WNC COVID-19 Regional Report - September 4, 2020

September 8, 2020

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Friday, September 4, 2020

 

This week’s report highlights COVID-19 trends, updated ob/gyn recommendations, health inequities in ob/gyn care, and new resources and training opportunities for providers and patients.

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Monitoring Trends

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*Women younger than 9 and older than 54 were not reported; Source: CDC

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Key Observations this Week

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Phase 2.5 Goes into Effect Today. After a month of relatively stable key metrics, Governor Cooper announced North Carolina will move into Phase 2.5 at 5 pm permitting indoor gatherings of up to 25 people and outdoor gatherings of up to 50 with social distancing and face coverings. Museums can reopen at 50% capacity, and gyms can open at 30% capacity. Movie theaters and bars will remain closed.

COVID-19 Dashboard and Testing Updates: NCDHHS has added testing turnaround times to the COVID-19 dashboard and has updated guidance for colleges and universities.

On August 24, the CDC updated its recommendations on who should be tested for COVID-19. North Carolina has elected to follow the broader guidelines set forth by the CDC on July 6.

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Spotlight: COVID-19 Ob/Gyn Best Practices

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COVID-19 has rapidly transformed the way we provide maternity care, leading to healthcare innovations and exacerbating health inequities. Below is a roundup of the current best practices for ob/gyn care.

COVID-19 Assessment and Management. ACOG has issued guidance on the care of pregnant patients who are suspected or confirmed to have COVID-19. This guidance includes an algorithm for assessing symptoms, exposure, and illness severity as well as recommendations for reducing risk.

Prenatal Testing. A detailed (targeted) mid-trimester ultrasound should be considered for pregnant patients who are infected with COVID-19 during their first trimester.

COVID-19 Hospitalization. Continuous fetal monitoring should be used with pregnant patients who are hospitalized for severe COVID-19 illness once it has been determined that the fetus is viable and delivery will not negatively impact maternal outcomes.

Labor and Delivery

  • Universal COVID-19 testing is recommended for all patients when testing supplies allow in communities where widespread transmission is occurring.
  • Masks should be worn by pregnant patients in accordance with CDC guidelines except during the second stage of labor, when wearing a mask may impede the ability to push.
  • Doulas, lactation support, and mental health services should be considered essential and made available through telehealth or by using PPE when in-person support is needed.

COVID-19 Neonatal Testing. Babies born to mothers who are COVID 19-positive should be tested within 24 hours after birth and, if negative, retested 48 hours later.

Hospital Rooming Recommendations. Vertical transmission occurring during pregnancy or delivery has been reported in the COVID-19 literature but is rare. Coronavirus does not appear to be transmitted through breast milk, but can occur from mother to infant during feeding and care through respiratory droplets. When deciding where a newborn should be roomed, healthcare providers should engage patients in a shared decision-making process that considers

  • severity of the mother’s illness
  • availability of an alternate caregiver who is not at risk for severe illness
  • ability to continue separation after hospital discharge

Newborn Care and Feeding. When rooming in, preventive measures should include physical distancing (>6 feet), use of face coverings, proper hand hygiene, and a temperature-controlled isolette if available.

Hospital Discharge. Expedited discharge is recommended for all patients with follow-up ob/gyn and pediatric telehealth care. Blood pressure monitoring should be conducted at home, when necessary.

For more information including health equity guidance and resources, please review the North Carolina Pregnancy & Continuity of Care During COVID-19 Task Force Recommendations.

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Maternal Health Inequities

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Pregnant women may be at greater risk for severe illness from COVID-19. This risk is exacerbated for Black and Brown women who are more likely to be infected by COVID-19 for a variety of reasons related to structural racism. The shift to reduce in-person prenatal visits has created additional health risks for women who do not have access to technology or a safe place to engage in telehealth, both of which are more likely to impact women in historically marginalized and rural communities.

COVID-19 has been associated with an increase in perinatal substance use and a 30-40% increase in overdose deaths. These increases may be due, in part, to increased isolation, anxiety about contracting the virus, difficulty accessing harm-reduction and recovery resources, and financial insecurity caused by the pandemic. MAHEC is offering a free monthly webinar series beginning Sept. 11 to help WNC providers build systems of care for patients with perinatal substance use disorders.

 

WNC Hospitals With and Without Labor and Delivery Services
and Percentage of Women of Childbearing Age

 

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Created by Joan Colburn, MLIS, UNC Health Sciences at MAHEC (2 September, 2020)

 

COVID-19 Practice Support Tip Sheets

 

For more ob/gyn resources, please see MAHEC’s COVID-19 Ob/Gyn LibGuide.

 

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NEW Resources to Help You Serve Your Patients

 

Provider Resources

Health Inequities and Social Support

Patient Education

 

NEW & Ongoing COVID-19 Virtual Trainings & Support

 

Vaya Health: QPR Suicide Prevention
Tuesday, Sept. 8 from 2:30 to 4:30 pm (additional dates available)

MAHEC COVID-19 Coordinating Community Resources in WNC
Wednesday, Sept. 9 from 7:00 to 8:00 am (biweekly series)

MAHEC Acute Care of Inpatient with COVID-19
Wednesday, Sept. 9 from 12:00 to 1:00 pm (biweekly series)

NC AHEC A Coordinated Response to Health Equity and Health Determinants in NC: Housing
Wednesday, Sept. 9, 12:00 to 1:00 pm

UNC Gillings School of Global Public Health 26th National Health Equity Research Webcast
Friday, Sept. 11 at 2:00 pm

NC AHEC Ethical Challenges in Small Community Practice
Saturday, Sept. 12 from 9:00 am to 12:15 pm

MAHEC Developing Resilience for the Healthcare Workforce
Monday, Sept. 14 through Nov. 16 from 12:00 to 1:00 pm

Charlotte AHEC Implicit Bias-Cleansing Our Lenses
Wednesday, Sept. 16 from 9:00 am to 4:30 pm

Southern Regional AHEC Optimizing Telehealth for the Geriatric Population
Wednesday, Sept. 16 from 5:30 to 7:30 pm

Charlotte AHEC Leadership and Management in the New Normal
Thursday, Sept. 17 from 9:00 am to 4:00 pm

The National Council Systematic Racism, Health Disparities, and COVID-19: Leading through Complex Trauma with Resilience and Hope
Thursday, Oct. 8 from 3:00 to 4:00 pm

NCDHHS COVID-19 Healthcare Coalition
Wednesdays from 1:00 to 2:00 pm
Click link above and select “add to distribution list” to receive weekly meeting invitations

WCMS Virtual Yoga and Meditation with Dr. Robyn Tiger
Thursdays from 11:15 am to 12:30 pm
Contact Robyn to register for classes

 

Archives

 

August 21August 7
July 31July 24July 17July 10July 2
June 26June 19June 12June 5
May 29May 22May 15May 8May 1
April 24April 17April 10

If you would like to receive this weekly report, please email Sam.Blankenship@mahec.net to be added to our distribution list. 

 

Regional Response Partners

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