- AANP News
The Centers for Disease Control and Prevention (CDC) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus that was first detected in December 2019. The World Health Organization (WHO) characterized the COVID-19 outbreak as a pandemic on March 11, 2020.
Among hospitalized patients, research frequently reports that the signs and symptoms of COVID-19 include:
Other less commonly reported respiratory symptoms include:
Some patients have experienced gastrointestinal symptoms, such as diarrhea and nausea, prior to developing fever and lower respiratory tract signs and symptoms.
The American College of Gastroenterology, in partnership with other gastroenterology (GI) organizations, has released a message sharing additional GI-related COVID-19 symptoms:
Reported cases have ranged from very mild (including some with no reported symptoms) to severe cases resulting in death. Those who are at a higher risk of developing serious COVID-19 symptoms include:
In addition to clinical symptoms, nurse practitioners (NPs) may want to consider whether:
Currently, 95 public health laboratories have completed verification and are offering testing, including one or more in all 50 states plus Washington D.C., Guam, the U.S. Virgin Islands and Puerto Rico. The CDC recommends health care providers should use their best judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. This includes:
In addition, as of March 14, public health laboratories using the CDC assay are no longer required by the Federal Drug Administration (FDA) to submit samples to the CDC for confirmation. The CDC is maintaining surge capacity while delivering other support to state public health laboratories and improving options for diagnostics for use in the public health sector.
As of April 1, 23 emergency use authorizations have been issued for diagnostic tests. Additionally, the FDA has been notified that more than 110 laboratories have begun testing.
All health care providers, including NPs, should take steps to prepare for COVID-19 in their practice as well as follow recommended infection control procedures to protect themselves and others:
The American College of Gastroenterology, in partnership with other gastroenterology (GI) organizations, has released a message sharing additional guidelines for infection control in for clinicians and GI practices, which includes:
Currently, COVID-19 transmission is thought to occur mostly from person to person via respiratory droplets among close contacts. If health care providers are in close contact with a patient confirmed to have COVID-19 while not wearing all recommended PPE, they may be at an increased risk of infection.
To limit this risk, health care providers should follow the CDC's recommendations for infection prevention and control:
As a public health reminder, the CDC encourages health care facilities and clinicians to prioritize urgent and emergency visits and procedures in order to preserve staff, personal protective equipment and patient care supplies; ensure staff and patient safety; and expand available hospital capacity during the COVID-19 pandemic.
The FDA has issued an emergency use authorization to allow for certain ventilators, anesthesia gas machines modified for use as ventilators, positive pressure breathing devices modified for use as ventilators, ventilator tubing connectors and ventilator accessories that the FDA determines meet specified criteria for safety, performance and labeling to be used in health care settings.
On March 30, 2020, the FDA issued guidance to help expand the availability of surgical apparel for health care professionals, including gowns (togas), hoods and surgeon’s and patient examination gloves. In addition, the FDA outlined an enforcement policy to help expand the availability and capability of sterilizers, disinfectant devices and air purifiers.
WHO has expanded its Operational Planning Guidelines to Support Country Preparedness and Response to include new Operational Guidance for Maintaining Essential Health Services During an Outbreak.
Telehealth is suggested by the CDC as an alternative for in-office appointments, as triaging and assessing ill patients by telephone, text monitoring system, video conference or other telehealth methods can reduce the chance of exposure for staff members and minimize a surge on health care facilities.
AANP's COVID-19 Telehealth Updates include several Centers for Medicare and Medicaid (CMS) documents related to telehealth, as well as information on policies and legislation affecting telehealth-delivered care.
On March 31, the FDA began the Coronavirus Treatment Acceleration Program (CTAP) to bring new therapies to sick patients as quickly as possible while supporting research to further evaluate whether these therapies are safe and effective.
On March 28, 2020, the FDA issued an emergency use authorization to allow hydroxychloroquine sulfate and chloroquine phosphate products donated to the Strategic National Stockpile (SNS) to be distributed and used for certain hospitalized patients with COVID-19.
As of March 24, the FDA has stated that there is no scientific evidence connecting the use of non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, with worsening COVID-19 symptoms.
A number of drugs are under investigation in clinical trials or are being considered for clinical trials to treat COVID-19.
On March 16, President Trump announced COVID-19 guidelines for the U.S., which have since been extended through April 30. The guidelines include, among other recommendations:
Mumps is a viral infectious disease that historically was a common childhood illness. The mumps vaccine, first licensed in 1967, has successfully decreased the number of cases to the point that mumps is no longer a frequently encountered disease. Prior to the mumps vaccine program, approximately 186,000 cases of mumps were reported each year in the United States (U.S.). Even with the sporadic clusters of re-emergence, there has been a 99% decrease in the number of reported cases since the inception of the vaccination program. As of July 15, 2017, there have been 3,886 cases of mumps reported this year in 45 states, making it a clinically relevant, though not prevalent, illness. Although not a new illness, many health care providers may not have diagnosed or treated patients diagnosed with mumps. Here, we provide vital information to NPs, so they may adequately diagnose and treat mumps as well as remain vigilant in their surveillance of such an old virus that continues to infect individuals today.
The CDC estimates that there were 37,600 new HIV infections in 2014. Pre-exposure prophylaxis (PrEP) is a highly effective tool for the prevention of new HIV infections that was approved by the FDA in 2012. PrEP is largely under utilized by primary care providers. This clinical feature addresses provider barriers that impede prescribing PrEP to high-risk patients and provides a straightforward approach for NPs to offer PrEP in the primary care setting.
Meningococcal Vaccine Information Tent
To increase awareness of the MenB vaccine, AANP developed a colorful 7” x 5” trifold informational tent with a concise review of meningococcal disease, signs/symptoms, and prevention through MenACWY and MenBvaccines. This tent can be printed, folded, taped and placed in the waiting room or exam rooms where patients and parents of adolescents will read it to initiate questions and conversations about meningococcal disease prevention with their health care provider
Hepatitis C HALO Patient Tool
Download, print and distribute this self-care guide to your patients after they are cured to give them easy to reference answers to common questions and tips for keeping their liver healthy long-term.
There are many resources available for both patients and providers and we have listed some of them below for your convenience. Inclusion of these links does not imply AANP endorsement.