Recorded on October 6, 2021

1. Team-Based Care Within the Setting of
COVID-19 – Review & Reintroduction
October 6th, 2021

2. Continuing Education Credits
In support of improving patient care, Community
Health Center, Inc. / Weitzman Institute is jointly
accredited by the Accreditation Council for
Continuing Medical Education (ACCME), the
Accreditation Council for Pharmacy Education
(ACPE), and the American Nurses Credentialing
Center (ANCC), to provide continuing education for
the healthcare team.
A comprehensive certificate will be sent after the
end of the series, December 2021.

3. Disclosures & Disclaimers
With respect to the following presentation, there has been no relevant (direct or indirect)
financial relationship between the faculty listed above or other activity planners (or spouse/partner)
and any for-profit company in the past 12 months which would be considered a conflict of interest.
The views expressed in this presentation are those of the faculty and may not reflect official
policy of Community Health Center, Inc. and its Weitzman Institute.
We are obligated to disclose any products which are off-label, unlabeled, experimental, and/or
under investigation (not FDA approved) and any limitations on the information that are presented,
such as data that are preliminary or that represent ongoing research, interim analyses, and/or
unsupported opinion.
This project is supported by the Health Resources and Services Administration (HRSA) of the
U.S. Department of Health and Human Services (HHS) as part of an award totaling $137,500 with 0%
financed with non-governmental sources. The contents are those of the author(s) and do not
necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S.
Government. For more information, please visit HRSA.gov.

4. At the Weitzman Institute, we
value a culture of equity,
inclusiveness, diversity, and mutually
respectful dialogue. We want to
ensure that all feel welcome. If there
is anything said in our program that
makes you feel uncomfortable,
please let us know.

5. med.stanford.edu
6 Oct 2021

6. COVID-19
Pandemic of the Century
• SARS-CoV-2
– Bat coronavirus, ‘jumped species’
• COVID-19
– Coronavirus Virus Disease 2019
– Caused a Pandemic (Pan- ALL, demos – PEOPLE)
– Spectrum of illness: asymptomatic/mild to vicious disease
– The vulnerable: Who we must protect
*This is best done in a coordinated concerted effort*

7. 43,699,391 cases on 10/4/21 with 701,377 deaths
https://coronavirus.jhu.edu/us-map
COVID-19 in the United States: TOTAL

8. COVID-19 Hot Spots
https://www.nytimes.com/interactive/2021/us/covid-cases.html
Hot spots around the USA
May 18, 2021

9. Local Epidemiology
https://coronavirus.jhu.edu/covid-19-daily-video

10. https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
Summer
Surge

11. https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

12. The Danger of Variants
• Variants Being Monitored (VBM):
• Alpha (B.1.1.7, Q.1-Q.8)
• Beta (B.1.351, B.1.351.2, B.1.351.3)
• Gamma (P.1, P.1.1, P.1.2)
• Epsilon (B.1.427 and B.1.429)
• Eta (B.1.525)
• Iota (B.1.526)
• Kappa (B.1.617.1)
• B.1.617.3
• Mu (B.1.621, B.1.621.1)
• Zeta (P.2)
• Variants of Interest (VOI)
None
• Variants of concern (VOC)
• Delta (B.1.617.2 and AY.1 sublineages)
• Variants of High Consequence (VOHC)
Thankfully none – yet!

13. Delta Variant
https://www.axios.com/coronavirus-variant-tracker-where-different-strains-are-spreading-
ffd71934-1596-43e6-923d-32c4698e2f8b.html
• Like COVID on steroids
• Outcompeted other strains
• April -> June -> accelerated

14. Breakthrough Infections
• Immunocompromised
– What exactly does that mean?
– Who are the weak, who are the vulnerable, who will the
virus attack?
– Very important to recognize this, and take action!
• Body follows the principle: ‘Use it or lose it’

15. Immunity 101
• Receive the vaccine, or experience natural disease
• Get a booster (either after the primary immunization series, or
after natural infection) – things go up!

16. COVID-19 Vaccinations Across the Nation
https://covid.cdc.gov/covid-data-tracker/#vaccinations

17. https://covid.cdc.gov/covid-data-
tracker/#vaccinations_vacc-people-fully-percent-total

18. Prevention Remains Key!
• You do not want to catch
this!
– Very severe disease
– Prolonged course
– Some degree of
uncertainty
• There is treatment available
and this is slowly improving…

19. Treatment Options
• Early in the disease course
(virus present)
– Monoclonal antibodies
(latch onto virus)
– Antivirals: Remdesivir
– Latest news: Molnupiravir - pill
• Late in the disease course
(inflammation predominates)
– Dexamethasone (steroid)
– IL-6 blockers (tocilizumab)

20. Treatment Options
• Non-hospitalized patients with mild to moderate COVID-19
who are at high risk of clinical progression:
– Bamlanivimab plus etesevimab; or
– Casirivimab plus imdevimab; or
– Sotrovimab intravenous (IV) infusion

21. We Have to do More…
• Thinking and acting as a team
member...
• Fighting back against
anti-science, anti-vaxx
• Protecting ourselves,
our families, our loved ones,
our patients, our neighbors!
https://www.unitypoint.org/interstitial.aspx

22. Special Focus: Prevention in Pregnancy
• CDC strong recommendation for those who are pregnant,
recently pregnant (i.e. lactating), trying or planning to become
pregnant - should be immunized
• Only 31% currently immunized
– 15.6% for pregnant non-Hispanic
Black women = health inequities
• Pregnancy carries an increased risk for severe illness
(including hospitalization, ICU admission, mechanical
ventilation, and death)
• Increased risk of preterm birth

23. Vaccination in Pregnancy
• Pregnant people have not reported different side effects from
non-pregnant people after vaccination with mRNA vaccines
(Moderna and Pfizer-BioNTech)
– Fever following vaccination? Recommended to take
acetaminophen (Tylenol®) because fever can be associated
with adverse pregnancy outcomes
• Johnson & Johnson’s Janssen (J&J/Janssen) Vaccine: Women
younger than 50 years old - rare risk of blood clots with low
platelets after vaccination
• Discuss with your healthcare provider!

24. Trusted Resources
• Johns Hopkins
https://coronavirus.jhu.edu/map.html
• 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
• Others
https://www.nytimes.com/interactive/2021/us/covid-cases.html
https://www.thelancet.com/coronavirus
https://covidactnow.org/

25. Care Delivery in the COVID-19 Landscape
Veena Channamsetty, MD
Mary Blankson, DNP, APRN

26. Care Delivery in the COVID-19 Landscape
• Balancing In-person care with Telehealth
o Clinical need
o Patient and staff safety
o Discipline and role specific
• Team Based Care and the Virtual Team
o On-site care team
o Virtual care team
o Extended care team

27. Balancing In-Person Care with Telehealth
• Clinical team driven follow up
• Recall for appointment type
• Centrally ‘approved’ in-person visit types

28. Balancing In-Person Care with Telehealth

29. Balancing In-Person Care with Telehealth

30. Team Based Care and the Virtual Team
• Organizing around new model of care
• In person vs telehealth planned care and rooming

31. Team Based Care and the Virtual Team
• Incident-to-care for
telehealth providers
• COVID-19 related care
and immunizations
• Staff recruitment and
retention efforts

32. Patient Satisfaction with Model of Care
Crossroads Group Survey
Data for April-June 2021
• Survey satisfaction with
telephone and video visits
• Aggregate overall
satisfaction based on visit
type

33. Upcoming Dates & Topics
• 10/20 – Boosters for Immunocompromised
and Patients at High Risk
• 11/3 – Pediatric Vaccines in the Team-Based
Care Model
• 11/17 – Community Engagement Pathways
• 12/1 – Supporting Staff & Sharing Best
Practices in Navigating COVID-19