Basic Physician’s Guide to COVID-19

Table of Contents

• Preparing the Health System for COVID-19
• Protecting Yourself from COVID-19
• Handling Patients with Suspected or Confirmed COVID-19
• Potential Exposure to Patients with COVID-19

With the continuous rise of COVID-19 cases in the United States and the majority of the world, the medical field was left no other choice but to keep up with the evolving situation and try to get at least a foot ahead of the pandemic. The unique and uncertain situation made every hospital and clinical units adapt and as a medical practitioner, you must keep track of every development being pushed by the medical authorities.

That said, the American Medical Association released a quick-start COVID-19 physician guide updated last April 2020. These resources were curated from the Centers for Disease Control and Prevention, the Journal of the American Medical Association, and the World Health Organization. Here are some of the comprehensive guide’s highlights to help prepare your practice and address concerns on the state of healthcare during the COVID-19 pandemic.

Preparing the Health System for COVID-19

The emergence of the coronavirus provided new hurdles for the health system to overcome. The World Health Organization released a communication package for the purpose of healthcare facility management.

Each healthcare facility must have a triage station at its entrance before the waiting area. A proper screening should be conducted to prevent patients with COVID-19 to catalyze infection throughout the facility. The place should also have visible information that reminds everyone to observe hand hygiene and good respiratory practices.

If you’re part of the triage workers, make sure that you properly received your training on the proper use of personal protective equipment (PPE). You should also be guided and familiar with your institution’s decision flow diagram when it comes to handling cases of suspected and infected patients.

Protecting Yourself from COVID-19

Your healthcare institution should have already released guidelines when it comes to COVID-19 protocols. Strictly follow the said guidelines and discuss with your colleagues and coworkers about agreed safety procedures.

Almost all healthcare workers are now required to wear personal protective equipment all the time. Despite limited resources, it’s important to observe proper usage and disposal of PPEs. Here are some reminders from the CDC for healthcare workers:

• PPEs should be completely changed between use for each different patient. Single-use PPEs shouldn’t be sterilized for re-use. Dispose everything properly and wash your hands thoroughly after use.
• Don’t touch your face with gloves or bare hands until you’ve observed proper hand hygiene.
• Depending on your institution, boots and coverall suits may not be required.
• Wear proper equipment when entering a room with a suspected or confirmed COVID-19 patient. If performing an aerosol-generating procedure, use a particulate respirator (like an N95) and conduct a seal check. If not, then the standard disposable gloves, long-sleeve gown, medical mask, and eye protection are sufficient.
• Proper hand hygiene should be exercised. Wash your hands with soap and water or use an alcohol-based hand rub when:
• Before touching a patient
• Before doing clean/aseptic procedures
• After body fluid exposure
• After touching a patient
• After touching patient surroundings

Physical distancing is also implemented. Maintaining 6 feet between people is a crucial strategy to avoid transmission of COVID-19. As physicians, certain practices are moved online in order to limit visitors to the healthcare facility. The use of alternative practices such as video-call applications are highly encouraged. Appointments should also be scheduled in a way that limits the number of patients in the waiting room.

Always remember that when it comes to COVID-19 transmission, your patients are not the only people you’re exposed to. Unprotected exposures to your co-workers who are asymptomatic are also a way for you to catch the virus.

Handling Patients with Suspected or Confirmed COVID-19

When it comes to diagnosing and treating patients with suspected or confirmed COVID-19, maximum caution should be exercised.

The Centers for Disease Control and Prevention released a recommendation when it comes to COVID-19 testing. These are subject to change depending on the additional information being available.

CDC doesn’t recommend using antibody testing as the sole basis for diagnoses. Serologic assays may be used to support clinical assessment or when a patient is suspected to have a post-infectious syndrome. Because serologic assays for COVID-19 determines whether the patient tested was previously infected, it’s not absolutely clear if a positive test shows immunity against the virus. CDC is strictly mandating that serologic tests shouldn’t be used at this time to show if a patient is immune. Additional data is still very much needed.

Authorized nucleic acid or antigen detection assays that have FDA EUA are recommended by the CDC to test patients with symptoms concerning COVID-19. They leave the judgment to the medical professions to determine if the patient should be tested.

All health care professionals must immediately notify their health departments for cases of COVID-19.

Potential Exposure to Patients with COVID-19

Being on the frontline of the pandemic, healthcare professionals have the highest risk of contacting the virus. If you believe to be exposed to COVID-19, the CDC has released guidelines for risk assessment to help clinicians:

• Consult the guidelines for risk assessment by the CDC for the risk levels and what to do if exposure occurs.
• When you’re assessing the risk, take note of the duration of exposure, the symptoms of the patient, and whether the patient is wearing a facemask. If you performed any aerosol-generating procedure, identify the type of personal protection equipment used.
• Immediately self-isolate and notify your healthcare facility. CDC recommends at least 14 days of monitoring for COVID-19 and its symptoms.
• Follow the contact tracing protocol and your hospital guidelines.
• Continuously monitor yourself during your self-quarantine. If symptoms occur, immediately contact your healthcare institution for testing and treatment. If not, finish the recommended self-isolation period and follow your institution’s guidelines for work clearance.

In times like this, it’s important to review your Medicare and Medicaid coverage information (or equivalent health care insurance provider) when it comes to COVID-19. Your healthcare institution should notify you about your updated insurance coverage. Review the congressional help pushed by the AMA and other physician organizations through Coronavirus Aid, Relief and Economic Security Act for the benefits and provisions for physicians and practices.

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