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Staff

A thank you to state employees from Governor Ned Lamont:

UConn Health Coronavirus Think Tank

Updates

COVID-19 Diagnostics

COVID-19 Testing at UConn Health

Contributor: Enrique Ballesteros, MD

What testing is available for COVID19?
The test for COVID19 is the Real-Time RT-PCR. The availability of this molecular test has been increasing rapidly across the United States as more manufacturers and laboratories have received Emergency Use Authorization (EUA) from the FDA for its use.

Where is UConn Health sending specimens for COVID19 testing?
Over the past few weeks the UConn clinical laboratory has sent specimens to the CT DPH, Quest Diagnostics and the Jackson Laboratory (JAX lab).
Currently, specimens are sent as follows:
Inpatients and Hospital staff: JAX Lab
Outpatients and Public: Quest

What are the turnaround times (TAT)?
JAX Lab – 24 hours
Quest – approximately 4-6 days

Is UConn doing any in-house testing for COVID-19?
No, we are currently not offering in-house testing for COVID-19.

We plan to bring the test in-house on an instrument we already have – the CEPHEID platform (this is the same instrument we test for influenza, RCV, MRSA). We have not received from the vendor the recently FDA approved reagents (test kits) for COVID-19 testing. In addition, the reported allocation of reagents to our lab will be very small (due to limited supplies, increased demand, and strict allocation to hospitals), so in the near future this option will only provide some very limited in-house testing.

Are there any other tests/platforms available that UConn is exploring?
Yes, we have reached out to Abbott regarding the recently FDA approved molecular based rapid test called ID NOW. We have not received any notification about availability of this platform. We continue to work with Abbott to bring this instrument to our laboratory.

What about serology?
Serologic tests are used to identify patients who have developed antibodies (e.g., IgG, IgM) to an infectious pathogen. The UConn Health clinical laboratory will be offering in the near future an IgG test (SARS-CoV-2 IgG assay) for COVID-19. Serologic tests for COVID-19 are currently not recommended for diagnosis in the acute setting (i.e. to determine whether a patient is currently infected) and should not replace RT-PCR. Of note, the immune response to COVID-19 is not yet fully understood, and serologic tests will be negative prior to development of antibodies which may be variable after infection with the virus. Please note positive results with this assay may be due to past or present infection with non-SARS-CoV-2 coronavirus strains.

What are the major roadblocks for laboratory testing for COVID-19?
Demand exceeds supplies. While new tests keep coming up and advertised, hospital-based clinical labs continue to face many challenges on availability on various components for testing.

  • Availability of new instruments
  • Availability of reagents/test kits
  • Availability of swabs for collection of specimens

Petherick, A. (2020). Developing antibody tests for SARS-CoV-2. Lancet, 395(10230), 1101-1102. doi:10.1016/S0140-6736(20)30788-1

If you have any comments or questions about COVID-9 testing, please let me know.

Enrique Ballesteros, M.D.
Chair, Department of Pathology and Laboratory Medicine
UConn Health
Office: 860-679-6714; Cell: 860-348-6122

SARS-COVID-2 and Acute Kidney Injury (AKI)

Rate of AKI reported in SARS-CoV-2 patients is around 5-8 % 1,2,3,4, some with urinary manifestations (proteinuria, albuminuria, hematuria), with or without evidence of AKI. Outcome data is generally lacking, especially in patients with underlying CKD. Past experiences with CoV (SARS CoV, MERS) kidneys involvement are not very well understood.

Pathogenesis of the AKI could be in the setting of either sepsis - cytokine storm syndrome, direct cellular injury due to the virus, or a combination of both.

SARS-CoV2 and AKI

  • Hematuria ~ 28%, proteinuria 44 % (even massive albuminuria) reported in patients during hospitalization4
  • Mortality risk, ICU admission and mechanical ventilation all increased when AKI present4
  • Virus most likely binds to ACE-2 receptor, which is highly expressed in the brush border of proximal tubular cells, less in podocytes, and not in glomerular endothelial and mesangial cells
  • Post mortem tissue analysis showed evidence of virus in tubular epithelium and podocytes. Parenchymal infection of tubular epithelial cells and podocytes, with marked acute tubular injury and sometimes necrosis. No evidence of vasculitis, interstitial inflammation or hemorrhage5

  SARS-CoV, and MERS-CoV and AKI

  • Acute kidney injury (AKI) developed in ~ 7 % of SARS-CoV cases and carried a high ~ 92% mortality rate vs ~ 9 % if no renal impairement6
  • Post mortem renal tissue analysis did not detect SARS-COV ultrastructurally, yet PCR fragments of CoV found in urine in 21-50 % of patients. Pathology findings consistent with ATN in all samples with no evidence of glomerular involvement or interstitial infiltrate6
  • Angiotensin converting enzyme-2 and dipeptidyl peptidase-4, both expressed on renal tubular cells, were identified as likely binding partners for SARS-CoV and MERS-CoV7
  • MERS-CoV associated AKI, limited statistical data available, not very common in general, no post mortem renal tissue data found7

Recommendations

Early screening for possible viral kidney involvement in otherwise relatively stable patient. In addition to routine blood tests, obtain complete automated urinalysis testing with microscopic urine sediment examination, urine protein creatinine ratio, urine microalbumin creatinine ratio, sodium, creatinine, and urea nitrogen in random urine samples. Establish early intervention strategy to avoid complications.

COVID-19 Prophylaxis

COVID-19 Treatment

There have been 3 recently published small case series on the use of convalescent plasma (CP) to treat severe COVID–19 out of China.  Several clinical trials are ongoing in the US and in other countries.

In the study by Shen et al 5 severely ill patients with coronavirus disease 2019 (COVID-19) were treated with CP (Shen et al., 2020). Convalescent plasma (1 400 mL: dose) was administered between 10 and 22 days after admission.  All patients had severe respiratory failure and were receiving mechanical ventilation; 1 needed ECMO and 2 had bacterial and/or fungal pneumonia.  Four patients received convalescent plasma around hospital day 20, and 1 was transfused at day 10. Although these patients continued to receive antiviral treatment primarily with lopinavir/ritonavir and interferon, the use of convalescent plasma may have contributed to their recovery because the clinical status of all patients had improvement approximately 1 week after transfusion, as evidenced by normalization of temperature as well as improvements in SOFA scores and Pao2/Fio2 ratio. In addition, the patients’ neutralizing antibody titers increased and PCR was negative between 1 and 12 days after transfusion.

In the study by Zhang et al 4 critically ill patients (including a 31-year old pregnant woman) improved and recovered after CP transfusions.  3 were mechanically ventilated; 2 received ECMO and CVVH.  All transfused between 16 and 19 days from admission.  2 patients received 1 200 mL dose; 2 received multiple doses of 200 or 400 mL. All became PCR negative and were discharged (Zhang et al., 2020).

In the study by Duan et al. 10 patients with severe COVID-19 received 1 200 mL dose of CP. The median time from onset of illness to CP transfusion was 16.5 d(Duan et al., 2020).  Three were on mechanical ventilation.  All received a variety of antivirals and antibacterials, as well as most on methylprednisolone. All symptoms in the 10 patients (fever, cough, shortness of breath) disappeared or largely improved within 1 to 3 d upon CP transfusion. Prior to CP, three patients were on mechanical ventilation, 3 received high-flow nasal cannula oxygenation, and 2 received conventional low-flow nasal cannula oxygenation. After treatment with CP, two patients were weaned from mechanical ventilation to high-flow nasal cannula, and one patient discontinued high-flow nasal cannula. On chest CTs, all patients showed varying degrees of improvement of pulmonary lesions after CP transfusion. Of the 7 patients who were PCR + prior to CP, all 7 were negative after.

A historic control group was formed by random selection of 10 patients from the cohort treated in the same hospitals and matched by age, gender, and severity of the disease. Baseline characteristics of patients showed no significant differences, while clinical outcomes of these two groups were different: three cases discharged while seven cases in much improved status and ready for discharge in CP group, as compared to three deaths, six cases in stabilized status, and one case in improvement in the control group (P < 0.001).

Given the lack of clinical trial data, it is not possible to determine the true clinical effect of this intervention. Also patients treated with CP have received numerous other therapies simultaneously (including antiviral agents, antibiotics and steroids), making it difficult to determine specific contribution of CP to the clinical course or outcomes. It is unclear what timing is associated with optimal clinical outcomes.

COVID-19 Convalescent Plasma Protocol.
Contributors: Lisa Chirch MD, Mauricio Montezuma, MD, MPH.

We are now a registered site for the Convalescent Plasma Mayo Clinic protocol. Treating providers (Infectious Diseases and Critical Care) have been enrolled online.

If needed we can still apply to the FDA for eINDs for individual patients.

Information for potential donors:

UConn Health employees who have recovered from COVID-19 have volunteered to donate convalescent plasma. Information is being collected through the Call Center. Potential donors are screened by the Infectious Diseases Provider, who will order necessary tests to determine donor eligibility. Convalescent Plasma Collection will take place at the American Red Cross.

In the near future, convalescent plasma collection will be open to the general public.

Links of interest:

All potential donors should register at the American Red Cross Website: https://www.redcrossblood.org/donate-blood/dlp/plasma-donations-from-recovered-covid-19-patients.html

General information page: https://www.uscovidplasma.org/

Link to consent form: https://www.uscovidplasma.org/pdf/EAP%20CP%20English%20Consent%2020.00331200.pdf

Link for detailed protocol (Mayo): https://www.uscovidplasma.org/pdf/20-003312%20COVID-19%20Plasma%20EAP%20Version%202.0.pdf

References

Duan, K., Liu, B., Li, C., Zhang, H., Yu, T., Qu, J., . . . Yang, X. (2020). Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A. doi:10.1073/pnas.2004168117

Shen, C., Wang, Z., Zhao, F., Yang, Y., Li, J., Yuan, J., . . . Liu, L. (2020). Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA. doi:10.1001/jama.2020.4783

 


RAS inhibitors and COVID
Contributor: Eric Mortensen, MD.

What we know:

  • SARS-nCov-2 binds to the ACE 2 receptor.
  • ACE inhibitor and ARB use causes increased expression of the ACE 2 receptor.
  • A recent study found that there is elevated level of angiotensin II in COVID19 patients, which may cause increased inflammation, lung injury, and cytokine storm (Liu et al., 2020).
  • Small RCT (abstract only) demonstrated lung protective effects with ACE inhibitor (Wirtz et al., 2017).
  • Studies have demonstrated improved outcomes with ACEI/ARB use in patients with pneumonia (Caldeira, Alarcão, Vaz-Carneiro, & Costa, 2012) and ARDS (Kim et al., 2017).
  • Professional societies are saying don’t stop these drugs in those who are on them but don’t start if not indicated for another indication.

Questions:

  • Can use of RAS inhibitors increase serum levels of ACE2 and reduce viral entry by competitive inhibition.
  • Can use of RAS inhibitors have immunomodulatory and/or lung protective effets in COVID patients.

Important issues/questions:

  • Almost all of studies in humans for pneumonia/ARDS have looked at prevalent use not incident use of these drugs.
  • Unclear safety data- Will starting these drugs after infection be detrimental by increasing binding sites before competitive inhibition?

References

Caldeira, D., Alarcão, J., Vaz-Carneiro, A., & Costa, J. (2012). Risk of pneumonia associated with use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers: systematic review and meta-analysis. BMJ, 345, e4260. doi:10.1136/bmj.e4260

Kim, J., Choi, S. M., Lee, J., Park, Y. S., Lee, C. H., Yim, J.-J., . . . Lee, S.-M. (2017). Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study. Korean J Crit Care Med, 32(2), 154-163. doi:10.4266/kjccm.2016.00976

Liu, Y., Yang, Y., Zhang, C., Huang, F., Wang, F., Yuan, J., . . . Liu, L. (2020). Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Science China Life Sciences, 63(3), 364-374. doi:10.1007/s11427-020-1643-8

Wirtz, H., Hasenclever, D., Schwabe, K., Jaschinski, U., Weyland, A., Kuhnt, E., . . . Hammerschmidt, S. (2017). Ace Inhibitor For Lung Protection During Mechanical Ventilation For Acute Lung Injury- Results Of The Double-Blind, Placebo Controlled, Randomised Acemevent Pilot Study. American Journal of Respiratory & Critical Care Medicine, 195, A2895.

 


UConn Health COVID-19 Treatment Guidelines

 

COVID-19 Treatment Protocol:

Contributor: Jeff Aeschlimann, Pharm D.

The findings of no significant benefits from a couple released manuscripts of trials of hydroxycholorquine were discussed at the meeting. At this time, the general recommendations for treatment of patients with hydroxycholorquine will remain unchanged from the previous version (Version #3) of the protocol.   

There will be some minor changes to the protocol to reduce the amount of laboratory testing in non-ICU patients, and specifically, blood typing & screening will be limited to all patients admitted to the ICU only.  Based on discussions during the meeting, general recommendations will be added to the protocol for the following:

·         A recommendation for prophylactic anticoagulation for all patients with COVID-19 infection

·         A recommendation to continue patient’s chronic maintenance medications such as ACE inhibitors, Angiotensin receptor blockers (ARBs), and/or statin medications unless there are acute contraindications such as hypotension and/or acute significant increases in LFTs

COVID-19 Complications

Role of thrombosis in COVID-19 patients and use of anticoagulants
Contributors: Michael Blechner, MD
Blood Bank Medical Director, UConn Health

Coagulopathy has been a significant management issue in ICU COVID patient. Current evidence suggests a possible increase in risk for VTE & DIC, confirmed by Autopsy findings of pulmonary microthrombi in Wuhan.

Elevated D-dimer on admission or 3-4-fold increase over time, associated with high mortality (Tang et al). Limited data suggests ~20% decrease in mortality with prophylactic anticoagulation in most severe patients (Tang et al).

Patients with significantly elevated D-dimers should be considered for admission even in the absence of other signs and symptoms

Worsening of DIC labs (PLT, PT, aPTT, D-dimer, fibrinogen) indicates progressive severity and suggests need for more aggressive care, experimental therapies might be considered

What is the role for anticoagulation?

  • Pharmacologic prophylaxis for all patients unless CI
  • Not therapeutic anticoagulation unless VTE (Recommendations for therapeutic anticoagulation from China may be skewed by settings where prophylactic anticoagulation was not used)

Pathophysiology

  • Mechanism for thrombosis likely multifactorial – SAR, stasis, endothelial damage
  • Anti-inflammatory properties of heparin
    • Bidirectional relationship between immune response and thrombin generation
    • Blocking thrombin generation with heparin may blunt the inflammatory response
    • Heparin binds and sequesters acute phase proteins including inflammatory cytokines and histones that can cause endothelial damage
    • Antiviral role of heparin studied in animal models showed possible interactions with spike protein. It is possible that spike protein is cleaved by FXa and FIIa and thus anticoagulation might inhibit infectivity

Guideline Summaries

Prophylaxis

  • All COVID-19 positive in-patients should receive pharmacological thromboprophylaxis unless otherwise contraindicated
    • For CrCl > 30: LMWH or fondaparinux
    • For CrCl < 30 or AKI: UFH 5000 units SC BID or TID
    • Immobilized patients can also benefit from intermittent pneumatic compression
    • Use mechanical thromboprophylaxis only if platelets < 30,000
    • Abnormal coagulation test results are not a contraindication in the absence of bleeding
    • Should be held for platelet count < 25,000 or fibrinogen < 50 mg/dL
  • Therapeutic anticoagulation has no known benefit and is not recommended unless documented VTE
    • Consider switching to therapeutic levels of LMWH or UFH for patients taking oral anticoagulants due to drug interactions (covid19-druginteractions.org) and easier reversal of anticoagulation

General Management

  • Patients with significantly elevated D-dimers should be considered for admission even in the absence of other signs and symptoms
  • Worsening of DIC labs (PLT, PT, aPTT, D-dimer, fibrinogen) indicates progressive severity and suggests need for more aggressive care … experimental therapies might be considered

Management of bleeding

  • FFP: 12-15 ml/kg (typically I unit for every 20 kg or 4 units in an adult) for PT or PTT > 1.5 times upper limit of normal or INR > 1.8
    • Consider 4F-PCC (KCentra) for patients with significant volume issues
  • Platelets: 1 dose for platelet count < 50,000
  • Cryoprecipitate: 2 doses (10 pooled units) for fibrinogen < 150 mg/dL
  • Abnormal coagulation test results do not require correction in non-bleeding patients

Management of Coagulopathy in DIC

  • Typically, not associated with bleeding, but active bleeding should be managed as above
  • Non-bleeding patients
    • Cryoprecipitate: 2 doses (10 pooled units) for fibrinogen < 150 mg/dL
    • Platelets: 1 dose for platelet count < 30,000

 Resources

  • ISTH (International Society on Thrombosis and Haemostasis) COVID-19 Resource page (https://academy.isth.org/isth)
  • ASH (American Society of Hematology) COVID-19 Resources page (https://www.hematology.org/covid-19)

 References

  • Thachil, J et al, ISTH interim guidance on recognition and management of coagulopathy in COVID‐19, peer reviewed and accepted for publication in J Thromb Haemost. https://onlinelibrary.wiley.com/doi/10.1111/jth.14810
  • Tang, N et al, Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy, J Thromb Haemost. 2020.
  • Wang, J et al, Tissue Plasminogen Activator (tPA) Treatment for COVID-19 Associated Acute Respiratory Distress Syndrome (ARDS): A Case Series, J Thromb Haemost. 2020 Apr 8Liu, X, et al, Therapeutic effects of dipyridamole on COVID-19 patients with coagulation dysfunction, not yet peer reviewed, accessed from medRxiv (https://www.medrxiv.org/content/10.1101/2020.02.27.20027557v1)

 


Cancer care during the COVID19 pandemic
Contributor: Bradford Whitcomb, MD.

Cancer care has been disrupted worldwide due to the COVID-19 pandemic.  Areas most impacted in the United States have adjusted treatment approaches to those with new malignancies and with recurrences to reduce transmission to these more susceptible patients.  There is limited information regarding specific treatment recommendations at this time, but early information from cancer patients affected by COVID in China revealed an increased risk of infection and severity.  A more recent pooled meta-analysis reiterated the risk in these patients (ref).  NCCN, ASCO, and other societies (such as the Society of Gynecologic Oncology) have made broad recommendations for care of our malignancy population which we have mostly adopted to our practice at UConn Health. Specific treatment, or delay of treatment, is very individualized, of course, and would defer to the patient and provider to formulate the ultimate plan. This is also dependent on the COVID infection curves in the specific region in which the patient is being treated.  More importantly, we must plan ahead for after the first wave. We will be very busy with surgeries and new diagnoses in the summer, but also need to be prepared for a seasonal resurgence of the virus.

References

-          Yu J, Ouyang W, Chua MLK, Xie C. SARS-CoV-2 Transmission in Patients With Cancer at a Tertiary Care Hospital in Wuhan, China. JAMA Oncol. Published online March 25, 2020. doi:10.1001/jamaoncol.2020.0980

-          Zheng, L. et al. Clinical characteristics of COVID-19-infected cancer patients: A retrospective case study in three hospitals within Wuhan, China. Ann. Oncol. https://doi.org/10.1016/j. (2020).

-          Liang, W., Guan, W., Chen, R., Wang, W., Li, J., Xu, K., . . . He, J. (2020). Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol, 21(3), 335-337. doi:10.1016/S1470-2045(20)30096-6

-          Sidaway, P. COVID-19 and cancer: what we know so far. Nat Rev Clin Oncol (2020).

https://doi.org/10.1038/s41571-020-0366-2

Links of Interest:

 

https://doi.org/10.6004/jnccn.2020.7560

https://www.sgo.org/clinical-practice/covid-19-communique/

https://www.asco.org/asco-coronavirus-information/provider-practice-preparedness-covid-19

https://ascopubs.org/doi/10.1200/GO.20.00097

 

COVID-19 UConn Health Research

2020-04-08 | About the UConn Health Coronavirus Think Tank

The UConn Health Coronavirus Think Tank was launched on April 3, 2020.

The objective of this committee is to review, synthesize and summarize external and internal clinical information including the most current literature related to coronavirus (COVID-19) infection for communication to clinical providers and employees for potential application to clinical care at UConn Health. Also to liaise with the research community to understand and communicate to UConn Health clinical providers and employees applicable research including work on future cures, vaccines and innovations.

Members

Dr. Raymond Foley – Co-Chair

Dr. Mauricio Montezuma-Rusca – Co-Chair

Dr. Pramod Srivastava

Jeff Aeschlimann, PharmD

Dr. Scott Allen

Dr. Enrique Ballesteros

Dr. David Banach

Dr. Michael Blechner

Dr. Lisa Chirch

Dr. Kevin Dieckhaus

Dr. Ibrahim Elali

Dr. Robert Fuller

Dr. Denis Lafreniere

Dr. Anil Magge

Dr. Mark Metersky

Dr. Eric Mortensen

Dr. Ruchir Trivedi

Dr. Bradford Whitcomb

Dr. Leo Wolansky

Dr. Kathleen Zacherl

Dr. Susan Tannenbaum

Dr. Vinay Thomas

Human Resources

Updates

2020-07-02 | Employee Domestic Travel – UConn Health

Dear UConn Health Colleagues,

On June 24th, Governor Lamont announced quarantine guidance for all travelers arriving in or returning to Connecticut from several southern and western states. As the situation remains dynamic, it’s important for employees traveling out of state domestically to review the state’s most up to date guidance before departing and returning from travel.  Employees should consider the impact of this guidance when considering whether to travel.

NON-CLINICAL EMPLOYEES

The following guidance is for employees returning from an identified “quarantine” state:

  • Employees will be required to fill out a form and notify their manager if they are planning to or have traveled to one of the states on the domestic travel list;
  • Where possible, employees should be permitted to telecommute for the recommended period of quarantine;
  • For classified employees unable to telecommute, employees who have not previously been granted paid COVID leave will (1) be granted up to fourteen (14) days (10 paid) COVID leave. If an employee has previously been granted paid COVID leave they will be required to use any available vacation time for any period of quarantine and if the employee does not have sufficient vacation time to cover the period of quarantine then the employee will be placed on unpaid leave.;
  • For unclassified employees unable to telecommute, employees will for the period of quarantine be required to use any available vacation time or compensatory time and if an employee does not have sufficient vacation or compensatory time then the employee will be placed on unpaid leave.

To ensure accurate tracking, employees must upon return, provide appropriate documentation (e.g. boarding passes, car rental receipts, hotel invoices, etc.) to support the need to provide leave upon return from travel.

Employees, classified or unclassified, who were traveling from one of the states listed at the time of the Governor’s travel guidance was issued and any updates thereto should notify their manager upon their return to Connecticut and if they have not already had paid COVID leave and cannot telecommute they will be granted paid COVID leave for the period of quarantine up to ten work days.

FRONT-LINE CLINICAL EMPLOYEES (EMPLOYEES IN CONTACT WITH PATIENTS)

Guidance for front-line clinical employees:

  • Employees will be required to fill out a form and notify their manager if they are planning to or have traveled to one of the states on the domestic travel list;
  • Report to work unless symptomatic;
  • Undergo several daily temperature checks (4-6 hour intervals);
  • Wear facemasks at all times on UConn Health premises;
  • Eat alone and separately from others;
  • Prohibited from sharing meals or socializing in circumstances that would require facemask removal;
  • Self-isolate when not at work.

NOTE:

To ensure accurate tracking, all employees must upon return, provide appropriate documentation (e.g. boarding passes, car rental receipts, hotel invoices, etc.) to support the need to provide leave upon return from travel.

The failure to report travel from a quarantine identified state could result in disciplinary action.

Questions on domestic travel may be sent to hr-employeeresource@uchc.edu.

Thank you,

Human Resources

 

2020-06-19 | Guidance – UConn Health – COVID-19 Testing for Employees

Introduction

UConn Health has implemented entry screening protocols and social distancing measures throughout our facilities, provided personal protective equipment (PPE), and put numerous other safety precautions in place to combat the spread of COVID-19. An employee SARS-CoV-2 testing program is another part of this strategy, helping us determine the prevalence of COVID-19 among our employees. Understanding this prevalence rate throughout and within specific areas will be an important tool as we continuously update our overall safety strategy and protocols. This employee testing program aligns with both state re-opening guidelines and sound principles for managing the pandemic risk as we ramp up our outpatient practices.

Guidance

  • Testing of Symptomatic Employees. UConn Health employees who experience symptoms of COVID-19 will continue to be referred to the UConn Health COVID-19 Call Center for assessment by a provider and the determination of whether SARS-CoV-2 testing is indicated.
  • Testing of Asymptomatic Employees. UConn Health will phase-in a program of randomized COVID-19 sampling for asymptomatic employees. Phase 1 of the program will involve randomly choosing UConn Health direct care employees working in both hospital and outpatient clinical environments (including Dental) for sampling, to determine COVID-19 prevalence. A statistically significant number of clinical employees will be chosen to participate in the Phase I sampling, to ensure confidence in the results.Participation in the Phase I sampling is voluntary, not mandatory. However, participation is strongly encouraged, as it will help our organization determine the prevalence of COVID-19 among our employees.

    Phase II of the program will move forward based upon the results of the Phase I sampling. Based on the prevalence of positive results and other data we obtain in Phase I, we will determine next steps, which may include testing additional employees, providing repeated surveillance testing, or focusing testing on certain areas.

  • Exceptions. UConn Health employees who are required by state law to be tested for COVID-19, such as those who work in nursing homes and assisted living facilities, will not be part of the phased-in program of randomized sampling. Such employees, as well as symptomatic employees, are required to be tested for COVID-19 to continue to perform their duties.
  • Positive Results. An employee who tests positive will be contacted by the UConn Health COVID-19 Call Center. The COVID-19 Call Center will notify Human Resources and the employee’s manager via secured email. The COVID-19 Call Center will also provide guidance and information to the employee on the need for self-monitoring or isolation, based on institutional and CDC guidelines and, where appropriate, will refer the employee to her or his primary care physician for medical care.Employees who test positive are also required to provide information to enable contact tracing to be performed. Accordingly, employees experiencing symptoms who seek testing outside of UConn Health must call the UConn Health COVID-19 Call Center with the results.

Download the Guidance Document

2020-06-19 | FAQ: Employee COVID-19 Testing Program

Q: Why are we starting a COVID-19 employee testing program?
As we return to more regular services at UConn Health, we want to ensure employee and patient safety. Part of this strategy is assessing the prevalence of the SARS-CoV2, the virus that causes COVID-19, in asymptomatic employees. We are currently only aware of the infection rate among employees who have presented with virus symptoms or had a specific exposure incident. Also, this employee testing program aligns with both state reopening guidelines and sound principles for managing the pandemic risk as we continue to ramp up our outpatient practices and return to providing regular services.

Q: Who is being tested?
We are taking a phased approach to our COVID-19 employee testing. We will begin with a point prevalence sampling of approximately 900 or 33% of our approximately 2,700 clinical workers, including those who work in the hospital or outpatient care settings, including dental. The individuals in the Phase I sample group will be chosen randomly.

Q: Who is included in the group of approximately 2,700 clinical workers from which the randomly selected sample size is chosen?

Based on guidance received from the State and UConn Health Infection Control, those included in the Phase I sampling are employees from across departments at UConn Health who spend greater than 10 minutes within 6 feet of patients; have prolonged/regular contact with blood or body fluids; or work with high risk individuals.

Q: How do employees actually get the test done? 

Employees who have been randomly selected to participate in the Phase I testing group are receiving emails with instructions about how to proceed. An employee must sign up for MyChart to be able to schedule his or her test.

Q: Will testing be expanded to all employees?
Based on the prevalence of positive results and other data we obtain in Phase I, we will determine next steps, which may include testing additional employees, providing repeated surveillance testing, or focusing testing on certain areas. 

Q: How will I be tested?
Phase I initial employee screenings for COVID-19 will be conducted by obtaining a clinical sample via nasopharyngeal swab for SARS-CoV2 RNA PCR testing. The dedicated employee testing location is the sampling tent outside of the Emergency Department.

Q: What if I test positive?
Should you test positive for the virus, our COVID-19 Call Center will promptly contact you to assess any health care needs and will provide guidance on next steps regarding work activities.  The Call Center also will send a secured email notification to Human Resources and your manager. Epic will safeguard the confidentiality of this information. Asymptomatic employees with a positive test will be notified by the COVID-19 Call Center to follow standard policy and quarantine at home for the required 10 days. Such employees will qualify for COVID-19 Sick Leave or given a telecommuting assignment as appropriate.

Q: What if I prefer not to be tested?
Participation in the Phase I sampling is voluntary, not mandatory. However, participation is strongly encouraged, as it will help our organization determine the prevalence of COVID-19 among our employees. Understanding the prevalence rates both throughout the organization and within specific areas will provide important data to help inform our ongoing safety strategy and protocols.

Q: The communication from Dr. Agwunobi stated that a future phase may include mandatory testing; under what conditions would UConn Health require mandatory employee testing in Phase II?
At this time, we do not anticipate mandatory testing of asymptomatic employees.  However, two potential scenarios that could lead to mandatory testing include: (1) an external mandate or recommendation to test health care employees from the State of Connecticut, the state’s Department of Public Health, or another governing body; or (2) ongoing transmission or even an outbreak of the virus within one area of the facility that can’t be mitigated with other interventions.  However, both of these scenarios at this point in time seem unlikely. Currently, there is only an executive order by the Governor mandating weekly COVID-19 testing for staff across nursing homes, senior housing, and assisted-living centers. This mandated testing began in June.

Q: Will I have to be tested again in the future?
Our current prevalence assessment for COVID-19 at this time is a one-time baseline PCR test for the random sample size of Phase I asymptomatic employee groups. Should our testing strategy change or the testing frequency needs to be adjusted, we will communicate updates to the UConn Health community.

Q: What if I have questions or concerns about testing, or if I am not sure if I am a Phase I selected participant?
If you have any questions, please contact the COVID-19 Call Center at 860-679-3199, Monday through Friday from 8 a.m. to 5 p.m.

For MyChart technical support, call the IT Help Desk at x4400.

Download this FAQ as a PDF

2020-06-17 | COVID-19 Employee Testing

As we return to regular services, based on consultation with our infection control and testing teams, I wanted to inform you that UConn Health will take a phased approach to COVID-19 employee testing beginning on June 23. This will involve:

Phase I: Prevalence testing for COVID-19 of approximately 900 (or 33%) of our 2,700 front-line clinical workers using a PCR test. Employees who provide direct patient care in the hospital or outpatient care settings will be randomly selected and invited individually by email to participate in the Phase I COVID-19 testing sample group. Participation in the Phase I sampling is voluntary not mandatory. However, participation is strongly encouraged, as it will help our organization determine the prevalence of COVID-19 among our employees.

Phase II: Based on the prevalence of positive results in Phase I we will determine whether testing of additional employees is warranted, what form that testing should take, and whether it would be voluntary or mandatory. It will also inform us regarding how to structure the Phase II testing, for example, whether to provide widespread repeated surveillance testing to focus testing on certain areas, or to include more employees in the testing sample.

This employee testing program aligns with both state reopening guidelines and sound principles for managing the pandemic risk as we continue to ramp up our outpatient practices and return to providing regular services. We will be closely monitoring our prevalence rate and comparing it to the infection rate within the local community and other area hospitals.

For convenience, we have set up a sampling tent outside of the Emergency Department dedicated to testing our employees. Those identified for the first phase of our employee testing program will be notified soon by email of how to schedule their test via MyChart. An employee must sign up for MyChart to be able to schedule his or her test. Note, you will not be eligible to participate if you’ve had a positive COVID-19 PCR test in the last six weeks.

Initial employee screening will be conducted by obtaining a clinical sample via nasopharyngeal swab for SARS-CoV2 RNA PCR testing by the UConn Health Clinical Laboratory. Should you test positive for the virus, our COVID-19 Call Center will promptly contact you to assess any health care needs, provide guidance on next steps regarding work activities and also will send a secured email notification to Human Resources and your manager. Epic will safeguard the confidentiality of this information.

Asymptomatic employees with a positive test will be notified by the COVID-19 Call Center to follow standard policy and quarantine at home for the required 10 days. Such employees will qualify for COVID-19 Sick Leave.

Thank you for your cooperation in the implementation of this COVID-19 prevalence assessment. Understanding the prevalence rates both throughout the organization and within specific areas will provide important data to help inform our ongoing safety strategy and protocols.

If you have any questions, please contact the COVID-19 Call Center at 860-679-3199, Monday through Friday from 8 a.m. to 5 p.m.

For MyChart technical support, call the IT Help Desk at x4400.

2020-05-15 | Resuming Regular Services at UConn Health– General Guidelines

MAY 15, 2020

RESUMING REGULAR SERVICES AT UCONN HEALTH

General Guidelines

 

As we begin to resume our regular services interrupted by the COVID-19, pandemic below are some guidelines and resources for your information.

Bookstore: The UConn Health Bookstore is closed until further notice. Until further notice, please contact Len Oser at SM8207@bncollege.com. Shop online for your UConn merchandise at https://uconn.bncollege.com.

Cafés: Meals will continue to be served in our cafeterias. Cafeterias will continue to restrict self-service options and will increase grab n’ go selections. Cafeterias in the MSI and Outpatient Pavilion 5th floor continue to run regular hours. Munson Café and OPPV 3rd floor café will open at a later date. Starbucks will reopen on June 1 with Starbucks core menu and limited hours. Please be sure to maintain a social distance of 6’ while eating in the café or outside when weather improves.

Childcare: We will resume regular operations, including fees, on June 1 at the Creative Childcare Center.

Cleaning: Facilities Operations cleans all PUBLIC/COMMON areas with appropriate disinfectants on a nightly basis and is disinfecting high-touch points frequently throughout the day. Facilities is also monitoring air ventilation rates and increasing the amount of outside air that can be brought in. DEPARTMENTS/UNITS are responsible for cleaning individual offices, their conference rooms, shared equipment, and other high-touch areas in their units throughout the day. The Office of Logistics Management (OLM) will provide disinfecting wipes and hand sanitizer to departments based on the number of office/lab/clinical spaces. Due to limited supplies each one will need to service multiple employees in one or more spaces. Empty containers should be retained for OLM to pick up when the next delivery is made.

Conference Rooms/Lounge Area: Employees should continue to use teleconferencing whenever practical and effective. If you need to use a conference room, we are asking that you book no more than 25% of maximum capacity, and in no case shall a room be booked to include more than 50% of allowable capacity for the room. Social distancing of 6’ should be able to take place. If you are unsure of the capacity, check with your department administrator. Please remember to wear masks and to clean high-touch areas such as tabletops, chairs, doorknobs, touch screens, key boards, etc. before and after each meeting. All IT/Telecomm screens need to be cleaned with wipes that have a 70% Alcohol base (White Top). Departments should order cleaning supplies from central supply for each conference room under their purview and make such supplies available for this purpose. 

Masking: Masks must be worn at all times. If you are eating or drinking please adhere to a strict social distance of at least 6’. Also, if you see colleagues or patients without a mask please respectfully remind them of the importance of wearing one, as doing so protects us all. Masks have been provided to department heads for their staff. If you don’t have a mask, contact your manager. Masks, along with other essential PPE products including wipes, will be issued by Office of Logistics Management using the email address PPE@uchc.edu. Emails received will be filled within 1-2 workdays. Weekend orders should be received no later than noon on the prior Thursday.

Parking Areas and Parking Garages:

Patient Parking

  • Self-Park Garages – The patient gates in Garage 1 and Garage 3 will be lowered in mid-June. At this time the posted fees will be required.
  • Valet Parking – Normal valet service and the associated fees will resume in mid-June, at the same time that the patient gates are lowered in the garages. Until that time valet staff will continue to greet and assist with arrivals and departures, manage the valet drive traffic flow, direct cars to use the adjacent self-park areas, and offer a limited valet service to patients with mobility challenges.

Employee Parking

  • Lower Campus – Due to the COVID-19 sampling operations in Lot L3 we will continue to provide temporary parking accommodation for employees who work in the lower campus. At this time employees with an Area 3 permit may use the upper levels (levels 4, 5 and 6) of Garage 1 as needed when Lots L2 and L4 are full. Employees should use the level 6 entrance and exit of the garage.
  • Upper Campus – Employees will continue to park in their assigned permit areas.

Screening Stations & Entry Points: To protect our patients and colleagues, we will continue to have designated screening entrances. Before reporting to work each day, you will need to undergo temperature screening and answer questions about possible COVID-19 symptoms and risks. Please use a designated entrance and be sure you are wearing your mask as you enter. Select offsite locations will develop their own employee screening methods.

Shuttle Service: We will resume limited service to 400 Farmington Avenue on May 20. Shuttle service will begin to increase in frequency to pre COVID times. Check the website/app for time changes.

Social Distancing: Social Distancing should be practiced at all times. Please do not relax your social distancing even within your own department and colleagues. It is important that we continue social distancing and encourage others to do so. We have taken numerous steps to ensure proper social distancing throughout our facilities. For example, we have put up signs on chairs in all waiting areas so people will be spread out. You will see Plexiglas at all front desk areas and large red arrows that are in place to guide patients and staff through the facility in a managed directional flow in order to limit congestion.  We have restricted elevators to a maximum of two people and three people in the Outpatient Pavilion. Please give courtesy to patients at the elevator when there are more than the maximum at one time. Employee workstations should be properly distanced as well. Departments in need of assistance in modifying work areas should contact Facility Operations.

Telecommuting: Based on assessment and approval of managers/directors, employees who are able to perform the essential functions of their jobs from home should continue to work from home. Check with your manager or director to update your telecommuting letter/agreement accordingly.

WebEx: Continue to use WebEx as your primary conferencing tool. Everyone who has a UCHC.edu email has access to WebEx. If you need help with the technology, please call 860-679-4400

Wellness Center: The Wellness Center is currently still closed. Stay tuned for further updates.

As always, if you are experiencing symptoms or have concerns of COVID-19, please contact your healthcare provider or our COVID-19 Call Center for further instruction.

The health and safety of our employees, patients, learners and visitors is our primary concern.  We will continue to assess our policies and practices and to make modifications based on available information, data, and evolving scientific knowledge, including newly established federal and state guidelines.

2020-04-09 | Timecard Guidance

2020-04-09

Due to the COVID-19 pandemic, employee timecards must track the categories of time shown in the grid below.

Please understand the grid may not have captured every particular situation. If you cannot make a determination with the aid of the grid, please contact the Employee Resource center for assistance. Please also understand that in addition to what you record on the timecard, you may be required to provide medical and/or leave documentation to the Leave Management unit. You may also contact the Employee Resource center for Leave team questions.

Faculty timecards are due this pay period. Faculty continue to only record vacation usage.

Updates to the guidance will be provided as appropriate. Thank you for your patience as we continue to work through the evolving time reporting requirements related to COVID-19.

 

Payroll Guidance for Regular Payroll Timekeepers
Situation Reason Details Classified Unclassified (UHP + Man/Con)
Reporting to Work Normal Duties Record Hours Worked or punches
Reassigned Duties
Telecommuting Pre-COVID Telecommuting  Agreement Normal Duties Record Hours Worked or punches
Quarantine Level 3 Travel Record Hours Worked or punches and add comment "COVID-Quarantine"
Household Member COVID Symptoms/Diagnosis
Physician Recommendation Due to Exposure or Underlying Condition
Employer Sent Home Due to Exposure
Recovery Following Illness
Self Distancing with Management Approval Employee or Employer Request for Social Distancing Record Hours Worked or punches and add comment "COVID-Telework"
Recommendation of Primary Care Physician
Childcare/Eldercare/
Transportation
Due to Childcare/Eldercare/Transportation Record Hours Worked or punches and add comment "COVID-Childcare"
Caregiver Needs Caregiver for sick immediate family member Record Hours Worked or punches and add comment "COVID-Caregiver"
Unable to Work and/or Telecommute Quarantine Level 3 Travel Record '421 - Paid Leave' up to 14 days and add comment "COVID-Quarantine"
Household Member COVID Symptoms/Diagnosis
Physician Recommendation Due to Exposure
Employer Sent Home Due to Exposure
Physician Recommendation Due to Employee's Own Underlying Medical Condition During Pandemic Record '421 - Paid Leave' up to 14 days and add comment "COVID-Quarantine" Use accrued time paycode and add comment "COVID-Quarantine"
Sickness Out Sick unrelated to COVID Use accrued time paycodes
Called out Sick due to COVID symptoms without medical documentation Record '421 - Paid Leave' up to 14 days and add comment "COVID-Sickness" Use accrued time paycodes and add comment "COVID-Sickness"
Called out Sick due to COVID symptoms with medical documentation Record '421 - Paid Leave' up to 14 days and add comment "COVID-Sickness"
Out Sick due to COVID diagnosis
Employer sent home due to COVID symptoms
Caregiver Needs Sick immediate family member - unrelated to COVID Use accrued time paycodes
Childcare/Eldercare/
Transportation
School/daycare/eldercare closings With management approval, Record '421 - Paid Leave' up to 14 days and add comment "COVID-Childcare" Use accrued time paycode (excluding sick) and add comment "COVID-Childcare"
Transportation disruptions
Prescheduled Time Off Pre-approved vacation, comp, or personal time (non COVID) Use accrued time paycode (excluding sick)
Time Off with Management Approval Employee COVID Concerns (i.e. health condition, age, family, etc.) Use accrued time paycode and add comment "COVID-Other Concerns"
Lack of Work Employee sent home due to lack of work with no ability to telecommute Record '421 - Paid Leave' until reassigned and add comment "COVID-Lack of Work"
Payroll Guidance  for Student & Special Payroll Timekeepers
Situation Reason Time Entry
Reporting to Work Normal Duties Record Hours Worked or punches
Reassigned Duties
Telecommuting Record Hours Worked or punches and add comment "COVID-Telework"
Unable to Work and/or Telecommute   No time entry:  These employees only receive pay for hours worked.

2020-04-06 | Frequently Asked Questions for Clinical Employees Regarding COVID-19 Exposure, Quarantine, and Testing

2020-04-06

Please note that FAQs relating to a host of other human resources questions, and FAQs for non-clinical employees may be found here. Please feel free to reach out to Human Resources with any questions you may have at HR-EmployeeResource@uchc.edu

Q.1     I am a clinical staff person and I am experiencing COVID-19 symptoms, what should I do?

A.1      If you are experiencing COVID-19 symptoms (fever, dry cough, body aches, loss of smell or taste, headache) you should immediately call the COVID-19 Call Center at 860-679-3199 and contact your manager.  The staff at the call center can order and schedule a COVID-19 test for you at UConn Health.  If you are experiencing symptoms, you should not report to work unless cleared by Employee Health to do so or until at least 1 week has passed since the onset of symptoms, symptoms have improved and you have been free of fever without any fever-reducing medications for at least 72 hours.  Prior to reporting back to work, you should notify (1) the COVID-19 Call Center at 860-679-3199 for clearance, (2) your manager and (3) human resources through email at HR-EmployeeResources@uchc.edu.

Q.2      I have tested positive for COVID-19, what should I do?

A.2      If you have received a positive test result, either through the COVID-19 Call Center process or through your personal physician and/or testing from another institution, you should immediately notify the COVID-19 Call Center at 860-679-3199.  You should notify your manager and Human Resources through email at HR-EmployeeResources@uchc.edu. You should follow the instructions of the COVID-19 Call Center and not return to work until at least 1 week has passed since the onset of symptoms, overall symptoms have improved and you have been free of fever without any fever-reducing medications for at least 72 hours. 

Q.3      What should I do if I have been exposed to someone who is experiencing COVID-19 symptoms or has tested positive for COVID-19?  Does it matter if this exposure was outside of work, with a co-worker, or with a patient?

A.3      Each of the scenarios noted above is addressed below in order:

a) If you have been exposed outside of work to a COVID-19 symptomatic or positive individual, you should call the COVID-19 Call Center at 860-679-3199. You may be instructed, depending on the date of last known contact or length and circumstances of the contact, to self-isolate and self-monitor for a recommended period of time up to 14 calendar days from the date of exposure. If you were determined to be at low risk, you may be instructed to self-monitor and can report to work as normal.  If you are recommended to be quarantined/self-isolate you should contact Human Resources at HR-EmployeeResource@uchc.edu.  If during this period you develop new symptoms, you should notify the COVID-19 Call Center at 860-679-3199 or your personal physician.

b) If you have been exposed to a co-worker who is positive for COVID-19, you will be contacted by the COVID-19 Call Center or your manager who will conduct a tracer and risk assessment as to whether you were a prolonged, close contact to such individual and may be required to be excluded from the workplace for a period of up to 14 calendar days for quarantine/self-isolation. If the symptomatic co-worker is discovered to not have COVID-19, you will be notified to return to work immediately. You will be instructed to contact the COVID-19 Call Center and your manager at the end of the recommended isolation period and prior to your return to work.  If during this period you develop new symptoms, you should contact your personal physician and notify the COVID-19 Call Center at 860-679-3199.

If you were not a prolonged close contact and are considered to be an individual who is at low risk for exposure, you may be eligible to continue working.  A close contact is defined as an individual who has been within 6 feet for a pro-longed period of time, i.e. for longer than 15 minutes, or someone who has had direct contact with the infectious secretions of a COVID-19 case, for example being coughed on while not wearing any PPE.  Close contact does not include a brief or passing interaction with an individual.

As with all potential exposures, the time period of quarantine/self-isolation is from the date of exposure to COVID-19.  If you have been cleared to return to work you should also contact Human Resources at HR-EmployeeResources@uchc.edu.

c) If you have been exposed to a patient who is positive for COVID-19 and you were in close contact with the patient or the patient’s secretions and you were not wearing a mask or other PPE, you will be notified by the COVID-19 Call Center, other medical staff or your manager that you have been exposed. Depending on the exposure you may be required to be excluded from the work place for a period of up to 14 calendar days for quarantine/self-isolation from the date of exposure. You will be instructed to contact the COVID-19 Call Center and your manager at the end of the recommended isolation period and prior to your return to work.

If you have any concern about a potential exposure to an individual with COVID-19, please contact the COVID-19 Call Center at 860-679-3199 to discuss the nature of the exposure.  As with all potential exposures the time period of quarantine/self-isolation is from the date of exposure to COVID-19.  If you have been cleared to return to work you should also contact Human Resources at HR-EmployeeResources@uchc.edu.

Q.4      Will I receive pay if I have been quarantined/self-isolated, have symptoms of COVID-19 or have been diagnosed with COVID-19?

A.4      If you meet the above criteria with regard to exposure to, suspected or diagnosed COVID-19 positive you will be eligible for up to 14 calendar days (typically 10 work days) of administrative leave that will not come out of your leave benefits, i.e. sick, vacation or personal leave.  If you are sick beyond the period noted above you will have to utilize your accrued leave benefits.

Any other illness will require the use of your leave benefits in accordance with normal process and procedures.  If you are asking for administrative leave for COVID-19 symptoms you must provide documentation of that fact and may only be provided administrative leave if testing is not available to you through the COVID-19 Call Center process.

Q.5      As a frontline clinical staff person am I limited to a single 14-day administrative leave if I have been exposed, quarantined and returned to work only to be notified I have again been exposed?

A.5      If UConn Health has excluded you from work for the safety of you, your co-workers and/or patients, you can be placed on paid administrative leave for quarantine/self-isolation or monitoring on more than one occasion.

Q.6      What do I do if I am in contact with someone who has been in contact with someone who has tested positive or is confirmed positive for COVID-19?

A.6      Close contacts of someone who has been in contact with someone with suspected or confirmed COVID-19 (i.e. "contacts of contacts") do not warrant quarantine or any special management.

Further, it should be noted that the now mandatory policy of UConn Health to mask all employees while working should result in the need for fewer circumstances where quarantine/self-isolation are warranted.

Q.7      I am a manager and I have been told that I have an employee who has been told to be out of work for quarantine/self-isolation, what are my responsibilities?

A.7      If your employee or Employee Health has contacted you because an employee has been recommended to be out for a period of time, you need to ensure that the following has been done (1) confirm with the employee (if that employee is notifying you directly) that the COVID-19 Call Center has been contacted, and (2) that Human Resources has been notified through email at HR-EmployeeResources@uchc.edu.

Q.8      I am experiencing child care issues and want to know what I can do?

A.8      Employees should first turn to trusted friends and family for assistance during this period of time to seek childcare help.  Also we are directing individuals to call 211 and in particular the dedicated healthcare employee childcare line at 860-756-0864.  We also recommend you contact UConn Health’s own Childcare Center.  We have been working with the State’s Office of Early Childhood to increase the capacity at our Childcare Center and can work with employees to accommodate the need during this time.

If you are non-clinical staff and/or telecommuting you should review the questions and responses to the FAQ provided on the Human Resources website where these topics are specifically addressed.

The following information may be helpful to you as you contact the COVID-19 Call Center in understanding and addressing issues:

Close Contact: (1) Being within approximately 6 ft of an individual who is COVID-19 positive for a prolonged period of time; examples include living with, working in close proximity with, caring for or visiting; OR (2) direct contact with the infectious secretions of a COVID-19 case, for example being coughed on while not wearing any PPE.

Self-monitoring: Taking your temperature 2x per day and remaining alert for respiratory symptoms, body aches or a loss of a sense of smell or taste.  If experiencing these symptoms, call the COVID-19 Call Center at 860-679-3199.

Active monitoring: Regular communication with public health authority, occupational health or infection control, and the potentially exposed healthcare provider to assess the presence of fever or respiratory symptoms.  If you have been exposed without the proper precautions or without wearing PPE, this should occur at least 1x per day.

 

2020-04-02 | Emotional Support Resources for Employees

2020-04-02

The COVID-19 pandemic has been an emotional time for all. To provide you with support during this unprecedented time we are sharing the following resources on our HR webpage.

In addition to these resources currently available, next week we will be announcing a new program, “Taking Care of our Own,” which will enable our employees to schedule telehealth private sessions and work team debriefings with UConn Health EAP and Department of Psychiatry clinicians.

Seek emotional support when you need it. Email or call 860-679-2877. Same day, confidential appointments are available now with the Employee Assistance Program. Just provide a number for them to call you, and a time you prefer to be contacted.

#FirstRespondersFirst an initiative to support and sustain the health and well-being of frontline workers amidst COVID-19 conceived by Harvard T.H. Chan School of Public Health and Thrive Global

Toolkit for Emotional Coping for Healthcare Staff.pdf developed by the Center for Pediatric Traumatic Stress.

Secondary Traumatic Stress for Healthcare Professionals.pdf developed by the Center for Pediatric Traumatic Stress.

Sustaining the Well-Being of Healthcare Personnel.pdf during coronavirus and other Infectious Disease Outbreak, CSTS.

Self-care Tips to Reduce Anxiety as COVID-19 cases increase, watch tips on what you can do to strengthen yourself.

Managing Stress

Coping With COVID? Mastering Social (But Not Emotional) Distancing Dr. Julian Ford shares his thoughts and recommendations on ways to handle the stress.

Download 5-, 10- and 20-minute meditations from our Department of Psychiatry to help you with enhancing immune functioning, sleep and overall stress management.

Livestream Guided Meditation recordings offered by the Copper Beech Institute.

Listen to the Labyrinth Podcast, mindfulness teachings, talks and discussions as well as helpful meditations offered by the Copper Beech Institute.

The meditation app Headspace has announced that it is making its premium tier free for all U.S. healthcare professionals who work in public health settings.

Ten Percent Happier is also offering free access to their app to all frontline health workers.

2020-03-16 | Telecommuting Guidance

2020-03-16
Telecommuting Guidance

Message from Christopher Delello, Chief Human Resources Officer

The University is reviewing telecommuting and COVID-19 guidance released by the State Of Connecticut late on Friday afternoon for certain segments in the workplace, but not all, across Connecticut. As a result, more information will be forthcoming in areas where the University is remaining open and where certain buildings have been closed to all operations (not just when the building is locked).

In the interim, our students, patients and each other, as colleagues, will continue to need our support. Some operations will change, now and in the days ahead, and we are all working to understand, without criticism, what those needs will be and how we can best support them.

Many managers are finalizing what their remote work plans will be and must be implemented, if not already, on an informal basis. The manager’s decision is in place until otherwise communicated - in other words, guidance from managers may evolve over the weeks ahead as more becomes known. However, we ask all managers to work with their employees to understand needs, how their work will change, how work can transition to remote work, if at all, and explore creative work from home arrangements and even flex time at home based on family needs. Again, more guidance is being issued by the state to inform UConn and UConn Health how to navigate and make our own decisions regarding secondary contact, childcare issues and employees in the workplace navigating new exposures.

First and foremost, UConn and UConn Health managers are directly responsible for determining who is eligible to telecommute and who is unable to telecommute and must provide for a continuity of operation during these difficult and urgent times. This communication outlines, in summary format, key considerations and processes that may be different than previous situations where telecommuting was considered and with prior knowledge of the policies at UConn, UConn Health and the state’s Telework program applicable to employees who are members of classified unions.

We know and understand that suddenly switching employees to remote work in a day or two notice without advance communication and processes in place is challenging and stressful for managers and employees alike. We ask for all of us to respect one another, rely on managers’ guidance and decisions and employee input and work through these difficult moments together as colleagues and with flexibility. During these moments before and after remote work implementation (or not where it is not possible), consider what was learned and whether remote work can be leveraged on an ongoing basis in new and creative ways working with the University and with the partnership of our unions now and in the future.

During these unprecedented times, we ask all of us to take care of our students, our patients, our family and loved ones and each other with patience and flexibility. There is much we do not yet know about this public health situation and many actions to date have been taken out of an abundance of caution or are needed to address the current continuity plans. Please know your managers, departments and the University is doing its best to support you and we know many questions are still unanswered. So many of you are showing the persistency and respect for one another that makes UConn a stronger place – thank you.

1. Informality – Until further notice, all telecommuting forms and guidelines previously known to us are not in use. Effective immediately, no telecommuting forms are required and HR approval of telecommuting or alternate work arrangements are not required with the caveat that 1) the total number of hours required from the role are worked in a work week and continuity of operations are continuing without a decrease in performance requirements AND 2) a manager and business unit must be in agreement with all telecommuting approvals at the department and organizational level before they begin.

2. Telecommuting Letters – HR has crafted telecommuting letters for Storrs/Regional employees and UConn Health employees. We ask all managers to complete a letter for every employee with whom you have developed a remote work arrangement – even if the arrangement is underway. No telecommuting forms are required and no HR approval is necessary, regardless of any previous communications, to the effect a remote work arrangement at this time and until further notice.

3. Key Considerations – When determining if work can be done remotely now and in the days ahead:

  • Evaluate department and team priorities.
  • Consider collaborator or consultant impact.
  • You, as a manger, are responsible for your own remote work plan and duties of your staff.
  • Review ITS’s guidance for technology and internet connectivity.
  • Identify the team member’s need for equipment and internet capabilities – for example, will they need a scanner, printer or other technology to carry out primary functions of their job?
  • Compile the cell phone, home numbers and addresses and how and with whom this information will be shared to maintain privacy.
  • Determine how schedules and availability will be known to colleagues and constituents.
  • Determine the preferred group communication method and collaboration tools your employees need.
  • Determine how frequently you as a supervisor will connect with your team members – trust works both ways.
  • Discuss how time and performance will be managed once remote work begins. Focus first on output and completion of deliverables when evaluating performance.
  • Can you include alternating or rotating schedules so that team members can share on-site responsibilities, even when all members would not have to be on site each day.
  • Experiment with different schedules – if it does not work one week, try something different the following week.
  • Everyone should be clear on duration, agreed upon schedules, work deliverables, communication approach and expectations.-

More FAQs about telecommuting will continue in the days ahead and will be placed on the University’s Coronavirus website. In addition, Payroll and Student Employment FAQs have been added to the existing HR FAQs, which were updated and re-organized today.

2020-03-12 | Large Group Meetings

2020-03-12
Large Group Meetings

Effective immediately, no events larger than 100 people will be permitted at any UConn Health site. This includes all events and meetings. If possible, alternatives such as teleconference or virtual conferencing methods should be used to hold large events; otherwise they should be cancelled or postponed. In addition, UConn Health strongly recommends the postponement or cancellation of any non-essential live gatherings and meetings of large groups, even those smaller than 100 people.

Facilities

Updates

2020-06-04 | UPDATED Employee Access and Screening

We want to ensure a healthy and safe environment for our patients and staff during the outbreak of novel coronavirus (COVID-19). Employee access to UConn Health facilities will be limited and all employees will be temperature screened and require their employee badge.

Employee Access and screening locations and hours include:

Screening

University Tower Main Entrance: – 5:30 am – 8 pm

Connecticut Tower Main Entrance: 6:30 am– 8 pm

University Tower Subbasement/Garage 2: 6 – 8:30 am, 2:30 – 3:30 pm, 6:30 – 7:30 pm, 10:30 – 11:30 pm

UConn Procedures Center: 6 am – 4 pm, will be locked at 4 pm

West Dock: 6 am – 6 pm

Academic Entrance: 6 am– 4 pm

Emergency Department: 24 hour coverage

Musculoskeletal Institute first and 3rd floor: 7:30 am – 4:30 pm

Administrative Services Building (ASB) : 8 am– 4:30 pm we are covering 7:30-10  and lunch  11:30-1:30p with Neuro MA.

Outpatient Pavilion 1st and 3rd Floor: 8 am – 4:30 pm

All Offsite Locations:

11 South Road 7:30 am to 4:30 pm

21 South  Road : 7:30am-9pm Monday- 7:30-6pm Tuesday and Wednesday and 8am-5pm Thursday and Friday  

Avon 7:30 am to 4:30 pm

Simsbury only handicap entrance is open.  Screening from 7:30-5pm

East Hartford 7:30 am to 4:30 pm

West Hartford 7:30 am to 4:30 pm

Southington 7:30 am to 4:30 pm

Canton Clinic Canton  M-F 7:30-8pm and S/S 8:45-5:15

Storrs Outpatient and Willimantic – 7:45 am to 4:00 pm daily

Storrs Urgent Care M-F 7:30-8pm and S/S 8:45-5:15

Munson Road M- F 7:00 – 9:30 am

400 Farmington Avenue*

195 Farmington Avenue*

 

*For employees entering these or other off campus locations, please follow the protocols posted at the building entrances.

 

PLEASE NOTE: Access Closures

All other entrances to the hospital will be closed.

MSI - Employee Entrance next to loading dock is closed

ASB - First floor by loading dock closest to MSI is closed

Loading Dock OPPV - Closed to Routine Ambulances

Back Employee OPPV - Entrance across from lot 3 will be closed

All patients, visitors, and vendors will receive a brief health screening and temperature screen before entry. If screeners determine that a visitor is a potential health risk, that person will not be allowed to visit and will be asked to consult their doctor for further guidance

2020-05-01 | New Screening Guidance

New Screening Guidance

Patients with COVID-19 Presenting for Care

  • It is recommended to delay non-urgent healthcare visits for at least 21 days from the date of diagnosis.
  • If a patient requires urgent outpatient evaluation or care within 21 days of their diagnosis, additional guidance is needed from the department of the anticipated encounter before entry can be permitted.

Plasma Donation

  • UConn Health has begun to use plasma from those who have recovered from COVID-19 in an effort to help patients fighting the disease.
  • Plasma donors must have been diagnosed at least 21 days ago, tested negative and have been asymptomatic for 14 days to visit the blood draw for required lab work.
  • Any employees interested in donating plasma are asked to call the UConn Health COVID-19 Call Center at 860-679-3199, option 1 for more details.

New Screening Workflow

  • Temperatures are monitored and screening questions are asked of all patients, visitors and staff.
  • Employees and badged contract staff provide a verbal response to the screener.
  • Patients and visitors are issued a screening pass to be kept during visit and returned when exiting.
  • New COVID-19 screening questions have been expanded based on CDC guidance and now include:
  • Have YOU, or someone you live with, been tested for or diagnosed with COVID-19?

If Yes: Who? ____   When? (date) ____

  • Are YOU having any of these new or worsening symptoms without a clear explanation?

o   Cough

o   Shortness of breath/difficulty breathing

o   Fever

o   Chills

o   Muscle pain

o   Headache

o   Sore throat

o   Loss of taste or smell

  • For any YES responses to screening questions and/or fever of ≥100.4:

o   Patient cannot proceed until approved by receiving department. Patient will be asked to wait in designated seating area while Information Desk staff call for further guidance.

o   Visitor will be courteously denied entry and advised to contact their PCP for guidance.

o   Employee reporting for work will be issued a yellow card and instructed to contact the COVID Call Center for further guidance.

o   Plasma donor less than 21 days from diagnosis will be asked to contact COVID Call Center.

o   Plasma donor at least 21 days from diagnosis may proceed to lab if afebrile and asymptomatic.

General Screening Guidelines

  • UConn Health is currently closed to visitors. Exceptions for extenuating circumstances such as end of life visitation and patient safety are to be made at the discretion of leadership.
  • All patients, visitors and staff members entering the facility will be subject to a screening process.

o   Staff members must have their UConn Health ID badge visible.

o   Employees are expected to wear a mask (provided by their manager) while at work.

o   Patients and visitors with an exception are required to wear a mask while at our facilities.

o   If a patient or visitor presents without a mask, one will be provided at screening.

  • Social distancing and hand-hygiene reminders are to be reinforced by the screeners.

2020-04-03 | COVID-19 Entry Screening

2020-04-03

New Guidance

  • All persons entering UConn Health facilities will have temperature taken and be screened for COVID-19 symptoms and risks.
  • Employees and badged contractors will be asked screening questions in addition to having their temperatures taken. Employee screening results will not be documented.
  • Screening questions have been updated to reflect current medical understanding of COVID-19 symptoms and risks. Patients and those with a visitation exception will be issued the new screening document.

Masking

  • Employees: All employees in all areas on our campus should be wearing masks while at work. Only one mask is issued per person by their department manager.
  • Homemade Masks: In clinical areas, home-made masks must be worn along with a surgical or procedure mask. In addition, wearing a home-made mask as a substitute is allowed in non-clinical areas.

New Process

Posters will be displayed at entry doors and screening stations with the following questions:

  1. Have you or someone you live with been tested for or diagnosed with COVID-19 in the last 4 weeks?
  2. Do you have any of the following?
    • Fever (100.4 or higher)
    • New or worsening shortness of breath
    • New or worsening cough
    • Loss of sense of smell or taste

    Employees

    • Ask the employee (or badged contractor) to review the screening questions and provide a verbal response. Do not document results.
    • Negative screen: Do not issue a screening card - reserved for patients and visitors with exception.
    • Positive screen: [Fever or YES to any of the questions] discretely issue a yellow card to the employee, instruct them to follow usual call-out procedures and to contact Covid-19 Call Center at 860-679-3199.
    • If you are uncertain how to interpret any response or situation: Discretely ask the employee to move to a private area to contact the COVID Call Center at 860-679-3199 for further guidance before reporting to work.

    Patients and Visitors (with exception)

    • Ask the screening questions and document results (include temperature in FEVER field) on white screening card.
    • Negative screen: Issue the white screening card to be kept at all times.
      • Ask patients and visitors to wear a mask. Send to Information Desk for badging (UT, Main, and ED only) and appointment look-up, wayfinding and other assistance.
    • Positive screen (a fever or yes to any of the question):
      • Patient: Ask patient to wear a mask and to wait in a designated area while we contact the supervisor/manager at the appointment department for guidance. Info desk staff can assist with this.
      • Visitor: Courteously deny access to the facility and suggest they follow up with their PCP.

     Thank you for all you do to keep our colleagues, our patients and community safe!

    2020-03-30 | Campus Shuttle Update

    2020-03-30

    Campus Shuttle Update Effective Monday, March 30

    As a result of significant changes in ridership the following changes will be made to the campus shuttle services beginning on Monday, March 30.

    • Route 1 (night shuttle) and Route 4 will temporarily be suspended.
    • Route 2 will continue service as scheduled.
    • Route 3 will continue service as scheduled.
    • Route 5 will continue service with extended hours from 6:15 a.m. through 7:50 p.m.

    Please refer to our online shuttle timetables for the most current schedule information.

    Parking, Transportation and Event Services

    parking.transportation@uchc.edu or x4248

     

    2020-03-26 | UConn Health Employee Access

    2020-03-26

    ACCESS TO 195 FARMINGTON AVENUE:  Entry into 195 Farmington Avenue will be by badge and/or code access only. Those with badge and/or codes will continue to have access to the building 24/7. 

    2020-03-20

    The Academic Entrance will be closed (even to employees with badges) on Saturday and Sunday.

    The main entrance and the primary entrance to the University Tower will be closed to visitors beginning at 8 p.m. Staff will continue to have 24 access to the building through the main entrance and University Tower main entrance.

    The UConn Procedures Center will be closed on Saturday and Sunday.

    No changes to access to the ED.

    2020-03-20

    In the continuing effort to keep our staff, patients, students and visitors safe, we will commence COVID-19 screening at the 400 Farmington Avenue facility Monday, March 23, 2020. Screening will take place from 8 to 10 a.m.

    Consistent with other buildings, all access will be through a central point going forward which will be the main entrance. All other entrances will be locked for entry.

    2020-03-20

    Employees at Munson Road facility will be temperature screened beginning, Monday, March 23, 2020 at 7:30 a.m.

    In addition, effective immediately and continuing for the foreseeable future all entrances except the Main Entrance on the 4th floor will be locked and no employee should enter through any entrance other than the one on the 4th floor Main Lobby

    All patients, visitors, and vendors will receive a brief health screening and temperature screen before entry. If screeners determine that a visitor is a potential health risk, that person will not be allowed to visit and will be asked to consult their doctor for further guidance. Screening will be conducted from 7:30 to 11:30 a.m.

    2020-03-18

    We want to ensure a healthy and safe environment for our patients and staff during the outbreak of novel coronavirus (COVID-19).  Employee access to the hospital will be limited and all employees will be temperature screened and require their employee badge.

    Employee Access and screening locations and hours include:

    Screening

    University Tower Main Entrance: – 5:30 a.m. – 8 p.m.

    Main Entrance: 6:30 a.m. – 8 p.m.

    University Tower Subbasement/Garage 2: 6 – 8:30 a.m., 2:30 – 3:30 p.m., 6:30 – 7:30 p.m., 10:30 – 11:30 p.m.

    UConn Procedures Center: 6 a.m. – 4 p.m., will be locked at 4 p.m.

    West Dock: 6 a.m. – 6 p.m.

    Academic Entrance: 6 a.m. – 4 p.m.

    Emergency Department: 24 hour coverage

    Musculoskeletal Institute: 8 a.m. – 4:30 p.m.

    Administrative Services Building: 8 a.m. – 4 p.m.

    Outpatient Pavilion 1st and 3rd Floor: 8 a.m. – 4:30 p.m.

    All Offsite Locations: 8 a.m. – 4:30 p.m.

     

    PLEASE NOTE: Access Closures

    All other entrances to the hospital will be closed.

    MSI - Employee Entrance next to loading dock is closed

    ASB - First floor by loading dock closest to MSI is closed

    Loading Dock OPPV - Closed to Routine Ambulances

    Back Employee OPPV - Entrance across from lot 3 will be closed

    All patients, visitors, and vendors will receive a brief health screening and temperature screen before entry. If screeners determine that a visitor is a potential health risk, that person will not be allowed to visit and will be asked to consult their doctor for further guidance.

    2020-03-25 | Munson Cafe Temporarily Closing

    MUNSON CAFÉ TEMPORARILY CLOSING: Please be aware that Munson Café will be temporally closing on Friday, March 27, at 2 p.m. until further notice.

    The following will still remain open:

    The Food Court in the Main Building

    Monday-Friday, 6:30 a.m.-8 p.m. and 11 p.m.-1 a.m.

    Saturday and Sunday, 7 a.m.-7 p.m.

    Outpatient Pavilion 5th Floor

    Monday-Friday, 7:30 a.m.-2 p.m.

    Marbles Café

    Monday-Friday, 6:30 a.m.-2 p.m.

    2020-03-18 | Parking Lot 3 Closing

    2020-03-18
    Parking Lot 3 Closing

    Effective today Wednesday, March 18 parking Lot L3 will temporarily be closed. While the lot is closed, people who typically park in Lot L3 may use any other available Area 3 locations, or the level 6, rooftop entrance of Garage 1. They may also park on the upper levels 4, 5 or 6. If the gate is in the down position please use the ‘call for assistance’ button to have the gate raised. Employees should also use the level 6, rooftop exit when leaving the garage. Here is a staff parking map https://health.uconn.edu/park/wp-content/uploads/sites/64/2019/02/staff-parking-map.pdf

    Additional Guidance

    Updates

    2020-05-15 | Masking Reminder

    DON’T FORGET YOUR MASKS!  In addition to UConn Health’s policy requiring universal masking in our facilities, Governor Lamont issued an Executive Order on April 20 requiring face coverings or masks in all public spaces.  As an important reminder, please be sure to wear a mask or face covering at all times during your daily routine, including when you enter and leave our facilities, and when you are passing through corridors and visiting community areas.  Thank you!

     

    2020-05-07 | UConn Health Is Now Recruiting Health Care Workers for a Research Study Involving COVID-19 Serological Testing

    UConn Health is now recruiting health care workers for a research study involving COVID-19 serological testing.

    Any UConn Health employee that has tested positive for COVID-19 virus will be asked to donate 1-3 teaspoons of blood to check for antibodies.

    • Participation is voluntary and strictly confidential.
    • Participation in this study requires several visits and involves blood draws.
    • The time for each study visit will be about 20 minutes.

    Study is being conducted by Dr. Bruce Liang, MD, Calhoun Cardiology Center

    For further information on how you can help, please call or text 860-480-6329.

    Or email research staff:
    Kristen Siedlarz, siedlarz@uchc.edu
    Ashley Raynock, raynock@uchc.edu
    Mike Kleinberg, kleinberg@uchc.edu
    Sharon DiMauro, dimauro@uchc.edu

    IRB Review
    IRB Number: 20-186-1
    IRB Approval Date: 04/30/2020

    2020-05-06 | Plans to Re-Start Regular Services at UConn Health

    Dear UConn Health Colleagues,

    As you are aware, the decline in UConn Health’s COVID-19 admitted patients and the State’s trending data suggests that we are beyond the peak census of COVID-19 patients. As such, along with providers, managers and employees, we are developing a thoughtful plan to resume elective surgeries, procedures and other non-emergent services in mid-May.

    This will be an incremental process, more like increasing the dimmer on a light rather than flipping a switch and it will be embarked upon with the single-minded goal of ensuring the safety of employees and patients.

    UConn Health and each service is still developing the plans, timelines and phases of restarting elective surgeries/procedures and other non-urgent services, but these plans will include testing protocols, continuation of our current safety measures and personal protective equipment (PPE) utilization. Other safety measures will also be implemented as necessary. As a part of continuing our safety and social isolation measures, employees currently working from home should continue to do so until you hear otherwise from your managers or supervisors.

    Thank you for all your efforts as we enter this next phase. Restarting regular services in this “new normal” manner marked by a continuation and enhancement of our safety measures will allow us as a public health system to serve the needs of all our patients in Connecticut during these unprecedented times.

    Warm regards,

    Andrew Agwunobi, M.D., M.B.A.
    Chief Executive Officer, UConn Health
    Executive Vice President for Health Affairs

    2020-05-06 | Temporary Housing for Employees Quarantining Due to COVID-19

    2020-05-06

    Objective:

    For those UConn Health employees who have been instructed by UConn Health to quarantine but cannot do so at home, housing will be provided at Central Connecticut State University or UConn Storrs/Mansfield.

    Activation:

    If you are instructed by the UConn Health COVID-19 Call Center to quarantine but cannot do so at home, email a quarantine housing request form to covidhousing@uchc.edu with the subject line QUARANTINE.

    Upon receiving a completed request form, the COVID Housing Office will perform the following:

    • Acknowledge receipt of request
    • Contact requestor to discuss the various housing options available
    • Provide a welcome package with basic information such as building/room assignment, keys/key cards, directions, GPS address, parking instructions, check-in/check-out instructions, quarantining guidelines, instructions for meals, Wi-Fi, etc.
    • Arrange for food and cleaning services
    • Requests received prior to 3 pm will be processed same day.  Requests received after 3 pm will be fulfilled the following day

    Additional Details and Guidelines:

    • Rooms are equipped with linens, towels, pillows, and Wi-Fi.
    • Meals are provided. Typical menu includes cold breakfast and lunch. Cold or microwaveable dinner. Meals will be delivered to designated areas for pickup at designated times.  Bottled water will be provided.
    • To the extent possible, rooms will be provided with refrigerators and microwave ovens.
    • Dorm buildings equipped with laundry facilities are offered at no charge. Please bring your own detergent.
    • Wear your facemask and practice social distancing whenever you exit your room/building.
    • Do not attempt to enter any building/room other than the one you are staying in.
    • Stay in your room as much as possible. Brief walks outside are allowed provided masks are worn and you practice social distancing.
    • Visitors are not allowed into any quarantining facility.
    • The typical quarantine period is 14 days or whenever the UConn Health COVID-19 Call Center determines it is no longer required. Please contact the COVID-19 Call Center at 860-679-3199 for assessment prior to ending your quarantine period.
    • Check your temperature twice daily and monitor yourself for symptoms. If you develop any symptoms (including worsening cough, shortness of breath, loss of taste or smell) or have a temperature >100.4 degrees Fahrenheit, please contact the COVID-19 Call Center ASAP at 860-679-3199. Also, email the COVID Housing Office at covidhousing@uchc.edu.
    • Email COVID Housing Office at covidhousing@uchc.edu for assistance, issues with room, building, etc.

    Note, the quarantine housing program is not a medical program.  If you need medical attention for any reason, please contact your healthcare provider and/or emergency services (911).

     

    2020-04-22 | Guidance to UConn Health Providers in Caring for Patients with COVID-19 Returning to Ambulatory Settings

    2020-04-22

    As the COVID-19 outbreak evolves this document provides guidance to healthcare providers in order to protect our patients, healthcare personnel, and community at large. It is essential that our healthcare teams continue to provide quality care, at the appropriate level for all patients, in order to preserve a functioning healthcare system. Robust public health measures will be required to reduce transmission of COVID-19, protect healthcare personnel and ensure patient safety.

    Published data suggests that SARS-2-CoV viral shedding, and thus the period of suspected contagiousness, is highest during periods of acute illness and then subsequently declines over time[1],[2],[3].  The decline is likely variable based on the severity of illness and patient-related factors[4].

    Patients diagnosed with COVID-19 returning to the community from home isolation

    Patients with newly diagnosed COVID-19 in the outpatient setting or those individuals recently admitted and discharged home, should be provided with detailed isolation recommendations. Detailed guidance from the CDC can be found at https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html. Patients with confirmed COVID-19 should be advised to continue home isolation until they are no longer contagious, based on a non-test-based strategy or a test-based strategy (two negative SARS-COV-2 RNA PCR tests separated by 24 hours).

    Using the non-test-based strategy home isolation may be discontinued under the following conditions:

    • Patient has been afebrile for at least 72 hours (without the use of fever reducing medications) AND
    • other respiratory symptoms have improved AND
    • at least 7 days have passed since symptoms first appeared

    Patients with COVID-19 presenting for care in UConn Health Ambulatory Care Settings

    For patients recently diagnosed with COVID-19 either in the inpatient or outpatient setting, recommendations regarding scheduling/coordinating their future healthcare visits at UConn Health are detailed below:

    At this time, it is recommended to delay non-urgent healthcare visits for 21 days from date of diagnosis of COVID-19. In particular, this guidance should pertain to following:

    • Non-urgent ambulatory care visits, including outpatient Radiology
    • Non-urgent admissions
    • Non-urgent surgical and procedural cases
    • Routine dental and eyecare visits

    If a patient has recently been diagnosed with COVID-19 and requires urgent outpatient evaluation within 21 days of their diagnosis, the healthcare provider should contact Infection Control for guidance on the anticipated encounter, including determining the optimal environment of care and the appropriate personal protective equipment needed for the encounter.  Individuals who are highly immunocompromised (medical treatment with immunosuppressive drugs, bone marrow or solid organ transplant recipients, inherited immunodeficiency, poorly controlled HIV) may warrant special infection control measures in recovery after COVID-19.  Please call Infection Control for additional guidance for these patients.

    [1] Chang D, et al.  Time Kinetics of Viral Clearance and Resolution of Symptoms in Novel Coronavirus InfectionAm J Respir Crit Care Med. 2020 Mar 23.

    [2] Zou L et al.  SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020;382(12):1177-1179.

    [3] He X. et al. Temporal dynamics in viral shedding and transmissibility of COVID-19.  Nature Medicine 2020 https://doi.org/10.1038/s41591-020-0869-5

    [4] Zhao F et al.  Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.  Lancet 2020; 395: 1054–62.

     

    2020-04-10 | Temporary Housing During COVID-19 Pandemic (Hoteling)

    2020-04-10

    Effective Date:  April 13, 2020

    Objective:

    To support the availability of critical staffing during the COVID-19 pandemic, UConn Health will provide temporary housing and meals to approved individuals at participating area hotels based on the following eligibility criteria and approval processes.

    Eligibility:

    Those eligible for the temporary housing under this protocol include UConn Health employees or residents who (a) are working in areas at UConn Health that are caring for COVID-19 positive patients or patients who are Persons Under Investigation (“rule outs”); and (b) have high-risk individuals residing with the employee are eligible.

    Other individuals may be considered to be eligible on a case-by-case basis.

    “High-risk individuals” are those with one or more of the following conditions:

    • Chronic lung disease or moderate or severe asthma
    • Serious heart conditions
    • Conditions causing the person to be immunocompromised such as cancer treatment, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, or prolonged use of corticosteroids and other immune weakening medications
    • Chronic kidney disease
    • Anyone undergoing dialysis
    • Severe liver disease
    • Pregnant
    • Elderly (> 65)

    Approval Process:

    Requests meeting the eligibility criteria should be directed to one of the below individuals for approval:

    Medical Staff

    • Emergency Department – Dr. Robert Fuller
    • Medicine/Critical Care/Hospitalists – Dr. Mark Metersky
    • Cardiology – Dr. Christopher Pickett
    • Residents - Dr. Steve Angus
    • UMG- Anne Horbatuck
    • All others – Dr. Scott Allen

    Nursing Staff

    • Caryl Ryan, Anna Humennyj or Michelle DeLayo

    Respiratory Staff & Radiology Staff

    • Morgan Hills

    Transport Staff

    • Jeff Boyko

    Public Safety

    • Maggie Silver

    All Other Requests in Areas Not Specified Above, and all individuals requesting temporary housing who do not meet the specific eligibility criteria listed above (i.e. those to be considered on a case-by-case basis)

    • Janel Simpson

    Approval to Activation:

    Approved requests should be emailed by the designated approver or his/her designee to covidhousing@uchc.edu with the subject line HOTELING.  Only those requests received from a designated approver or designee will be processed by the COVID Housing Office.

    Upon receipt of the request, the COVID Housing Office will perform the following:

    • Acknowledge receipt of request to employee and requestor
    • Contact hotel to make reservation
    • Email employee with name of hotel, address, confirmation number, etc.
    • Update COVID Housing records with name, department, hotel, confirmation number, check in date, etc.

    Approvals will only be approved for the minimum number of days needed; a room shall not be requested or approved for blocks of time unless the individual intends to stay in such room for each and every night in such block of time. Approvals will be issued for no longer than two weeks at a time; should an individual need hoteling for longer than two weeks, a request to extend per the approval process outlined above should be made.

    While in the program, approved participants will receive email updates and additional instructions on such items as meals, shuttle services, check-out, etc.

    All approved accommodations will be directly billed to UConn Health for the approved period of time.  Incidental charges for such things as room service or entertainment will be the responsibility of the individual.

     

    2020-04-03 | Universal Masking for all UConn Health Employees

    2020-04-03

    Please note the following changes to the Masking Protocol

    Expanded Masking Protocol (Effective 4/3/20)

    We have decided to institute a universal masking policy that includes all employees on our campus, i.e., masking will no longer be limited to clinical care employees and staff who support such employees in the clinical areas. Effective 4/3/20 it is expected that all employees on our campus will wear masks while at work.

    Provision of Masks

    Starting on 4/3/20, managers in the non-clinical areas will issue surgical and procedure masks to employees (managers should contact Kim Varasconi, x3759, for issuance). Please note however that because of the short supply of surgical and procedure masks and the need to preserve as many masks as possible for clinical employees and those who support them in the clinical areas, we anticipate that unless we receive an adequate replenishment of supplies, we may run short of surgical masks for non-clinical/clinical support employees. As such, only one mask at a time will be issued per person and the employee must safeguard it and use until it is no longer appropriate for use. In addition, wearing a home-made mask as a substitute is allowed in non-clinical areas. In the clinical areas, homemade masks must be worn along with a surgical or procedure mask. We will continue to explore sources for additional surgical and procedure masks. Finally, please be patient with logistics as it may take some time to issue masks to all areas.

    Thank you as always for all you are doing.

    Regards,

    Andrew Agwunobi, M.D., M.B.A.
    Chief Executive Officer, UConn Health
    Executive Vice President for Health Affairs

     

    2020-03-30 | Updated Protocols – Mandatory Masking for Patients and Clinical Employees

    2020-03-30

    Dear Colleagues,

    I am writing to inform you that we currently have 15 COVID-19 positive patients in our hospital representing a significant increase from 3 patients a week ago. We also have 8 “rule/out” COVID-19 patients. I want to thank the amazing employees and providers who are taking care of these patients during this difficult time.

    UConn Health strictly follows and in some cases goes beyond the precautions recommended by the CDC to protect our staff, visitors, patients, and learners. However two of the 15 patients were admitted to our hospital for unrelated diagnoses before it became apparent they were also suffering from COVID-19. As such a number of our employees interacted with the patients before the patients were masked and placed in isolation. Fortunately, due to our recent universal masking policy for healthcare workers, most employees were wearing masks when they encountered the patients. Given specific issues pertaining to the recent exposures we are customizing the approach to quarantine for these employees so as to err on the side of caution. However today we are also announcing two new protocols below to ensure to the extent possible that should we have similar exposures in future they would fall into the “Low Risk” category not requiring quarantine as per CDC guidelines.

    https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html

    New Masking Protocols (effective 03/31/20)

    1. Patient Masking: All UConn Health inpatients and outpatients to the extent practical will now be required to wear a surgical or procedure mask.
    1. Employee Masking Now Non-Voluntary: UConn Health employees involved in patient care or supporting those involved in patient care are expected to wear a surgical or procedure mask at all times in the patient care areas.

    NB: Home-Made Masks: Although UConn Health does not endorse the effectiveness of, nor promote the use of home-made masks such masks are now allowable as long as a standard procedure mask or surgical mask is worn at the same time.

    For information on the protocol for low-medium and high risk exposures please see the attached “Guidelines for the Asymptomatic Healthcare Worker with Exposure to an Individual with COVID-19 with Prolonged Contact in the Healthcare or Community Setting” compiled by Dr. David Banach, UConn Health’s Hospital Epidemiologist and Head of Infection Prevention.

    Again I would personally like to thank all the providers and staff who are working on the frontlines of this pandemic. We will continually evolve our guidelines to keep everyone as safe as possible while delivering much needed care. If you have questions or want to report a case of suspected employee exposure please call the COVID-19 Call Center at 860-679-3199.

    We will get through this together.

    Best Regards,

    Andrew Agwunobi, M.D., M.B.A.
    Chief Executive Officer, UConn Health
    Executive Vice President for Health Affairs

     

    2020-03-30 | Guidelines for the Asymptomatic Healthcare Worker with Exposure to an Individual with COVID-19 with Prolonged Contact in the Healthcare or Community Setting

    2020-03-30

    Individuals with prolonged, close contact with an individual with COVID-19 may be at increased risk for infection with SARS-CoV-2, the virus that causes COVID-19. For the purpose of this evaluation, exposed prolonged contact is defined as being within 6 feet of the infected individual for > 15 minutes.

    Several factors, including the type of exposure as well as the use of any personal protective equipment dictate the overall risk to the exposed healthcare worker.

    High-Risk Exposure

    The following categories meet the criteria of a High-Risk Exposure

    1. A Healthcare Worker not wearing a facemask or respirator is exposed to a patient with COVID-19 who is not wearing a facemask.
    2. A Healthcare Worker not wearing a mask or respirator is exposed to a patient with COVID-19 and one of the following has occurred:
      1. The Healthcare Worker had extensive body contact with the patient or
      2. The Healthcare Worker was present during an aerosol generating procedure such as intubation/extubation, bronchoscopy or sputum induction without wearing a respirator
    3. Living in the same household as or providing direct care for a person with symptomatic, laboratory-confirmed COVID-19 infection without using the recommended precautions.

    Individuals with High-Risk Exposure should contact the COVID-19 Call Center and report their exposure to Employee Health. If the criteria are met a 14-day quarantine will be recommended.

    Low-Medium Risk Exposure

    All other scenarios not classified as High-Risk Exposure generally meet the criteria for Low-Medium Risk Exposure.

    These may include but are not limited to:

    1. A Healthcare Worker who was in prolonged close contact with a patient with COVID-19 while wearing a facemask at all times even though the patient was not wearing a mask.
    2. A Healthcare Worker who was in prolonged close contact with a patient with COVID-19 while the patient was wearing a mask at all times.
    3. A Healthcare Worker who has recently traveled to a country with widespread community COVID-19 transmission.
    4. Close contact with an individual with symptomatic COVID-19 infection outside a healthcare setting that does not meet criteria for High-Risk Exposure.

    A healthcare worker who has had Low Risk exposure may continue to work, provided he/she remains asymptomatic, following the guidance below. A healthcare worker who has had Medium Risk exposure may continue to work, if he/she remains asymptomatic, if staffing needs reach critical levels, under the guidance of Employee Health and/or an Employee Health designee. In doing so, he/she must adhere to the following requirements:

    1. A procedure or surgical mask must be worn at all times in all settings for 14 days from the date of exposure.
    2. The healthcare worker must take his/her temperature twice daily and record this value on a temperature log and check in with their supervisor daily. If the healthcare worker has a temperature > 100 F he/she must notify Employee Health through the COVID-19 Call Center immediately.
    3. If the healthcare worker develops any new onset of cough, shortness of breath, subjective fever, chills, body aches he/she must notify Employee Health through the COVID-19 Call Center immediately.

    Please call the COVID-19 Call Center if there are any questions about a potential COVID-19 exposure.

    2020-03-27 | Universal Masking for Clinical Areas

    2020-03-27

    As a follow up to the message below, please understand that our Logistics Department is stocking all clinical areas with an increased amount of masks to satisfy the needs associated with this new broadened surgical/procedure mask protocol. We expect all areas to be adequately stocked by end of day tomorrow. In the meantime please continue to use handwashing and other infection control safeguards as usual. I would also like to clarify that the 5-7 days noted in the letter is only a guideline aimed at conserving the supply of masks; if masks are soiled or damaged before then they will of course be replaced. Thank you for your patience.

    Regards,

    Andy

    2020-03-26

    The safety of our providers and employees is always our top priority. As you may be aware on March 25th Partners Healthcare in Boston implemented a new surgical mask protocol based on the community transmission of Covid-19. Specifically they announced that their employees would begin to wear face masks (Surgical or procedural) at all times. As such, over the last two days, UConn Health’s leadership team has been considering whether to implement a similar practice. Our main considerations have been whether we have enough surgical and procedure masks to implement such a policy and which categories of healthcare employees would it pertain to in order to ensure a combination of employee safety and adequacy of supplies.

    I am therefore announcing that after much consideration and in an abundance of caution we have decided that we will also provide surgical or procedure masks to our employees in clinical areas to wear at all times. This would include doctors, other providers, nurses, front desk workers, Clinical Office Assistants, Medical Assistants, housekeepers, maintenance workers, and other employees who come in contact with patients or who enter clinical areas to support healthcare workers. Please note this new expanded masking practice pertains to the provision of surgical masks and procedure masks not to N-95 respirator masks. N-95 masks are reserved for interactions with confirmed or suspected Covid-19 positive patients and other specified clinical interactions.

    To conserve surgical and procedure masks, each mask should be worn for 5-7 days or as long as they remain intact and are not visibly soiled. Please mark your mask with your name and store the mask in an envelope or paper bag in a secure place at work when you leave for home. Employees should request a mask from their supervisor for replacement if the existing mask becomes soiled or damaged.

    Thank you for your wonderful work and we will continually review this policy based on the utilization of masks as well as the evolution of national guidelines.

    Regards,

    Andrew Agwunobi, M.D., M.B.A.
    Chief Executive Officer, UConn Health
    Executive Vice President for Health Affairs

    2020-03-24 | Medical Students Offer Child and Pet Care Services

    2020-03-24

    Dear UConn Health Community,

    During these unprecedented times dealing with COVID-19, we know that there has been an increased strain on the employees of UConn Health and their families. We strive to personally help those in need as they continue to deliver patient care. We understand that there has been an increased need in childcare and pet care services.

    Currently, we have over 50 students willing to aide families in need of childcare and/or pet care services. See below two forms that you can fill out in order for us to connect you directly with someone that can help with your specific needs. Unfortunately, we have a limited number of individuals that can help so please understand our limitations. However, we will try our best to help as many families as possible. If you have any questions, please do not hesitate to email us directly at mimartins@uchc.edu.

    Please Be Aware:

    • Students are providing assistance on their own personal capacity, not as their roles as students
    • These services are not connected to a UConn Health initiative
    • We are not providing advice, training or supervision by UConn Health, UConn School of Medicine, or UConn School of Dental Medicine
    • UConn Health and UConn School of Medicine are not endorsing these services, but are providing this information as a public service

    Childcare Services

    https://docs.google.com/forms/d/e/1FAIpQLSdfQ704k1oDB2YXAGjOqxp2fRH48ZWOKdaADpnzLgAOriUhFg/viewform?usp=sf_link

    Pet Care Services

    https://docs.google.com/forms/d/e/1FAIpQLSdT2-qZoe6RT6bbiZKhoZNSHHtLLfERJV-TEFqXh1VwCXyzvA/viewform?usp=sf_link

    Sincerely,

    -Michael, Sam, Kate L., Alex, Zach, Nick, Taylor and Kate T.

    2020-03-19 | Guidance Regarding Reassignment Requests from Individual at Higher Risk for Severe COVID-19

    2020-03-19

    As per the Guidelines for Individuals Who May Be at Higher Risk for Severe COVID-19, published via email on March 18, 2020, individuals who may be at higher risk for severe COVID-19 disease who would like to request to be re-assigned, should reach out to their Director/Manager, Service Chief or Department Chair and Employee Health to request a re-assignment. As noted in #2 below, Employee Health will make the evaluation and certify eligibility for re-assignment, but will not provide the specific reason for the certification.

    To process such requests in the appropriate manner, it is very important that you observe the following steps:

    Step #1: Employee (“requestor”) communicates to his/her Director/Manager or Service Chief or Department Chair that he/she meets one of the criteria listed in the March 18, 2020 email. It is extremely important that the Director/Manager does not request or solicit any information from the requestor as to which specific condition the requestor has or what specific medication the requestor takes. Please avoid soliciting medical information from the requestor.

    Step #2: Upon notice from the requestor, his/her Director/Manager or Service Chief or Department Chair will direct the employee to contact Employee Health, which will confirm that the requestor meets one of the criteria for reassignment. As part of the confirmation process, Employee Health may require a medical certificate or other evidence that the employee meets the high-risk criteria. The requestor shall inform Employee Health of the name and contact information of his/her Director/Manager or Service Chief or Department Chair. Employee Health will promptly notify the Director/Manager or Service Chief or Department Chair whether the requestor in fact meets the criteria to be reassigned. Employee Health will not share specific medical circumstances with the Director/Manager or Service Chief or Department Chair.

    Step #3: Director/Manager or Service Chief or Department Chair will determine and, where appropriate, will work with eligible requestors on where they will be reassigned. The Director/Manager or Service Chief or Department Chair will then provide notice to Human Resources at HR-employeeresource@uchc.edu with the following information:

    • Name of Provider/Staff
    • Job Title and department
    • Approval for re-assignment
    • New assignment and its duration

    Note: UConn Health reserves the right to change or to end the reassignment as circumstances warrant.

    2020-03-18 | Guidelines for Individuals Who May Be at Higher Risk for Severe COVID-19

    2020-03-18

    n order to address concerns regarding the groups of individuals who may be at higher risk for severe COVID-19 disease, we are providing the following clarifying guidance and are specific to this circumstance.

    If you meet one or more of the risk factors for higher risk individuals identified below, are concerned about the potential exposure to COVID-19, and you would like to request to be re-assigned, you should reach out to your Director/Manager, Service Chief or Department Chair and Employee Health to request a re-assignment.

    For this guidance, we are utilizing the CDC guidance for the definition of severe immunocompromised based on medical conditions and medications, which may be found at:

    https://wwwnc.cdc.gov/travel/yellowbook/2020/travelers-with-additional-considerations/immunocompromised-travelers

    1. AGE: If you are age 65 or older, you may be considered for re-assignment.
    2. PREGNANCY: If you are pregnant, you may ask for an assignment that would limit your exposure to confirmed or suspected COVID-19 patients during higher risk procedures, e.g., aerosol generating procedures.
    3. UNDERLYING MEDICAL CONDITIONS: ​If you have any of the following medical conditions, you may be considered “severely immunocompromised”:
    • Active leukemia or lymphoma
    • Generalized malignancy
    • Aplastic anemia
    • Graft-versus-host disease
    • Congenital immunodeficiency
    • Recent radiation therapy or checkpoint inhibitor treatment
    • Solid-organ transplant recipients and who are on active immunosuppression
    • CAR-T cell transplant recipients within 2 years of transplantation or still taking immunosuppressive drugs
    • Hematopoietic stem cell within 2 years of transplantation or still taking immunosuppressive drugs
    • Human Immunodeficiency Virus infection and a CD4 count < 200 cells/mm3
    1. MEDICATIONS: If you are taking any of the medications listed below, you may be considered “severely immunocompromised.”

    If you meet any of the above criteria you may request to be voluntarily re-assigned.

    If you have any questions please work with Director/Manager, Service Chief or Department Chair and Employee Health.  Any re-assignments should include a notice to Human Resources at HR-employeeresource@uchc.edu with the following information:

    Name of Provider, position and department, reason for re-assignment and new assignment, duration of assignment.

    List of Medications that Constitute Severe Immunocompromise

    • High-dose corticosteroids

    o   defined as a dose of either >2 mg/kg of body weight or ≥20 mg per day of prednisone or equivalent in people who weigh >10 kg, when administered for ≥2 weeks

    • Alkylating agents(such as cyclophosphamide)
    • Antimetabolites(such as azathioprine, 6-mercaptopurine, methotrexate).
    • Transplant-related immunosuppressive drugs(such as cyclosporine, tacrolimus, sirolimus, everolimus, azathioprine, and mycophenolate mofetil)
    • Cancer chemotherapeutic agents
    • Tumor necrosis factor (TNF) blockers(e.g. etanercept, adalimumab, certolizumab pegol, golimumab, and infliximab)
    • Lymphocyte-depleting agents (thymoglobulin or alemtuzumab)
    • Other biologic agentsthat are immunosuppressive or immunomodulatory including the following:

    GENERIC NAME         TRADE NAME

    Abatacept                           Orencia

    Adalimumab                      Humira

    Alemtuzumab                   Campath

    Anakinra                              Kineret

    Atezolizumab                    Tecentriq

    Avelumab                           Bavencio

    Basiliximab                          Simulect

    Belatacept                          Nulojix

    Bevacizumab                     Avastin

    Certolizumab pegol         Cimzia

    Cetuximab                          Erbitux

    Dasatinib                             Sprycel

    Dimethyl fumarate          Tecfidera

    Etanercept                          Enbrel

    Fingolimod                          Gilenya

    Glatiramer acetate          Copaxone

    Golimumab                        Simponi

    Ibritumomab tiuxetan    Zevalin

    Ibrutinib                               Imbruvica

    Imatinib mesylate            Gleevec, STI 571

     

    GENERIC NAME           TRADE NAME

    Infliximab                            Remicade

    Interferon alfa                   Pegasys, PegIntron

    Interferon beta-1a          Avonex, Rebif

    Interferon beta-1b          Betaseron

    Natalizumab                       Tsabri

    Nivolumab                          Opdivo

    Ofatumumab                     Arzerra

    Panitumumab                   Vectibix

    Pembrolizumab                Keytruda

    Lenalidomide                     Revlimid

    Rilonacept                           Arcalyst

    Rituximab                            Rituxan

    Sarilumab                            Kevzara

    Secukinumab                     Cosentyx

    Sunitinib malate               Sutent

    Tocilizumab                        Actemra

    Tofacitinib                           Xeljanz

    Trastuzumab                      Herceptin

    Ustekinumab                     Stelara

    Vedolizumab                     Entyvio

    Human Resources
    HR-employeeresource@uchc.edu

     

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