CMS has prepared a press release summarizing the steps that Medicare has taken in Oregon to help make health care available to wildfire victims, including opening special enrollment periods to allow out-of-season initiations or changes to Medicare coverage, various kinds of assistance to healthcare facilities, and help to displaced dialysis patients. Find the press release at https://www.cms.gov/newsroom/press-releases/cms-offers-comprehensive-support-oregon-due-wildfires.
CDC has launched a new web page on Natural Disasters, Severe Weather, and COVID-19, to provide information on how people can stay safe during and after natural disasters during the COVID-19 response. The page and a few of its useful links follow:
- Natural Disasters, Severe Weather, and COVID-19:
- Wildfire Smoke and COVID-19:
- Hurricanes and COVID-19 – most of this information applies as well to other wide-area disasters:
- Going to a Public Disaster Shelter During the COVID-19 Pandemic:
- COVID-19 Resources for Professionals & Emergency Workers:
Understand that your planning and preparation may be different this year because of the need to protect yourself and others from COVID-19.
Give Yourself Time: Give yourself more time than usual to prepare your emergency food, water, and medicine supplies. Home delivery is the safest choice for buying disaster supplies, but it may not be an option for everyone. If in-person shopping is your only choice, take steps to protect your and other’s health when running essential errands.
Pack Your Go Kit: If you need to evacuate, prepare a “go kit” with personal items you cannot do without during an emergency. Include items that can help protect you and others from COVID-19, such as hand sanitizer with at least 60% alcohol, bar or liquid soap, disinfectant wipes (if available), and two masks for each person. Masks should not be used by children under the age of 2. They also should not be used by people having trouble breathing, or who are unconscious, incapacitated, or unable to remove the mask without assistance.
Keep Your Distance: When you check on neighbors and friends, be sure to follow social distancing recommendations (staying at least 6 feet from others) and other CDC recommendations to protect yourself and others.
Read more about COVID-19 specific key disaster messages in Hurricane Key Messages: COVID-19 Annex (Spanish), in addition to the Preparedness and Safety Messaging for Hurricanes, Flooding, and Similar Disasters (Spanish).
A recent CDC announcement comments on wildfire smoke:
“Wildfire smoke can irritate your lungs, cause inflammation, affect your immune system, and make you more prone to lung infections, including SARS-CoV-2, the virus that cause COVID-19. Because of the COVID-19 pandemic, preparing for wildfires might be a little different this year. Know how wildfire smoke can affect you and your loved ones during the COVID-19 pandemic and what you can do to protect yourselves.”
The rest of the announcement details what you can do about it. Find it at https://www.cdc.gov/disasters/covid-19/wildfire_smoke_covid-19.html.
In all of the resources below, remember that dialysis patients must still control their fluid intake. For tips on Dialysis Fluids Management in English, see https://s3-us-west-2.amazonaws.com/nwrn.org/files/NW18/Fluids.Eng.pdf and in Spanish, see https://s3-us-west-2.amazonaws.com/nwrn.org/files/NW18/Liquidos.esp.pdf. These should override the water-consumption suggestions in all of the documents below.
The Oregon Health Authority has an excellent web page on Extreme Heat, that includes FAQ sheets in English, Español (Spanish), Русский (Russian), 简体中文 (Simplified Chinese), Af Soomaali (Somali), and tiếng Việt (Vietnamese). Find it at https://www.oregon.gov/oha/ph/Preparedness/Prepare/Pages/PrepareForExtremeHeat.aspx.
Homeland Security’s “Ready.gov” website has a thorough discussion of how to stay cool and safe in extreme heat, at https://www.ready.gov/heat. The National Institute for Occupational Safety and Health (NIOSH) has a page on how to identify signs of heat exhaustion or heat stroke, and what to do about it, at http://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html. CDC has a program that sends out a weekly email on Five Minutes or Less for Health Weekly Tip, which also covers skin cancer, hydration, and communicable diseases from mosquitoes and ticks. Review their hot weather Tips or sign up at https://www.cdc.gov/family/minutes/tips/summersavvy/index.htm.
CMS requires ESRD Networks to track the status of facility operations and patient access to treatment during emergency events at all facilities, including disruptions due to wildfire, excessive heat, water pollution, or any other natural or man-made event that interrupts your normal schedules. If the operations of your facility, or ability for patients to have access to dialysis, are impacted by emergency events, please let your Network know right away.
For Washington, Oregon, Idaho, Montana, and Alaska (Network 16), call Lisa Hall at 206-923-0714 or email LHall@Comagine.org. We also ask that you fill out and submit the Network Disaster Reporting Form at http://www.esrdnetwork18.org/machform/view.php?id=44393. Network 18 will forward the completed form back to Network 16.
In Southern California (Network 18), call Brianna Smith at 206-923-0714 or email BSmith2@Comagine.org, and fill out the form at http://www.esrdnetwork18.org/machform/embed.php?id=16298.
Never put PHI or PII in an email or online form. Examples include patient name or initials, birthdate, SSN, and other identifying information.
Now that high summer and higher temperatures have arrived, Harmful Algae Blooms (“HABs”) are an increasing threat to recreational and subsistence uses of bodies of fresh- and salt-water. HABs can impact, sometimes fatally, harvesting of water- and shoreline-dwelling animals and plants, drinking, swimming, wading, and boating. Pets and children are particularly vulnerable because they can rush into water before you even realize they’re out of the car. The Oregon Health Authority advises,
“Don’t go into water that looks foamy, scummy, thick like paint, pea-green, blue-green or brownish red. A good rule of thumb for you and your pet is: When in Doubt, Stay Out!” (https://www.oregon.gov/OHA/PH/HealthyEnvironments/Recreation/HarmfulAlgaeBlooms/pages/index.aspx).
Bear in mind that most waters are not monitored for toxicity, so the lack of a warning sign is not enough to assure safe use. The following websites provide information on identifying and responding to toxic waters and their impacts, and include alerts on the few, most popular, waters that are monitored and posted:
- Shellfish Poisoning:
- Alaska – https://aoos.org/alaska-hab-network/,
- California – https://mywaterquality.ca.gov/habs/index.html,
- Idaho – https://www.deq.idaho.gov/water-quality/surface-water/recreation-health-advisories/cyanobacteria-harmful-algal-blooms/,
- Montana – https://dphhs.mt.gov/publichealth/Epidemiology/hab,
- Oregon – https://www.oregon.gov/OHA/PH/HealthyEnvironments/Recreation/HarmfulAlgaeBlooms/pages/index.aspx,
- Washington – https://www.nwtoxicalgae.org/.
The Washington website is also available in Spanish, Somali, and Viet. As an example of a posted warning, Odell Lake near Willamette Pass, between Eugene and Klamath Falls OR, has recently been posted; see the Oregon website above.
ESRD Networks 16 and 18 have prepared their Summer 2020 patient newsletters. Major articles and sidebars for summer include:
- COVID-19: a New World for Dialysis Patients.
- Telehealth: How to connect virtually with your healthcare providers.
- Are you up to date on all your vaccines?
- How to Report Patient Grievances.
- How to Get Our Newsletter! and Join Our Blog!
- Introduction to The KidneyHub.org Mobile Tool (Network 16).
- Invitation to Get Involved! in helping the Network improve patient care (Network 18).
Find Network 16 patient newsletters, in English and Spanish, at https://nwrn.org/patients-a-family/ptedres/quarterly-patient-newsletter.html.
Find Network 18 patient newsletters, in English and Spanish, at http://www.esrdnetwork18.org/patients/newsletters/.
NCC has created an internet “hub” for patient education information, their ESRD NCC Patient Web Tool, to help people find resources created by patients for patients. It’s major subsections include COVID-19. transplant, home dialysis, infection prevention, well-being, new patient information, and the Kidney Community Emergency Response Coalition or KCER. Find it at https://thekidneyhub.org/.
The California Department of Aging will present an April 29, 2020, 1pm PDT webinar for patients and the general public on Essential Conversations: Planning for Care and Serious Illness During the COVID Crisis. Join by phone or computer. For details and registration see https://mailchi.mp/coalitionccc.org/no-one-should-die-alone-on-the-street-745960?e=67e1ad4c31.
AAKP HealthLine will present an April 29, 2020 webinar on Fighting Coronavirus Upstream – What Early Stage Kidney Disease Patients Need to Know, about how people with CKD Stages 1-4 may be able to fend off COVID-19 (I’m extrapolating that from limited information). Find more information and register at https://aakp.org/programs-and-events/aakp-healthline/.