Academy Exchange

Dear All, 

I would appreciate your creativity, commentary, and reflections on the CDC guidance letter released on 04/06/2020 outlining STD treatment during the SARS-COV-2 pandemic. 

https://www.cdc.gov/std/dstdp/DCL-STDTreatment-COVID19-04062020.pdf

While providing telehealth services, I've had many patients this month with symptomatic STD concerns with barriers such as: laboratory closures, infrequent walk-in availability, calls during after clinic or pharmacy hours, inability to prescribe and administer recommended IM treatment, all of course, coupled with risk/benefit decision-making/counseling between COVID-19 and presenting to a lab, clinic, or pharmacy!

I've been recommending that patients who need empiric treatment who either decline or don't have access to testing receive some of the treatments listed here and also encouraging them to use mail-order pharmacies, download pharmacy apps so they can prepay or have medications delivered, etc. I'm also wondering if anyone has experience with ordering IM medications at retail pharmacies and their ability to administer an IM prescription.

I've also been adding COVID-19 shared decision-making documentation to notes when patients insist on presenting for walk-in STD treatment or laboratory testing. 

Thanks!

------------------------------
Morgan Mako, APRN, FNP-C, AAHIVS
Pronouns: he/him/his
Lynn Community Health Center
------------------------------

Original Message------

Dear All, 

I would appreciate your creativity, commentary, and reflections on the CDC guidance letter released on 04/06/2020 outlining STD treatment during the SARS-COV-2 pandemic. 

https://www.cdc.gov/std/dstdp/DCL-STDTreatment-COVID19-04062020.pdf

While providing telehealth services, I've had many patients this month with symptomatic STD concerns with barriers such as: laboratory closures, infrequent walk-in availability, calls during after clinic or pharmacy hours, inability to prescribe and administer recommended IM treatment, all of course, coupled with risk/benefit decision-making/counseling between COVID-19 and presenting to a lab, clinic, or pharmacy!

I've been recommending that patients who need empiric treatment who either decline or don't have access to testing receive some of the treatments listed here and also encouraging them to use mail-order pharmacies, download pharmacy apps so they can prepay or have medications delivered, etc. I'm also wondering if anyone has experience with ordering IM medications at retail pharmacies and their ability to administer an IM prescription.

I've also been adding COVID-19 shared decision-making documentation to notes when patients insist on presenting for walk-in STD treatment or laboratory testing. 

Thanks!

------------------------------
Morgan Mako, APRN, FNP-C, AAHIVS
Pronouns: he/him/his
Lynn Community Health Center
------------------------------

Hello,
We are doing a combination of telemedicine and having symptomatic patients come in. We couldn't see any way around it. We deal with a lot of indigent patients who would not be able to go to a lab anyway, so they would have to come thru us in order to have their STI testing processed. Despite telemedicine I find there are some patients I just have to physically have eyes on. I have a few complex cases where telemedicine will not suffice.

------------------------------
Amber Siegel
Oviedo FL
------------------------------

Original Message:
Sent: 04-16-2020 01:07
From: Morgan Mako
Subject: STD Care & Prevention During Disruption of Clinical Services

Dear All, 

I would appreciate your creativity, commentary, and reflections on the CDC guidance letter released on 04/06/2020 outlining STD treatment during the SARS-COV-2 pandemic. 

https://www.cdc.gov/std/dstdp/DCL-STDTreatment-COVID19-04062020.pdf

While providing telehealth services, I've had many patients this month with symptomatic STD concerns with barriers such as: laboratory closures, infrequent walk-in availability, calls during after clinic or pharmacy hours, inability to prescribe and administer recommended IM treatment, all of course, coupled with risk/benefit decision-making/counseling between COVID-19 and presenting to a lab, clinic, or pharmacy!

I've been recommending that patients who need empiric treatment who either decline or don't have access to testing receive some of the treatments listed here and also encouraging them to use mail-order pharmacies, download pharmacy apps so they can prepay or have medications delivered, etc. I'm also wondering if anyone has experience with ordering IM medications at retail pharmacies and their ability to administer an IM prescription.

I've also been adding COVID-19 shared decision-making documentation to notes when patients insist on presenting for walk-in STD treatment or laboratory testing. 

Thanks!

------------------------------
Morgan Mako, APRN, FNP-C, AAHIVS
Pronouns: he/him/his
Lynn Community Health Center
------------------------------

to morgan.mako

------------------------------
Daniel Pearce, DO FACOI, AAHIVS
Borrego Community Health Foundation
San Bernardino, Riverside, San Jacinto California
------------------------------

Original Message:
Sent: 04-19-2020 00:42
From: Amber Siegel
Subject: STD Care & Prevention During Disruption of Clinical Services

Hello,
We are doing a combination of telemedicine and having symptomatic patients come in. We couldn't see any way around it. We deal with a lot of indigent patients who would not be able to go to a lab anyway, so they would have to come thru us in order to have their STI testing processed. Despite telemedicine I find there are some patients I just have to physically have eyes on. I have a few complex cases where telemedicine will not suffice.

------------------------------
Amber Siegel
Oviedo FL

Original Message:
Sent: 04-16-2020 01:07
From: Morgan Mako
Subject: STD Care & Prevention During Disruption of Clinical Services

Dear All, 

I would appreciate your creativity, commentary, and reflections on the CDC guidance letter released on 04/06/2020 outlining STD treatment during the SARS-COV-2 pandemic. 

https://www.cdc.gov/std/dstdp/DCL-STDTreatment-COVID19-04062020.pdf

While providing telehealth services, I've had many patients this month with symptomatic STD concerns with barriers such as: laboratory closures, infrequent walk-in availability, calls during after clinic or pharmacy hours, inability to prescribe and administer recommended IM treatment, all of course, coupled with risk/benefit decision-making/counseling between COVID-19 and presenting to a lab, clinic, or pharmacy!

I've been recommending that patients who need empiric treatment who either decline or don't have access to testing receive some of the treatments listed here and also encouraging them to use mail-order pharmacies, download pharmacy apps so they can prepay or have medications delivered, etc. I'm also wondering if anyone has experience with ordering IM medications at retail pharmacies and their ability to administer an IM prescription.

I've also been adding COVID-19 shared decision-making documentation to notes when patients insist on presenting for walk-in STD treatment or laboratory testing. 

Thanks!

------------------------------
Morgan Mako, APRN, FNP-C, AAHIVS
Pronouns: he/him/his
Lynn Community Health Center
------------------------------

Original Message------

Hello,
We are doing a combination of telemedicine and having symptomatic patients come in. We couldn't see any way around it. We deal with a lot of indigent patients who would not be able to go to a lab anyway, so they would have to come thru us in order to have their STI testing processed. Despite telemedicine I find there are some patients I just have to physically have eyes on. I have a few complex cases where telemedicine will not suffice.

------------------------------
Amber Siegel
Oviedo FL
------------------------------

Original Message------

I can identify with the dilemma of seeing patients during this COVID-19 pandemic and it is challenging with regards to issues about telemedicine as we balance the risks versus benefits of various health care delivery modes of prevention and treatment. My personal option is that we should pay careful attention to reverting to face to face interaction if;

1) It is a new patient

2) It is a complicated patient that needs close monitoring

3) It is patient that we do not have any data or medical records

4) It is a patient that requires a physical examination owing to the risk of complications

There are so many patients that are having STD/HIV disease progression because of delayed access to treatment due to the fear of acquiring COVID-19. Life has to go on in parallel to COVID-19. Have a great day.

Regards 

Cleophas

Hello Morgan,
Have you seen the very helpful California Prevention Training Center's 1-page summary of the CDC interim guidance for treating symptomatic patients when in-person exams are limited due to COVID-19?   You can view or download it from the National STD Curriculum. 
Julia

------------------------------
Julia Freimund
National HIV Curriculum, University of Washington Infectious Diseases Education and Assessment (IDEA) Program
www.hiv.uw.edu
------------------------------

Original Message:
Sent: 04-16-2020 01:07
From: Morgan Mako
Subject: STD Care & Prevention During Disruption of Clinical Services

Dear All, 

I would appreciate your creativity, commentary, and reflections on the CDC guidance letter released on 04/06/2020 outlining STD treatment during the SARS-COV-2 pandemic. 

https://www.cdc.gov/std/dstdp/DCL-STDTreatment-COVID19-04062020.pdf

While providing telehealth services, I've had many patients this month with symptomatic STD concerns with barriers such as: laboratory closures, infrequent walk-in availability, calls during after clinic or pharmacy hours, inability to prescribe and administer recommended IM treatment, all of course, coupled with risk/benefit decision-making/counseling between COVID-19 and presenting to a lab, clinic, or pharmacy!

I've been recommending that patients who need empiric treatment who either decline or don't have access to testing receive some of the treatments listed here and also encouraging them to use mail-order pharmacies, download pharmacy apps so they can prepay or have medications delivered, etc. I'm also wondering if anyone has experience with ordering IM medications at retail pharmacies and their ability to administer an IM prescription.

I've also been adding COVID-19 shared decision-making documentation to notes when patients insist on presenting for walk-in STD treatment or laboratory testing. 

Thanks!

------------------------------
Morgan Mako, APRN, FNP-C, AAHIVS
Pronouns: he/him/his
Lynn Community Health Center
------------------------------