I am writing to provide an overview of our ongoing COVID-19 work and an outline of GNYHA staff in charge of various aspects of the issue. We are very fortunate to have a deep bench of subject matter experts and years of institutional experience with similar emergencies to support your preparedness for and response to COVID-19.

While this memo mostly addresses New York State activities, we are mindful that all GNYHA members are being affected by COVID-19. I invite our New Jersey, Connecticut, and Rhode Island members to contact me directly with questions or concerns, and we will assist you.

Testing

We are acutely aware of the problems with testing capacity and that this problem goes beyond having enough testing kits. We have been actively involved in facilitating an expansion of testing capacity by helping you get your needs met, whether it is additional supplies or approvals to use certain automated equipment.

New York State’s Wadsworth Center, the New York City Public Health Laboratory, and several New York State hospital and commercial laboratories have been authorized to test for COVID-19. New York State is interested in expanding the laboratory capacity available. Please note that the FDA recently released a policy permitting the issuance of emergency use authorizations for tests developed and used in laboratories certified to perform high-complexity testing under the Clinical Laboratory Improvement Amendments. GNYHA will be in touch with members shortly about expanding testing capability.

Anticipated Increases in Case Counts and Surge Planning

There are now more than 100 confirmed COVID-19 cases across New York State. Based on academic modeling, New York City officials are developing projections for significant increases in cases. GNYHA is helping members with several aspects of surge planning. Yesterday we asked every member to complete a critical care surge tool to inform regional planning and ongoing dialogue with public health and emergency management agencies. We have sent this tool to the appropriate clinical leaders in your facilities and would appreciate your encouraging its prompt completion.

Supply Shortages and Stockpile Requests

By agreement with the New York State Department of Health (DOH) and New York City Department of Health and Mental Hygiene (DOHMH), GNYHA is collecting hospital requests to be made to local stockpiles using a request form that we developed. The authorities will consider those requests in accordance with their allocation protocols and taking into account supply availability. Please submit supply shortage requests to Glenn Wexler.

Other Ongoing Work

Below are highlights of our other work. We will add new streams of work as warranted. Note that GNYHA has suspended on-site meetings for the next 60 days (the programming referenced below will be via remote technology).

  • We have spoken directly with Food and Drug Administration (FDA) Commissioner Stephen Hahn seeking approval of licensed automated testing systems and, with one of our world-class medical researchers, development of rapid response testing.
  • Among the many aspects of surge planning that we are working on, we are convening on a weekly basis your Chief Medical Officers and Chief Nursing Officers to help address questions and share information (Susan Waltman, Jenna Mandel-Ricci, Zeynep Sumer King).
  • As more of you have been gaining experience treating COVID-19 patients, we are convening a Grand Rounds on that topic. We are also developing, with input from bioethicists and attorneys, alternative/crisis standards of care (Lorraine Ryan).
  • Two areas of active consideration are a change in guidance from the Centers for Disease Control on standards for health care workers’ use of personal protective equipment and addressing asymptomatic health care workers with exposure or potential exposure to COVID-19 (Zeynep Sumer King).
  • We have communicated information about two alternative medication treatment regimens to a number of our health care systems for consideration by their investigational review boards.
  • There is an identified need for additional waivers of New York State statutory and regulatory provisions to support your planning and response efforts, and we are working with DOH on an ongoing basis (Laura Alfredo).
  • We are collecting and sharing data using our situational awareness platform, Sit Stat 2.0 (Jenna Mandel-Ricci, Samia McEachin).
  • I am briefing 1199SEIU United Healthcare Workers East President George Gresham directly on all our efforts on your behalf. GNYHA’s Lee Perlman is spearheading the development of an educational video for health care workers in collaboration with our partners at 1199SEIU.

Primary GNYHA COVID-19 Staff

The core group below is drawn from our Legal, Regulatory, and Professional Affairs team and is working with many other GNYHA colleagues.

  • Susan Waltman, 646-483-2647, Executive Vice President, lab capabilities; critical resources; certificate of need/facilities management
  • Jenna Mandel-Ricci, 347-489-0696, Vice President, COVID-19 incident commander; surge planning; interagency coordination
  • Zeynep Sumer King, 917-734-6229, Vice President, infectious diseases/infection control; personal protective equipment (PPE) strategies; surge planning
  • Lorraine Ryan, 917-453-9384, Senior Vice President, alternate standards of care; clinical management
  • Laura Alfredo, 646-206-8051, Senior Vice President, legal and regulatory issues including waivers; workforce

We are here to support you. As this dilemma unfolds, I am sure there will be many new problems discovered and potential course changes. The hospital community has a stellar record of meeting these sorts of challenges, and we are proud to be of service to you as we confront these future challenges.

– Kenneth E. Raske