INFORMATION ABOUT COVID-19 (CORONAVIRUS) IS BEING RELEASED RAPIDLY. WE WILL POST UPDATES AS WE RECEIVE THEM.

COVID-19 (CORONAVIRUS) BULLETIN

Updated: March 26, 2020


INFORMATION ABOUT COVID-19 (CORONAVIRUS) IS BEING RELEASED RAPIDLY. WE WILL POST UPDATES AS WE RECEIVE THEM.


CLICK TO READ: COVID-19 AOPO Letter to Trump Administration – March 17, 2020

  • AOPO will follow the response and recommendations provided by the CDC (www.cdc.gov) with regards to COVID-19 risks, exposure and isolation.  This is a rapidly emerging situation and if the CDC releases additional guidance we will revise accordingly. Please check back for updates.
  • Take steps to ensure all persons with symptoms of suspected COVID-19 or other respiratory infection (e.g., cough, shortness of breath, fever) adhere to respiratory hygiene and cough etiquette, hand hygiene, and triage procedures throughout the duration of the contact.
  • Standard Precautions assume that every person is potentially infected or colonized with a pathogen that could be transmitted in the healthcare setting. Elements of Standard Precautions apply to patients with respiratory infections, including those caused by COVID-19.  Attention should be paid to training on correct use, proper donning (putting on) and doffing (taking off), and disposal of any Personal Protective Equipment (PPE). 

    This is a great reference from the CDC on the correct way to put on and safely remove PPE. https://www.cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf
    • Health Care Professionals (HCP) should perform hand hygiene using alcohol-based hand sanitizer before and after all patient contact, contact with potentially infectious material, and before putting on and upon removal of PPE, including gloves. Washing hands with soap and water for at least 20 seconds can also provide appropriate hand hygiene.
  • Employees who may have symptoms or come in contact with a known COVID-19 case should self-quarantine for 14 days and contact their physician for instructions on next steps.
  • Screen referrals based on symptoms and possible exposure risks (flu-like symptoms, fever, signs of respiratory infection, recent travel to high risk areas).

SPECIFIC TO OPOS:

Organ Donor Criteria:

  • OPO personnel should not enter the isolation room of potential donors who are in hospital isolation and pending COVID-19 testing. Patients in hospital isolation and pending COVID-19 testing should not have direct contact with OPO personnel.  Approaches may be made by phone pending testing results.
    • Patients testing negative may be reconsidered for donation suitability
    • Patients that test positive for COVID-19 will be medically ineligible for donation
    • Donor deferral may also be considered if (i.e.: testing not immediately available):

Tissue and Eye Donation Criteria:

  • Deferral will be based upon infection status in the last 28 days before donation:
    • Positive test for COVID-19 (infection with 2019-nCoV)/Confirmed infection
    • Symptoms consistent with COVID-19 infection (e.g., unexplained fever, cough, shortness of breath) in a patient with suspected COVID-19 infection
    • Donor defined as a Person under Investigation (PUI)1 for COVID-19 according to the criteria published by the CDC: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html
    • Fever with severe acute lower respiratory illness (e.g., pneumonia, ARDS) requiring hospitalization without alternative explanatory diagnosis (e.g., influenza) and without a negative SARS-CoV-2 diagnostic test
  • Additionally, deferral will be based upon exposure in the last 28 days before donation:
    • Close contact2 with a person who has confirmed COVID-19 infection
    • Close contact2 with a Person under Investigation (PUI)1 for COVID-19
    • Travel geographic areas designated3 by CDC as Warning Level 3 or Alert Level 2 regardless of symptoms
    • Travel to geographic areas designated3 by CDC as Watch Level 1 or other destinations with risk of community spread4 will be evaluated on a case by case basis

OPO Personnel:

  • OPO personnel should follow all hospital-based protocols for the isolation and management of COVID-19 patients.
  • Any questions or concerns about the infectious status of a potential donor should be referred to your AOC and/or Medical Director for further guidance.
  • If a donor is being ruled-out due to hospital considerations, local health authorities and/or the CDC, be sure to indicate document this information in your online system and if registered in DonorNet to document there as well. It is imperative that this information be documented clearly and accurately.   Documentation should include transmittable disease status, COVID-19 testing status/high risk suspicion and/or individual organ suitability.
  • Screening questions on DRAI should reflect updated questions around COVID-191
  • This is a rapidly emerging situation and if the CDC releases additional guidance we will revise accordingly. Please check back for updates.
  1. Person under Investigation (PUI) for COVID-19 according to the criteria published by the CDC: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html
  2. Close contact is defined as (i) being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time; close contact can occur while caring for, living with, visiting, or sharing a health care waiting area or room with a COVID-19 case; or (ii) having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on). Considerations when assessing close contact include the duration of exposure (e.g., longer exposure time likely increases exposure risk) and the clinical symptoms of the person with COVID-19 (e.g., coughing likely increases exposure risk as does exposure to a severely ill patient).
  3. Travel Health Notices by the CDC (https://wwwnc.cdc.gov/travel

ADDITIONAL RESOURCES:

Below is a listing of other resources pertaining to COVID-19.

CDC:
https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://emergency.cdc.gov/han/2020/han00429.asp?deliveryName=USCDC_511-DM22015

How to properly PUT ON and SAFELY REMOVE PPE
https://www.cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf

CMS:
Access for Healthcare Staff – Including OPOs, into Donor Hospitals  (see page 8) https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and/prioritization-survey-activities

Current Emergencies Website
https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page

Press Release on Elective Surgeries and Non-Essential Procedures
https://www.aopo.org/cms-releases-recommendations-on-adult-elective-surgeries-non-essential-medical-surgical-and-dental-procedures-during-covid-19-response/

CMS Guidance on Elective Surgeries and Non-Essential Procedures
https://www.cms.gov/files/document/31820-cms-adult-elective-surgery-and-procedures-recommendations.pdf

AATB: 
https://www.aatb.org/content/covid-19-updates

AHA:
https://www.aha.org/2020-01-22-updates-and-resources-novel-coronavirus-2019-cov

ASN and AST:
https://www.healio.com/nephrology/infection-control/news/online/%7B3189112e-4db9-44fd-ac2b-03cad45f0ac5%7D/american-society-of-nephrology-american-society-of-transplantation-release-guidance-on-coronavirus

AST:
https://www.myast.org/information-transplant-professionals-and-community-members-regarding-2019-novel-coronavirus

Organ Donation and Transplant Town Hall
https://www.youtube.com/watch?v=LUM8-vDH-kI&t=3s

ASTS:
https://asts.org/news-and-publications/asts-news/article/2020/03/11/asts-response-to-covid-19#.XnD4P3IpA2w

EBAA:
https://restoresight.org/covid-19-updates/

NKF:
https://www.kidney.org/coronavirus/transplant-coronavirus
https://www.kidney.org/contents/be-prepared-kidney-patient-prep-coronavirus

OPTN:
https://optn.transplant.hrsa.gov/news/information-for-transplant-programs-and-opos-regarding-2019-novel-coronavirus/

OSHA:
Preparing Workplaces for COVID-19
https://www.osha.gov/

UNOS:
https://unos.org/news/member-information-regarding-covid-19/

WHO:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports