April 3: DAILY COVID-19 UPDATE

NEW TODAY: Here’s the latest information about Michigan Medicine’s management of the COVID-19 pandemic:

• DAILY STATS
• COURTYARD ENTRANCES
• UPDATED AEROSOL-GENERATING PROCEDURES
• PPE UPDATE
• MASK REPROCESSING TO BEGIN SATURDAY
• VISITOR MASKS
• HIGH RELIABILITY PRACTICES
• PARKING AND TRANSPORTATION UPDATE
• REMINDER: HOTLINE NUMBERS

DAILY STATS

Today’s census for COVID-19 inpatients and those patients under investigation (PUI) are noted below: 

Discharges: 89 COVID-19 discharges to date, 11 in the last 24 hours.

COURTYARD ENTRANCES

Effective Saturday, April 4, the courtyard entrances in University Hospital and University Hospital South will be opened for employees to access and enjoy the outdoors as the weather improves. The outer perimeter gates of the courtyard will remain secured 24/7. Employees are expected to continue wearing masks and maintain 6-feet social distancing practices within the courtyard area. DPSS will secure and monitor the courtyard at all times to ensure the safety of our employees.

UPDATED AEROSOL-GENERATING PROCEDURES

The list of potential Aerosol-Generating Procedures (AGPs) has been revised based on recommendations of a multidisciplinary group including Infection Prevention and Epidemiology (IPE), Respiratory Therapy, and Pulmonary Medicine. 

The Special Pathogens Precautions pale yellow signs have been updated to reflect these changes. AGP Stop Signs should still be posted and appropriate PPE guidance followed whenever these procedures are performed.  Please contact IPE with any questions.

PPE UPDATE

The safety of our team members remains our highest priority.  We’ve received several questions from staff and are addressing in this segment:

When do I need to wear a N95 mask?

N95 masks should be worn by health care workers who are in the room during an aerosol-generating procedure (see AGP above). N95 masks filter out small particles that may be formed during AGPs and must be fit tested to be effective.  

Because COVID is primarily spread through respiratory droplet transmission, a standard medical mask together with eye protection, gown and gloves, is protective in preventing transmission of COVID when no aerosol generating procedures are being performed. Please see click here to view Michigan Medicine’s PPE recommendations.

Can I bring in my own PPE, specifically an N-95 mask?

For the safety of all team members and patients, we do not support this.

1. It is not possible to guarantee that masks brought from home meet the safety requirements of the FDA.
2. Even if the mask was formerly FDA-certified, the integrity or condition cannot be assured.
3. The mask may not fit properly. N95 masks must be fit tested to be effective. We are unable to provide fit testing for every type of mask that may come from home.
4. Masks which have not been properly stored may be compromised or contaminated. We can ensure that hospital-supplied masks have been stored properly.

We would be happy to partner with any staff who say they have a source of N95 masks. Our Supply Chain team is working around the clock to accept donations, assess for FDA regulations, and get quality product into our hospitals.      

MASK REPROCESSING TO BEGIN SATURDAY

Many health systems have incorporated reprocessing of N95 masks as a conservation strategy.  Michigan Medicine researchers have studied these processes to ensure they are effective and do not damage the masks and Michigan Medicine is now implementing reprocessing of N95 masks in some areas.

Our researchers showed that a combination of moist heat and UV light is effective in disinfecting N95 masks. In addition, our researchers have shown that the N95 masks retain their filtration efficacy, fit testing, and overall integrity after multiple cycles of UV-light and moist heat.

Because the CDC and mask manufacturers have stated that reprocessing of masks is safe for conservation of masks in this time of crisis, reprocessed masks should continue to be handled in a manner to avoid touching the inside of the mask.  Clean gloves should be used for donning a reprocessed mask according to N-95 mask reuse protocols linked here:  http://www.med.umich.edu/i/ice/resources/coronavirus/ppe_reuse_no_bouffant.pdfs

VISITOR MASKS

Effective Saturday, April 4, all visitors will be asked to wear a mask after entering a Michigan Medicine patient care facility. Security will distribute masks at building entrance points and ask visitors to continue wearing masks for the duration of their visit.

HIGH RELIABILITY PRACTICES

The COVID-19 environment is reinforcing our high reliability journey and focus on safety as a top priority. Below are four universal skills that will help reduce errors during the COVID-19 pandemic. See more resources on the HRO website, or email HRO-training@med.umich.edu for additional support.

Clarifying questions assist in understanding. 

• Michigan Medicine safety phrase: “I have a clarifying question.” 
• Use in high-risk or uncertain/unclear  

Self-check using STAR (Stop, Think, Act, Review) keeps your attention to the task at hand.

• Use when feeling rushed, multi-tasking, or distracted

Cross-checking keeps our attention on the people, equipment and environment around us. 

• We will check each other and are willing to be checked.
• Michigan Medicine safety phrase: “Thanks for saying something.” 
• Use to point out an unsafe condition or provide a second opinion.

Speak up for safety using ARCC (Ask a question, request a change, voice a Concern, use Chain of command). 

• Michigan Medicine safety phrase: “I have a safety concern.”
• Use when patient, employee or visitor safety may be compromised.

PARKING AND TRANSPORTATION UPDATE

For active faculty and staff permit holders with payroll deductions, your payroll deductions for the months of April and May 2020 will be suspended based on your monthly permit expense (please refer to your previous pay stub). You do not need to return your parking permit.

Departmental university contributions (“UC”) will also be suspended for April and May 2020.

For active faculty and staff pay-in-full parking permit holders, a two-month credit will be added to your account based on FY20 monthly permit fees at the time of permit purchase for the next fiscal year (FY21). You do not need to return your parking permit.
 
If you cannot participate in the FY21 credit noted above, mail in your parking permit for a refund (refund requires 8-10 weeks for processing) via U.S. Certified Mail or FedEx with tracking to:       

Parking Customer Services
523 S. Division St.
Ann Arbor, MI 48104 

Reminders for those traveling to the medical campus:

Parking permit enforcement has been suspended for Medical Center Campus lots and structures, with the exception of P1, P2, P3, P4, and P5 garages. Access gates are open in the following garages: Ann/Catherine, Glen, Wall Street, Palmer and Fletcher.  

Individual parking spaces signed for 24/7 enforcement (such as Accessible, Gold, Service or Business Vehicle) or areas signed for 24/7 enforcement will still remain enforced on all campuses.  

Please note that the Yellow AVI and Blue off-shift parking programs will not have 24/7 access to P-structures on weekdays.  Regular weekday restrictions for these programs still apply.  Please adhere to this to maintain a sufficient supply of patient/visitor parking.

For more information on parking and transportation changes related to COVID-19, click here.

REMINDER:  HOTLINE NUMBERS

Occupational Health Services: All employee visits must be triaged by first calling OHS for an appointment at 734-764-8021. Phone lines are available 24/7.

COVID-19 Hotline: Michigan Medicine patients should call the COVID-19 Hotline for questions about symptoms, home management, and specific steps to receive care or testing. The hotline is 734-763-6336, available 24/7. 

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