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Weitzman ECHO: Connecting Vulnerable Populations with Resource to Support Self-Isolation

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Weitzman ECHO: Connecting Vulnerable Populations with Resource to Support Self-Isolation

  1. 1. Connecting Vulnerable Populations with Resources to Support Self-Isolation: Innovations and Lessons Learned from IsoCare August 5, 2020
  2. 2. CME Credit • Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State Medical Society to sponsor continuing medical education for physicians. The Bridgeport Hospital Yale New Haven Health designates this live activity for a maximum of one (1) AMA PRA Category 1 CreditsTM. Physicians should claim only credits commensurate with the extent of their participation in the various activities. • This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Bridgeport Hospital Yale New Haven Health and the Weitzman Institute. Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State Medical Society to provide continuing medical education for physicians. • The content of this activity is not related to products or services of an ACCME- defined commercial interest; therefore, no one in control of content has a relevant financial relationship to disclose and there is no potential for conflicts of interest. 2
  3. 3. Connecting Vulnerable Populations with Resources to Support Self-Isolation www.careinnovations.org/
  4. 4. 4,771,080 cases on 8/5/20 up from 4,341,201 cases on 7/28/20 156,801 deaths https://coronavirus.jhu.edu/map.html COVID-19 by population- US & World
  5. 5. Daily New Cases per 100k people Data shown from 1/22/20 to 8/4/20 https://coronavirus.jhu.edu/data/new-cases-50-states LAST week:
  6. 6. A Tale of Two States: FL and CT Florida Connecticut 250+ cases/day end of July 7166 cases Aug 2nd; decline from 10,145 July 26th
  7. 7. USA trends: New cases by Day https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html
  8. 8. News updates • Israeli school openings – May 17th – “They definitely should not do what we have done” – Dr. Waxman – Take strict precautions when reopening schools: • Smaller classes • Mask wearing • Keeping desks six feet apart • Providing adequate ventilation
  9. 9. News updates • Developing world: Collateral damage: reduced availability of drugs for HIV, TB and malaria – interrupting supply chains – diverting manufacturing capacity – physical barriers for patients • travel to clinics to obtain medications
  10. 10. News updates • Vaccine progress – Novavax’s Covid-19 vaccine - promising immune response • Protein based – adjuvant vaccine (Spike protein) • Scientists: Improved understanding of inflammation in COVID-19
  11. 11. Resources • Isocare: https://disastercrashcart.org/isocare.php • Nuvance health:https://spark.adobe.com/page/LPYqVcgQFwqqh/ • CDC: https://www.cdc.gov/coronavirus/2019-ncov/index.html https://emergency.cdc.gov/coca/calls/2020/ • WHO: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 • Johns Hopkins: https://coronavirus.jhu.edu/map.html • Others https://www.thelancet.com/coronavirus https://covidactnow.org/
  12. 12. Supporting Isolation Panna Lossy, MD; Family Medicine Physician, Santa Rosa Family Medicine Residency; Co- founder, IsoCare Deirdre Bernard-Pearl, MD; Pediatric Medical Director, Santa Rosa Community Health Center; Co-founder, IsoCare
  13. 13. How It Started
  14. 14. Gaps Identified • Lag time from symptom onset to test result • Need for timely support for many to actually isolate/quarantine
  15. 15. Test turn around is longer than infectious period! • Peak Infectious period is likely 2 days before symptoms until ~ 5 days after symptoms. • To stop spread we need to intervene quickly after someone gets symptoms! How-Yuen Chen et al, JAMA Internal Medicine, May 2020
  16. 16. • Community Health Centers refer patients who must isolate or quarantine while awaiting test results • Provides telephone health education, resources and support for people who have been told to home isolate or quarantine • Has trained over 150 volunteers and supported over 1300 clients since April 2, 2020 • Partnered with Petaluma People Services Center as Fiscal Agent
  17. 17. What Does • Education on how to prevent spreading Covid to close contacts and community. • Problem solving for individual situations • Emotional support • Link client to resources like food, masks, $, etc. • Safety net for people who can’t isolate safely
  18. 18. What Is NOT Their doctor Law Enforcement
  19. 19. Are and PH doing the same thing? • Public Health is focused on tracking known positive cases and tracing contacts (Who, Where, When) • IsoCare supports people in isolating and quarantining when they don’t yet have a positive test – 5-15 days before they get a call from PH • IsoCare is focused on helping people understand what it really means to home isolate and how to protect the rest of their household and the larger community • IsoCare deploys community resources to help people stay home
  20. 20. Sirius Activist Phone Bank
  21. 21. Over 1500 people supported
  22. 22. Easy to learn about clients
  23. 23. Slightly more English Speakers Leave the House
  24. 24. But almost all the Spanish Speakers who leave are going to work!
  25. 25. Some things we have learned • You can’t wait until the positive test result to engage patients in stopping Covid spread! • Isolation and Quarantine are really hard to do! • Most people don’t read the handouts • If you want people not to go to work, you need to give them a work excuse • Financial support would make a big difference in compliance
  26. 26. Strategies that are Key to Success • Train Community Health Workers (CHWs) to use a Case Management model to provide support, increase connection, and build trust • Utilize interactive scripts (on-line) to support and guide community health workers • IT platform that easily collects data can be used to inform the model and future interventions • Comprehensive, initial Training for CHWs in Isolation/Quarantine, resources, motivational interviewing • Minimum weekly collaboration/update meetings for CHWs • IsoCare staff available for CHWs so they can get questions answered real time and support for complex patient needs • Close collaboration with other Community Based Organizations – partnerships for client resources
  27. 27. Where could we go from here? • Spread it - Other areas could create an IsoCare Collaborative • Integrate It – Use the information from Intake to prioritize case investigation and potentially do case investigation or contact tracing with people in the program • Need financial sustainability!
  28. 28. Community County Health Dept Test Order Isolation Contact Trace Release Isolation Patient Needing Home Isolation For Covid Medical Care Test Triage Sx Control Mental Health Community Resources Food Bank Financial assistance Laundry Supplies Phone support for home isolation & linkage to resources
  29. 29. People Behind
  30. 30. Organizations Behind
  31. 31. Join Us! www.disastercrashcart.org/isocare.php
  32. 32. 33 * This initiative is supported by 33
  33. 33. Thank You! www.weitzmaninstitute.org/coronavirus 34

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