April 19: DAILY COVID-19 UPDATE
COVID-19 UPDATE
NEW TODAY: Here’s the latest information about Michigan Medicine’s management of the COVID-19 pandemic:
- DAILY PATIENT STATS
- DAILY TEAM MEMBER TESTING STATS
- UNIVERSITY OF MICHIGAN ATHLETICS SAYS THANK YOU!
- MORE FACTS ON REPROCESSED MASKS
- VIRTUAL TOWN HALL VIDEO & FAQs
DAILY PATIENT STATS
Today’s census for COVID-19 inpatients and those patients under investigation (PUI) are noted below:
Discharges: 297 total COVID-19 discharges to date, 8 in the last 24 hours. These numbers include patients discharged to skilled nursing facilities but excludes deaths and discharges to hospice.
DAILY TEAM MEMBER TESTING STATS*
* Data from 3/5 through 4/17. Updated numbers for 4/19 will be provided on 4/20. The testing stats reflect just Michigan Medicine employees, not all University of Michigan employees. It also reflects only those who sought testing at or were hospitalized at Michigan Medicine or reported their testing to Occupational Health Services. Some Michigan Medicine employees may have been tested outside our system.
UNIVERSITY OF MICHIGAN ATHLETICS SAYS THANK YOU!
U-M Athletics coaches and athletes did a big “shout out” to healthcare workers on their social media channels this past week. To hear the messages, go to:
https://www.instagram.com/p/B_DuJfzFfxY/
MORE FACTS ON REPROCESSED MASKS
Michigan Medicine is currently using a process that combines UV light and heat to reprocess N95s. This approach is effective at inactivating 99.98% of influenza virus (used as a viral surrogate). Testing was also done to ensure that mask filtration and proper fit testing were maintained after reprocessing.
Two recent questions have been sent to the hospital command center regarding this process.
- My mask has an odd odor after it is returned to me for reprocessing. What is causing that? We believe that the smell may be coming from the rubber straps when they are heat-treated. We have heard it is worse for those who are using plastic containers instead of paper bags to store their masks. This may be related to the accumulation of moisture in the container. It is recommended to use the clean paper bags for mask storage.
- Is it ok to use plastic storage containers to store my reusable mask in? We do not recommend that you use plastic containers to store reprocessed masks.
- Plastic containers may not allow N95s to dry out as stated above.
- Clean paper bags assure a clean storage space each time an N95 is used.
- Paper bags are used as part of the N95 reprocessing process to support the high volume of mask reprocessing.
- A standard process for N95 reuse is important to ensure adequate training and keep the process highly reliable and safe
VIRTUAL TOWN HALL VIDEO & FAQs
Michigan Medicine leaders hosted a Virtual Town Hall on Friday. If you missed it, you can view the meeting by clicking here. Below are answers to some of the FAQs raised during the Town Hall. Additional questions will be answered in subsequent issues of the COVID-19 Update. For the latest updates related to COVID-19, visit the Headlines COVID-19 page.
Projections/Analytics
Why is the percentage of deaths higher in Michigan in comparison to other states with similar number of positive tests?
The percentage of deaths expressed as a percent of confirmed cases varies widely amongst states. For states reporting greater than 10,000 confirmed cases, the death rate ranges from 2.5% to 7.4% and Michigan has one of the highest rates. There are many possible reasons for this including low overall testing numbers in Michigan compared to other states suggesting we are not reporting less severe cases and thus artificially inflating our death rate, potential differences in reporting and tracking across states and the overall health and level of comorbidities in the population within each state most impacted by COVID-19. Even within Michigan there is wide variation in death rates across counties with variation that seems in part explained by the level of testing, age of population, underlying disease burden, racial and ethnic differences and socioeconomic status of the population.
Can you talk about a second wave of COVID and how this is being incorporated into future planning?
There is much we cannot predict about the potential for a second wave but we know from other similar infections that there is a possible risk of a second wave. Our planning will thus include considerations for how we would have adequate surveillance and testing in place to detect a potential second wave early so we might be able to intervene early enough to limit it, as well as planning to ensure we could rapidly react to a second wave and have a plan to quickly create health system capacity to handle any second wave.
Finances
Will our institution see any aid from the government?
The health system has and will see federal and state aid in the form of grants and loans. To date $42 million and $1.4 million grant funding has been received from the federal and state governments, respectively. The federal government has provided $275 million in advance payments representing up to six months of expected future claims. Payback of this advance will begin in August 2020 as claims are processed.
The health system will also pursue FEMA funding for expenditures made in preparation for the pandemic. In the short-term, relief will be provided through the Medicare program increasing payments through December 2020. Approximate effect is up to $10 million.
Will we be holding off on building the new tower? Seems like a good way to save on money.
Tower construction has been on hold resulting from Governor Whitmer’s executive orders declaring construction workers to be non-essential. A centralized review of all existing and proposed capital projects will be conducted to reprioritize and determine cost savings potential and provide a new schedule for completion.
General Operations
Are we going to have separate units in the hospital for COVID+ patients?
We are considering how to safely and effectively care for both COVID and non-COVID patients. We have attempted to cohort COVID patients to some degree now. As we anticipate needing to provide ongoing care for COVID and non-COVID patients, our ability to meet the specific care needs of the patients will determine how completely we can cohort COVID+ patients.
Will all surgical patients be tested for COVID preoperatively?
Right now we have a risk-based algorithm for preoperative testing. When there are greater and more reliable supplies for testing, we will expand testing for more pre-operative and pre-procedure patients.
Will units start to reopen some elective services soon; if not, is there a projected date?
Our first priority will be to address patients whose care has been deferred during the peak of the pandemic. We are carefully increasing the number of time-sensitive operations and procedures, which have been deferred to reduce risk of harm to our patients. Some elective and ambulatory care visits will be dictated by the Governor’s Executive Order limiting mobility. This is in effect until April 30th, but may be extended or revised. It is clear that social distancing has made a large impact in reducing spread of COVID-19 disease. If there is loosening of social restrictions, we will need to be prepared for a potential increase in COVID-19 disease.
Therapies are going to be a significant part of these patients’ recovery (physical, occupational, speech therapy). Are therapists a part of the future planning process?
We have recognized that many patients, particularly those who have been severely ill, have significant debility and deconditioning. They will need therapy both in the hospital and after discharge. We have a team that has been asked to assess these patient needs and provide recommendations for how best to provide and coordinate these essential services as part of our overall COVID response planning.
Still have questions?
We are also posting all daily bulletins and policies on Michigan Medicine Headlines at https://mmheadlines.org/covid-19-updates/. Please bookmark that site and refer to it throughout the day for the most up-to-date information. An FAQ for staff is also posted and updated frequently.
If you still can’t find what you’re looking for on these web pages, please email coronavirus-info@med.umich.edu and your question will be answered as quickly as possible. Do not use this email for sharing patient health information.
Jeffrey Desmond, M.D.
Chief Medical Officer
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