AAOS released updated guidelines on elective surgery during the COVID-19 pandemic. These guidelines should be applied judiciously depending on your location, where your area/institution happens to be situated relative to the curve of the disease, and the availability or scarcity of your resources, including personal protective equipment, intensive care unit (ICU) beds, respirators, and personnel. It is AAOS’ position that every locality should be making their own decisions based on the availability of resources and personnel. In these situations, a panel that includes the head of the hospital (or the designee), chief of the ICU, chief of anesthesia, and chief of orthopaedic surgery should form a committee to review any prospective surgery. W
here feasible, input from the state department of health should be solicited.
Read the guidelines…
AAOS President Joseph A. Bosco III, MD, FAAOS, sent a letter to members detailing the online actions AAOS is taking to help manage and emerge from the COVID-19 pandemic as strong as possible.
AAOS temporarily pivoted off its Strategic Plan to devote nearly all of its resources to helping members mitigate the effects of COVID-19.
The three pillars of the AAOS COVID-19 Action Plan are: (1) communication, (2) advocacy, and (3) practice management.
Dr. Bosco said in closing, “I have faith that each of us will contribute in whatever way we can or have to. There is work and sacrifice to be made, and our profession has a rich history of selflessness in the face of adversity. I am certain that the upcoming weeks will be no exception.”
> Read the letter
On April 2, 2020, New York passed legislation, entitled "Emergency Disaster Treatment Protection Act," (the "Act") that provides comprehensive immunity from liability to health care professionals and health care facilities. Previously, New York's Governor issued Executive Orders that provided for limited liability for thirty day periods. The Act is retroactive to cover acts or omissions that occurred on or after March 7, 2020, the date of the COVID-19 emergency declaration in New York State , through the expiration date of that declaration.
The stated purpose of the Act, which took effect immediately, is to promote the public health, safety, and welfare of all citizens by broadly protecting the health care facilities and health care professionals in New York State from liability that may result during the public health emergency.
The most significant difference in the Act from the Executive Orders is that the health care facilities, along with volunteer organizations and an expanded class of individuals , are protected from liability. The Act also provides immunity protection from criminal liability in addition to civil liability. Finally, the Act clarifies that the exemption for willful or intentional misconduct does not include acts, omissions, or decisions that result from a resource or staffing shortage. This language will protect professionals and facilities against actions and decisions in rationing medical devices and services, among others.
Read the complete summary provided by MLMIC
Healthcare entities should continue to submit requests for PPE through their local Office of Emergency Management. New York State continues to fulfill requests for PPE, as available. However, NYSDOH has become aware of instances in which healthcare providers, facilities, or practices are using or considering alternative means to manage PPE shortages,such as:
If all efforts to obtain PPE through vendors and local Office of Emergency Management are exhausted or unsuccessful, healthcare providers should refer to the CDC guidance entitled “Strategies for Optimizing the Supply of PPE”
Conventional, then contingency, then crisis capacity strategies should be used in that order, as feasible.
Many of the options from the CDC guidance document are summarized in the advisory.
For general guidance on the use of PPE in healthcare settings, please refer to CDC guidance entitled “Healthcare Supply of Personal Protective Equipment”
The Governor announced that, through June 1, 2020, consumers and businesses experiencing financial hardship due to COVID-19 may defer paying premiums under individual and small group health insurance policies. DFS shall consider any liquidity or solvency concerns of the health plans. During this period, health plans will be required to continue to pay claims, not to report late payments to credit rating agencies, and to work with individuals to help them transition to new coverage, if appropriate. In addition, insurers are reminded that they cannot impose late payment fees. Governor Cuomo thanked Connecticut Governor Ned Lamont for his collaboration on this initiative.
Access the complete release (Information found on page 2)
The Federal Bureau of Investigation (FBI) has released an article on defending against video-teleconferencing (VTC) hijacking (referred to as “Zoom-bombing” when attacks are to the Zoom VTC platform). Many organizations and individuals are increasingly dependent on VTC platforms, such as Zoom and Microsoft Teams, to stay connected during the Coronavirus Disease 2019 (COVID-19) pandemic. The FBI has released this guidance in response to an increase in reports of VTC hijacking.
The Cybersecurity and Infrastructure Security Agency encourages users and administrators to review the FBI article as well as the following steps to improve VTC cybersecurity:
CISA also recommends the following VTC cybersecurity resources:
This advisory supersedes specimen collection and handling guidance from NYSDOH, released originally on March 25, 2020.
This update further extends previous recommendations that nasal and oropharyngeal swab specimen collection is an acceptable alternative, with recommendations for the collection of one (1) nasal swab AND one (1) saliva specimen through healthcare personnel (HCP) observed patient self-collection for specimens submitted to Wadsworth Center,if nasopharyngeal (NP) supplies are unavailable.
If you are using a laboratory other than the Wadsworth Center, follow the laboratory’s guidance for all specimen collection, handling, and transport processes, including whether nasal swab AND saliva specimen, or nasal swab AND OP swab specimen collection methods are acceptable alternatives to an NP swab.
This advisory supersedes guidance from the New York State Department of Health issued on March 28, 2020, to clarify that this guidance applies to essential personnel who have been exposed to a confirmed OR suspected case of COVID-19.
Public and private sector organizations that provide essential services or functions where personnel are needed to perform critical functions, including infrastructure, public safety, and other essential operations, may allow personnel who were exposed to or are recovering from COVID-19 to work in the workplace setting,if needed to maintain essential operations.
Essential services or functions include but are not limited to public health personnel, utility and water operators, skilled manufacturers and supporting supply chains, transportation infrastructure, law enforcement, and emergency response personnel.
Essential personnel who have been exposed to a confirmed or suspected case of COVID-19 can return if the following conditions are met.
This advisory supersedes guidance from the New York State Department of Health to Hospitals, Nursing Homes (NHs) and Adult Care Facilities (ACFs) pertaining to the COVID-19 outbreak, released on March 16, 2020, and further clarifies the updated guidance issued on March 28, 2020.
Entities may allow healthcare personnel (HCP) who are confirmed with COVID-19 or have been exposed to a confirmed or suspected case of COVID-19, or who have traveled internationally in the past 14 days, whether healthcare providers or other facility staff, to work if all of the following conditions are met.
As the COVID-19 pandemic has heavily impacted the U.S. economy, Congress has sought to intervene through the passage several legislative packages striving to minimize the overall impact to workers, businesses and the economy. Through these packages, two small business support programs were created both of which are detailed below.
The first program was created through the passage of the first COVID relief package, the Coronavirus Preparedness and Response Supplemental Appropriations Act. That bill created a $1 billion fund to immediately assist small businesses hit hard by the current economic shutdown. Unlike traditional Small Business Administration (SBA) funding mechanisms, this program is being administered directly by the SBA and is live and accepting applications currently.
The second program was created when the U.S. Senate unanimously passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020. This historic $2 trillion economic stimulus package, including $349 million in federal funds appropriated specifically to support small business, outlines two loan programs intended to assist those impacted economically by this global pandemic.
Small Business Administration Loan Program Note: Small businesses may apply to both programs but cannot participate in or accept funds from both programs. It is up to businesses to determine which program best fits the needs business before enrolling.
Access the AAOS chart that defines eligibility, what the program does, loan forgiveness, and how to participate.
The Coronavirus Aid, Relief, and Economic Security (CARES) Act is the third Covid-19 relief-related package that was considered by Congress and signed into law by President Trump.
See the provisions most relevant to orthopaedic surgeons and their patients.
Advocating for the orthopaedic surgeon, patients and musculoskeletal health in New York.
Address: PO Box 38004, Albany, NY 12203