Zika Update #5

With the news this afternoon of two new cases of Zika in Miami Beach, the number of non-travel-related cases of the Zika virus continues to tick upward. As of yesterday, there were 33 such cases in the state, as well as 461 travel-related cases and 63 cases involving pregnant women.

As a healthcare organization, we’re working to ensure that we are providing our patients and community with adequate resources and information. This week, our community health team hosted a seminar on Zika at South Miami Hospital. A special thanks goes to Jorge Perez, M.D., Rafael Perez, M.D., and Tomas Villanueva, D.O., for taking part in the panel and to our community health team for organizing the event. More than 100 people were there to hear from our experts and ask questions. It was also a great opportunity to reach our community through the media. The Miami Herald, WLRN, Telemundo and Univision covered the event.

Per the governor’s direction earlier this month, all county health departments are now offering free Zika risk assessment and testing to pregnant women. At Baptist Health, we are conducting testing through the health department at our outpatient hospital labs as well as at several of our diagnostic imaging centers. The list of locations and testing information can be found at BaptistHealth.net/Zika. Patients are required to have a physician’s prescription as well as completed health department forms in order to be tested for Zika at a Baptist Health facility. Patients who are not pregnant must also have pre-approval from the health department.

As the situation evolves, I want to stress the importance of prevention. We are in a unique and critical position to encourage our patients and our community to take precautions in order to prevent a wider spread of the virus. While the virus is of most concern to women who are pregnant or planning to become pregnant, those who do not fall in that category should be encouraged to protect our pregnant community by taking precautions themselves. Each of us, when not protected, provides an opportunity for mosquito vectors to transmit the virus.

The CDC has great information on prevention. I encourage you to take a moment to read through it and ensure that you’re doing everything possible to protect yourself and your community. As Baptist Health South Florida employees, we are often looked to by friends and family for advice and expertise on any issue affecting the health of our community ­– including this one. That’s a good thing, and even if we aren’t experts in every area, we usually have access to the information. Here are the links to two simple handouts from the CDC with an overview and prevention information that I think will be useful to you when you get questions about Zika. You can print them out or forward them electronically (I texted them to my sons, who don’t know what paper is). Having 15,000 people pushing out facts to the community has a big impact.

Thank you,

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Zika Update #4

Dear Colleagues:

As you know, the Zika virus and its implications for South Florida continue to be an important topic of conversation for our community and for us as healthcare providers. The situation is changing rapidly, and we’re following it and making appropriate changes to our response and to our plans along the way. We remain at a level 3 activation, which means we’re closely monitoring the situation and are responding accordingly.

As of today, there are 406 cases of the Zika virus in the state of Florida. Fifteen of those cases involve local transmission in Miami-Dade County. The Florida Department of Health still believes that local transmission is only taking place within the identified one-square-mile area that includes Wynwood, north of downtown Miami.

Earlier this week, Florida’s governor instructed the health department to request a CDC Emergency Response Team. That team is now here in South Florida helping the health department with its investigation, outreach and mosquito control efforts.

At Baptist Health, we’ve assembled a Zika task force that includes physician leaders within our system, private practice physicians (including local OB physicians), entity leaders, infection control professionals and others to ensure that our response plan is well-rounded and well communicated. The expertise of these individuals has been extremely valuable as we prepare to respond to the needs of our community under various scenarios. With extensive media coverage of the Zika issue, Baptist Health’s experts have also been front and center in national and local media interviews, including the Wall Street Journal, LA Times, Boston Globe, NPR, Univision and the Miami Herald. Special thanks to Jorge Perez, M.D., Rafael Perez, M.D., Ellen Schwartzbard, M.D., and Jack Ziffer, Ph.D., M.D. for lending their expertise to the task force and for numerous media stories. Our nursing staff and leaders across the organization – and especially in labor and delivery, the labs, emergency rooms and urgent care centers – have been performing at their usual exceptional level during these special circumstances, and I thank them now, and will many times to come, as we help our patients and community work through this.

One of our priorities is community education. While patients with symptoms should always seek appropriate treatment, it is important for people with no symptoms who may be concerned about the virus to talk with their physician. Whether it’s a primary care physician or an obstetrician, it is important for concerned individuals to speak with their doctor. The doctor can then determine, along with the health department, whether the patient meets the testing criteria and can help manage the patient’s follow-up care.

We’ve added the latest information about the Zika virus to our website, BaptistHealth.net/Zika as well as our employee Intranet to keep everyone up to date. We’ll continue to update both as the situation changes.

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Monitoring Local Transmission of the Zika Virus

This morning, Florida Gov. Rick Scott confirmed that it is likely that Zika virus is actively being transmitted by local mosquitoes.  The Florida Department of Health gathered enough information as part of its ongoing investigation into non-travel related cases of the virus in Miami-Dade and Broward counties to conclude that a high likelihood exists that four cases are the result of local transmission. Two of those cases are in Miami-Dade, and two are in Broward.  The health department believes that active transmission is occurring in one area in Miami-Dade County, just north of downtown.  They’re working to test neighbors and increase mosquito control in the impacted area, and continue prevention efforts around South Florida.

At this time, Baptist Health is operating at a level 3 activation (our lowest level of alert), which means we’re monitoring and assessing the event and collaborating with health officials.  Our Emergency Preparedness and Security Department ― partnered with our Infection Control experts – is working closely with the local health department, which also links us to those at the state and federal levels.

As of yesterday, 383 cases of the Zika Virus have been confirmed in Florida.

Our blood provider resumed blood collection today, after being temporarily asked to suspend collections yesterday.  The provider currently tests all donors for the Zika virus.

As you are probably aware, many patients with Zika have few or mild symptoms that may include fever, rash, joint pain and conjunctivitis. Yet there can be some serious consequences of the disease. Babies born to mothers who are infected while pregnant are at risk of microencephaly, a birth defect that causes abnormally small heads and a number of health concerns. In addition, a few patients have also suffered from Guillain-Barré syndrome, a neurological disorder often accompanied by temporary paralysis. There is no vaccine to prevent Zika and no specific treatment for the illness. Patients are advised to rest, stay hydrated and take acetaminophen to reduce fever.

When patients come in to our facilities and meet the testing criteria, our infection control practitioners work quickly to receive approval for testing through the health department. Urine and blood tests that detect the virus are available, and results take several days to obtain. All positive results are reported as required to the county health department.

John Braden, M.D., our medical director for emergency preparedness, reports: “The number of cases continues to trickle in mostly being seen in the urgent care setting. We continue to closely follow any new developments through our health department contacts.”

The Centers for Disease Control and Prevention recommends that women who are pregnant or thinking of becoming pregnant postpone travel to areas with widespread Zika infection. Florida’s small case cluster is not considered widespread transmission. According to CDC guidance, providers should consider testing all pregnant women with a history of travel to a Zika-affected area. CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds.

In addition, the Florida Department of Health suggests the following:

•   Remove any standing water from small pools, bird baths, fountains, buckets or other containers that are outside around your home. Mosquitoes breed in these waters.
•   Apply mosquito repellent and cover exposed skin, particularly when outdoors during times mosquitoes are most active.
•    In Miami-Dade County, call 3-1-1 to report mosquito infestations in your neighborhood. In Broward County, call 954-765-4062. In Monroe County, go to www.keysmosquito.org.
•    Consider postponing travel to countries where Zika is present.
•    Good sites for Zika information and background are: http://miamidade.floridahealth.gov/, which gives the daily report from the Department of Health and www.cdc.gov/zika/. Florida also operates a Zika Virus Information Hotline at 1-855-622-6735.

If you have questions about Zika that relate to the workplace or your care of patients, talk to a member of the Infection Control or Emergency Preparedness staff. Watch for updates in your entity newsletters and on Baptist Health’s blogs at https://baptisthealth.net/baptist-health-news/.

As always, we’ll continue to keep you updated as this develops.

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Ebola Update #4 to Baptist Health Staff – Oct. 31, 2014

Today, we are moving off of the Level 3 activation as it relates to the Ebola situation, and we are returning to normal operations across the organization. Moving forward, we are going to focus on a few key actions:

• We are going to consolidate the groups that have been working on Ebola readiness and form one smaller task force to continue our planning and preparation.

• We will utilize our system-wide Emergency Response Team to advance our training, readiness and response to any infectious disease outbreak.

• We will be developing a Code to be used specifically for an infectious disease emergency situation. This will help streamline our response to patients and be especially helpful to non-clinical employees who may not feel comfortable in the situation.

• We continue to refine the amount and type of Personal Protective Equipment (PPE). Based on staff feedback and evolving CDC guidelines, we are looking at obtaining the most effective, comfortable and easy-to-use PPE. And, we will continue our rigorous training programs at all entities to ensure employees know how to properly and safely use PPE.

• We are developing a plan to utilize our Telehealth Center, which you may know more commonly as our eICUs. We have the opportunity to tap the expertise of our eICU physicians and nurses to remotely monitor patients with Ebola or who may be suspected of having Ebola or another highly infectious disease. This approach follows the CDC guidelines for minimizing contact with an affected patient.

Is the current situation over? No, it’s not. However, the extensive training and education that we have done, and will continue to do, across our entire system have made all of us better prepared to care for potential patients with Ebola – with safety as a top priority.

In a healthcare crisis, we play a vital role in reassuring the community that Baptist Health is well-prepared, well-informed and well-equipped for a safe and effective response. Thank you for your part in sharing that important message with our patients, guests, neighbors and your coworkers. We’ll keep you updated as we learn more and continue our preparation.

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Ebola Update #3 to Baptist Health Staff – Oct. 24, 2014


In the News

•  The NIH reports that the nurse who contracted the Ebola virus after treating a patient in Dallas is now free from the virus.
•  The other Dallas nurse, who is being treated for Ebola at Atlanta’s Emory University Hospital, is regaining her strength and continues to improve.
•  Reports also indicate that A Doctors Without Borders physician who recently returned to New York from West Africa has become the first Ebola case in New York City.

Level 3 Activation Status
Overall, the situation here for us at Baptist Health South Florida remains the same. We continue at our Level 3 activation status, our lowest level. Three times each week we are conducting calls with our CEOs, CNOs and physician leaders, along with a weekly Ebola Task Force meeting, to coordinate our efforts, strengthen our processes and continue to improve our overall communication and preparedness in accordance with the CDC.

Precautions and Training
A safe working environment is essential for us to care for all patients, no matter what the condition. We continue to have all of the necessary personal protective gear available and on-site. We are adding to our stock on hand every day, and if better equipment is recommended, we will acquire it. If we do have an actual Ebola patient show up at any of our facilities, we can immediately redeploy needed supplies from our sister facilities on a moments notice.
Training on the four levels of personal protective equipment (PPE) required for the safe care of an Ebola patient is being conducted throughout Baptist Health. In this last week alone, more than 600 physicians, nurses and clinical staff have gone through the Ebola readiness training. This is an enormous milestone, and we applaud your efforts. We were fortunate to have had Dr. Aileen Marty, a national expert on Ebola from the FIU College of Medicine, address our physicians and nurses in two seminars this week. She shared her experiences treating patients in Africa, including techniques and protocols.

Thank you, as always, for your hard work and dedication to our community, and each other. We will keep you informed as we all learn more about this evolving situation.

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