The University of Michigan KECC is conducting an ESRD Patient Reported Outcomes Quality Initiative Project Patient Life Goals Study, and seeks dialysis patients at least 18 years old to answer a new Survey that asks about your individual life goals and your dialysis facility care team. Life goals are personal goals that you think are important to achieve, such as having the ability to go to work, go to school, travel, or spend time with family. The Study aims to improve the odds that your care team will consider your individual life goals in the treatment planning process. Find an introductory letter and the Survey at https://redcapproduction.umms.med.umich.edu/surveys/index.php?s=DT4N3P48AC. There’s an easy-to-miss check box at the bottom of this page, which you have to check before the Survey questions appear. The Survey doesn’t seem to specify an expiration date.
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/.
CDC has released a new HAN Health Alert Advisory on Severe Illness Associated with Using Non-Pharmaceutical Chloroquine Phosphate to Prevent and Treat COVID-19. The Summary includes “Chloroquine phosphate, when used without a prescription and supervision of a healthcare provider, can cause serious health consequences, including death. Clinicians and public health officials should discourage the public from misusing non-pharmaceutical chloroquine phosphate (a chemical used in home aquariums). Clinicians should advise patients and the public that chloroquine, and the related compound hydroxychloroquine, should be used only under the supervision of a healthcare provider as prescribed medications.” Find the CDC HAN at https://emergency.cdc.gov/han/2020/han00431.asp?deliveryName=USCDC_511-DM24285.
AAKP is asking dialysis patients to take a survey on their experience with and concerns about COVID-19. AAKP’s introduction follows:
“AAKP works closely and constructively with Federal and state officials on health issues of concern to both the general public and those who are immunocompromised – like kidney patients. As we have in the past with flu and vaccines, we are interested in relaying your insights about the Coronavirus to relevant officials so that their actions and communications are better informed and responsive to your concerns. As a dialysis patient, has the Coronavirus impacted your thinking or behavior? What communication, if any, have you, as a dialysis patient, received with your healthcare team and/or dialysis facility? TAKE A FEW MINUTES, TELL US YOUR THOUGHTS! AAKP will share insights gleaned from you with the brave medical and scientific professionals fighting the Coronavirus! … Answers and any comments provided will not be attributed to any individual – the FLASH SURVEY is completely anonymous.”
Idaho: “Call your health care provider if you believe you need to be tested. Any provider can request a test from the state, as long as they meet CDC infection control requirements for collection. However, not all providers in the state are set up to meet those requirements, according to the Department of Health. Test results are usually available 24 hours after they are sent to the state lab. There are four private labs conducting tests in the state that may have different response times. For more information, call 2-1-1 or your local public health district [see https://coronavirus.idaho.gov/contact/], or visit Idaho’s coronavirus website [at https://coronavirus.idaho.gov/].”
Washington: “Call your health care provider to discuss whether you should be evaluated in person and considered for testing. Currently, there are no restrictions on who can be tested, however, it’s up to the provider to decide. Sample collection is done at the provider’s office. Samples are then sent to facilities such as the Washington State Public Health Lab or the University of Washington Virology Lab for analysis. Results are generally available within 24 to 48 hours. Turnaround time can be affected by demand. For more information, read the Washington State Department of Health’s medium article on testing [at https://medium.com/wadepthealth/covid-19-testing-process-what-you-need-to-know-ad741ed1a806] or visit the department’s coronavirus website [at https://www.doh.wa.gov/Emergencies/Coronavirus].”
Dialysis Patient Citizens has published a recording of their March 13, 2020 webinar on What the COVID-19 Means for Kidney Patients. The webinar goes into far more useful detail than most of the available material on the subject. Find the recording at https://www.youtube.com/watch?v=lWXHlHp7wqs. The first four minutes are unintelligible, but after that the sound quality is a little muddy but understandable, so it’s very worthwhile to persevere. As usual, ignore the beeping hospital-room-monitor alarm.
“Ensure rapid triage and isolation of patients with symptoms of suspected COVID-19 or other respiratory infection (e.g., fever, cough). Identify patients before or immediately upon arrival to the dialysis facility (e.g., during or before patient triage or registration at the time of patient check-in). Ask all patients about fever or symptoms of lower respiratory tract infection, including cough or trouble breathing. Ask all patients about travel to an affected geographic area in the last 14 days OR contact with a patient with known COVID-19 illness.”
“At present, samples should be taken in an airborne isolation room or examination room with a door closed by a healthcare provider wearing appropriate PPE (gown, gloves, eye protection,and a fit-tested N-95 mask or higher-level respirator). Dialysis patients who require testing will need to be transferred to a facility with these capabilities. Notify and discuss with the health department prior to transfer to determine appropriate disposition. In addition, notify the receiving facility before transferring a patient who meets PUI criteria.”
“Shared decision making between health departments and clinicians should occur when testing is considered. The ‘Person Under Investigation’ (PUI) definition can be used to help inform testing decisions but reliance on the PUI definition should never impede or override clinical judgment. The PUI definition can change over time as more is learned so check here for the current definition: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html.”
“Most dialysis facilities do not have airborne isolation rooms (AIIR). Currently PUIs or individuals with confirmed COVID-19 should not receive dialysis in an outpatient dialysis facility due to inability to perform dialysis in an AIIR. Therefore, if unable to perform home dialysis, these individuals will need to undergo dialysis in an acute care hospital in an AIIR. The decision to transfer care back to the dialysis facility should be determined on a case-by-case basis, in conjunction with local, state, and federal health authorities.”