later, experienced sore throat, muscle aches, waking up at night, and difficulty breathing.

• Tested negative for influenza.

• Alex is asthmatic.

What would you do?

A. Send Alex to the ER.

B. Have Alex come to your office, wait in vehicle, complete evaluation, and undergo nasopharyngeal swab, sending specimen to reference lab.

C. Send Alex to a Covid-19 testing site.

D. Nothing, instructing Alex to self-isolate for a total of 14 days.

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COVID-19 Case Study (Fictitious)

Kellan (retiree)

• Kellan is 76 years-old and calls your office to report a temperature of 101.0 F.

• He also is experiencing a dry cough as well as mild shortness of breath with activity.

• He returned on a plane from NYC 5 days ago and is self-isolating at home.

• He is unaware of any direct contact with COVID-19 positive individuals, but reported "there sure were a lot of people coughing on the plane.”

What would you do?

A. Send Kellan to the ER.

B. Have Kellan come to your office, wait in vehicle, complete evaluation, and undergo nasopharyngeal swab, sending specimen to reference lab.

C. Send Kellan to a Covid-19 testing site.

D. Nothing, instructing Kellan to self-isolate for a total of 14 days.

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Questions and Comments

Documents

ECHO Session: Update on COVID- 19 in NM & Social Isolation … · 2020-03-19 · 1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 •