The global spread of novel Coronavirus (COVID-19) is affecting all of us. At CAN Community Health, our top priority is the health and safety of our clients and employees.
Our effort to protect the most vulnerable requires our communities’ compassion and all our participation. As national not-for-profit whose mission is to inspire and contribute to the well-being of those affected by HIV, hepatitis C and other sexually transmitted diseases. We do that by providing care through outreach, integrated clinical practice, advocacy, education and research.
Our mission is supported by collaborations with local organizations that serve high-risk populations. Established in Sarasota in 1991, we now provide services in Arizona, New Jersey, South Carolina and Virginia. Our 36 sites offer treatment, education and support services.
We have been closely monitoring the spread of COVID-19 and have a team of experts to address the potential threat of the virus following the guidance from the Centers for Disease Control and Prevention (CDC). This cross-functional task force meets daily.
We have taken rigorous efforts to follow CDC guidance in crafting protocols for our clinics. We launched our Telehealth platform March 19, which clients can utilize to access healthcare professionals by video or telephone.
In addition, we have implemented plans to help shield our clients and employees, enhancing our already comprehensive cleaning and sanitization processes. We have also continued to emphasize proper hygiene, including more frequent handwashing and the appropriate use of hand sanitizer and personal protective equipment, or PPE. Providers have discussed COVID-19 prevention methods with patients during telephone visits, including rigorous hand hygiene, appropriate respiratory etiquette and frequent disinfection of high touch surfaces.
Furthermore, we have established workflows to preserve our ability to offer care. These services include HIV and viral hepatitis testing, initiation and continuation of HIV treatment without interruption of the treatment course, Pre-exposure Prophylaxis (PrEP) for HIV, initiation and continuation of hepatitis C treatment without interruption of the treatment course, laboratory monitoring as clinically appropriate and screening and treatment of sexually transmitted diseases.
If an in-person visit cannot be avoided, providers are advised to strictly adhere to the use of PPE. All patients arriving for in-person clinic visits are screened for respiratory symptoms, fever and travel in the last 14 days upon check-in at the front desk. If any of these are present, patients are given a surgical face mask to wear in the waiting room. Each clinic is advised to maintain at least six feet between patients in the waiting area, to designate only one patient room per clinic for evaluation of patients with acute fever or respiratory illness and to reinforce protocols for daily terminal cleaning of all rooms in the clinic by existing environmental service providers.
The consensus among HIV specialists is that persons on antiretroviral medications who are not immunosuppressed have similar risk from infection as the general population. In these persons, the risk is best defined by typical risk factors for severe infection such as elderly age and chronic medical conditions. Conversely, persons who are immunosuppressed with T-cell count ≤ 200 are at elevated risk for severe infection in guidance to patients. Currently, there is no published literature or case studies on the impact of COVID-19 on persons living with HIV.
CAN is regularly reviewing and updating protocols to adhere to CDC guidance for our healthcare workers and the clinical care of persons under investigation for COVID-19. Any patient with respiratory symptoms is screened for warning symptoms which, if present, would prompt a recommendation for evaluation in an emergency department. If such warning symptoms are not present, but respiratory illness with fever is, providers are encouraged strongly to evaluate these patients by telephone visits and avoid in-person visits.
In support of national efforts to promote social distancing, CAN has implemented widespread use of teleworking for clinical and non-clinical staff. In-person clinic consultations are being limited to only once per week for medically necessary visits, such as directly observed treatment for sexually transmitted infections.
Staff is required to self-monitor temperature at least twice daily and self-report any subjective fever or respiratory symptoms to an occupational health provider. Persons with symptoms of infection are encouraged to obtain COVID-19 testing locally and are self-quarantined at home. Healthcare workers have been discouraged from traveling domestically or internationally. Likewise, clients are encouraged to avoid similar travel and to avoid any gatherings of over 10 people.
We must come together as a community and heed the recommendations of our medical professionals in a further effort to slow the spread of COVID-19. The entire CAN family is indebted to the heroic efforts of our nations’ first responders, doctors, nurses, researchers, and public health experts. We do not yet know with certainty when the most significant risk will be behind us but are committed to continuing in our role as dedicated community partners.
Richard E. Carlisle became CAN’s third president and CEO in 2015 and served as vice president of Sarasota Memorial Hospital for 15 years. CAN Community Health is the third-largest private provider of HIV services in the nation.
