June 3, 2020

1. Adapting Patient Care for Rural
Populations During COVID-19
June 3, 2020

2. CME Credit
• Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State
Medical Society to sponsor continuing medical education for physicians. The
Bridgeport Hospital Yale New Haven Health designates this live activity for a
maximum of one (1) AMA PRA Category 1 CreditsTM. Physicians should claim only
credits commensurate with the extent of their participation in the various
activities.
• This activity has been planned and implemented in accordance with the Essential
Areas and policies of the Accreditation Council for Continuing Medical Education
through the joint sponsorship of Bridgeport Hospital Yale New Haven Health and
the Weitzman Institute. Bridgeport Hospital Yale New Haven Health is accredited
by the Connecticut State Medical Society to provide continuing medical education
for physicians.
• The content of this activity is not related to products or services of an ACCME-
defined commercial interest; therefore, no one in control of content has a relevant
financial relationship to disclose and there is no potential for conflicts of interest.

4. COVID-19 cumulative cases in the U.S.
1,827,206 cases on 6/26/20 – up from 1,680,913 cases last week (5/26/20) –
106,028 deaths https://coronavirus.jhu.edu/map.html

5. Active COVID-19 cases in the U.S.
https://coronavirus.jhu.edu/map.html

6. COVID-19 testing rate in the U.S.
https://coronavirus.jhu.edu/map.html

7. Any good news?
• Physical distancing works:
– 82% reduced risk with distance of 1 m
• both health-care and community settings
– Farther is better: 1 m more doubled protection
• Masks work:
– Respirators 96% effective (aOR 0·04, 95% CI 0·004–0·30) vs
other masks- 77% effective (aOR 0·33, 95% CI 0·17–0·61; pinteraction=0·090)
Chu DK et al. Physical distancing, face masks, and eye protection to prevent person-to-person
transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis.
Lancet. 2020 https://doi.org/10.1016/S0140-6736(20)31183-1

8. Any good news?
• Eye protection works:
– 78% reduction in infection (aOR 0·22, 95% CI 0·12–
0·39)
• Universal face masks might enable safe lifting of
restrictions
– Resume normal activities?
– Protect people in crowded public settings and
– Protect within households
Chu DK et al. Physical distancing, face masks, and eye protection to prevent person-to-person
transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis.
Lancet. 2020 https://doi.org/10.1016/S0140-6736(20)31183-1

9. Resources
• Nuvance
health:https://spark.adobe.com/page/sfiiwxxjnI8yc/
• CDC:
https://www.cdc.gov/coronavirus/2019-ncov/index.html
https://emergency.cdc.gov/coca/calls/2020/
• WHO:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
• Johns Hopkins:
https://coronavirus.jhu.edu/map.html
• Others
https://www.thelancet.com/coronavirus
https://covidactnow.org/

10. Adapting Patient Care for
Rural Populations During
COVID-19
Dr. Sarah Chouinard, MD
Chief Medical Officer
Community Care of West Virginia

11. 11
Free COVID-19 eConsults
• Web-based portal
• Free to all Safety Net Primary Care Practices
– FQHC, FQHC-look alike, Migrant Clinicians, Healthcare for the
Homeless, Free Clinics
• No Protected Health Information (PHI)
• Consults Addressed by:
– Infectious Disease Specialists
– Public Health Nurses
* This initiative is supported by

12. 12 * This initiative is supported by

13. Thank You!
www.weitzmaninstitute.org/coronavirus