Fort Worth-area hospitals prepared for coronavirus ‘worst-case scenario,’ leader says

by Nichole Manna

Originally published in the Star-Telegram.

The leader of the Tarrant County Medical Society said he believes county health care professionals are prepared for a possible surge of COVID-19 patients. Furthermore, he’s been struck by the amount of specialty and retired physicians who have told him they want to help people who become infected with the novel coronavirus.

The spike of patients could hit Texas around May 5, according to projections from the University of Washington’s Institute for Health Metrics and Evaluation.

Brian Swift, the society’s chief executive officer, said on Tuesday that he participates in two phone calls a day with professionals from across the state about their response to COVID-19 and the issues facing doctors. Based on those calls, Swift said he thinks Tarrant County is prepared for the worst-case scenario.

“I feel very good just talking with some of the medical directors,” he said. “I do feel optimistic that we know what to do. It is just a matter of execution on a lot of these things.”

Click here to read the entire article.

Updated TMA White Paper Explains Non-Urgent Surgeries Rule

Worried, concerned, confused about the Texas Medical Board’s emergency rules on “non-urgent elective surgeries or procedures” during the COVID-19 crisis? What about the new FAQ the board issued over the weekend? You’re not alone.

Many Texas physicians have called the Texas Medical Association about the rules.

If you’re uncertain about what are considered non-urgent, elective surgeries and procedures – as well as what you or your practice will be required to report – TMA’s Office of the General Counsel produced this white paper to help you better understand the emergency rules.

In addition, the TMA COVID-19 Task Force has created a document that provides links to COVID-19 resources, including state and federal guidance as well as specialty societies that have published resource pages.

Tarrant County COVID-19 Activity – 3/30/20

COVID-19 Confirmed Cases: 155

COVID-19 Active Cases: 146

COVID-19 Provisional cases: 83

COVID-19 related deaths: 1      

Recovered COVID-19 cases: 8

Data from Tarrant County Public Heath’s (TCPH) report of COVID-19 activity in Tarrant County, updated Monday, March 30, 2020 at 1:15 p.m. Find more COVID-19 information from TCPH here.

PPE Supply and Shortage FAQ Answered by TMA’s COVID-19 Task Force

One of the biggest obstacles physicians are facing in the COVID-19 pandemic is a lack of access to personal protective equipment (PPE). The TMA COVID-19 Task Force has worked to compile a list to answer the most common PPE questions. Read the PPE Supply and Shortage FAQ to find out more information, from conservation strategies to the best course of action if N95 respirators or face masks are not available.

Dr. Robert Rogers highlights the difference between spring allergies and coronavirus symptoms

By Dr. Robert Rogers

Originally published in the Star-Telegram. Find the original here.

If it weren’t for the coronavirus pandemic, health reporters in North Texas would be focused on allergies now, as we have entered the spring pollen season.

The beauty of the emerging leaves on the trees, the greening of grass and the appearance of flowers is accompanied by prodigious amounts of tree and grass pollen. Also, because many of us are spending more time at home and are looking for activities, people will be spending more time outside than usual, and thus be exposed to more pollen.

Cough is one of the most telling symptoms of COVID-19, and cough is also very common for those with allergies and asthma. So it’s more important than ever for those with allergies to keep their symptoms under control.

One of our patients said: “It’s a bad time to have allergies because every time you cough, someone looks at you scared!”

So, if you have allergies, how can you distinguish between allergy and COVID-19? First, although many call their allergies “hay fever”, allergy never causes a fever. Never.

If you have a dry cough and a fever, don’t blame your allergies. Talk with your doctor to see if you need to be evaluated for COVID-19.

The symptoms of allergy that are not commonly described in patients with COVID-19 include sneezing, itching of the eyes, ears, or nose, and nasal stuffiness. If there is no fever with these symptoms, they are likely due to seasonal allergies.

As mentioned, cough is common to both COVID-19 and allergy and/or asthma, so that complaint is a little trickier. Nasal allergies can trigger coughing due to postnasal drainage, and asthma causes coughing through irritation of the bronchial tubes. Again, if there is no fever, there is less concern about COVID-19.

People with mild-to-moderate nasal allergies can typically control their symptoms well by using safe, inexpensive medicines (non-sedating antihistamines and nasal cortisone sprays) that are available without a prescription. Those who have asthma will need help from a physician, as there are no effective asthma medicines in the over-the-counter market.

With stay-at-home orders in place, many people are hesitant to call their doctors because they are worried about going to a clinic where people might be sick. Many doctors now have the ability to do telemedicine visits through a smartphone, tablet, or computer. There is no need to suffer in silence – call for help!

I have been an allergist in Fort Worth for 36 years. It has never been this quiet in our office in the spring, and I suspect this is true for all allergists. If you are having trouble with your allergies, call your primary care physician or an allergist.

We are ready to help.

Dr. Robert Rogers is a Fort Worth allergist and former president of the Tarrant County Medical Society.

PHYSICIANS NEEDED FOR TASK FORCE

TCMS is organizing a Physician Task Force to supplement community hospitals at this critical time. We need your support – please join this effort on the front lines of the coronavirus pandemic.

If you are interested in volunteering, fill out this form and contact Brian Swift at (312) 330-4894 or bswift@tcms.org.

A Summary of the Stimulus Legislation

Late Wednesday night the Senate approved a massive $2 trillion stimulus and COVID-19 relief package.

Provisions of particular interest to physicians and their practices include the following:

  1. Creates a new loan product within the Small Business Administration for loans of up to $10 million to help cover payroll and overhead costs, with expanded loan forgiveness criteria. Physician practices with not more than 500 employees may qualify.
  2. $100 billion in direct financial support to hospitals, physician practices, and other health care providers under the Public Health and Social Services Emergency Fund. This support is for costs of treating COVID-19 patients as well as to ease the financial impact on those who lose revenue due reductions in other services as a result of the pandemic. Exact eligibility criteria and application process is not yet defined pending implementation.
  3. Suspension of the 2% Medicare sequester in May through December 2020.
  4. Limitations on liability for volunteer health care professionals during COVID-19 emergency response.
  5. A temporary waiver of the face-to-face visit requirement with home dialysis patients.
  6. Authority for the Secretary of HHS to waive telehealth coverage requirements for new patients during a national emergency. Previous legislation provided flexibility only for established patients seen within the past three years.
  7. Secretary will also allow for enhanced use of telehealth under Medicare for federally qualified health centers.

Also of interest, the “health extenders” package that was set to expire on May 22 has now been extended to November 30.

House passage is expected on Friday and the President is expected to sign the bill into law.

What Physicians and Health Care Workers Need to Know about Tarrant County’s Stay-at-Home Order

Excerpts from an article by Sean Price that was originally published on the Texas Medical Association website. Find the original here.

Texas’ largest counties and cities have issued stay-at-home orders designed to keep residents at home and away from each other as much as possible. Most of the orders exempt health care activities, but the specific language in each varies.

Most of them are set to expire in early April, though they could be revised or renewed.

Texas already is under a statewide order issued by Gov. Greg Abbott forbidding social gatherings of more than 10 people. That order also forced restaurants to close dining rooms – though they can still deliver food and provide takeout service – and closed establishments like bars, theaters, and gyms.

As of Wednesday, 18 counties have issued stay-at-home orders, including the six largest – BexarDallasEl PasoHarrisTarrant, and Travis. In many cases, large cities within these counties – including Fort Worth and San Antonio – issued joint orders along with their county governments.

The local orders have shut down all businesses except those exempted as “essential,” such as health care facilities, grocery stores, gas stations, and news media outlets. Orders typically followed guidelines on “critical infrastructure” established by the U.S. Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency, which include health care. 

 Tarrant County

Took effect March 24 and ends April 7, 2020

  1. “That this Executive Order authorizes the County to take any actions necessary to promote health and suppress disease, including quarantine, evacuation, regulating ingress and egress from a disaster area and controlling the movement of persons and the occupancy of premises, pursuant to § 418.108(f), (g) of the Texas Government Code.”
  2. “All elective medical, surgical, and dental procedures are prohibited anywhere in Tarrant County. Hospitals, ambulatory surgery centers, dental offices, and other medical facilities are directed to identify procedures that are deemed ’elective’ by assessing which procedures can be postponed or cancelled based on patient risk considering the emergency need for redirection of resources to COVID-19 response.”
  3. “That no person shall sell any of the following goods or services for more than the price the person charged for the goods or services on March 16, 2020, and continuing during the pendency of this Executive Order:
  4. groceries, beverages, toilet articles, ice;
  5. restaurant, cafeteria, and boarding-house meals; and
  6. medicine, pharmaceutical, and medical equipment and supplies.”
  7. Essential activities include:
    • “To engage in activities or perform tasks essential to their health and safety, or to the health and safety of their family or household members (for example, obtaining medical supplies or medication, visiting a health care professional, or obtaining supplies need to work from home).”
    • “Essential Businesses means:
    • Essential Health Care Services. Health care operations, including hospitals, clinics, doctors, dentists, pharmacies, pharmaceutical and biotechnology companies, other health care facilities, health care suppliers, home health care services providers, mental health providers, substance abuse providers, blood banks, medical research, or any related and/or ancillary health care services, veterinary care provided to animals. Home-based care for seniors, adults, or children. Residential facilities and shelters for seniors, adults, and children. Health care operations do not include fitness and exercise gyms and similar facilities. Health care operations do not include elective medical, surgical, and dental procedures as established in accordance with this Executive Order.”