Austin Medical Times

April Edition 2020

Inside This Issue

The Growing Role of Telehealth During Covid-19 Outbreak

By Mary Leigh Meyer

T Dell Medical School Candidates Match to Residency Programs See pg. 8

INDEX Legal Matters ...................... pg.3 Mental Health...................... pg.4 Oncology Research......... pg.6 Healthy Heart....................... pg.9 Financial Forecast .......... pg.10

Stopping the Spread of Covid-19 See pg. 12

he coronavirus, COVID-19, is rapidly spreading across the globe.

Those individuals with a suspected case of COVID-19 are being asked to self-quarantine for up to two weeks.

Similarly, more and more health care providers are coming into routine contact with infected individuals, putting them at risk for contracting the disease themselves.

“With the restrictions this virus is putting on people and required quarantines, the medical and mental health fields are searching for creative solutions to care for COVID-19 patients while protecting communities from widespread exposure,” said Carly McCord, PhD, director of Telebehavioral Care at the Texas A&M University Health Science Center (Texas A&M Health) and clinical assistant professor in the Texas A&M College of Medicine and Texas A&M College of Education and Human Development.

“Already, telehealth and telebehavioral health is being seen as part of the solution to some of the COVID-19 specific barriers to care.”

Telehealth during times of crisis

“Telehealth has always been a great option, but COVID-19 is now forcing the option for a lot of providers across

the nation,” said Katie Console, program coordinator at Texas A&M Telebehavioral Care and counseling doctoral psychology student in the College of Education and Human

Officials advise those who believe they may have the virus to call ahead to their health care providers to limit contact with others in waiting rooms.

Telehealth and telebehavioral care could take these precautions to the next level.

Telehealth considerations and best practices “Right now, we have seen a surge of health care providers seeking to add the telehealth model to their practice.

We recommend they first consider proper training and learn best practices to provide highest-quality services possible to their patients,” McCord said. “Providers should not rush into the telehealth model without the proper supports. We offer online trainings and resources to help.”

All health care providers have laws and codes of ethics to abide by during practice. “These rules still apply if you change your method of health care delivery,” said Alexander Giovanetti, program coordinator at Texas A&M Telebehavioral Care and counseling doctoral psychology student at the College of Education and Human Development. “For example, providers

With the restrictions this virus is putting on people and required quarantines, ...health fields are searching for creative solutions to care for COVID-19 patients...

—Carly McCord, PhD

Development. “Everyone is now asking the question if health care and society as a whole is ready for a potential viral outbreak of this scale.”

If a health care provider is believed to be exposed to COVID-19 while treating a patient, they are required to self-quarantine. This means providers will be unable to see patients in-person until they are proven to be free of the disease, a problem amid an already strained health care system.

Similarly, patients may feel hesitant to seek help due to the fear of spreading the coronavirus to their community.

see Telehealth... page 13

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Legal Matters Responding to Covid-19 In the Workplace: Five Things an Employer Should Do

By Lindsay Ryan, J.D. Polsinelli, PC

T

he rapidly developing COVID-19 pandemic has left many health care providers carefully balancing the sometimes competing concerns of maintaining a safe and healthy workplace and retaining sufficient staffing to care for patients during a period of high demand.

As the country confirms an increasing number of COVID-19 cases, employers must prepare for the probable scenario where one of their employees contracts COVID-19 or reports that he or she has been exposed. Health care providers will be expected to act quickly to protect the health and safety of their employees, patients and visitors and should have a response plan ready to execute. The following outlines the critical steps any facility should follow in response to an infected or exposed

employee: • Isolate Affected Employee: If an employee has reported a confirmed case of or exposure to COVID-19, the employer should immediately isolate the affected employee and take steps to limit the spread of the person’s infectious respiratory secretions, including by providing them with a facemask. In contrast to Personal Protective Equipment (“PPE”) intended for workers, the mask acts to contain any infectious secretions from the individual’s nose or mouth. Unless urgent medical attention is required, the employee should ultimately self-quarantine at home and consult their health care provider.

• Investigate and Assess Potential Exposure to Others: Employers should promptly investigate and determine who may have been in close or direct contact with the affected employee and who may need to self-quarantine.

Pursuant to CDC guidance, “close contact” includes “being within

approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time” or “having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on).” [https://www.cdc. gov/coronavirus/2019-ncov/hcp/ clinical-criteria.html] In making this assessment, employers should consider both duration of exposure, the clinical symptoms of the person with COVID-19, and whether potentially exposed individuals were wearing PPE at all relevant times. Close contact generally does not include brief interactions, such as walking past a person.

• Identify and Decontaminate Impacted Workspaces: In addition to identifying exposed individuals, employers should investigate and identify workspaces occupied by the affected employee (or others

who may have been exposed to the virus), as well as surfaces, tools and equipment utilized by affected employees, and take measures to thoroughly decontaminate such areas and objects. Health care facilities should consult the CDC for specific guidance on cleaning and disinfecting work areas.

Importantly, employers must also comply with all OSHA regulations applicable to workers engaged in these cleaning efforts to ensure they are properly protected from exposure to blood, certain bodily fluids, and other potentially infectious materials or hazardous chemicals.

• Report and Provide Appropriate Notice of Exposure: Health care providers should notify local health authorities of any see Legal Matters...page 14

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Mental Health Managing Stress During The COVID-19 Pandemic

By Simone Sonnier

W

hile we are all focusing on taking care of our physical health as the outbreak of COVID-19 develops, it’s also important to keep our mental health a priority. When there is a major concern for ourselves or our loved ones falling ill, the emotional impact of that can be great.

It’s human nature to want to stay informed, however it is important that overexposure of media coverage can cause more stress.

“Many people will turn to social media or the news to learn more about what’s happening, thinking that this will help. While being informed is important, continuously checking the news and seeing repeated images and reports about the virus can provoke more anxiety without necessarily increasing knowledge about virus transmission,” said Leslie K. Taylor, PhD, an assistant professor in the Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern

Medical School at UTHealth.

Instead of information overload, consider designating specific time to check reliable sources such as the Centers for Disease Control and Prevention and the World Health Organization. Both organizations give regular updates on COVID-19 and share methods for coping with the outbreak.

Individuals with preexisting mental health conditions, including substance use, may be more vulnerable to stress.

“Keeping a routine, eating healthy, and resting will help alleviate stress. If self-quarantining, maintaining a sense of connection with friends, family and community is also important. Isolation from others can result in feeling sad or hopeless,” said Taylor, who is also a psychologist specializing in post-disaster behavioral health functioning at UT Physicians Psychiatry Outpatient Clinic.

Taking time for ourselves by

doing things that we enjoy or keep us calm can help us get through this difficult time. Create a list of practical relaxation activities and perform them a few times a day. This can be meditating, deep breathing, stretching or even just sitting quietly and mindfully.

“It’s okay to be upset, but we should all stay hopeful. Experts in public health are working across the world to deliver high-quality care and

ensure everyone’s safety,” said Taylor.

Prolonged isolation and separation as a result of quarantine or illness could have a traumatic impact on families as a whole. UT Physicians patients who are experiencing emotional distress due to COVID-19, may consider booking an appointment at the UTHealth Trauma and Resilience Center.

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Oncology Research Never Too Young: What Adults Under 50 Need to Know About Colorectal Cancer

By Mika Cline, M.D., Texas Oncology Austin Midtown

A

h, youth! A time of mostly carefree, exuberant living, right?

That’s what it should be. But the truth is unexpected health concerns can cloud that ideal vision. Recent research indicates that colorectal cancer is on the rise in younger adults, an emerging and troubling trend for oncologists like me. In the past 25 years, cases of colorectal cancer in those under the age of 50 have increased by 51 percent, according to the National Cancer Institute. While the direct cause of this increase varies by patient, one thing is clear: cancer knows no age restrictions.

That’s why it’s crucial for adults of all ages to become more informed about their colorectal health and learn to recognize cancer signs and

symptoms. The good news is that colorectal cancer death rates continue to drop due to advancements in screening, prevention, and treatment.

The questions and answers below can help you better understand how to take control of your health.

Am I at risk? Age is just one of many risk factors related to colorectal cancer.

It’s vital for people for people under the age of 50 to become familiar with the other risk factors. Diets heavy in red and processed meats have been linked to increased risk, as has obesity, diabetes, and inactivity. Those with a history of polyps or inflammatory bowel disease may also be at higher risk. Risk is also tied to family history or inherited syndromes, such as Lynch Syndrome.

When should I get screened? If you were born around 1990, you have double the risk of colon cancer and quadruple the risk of rectal cancer compared to people born around 1950, when risk was lowest, according to the American Cancer Society. This trend led the ACS to revise its colorectal

cancer screenings guidelines to recommend most people begin regularly screening at the age of 45, instead of 50. Those with increased risk factors should consult their physician about whether to begin screenings earlier than age 45.

What signs and symptoms should I watch for? Even those under the age of 45 should pay close attention to the signs and symptoms of colorectal cancer – and so should their doctors. While colorectal cancer often doesn’t have symptoms until later stages, the most common signs include changes in bowel habits, rectal bleeding, dark or bloody stool, cramping or abdominal pain, weakness and fatigue, and unexplained weight loss. No matter your age, don’t hesitate to see a doctor.

What are the key challenges? The Colorectal Cancer Alliance found that 85 percent of young adults with early-onset colorectal cancer experienced anxiety or depression, 64 percent took a leave of absence from work or school, and 62 percent experienced financial difficulties.

Young adults living with colorectal cancer shouldn’t be afraid to seek help.

Many resources, such as counseling and social work, tips for managing cancer in the workplace, and guidance on family planning, are available through providers like Texas Oncology.

When it comes to colorectal cancer, the facts tell the story. The five-year survival rate for colorectal cancer discovered early and before the cancer spreads is 90 percent, but only 39 percent of colorectal cancer cases are identified in this early stage, according to the ACS. Even as we see more younger patients with colorectal cancer at Texas Oncology, there is plenty of reason to have hope for positive outcomes as treatment advances. 

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All Dell Medical School Candidates Match to Residency Programs; Almost Half Will Stay in Texas

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he first graduating class of Dell Medical School at The University of Texas at Austin learned today that all students who applied for medical residencies have successfully matched and been placed into programs as part of national Match Day, and that nearly 45 percent of the Class of 2020 will hone their skills as new physicians here in the Lone Star State.

Among the 49 future medical residents set to graduate this May, 28 will specialize in primary care disciplines including pediatrics, obstetrics and gynecology, emergency medicine, family medicine and internal medicine.

While residents are headed for various regions across the country, 22 will stay in Texas, 11 to remain in Travis County where they will continue to learn from Dell Med faculty as part of residency programs jointly led with its academic medical partner, Ascension Seton.

“This is an amazing feeling, and we are thrilled to head back to a community we truly love,” said Anatoli Berezovsky, who will pursue a family medicine residency at John Peter Smith Hospital in Fort Worth, Texas. A native of Wisconsin, 27-year old Berezovsky taught high school chemistry in Fort Worth before Dell Med. He and his wife were hoping they would spend more time there, he said.

The matches were revealed this morning, when fourth-year medical students across the country opened emails revealing where they would spend the next stage of their medical careers. In light of the COVID-19-related restrictions against large gatherings, traditional in-person celebrations were cancelled among all U.S. medical schools, according to the Association of American Medical Colleges (AAMC).

Stepping up to Fill a Growing Gap in the Medical Profession

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The concentration of primary care residency matches among Dell Med students reflects a growing concern about the dearth of these providers across the country. The AAMC predicts the U.S. will face a shortage of primary care physicians by 2032 ranging between 21,100 and 55,200 providers. In Texas, the shortage is projected to skyrocket by 67 percent by 2030.

“Primary care is perhaps the greatest need in the medical profession now and for the foreseeable future, and we are thrilled to see so many of our graduates stepping in to fill the gap,” said Sue Cox, M.D., executive vice dean of academics and chair of the Department of Medical Education at Dell Med.

Highly skilled residents are also a key component of the health care workforce, says Cox. In 2012, 218 medical residents were providing care in Travis County community clinics and hospitals. That number has since grown to 320 residents and fellows as of this January. “Having such a large percentage of our students staying in Austin means our community will continue to directly benefit from the investment it made by voting to create Dell Med back in 2012,” Cox said.

How Match Day Works

A rite of passage for most fourth-year medical students, the see Match 2020...page 14

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Healthy Heart What People With High Blood Pressure Need To Know About COVID-19

By American Heart Association

A

few Many people have concerns about staying healthy during the COVID-19 pandemic. Those with a chronic condition such as high blood pressure — a reading above 130/80 — may face an increased risk for severe complications if they get the virus[i].

With nearly half of Americans dealing with high blood pressure, the American Heart Association, the world’s leading nonprofit organization

focused on heart and brain health for all, is sharing information about the risks as the situation rapidly evolves.

What is the real risk?

Based on what we know today, elderly people with coronary heart disease or high blood pressure may be more susceptible to the coronavirus and more likely to develop more severe symptoms. That means it’s vital to follow guidance about keeping other conditions well controlled and maintaining good health and hygiene.

Data from the outbreak in Wuhan, China[ii], shows a 10.5% death rate among people with COVID-19 who also have cardiovascular disease, 7.3% for those with diabetes, 6.3% for those with respiratory disease, 6% for those with high blood pressure and 5.6% for those with cancer.

Could blood pressure-lowering medicines make people with COVID-19 sicker?

According to the latest guidance from the American Heart Association, Heart Failure Society of America and the American College of Cardiology, issued March 17,2020:

Do not stop taking prescribed angiotensin converting enzyme

inhibitors (ACE-i) or angiotensin receptor blocker (ARB) medications for high blood pressure, heart failure or heart disease.

• These medications don’t increase your risk of contracting COVID-19.

They are vital to maintaining your blood pressure levels to reduce your risk of heart attack, stroke and worsening heart disease.

• If you’re a cardiovascular disease patient with COVID-19, your health care provider should

evaluate you before adding or removing treatments. Changes should be based on the latest scientific evidence and shared decision-making.

Caution is key. Some common habits or over-the-counter medicines and supplements can be “BP raisers.”

Over-the-counter medications.

Common pain medicines called NSAIDs (e.g., naproxen and ibuprofen) can increase your blood pressure.

Decongestants are also known BP-raisers. People with heart concerns should limit or avoid them, especially if their blood pressure is uncontrolled.

Drugs such as acetaminophen are less likely to increase blood pressure. People should ask their doctors about OTC medicines.

Some prescription medicines. People taking medication for mental health, corticosteroids, oral birth control, immunosuppressants and some cancer medications, should monitor blood pressure to make sure it’s under control.

Alcohol and caffeine. People should limit both, because too much can raise blood pressure. Caffeine should be

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Financial Forecast Tax Traps to Avoid when Using Life Insurance as a Financial Planning Tool

By Grace S. Yung, CFP

Be Careful If You Use Life Insurance

F

ollowing the passage of the SECURE Act, life insurance has become even more attractive as an estate planning tool. For example, with the elimination of the “stretch IRA” – which allowed traditional IRA beneficiaries to access funds over a long period of time (and in turn, reduce the impact of taxation) – life insurance proceeds can help replace this lost wealth.

A life insurance retirement plan, or “LIRP,” can provide another benefit in your strategy, via tax-free income that is accessed as a policy loan rather than a taxable withdrawal. Likewise, this cash could also be used for paying off debt and/or financing large purchases like a new vehicle.

But while life insurance can offer

many tax-advantaged opportunities, it is critical that the policy is properly structured. Otherwise, it could end up losing its enticing tax benefit, and you could find yourself (and/or your beneficiaries) still having to pay taxes.

How to Ensure that the Life Insurance Tax Benefits in Your Estate Plan Don’t Backfire

Throughout the years, more advanced life insurance strategies have been implemented, primarily because they can provide some significant tax-related advantages. For example, death benefits are received income tax free to beneficiaries.

In addition, cash value on permanent life insurance policies allow tax-deferred build-up of the funds inside the policy, meaning that no taxes are due each year on the gain in the account. This can equate to a substantial, compounded increase in the cash value over time.

But using such strategies can end up backfiring if they are not properly structured. So, it is important to follow the rules pertaining to using

this coverage in your overall planning.

Otherwise, you could find that can cause some unpleasant tax-related issues.

Even with the right policy in place, you could face issues that can turn a policy with numerous tax advantages into a taxable situation. For example, “overfunding” a permanent life insurance policy, could turn it into a Modified Endowment Contract.

This is a life insurance plan where the cumulative premiums that have been paid into it during the first seven years are more than the amount that is necessary for providing a “paid up” policy, based on seven “statutorily defined” level annual premiums. This therefore would make withdrawals taxable.

There are other life insurance “tax traps” to be mindful of, too, which could even deem the policy’s death benefit as taxable. For instance, “the

Goodman Triangle” can arise when three different people / entities play the roles of the insured, beneficiary, and policy owner.

In this case, if Person A (the owner) owns a life insurance policy on Person B (the insured), and names Person C as the beneficiary, if the insured dies and the beneficiary receives the death benefit proceeds, these funds can be viewed as a taxable gift from the owner to the beneficiary, and can subject the owner to gift taxes (on the amount that is over the $15,000 gift tax exemption in 2020).

It is also important not to pull out all of the policy’s cash value, as this could trigger a taxable event.

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Fast Facts: Stopping the Spread Of Covid-19 A Nurse Explains How the Novel Coronavirus Spreads So Quickly and How You Can Help Flatten The Curve

By Lauren Rouse

M

any states across our nation have issued shelter-in-place or stay-at-home orders. Why is it so important for us to follow these guidelines? Cindy Weston, DNP, RN, CCRN, CNS-CC, FNP-BC, assistant professor and associate dean for clinical and outreach affairs at Texas A&M College of Nursing, explains how it is up to each of us to do our part to reduce the risk of further spread in our communities.

What does it mean to “flatten the curve”?

By doing your part to stop the spread of the coronavirus, you help flatten the curve. In other words, you help to reduce the number of people needing hospitalization for COVID-19 and prevent overburdening our health care system.

Following stay-at-home

recommendations directly correlates to a reduced opportunity for additional people to contract the virus. This means you have the power to directly reduce the population able to spread it, Weston explains.

This in turn supports the health care system and its providers as they work tirelessly to assure resources needed to care for patients remain available for those that have tested positive for the novel coronavirus, as well as those who have non-coronavirus related health care needs.

“COVID-19 is not to be feared but it is to be respected. We are all charged with doing our part to prevent spread,” Weston said.

How do I protect myself when I have to leave my home?

Essential items, like groceries and prescriptions, provide legitimate reason and need to leave your home.

There are steps you can take to help protect yourself and your loved ones from contracting COVID-19 when you are out and about.

Rather than the entire family going to the grocery store, send only one family member. If you can, opt for curbside pickup and utilize drivethru services so you can maintain a physical distance of at least six feet between yourself and those assisting you. “This will help greatly in reducing the opportunity for you to come into contact with someone or something that can further spread the virus,” Weston said. “When in doubt, don’t get out.”

If you are an essential employee who must report to a physical location for your job, it is important to follow recommendations outlined by the Centers for Disease Control and Prevention (CDC) to

help maintain your wellness and that of your coworkers. It is imperative to adhere to social distancing guidelines: • Keep six or more feet between you and any other person.

• Use teleconferencing for group meetings as much as possible.

• Consistently wash your hands.

• Avoid the urge to touch your face.

Why is COVID-19 so contagious and so easily spread?

The COVID-19 infection is carried from droplets released when someone sneezes, coughs or laughs.

According to the National Institutes of Health (NIH), these droplets can live on a surface for up to three days.

This is why it is so important to follow public health guidelines and wash your hands as often as possible—for at least 20 seconds with soap and

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Age Well Live Well

• Shortness of breath • Extreme pain or discomfort • Clammy or sweaty skin

“If you’re caring for a loved one or spouse and you notice some changes out of the ordinary in them or they seem confused, don’t assume it’s aging,” said Karen Kendrick, Vice President of Clinical Initiatives and Quality at Texas Hospital Association Foundation who has 30 years

of experience as a nurse. “Go ahead and have that person seen by a physician to make sure it’s not an infection or some other serious condition.”

In her experience treating patients, Kendrick said the top two conditions that lead to sepsis in older adults is respiratory infection and urinary tract infection.

“Practicing good hand hygiene and avoiding people who are sick goes a long way,” she said. “Some other good advice for seniors to avoid sepsis is for them to stay hydrated, keep up with their vaccines, make sure they get the flu shot every year and pneumonia shot — a shot they only

need to take once.”

To learn more about best practices, visit the HHS webpage on infection control at https://hhs.texas.gov/ doing-business-hhs/provider-portals/longterm-care-providers/nursing-facilities/ quality-monitoring-program/evidencebased-best-practices/infection-control.

If you have any questions regarding care for an older adult, contact your local Area Agency on Aging by locating the closest AAA to you in the directory webpage at https://apps.hhs. texas.gov/contact/aaa.cfm, or by calling 1-800-252-9240.

telehealth-specific training.

There are a lot of things you have to think about before you transition to the telehealth and telebehavioral care model. “You do not know what you do not know,” they said.

The fundamentals of telehealth

For those who do not know, telehealth uses technology for direct service or as an adjunct to health care services. For example, the telehealth model uses video conferencing, wireless communications, remote data collection and image streaming, so health care professionals can reach

patients who cannot make it to a clinic.

This model mitigates the potential health care barriers of distance, lack of transportation, cost and a lack of providers. Furthermore, this model works especially well with chronic disease management—both physical and mental.

McCord and the rest of the Texas A&M Health Telebehavioral Care program provide grant-funded telehealth counseling to underserved residents across Texas. The clinic also sells time blocks to organizations across the state including institutions

like the Washington County Jail, so they can offer mental health services “in-house.”

Texas A&M has led the movement towards telehealth through programs like this one and the Center for Excellence in Forensic Nursing, a program designed to develop and implement a telehealth program to bring forensic nurse expertise to areas that may not have a forensic nurse available.

enough prescription medications to last for a prolonged period or see if they can get a larger supply than normal.

• Mail-order systems may be available for people who can’t or don’t want to leave home.

• Medications should be taken exactly as prescribed. Decreasing or stopping them could raise blood pressure to dangerous levels. People

with concerns should talk to a doctor or pharmacist.

Keep follow-up appointments. Some doctor’s offices offer virtual visits when possible.

Getting support. The American Heart Association’s free online Support Network offers support for those with similar conditions or health concerns.

Emergencies don’t stop for COVID-19

High blood pressure increases the risk for heart attack and stroke. Certain heart and stroke symptoms require immediate medical intervention, and every second matters. Calling 9-1-1 at the first sign of heart attack, stroke, or cardiac arrest saves lives. Fast access to medical treatment is the No. 1 factor for surviving a cardiovascular event.

Older Adults are More Vulnerable to Infections, Sepsis

A

variety of chronic health conditions more common with adults 65 or older can lead to a weakened immune system making older adults more vulnerable to infection. If an infection goes untreated, it can result in sepsis — a potentially life-threatening condition that disrupts the body’s release of chemicals into the bloodstream to fight an infection triggering changes that can damage multiple systems.

On average, more than 4,000 Texans a year die of septicemia — the invasion and persistence of pathogenic bacteria in the bloodstream. Septicemia is a top cause of death in Texas especially affecting older adults, according to the Texas Department of State Health Services.

A person with sepsis might have one or more of the following signs or symptoms, according to the Centers for Disease Control and Prevention: • Higher heart rate • Fever while feeling cold and shivering • Confusion or disorientation

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Telehealth

Continued from page 1 adopting the telehealth model should make sure the video-conference program is HIPAA-compliant; otherwise they may violate laws, guidelines or professional ethics codes.

Furthermore, if they do not know how this new, secure software works and are unable to help the patient troubleshoot from a distance, then they may be unable to successfully deliver services, and patients could go without much-needed care.”

McCord, Console and Giovanetti emphasized the importance of learning best practices and receiving

Healthy Heart

Continued from page 9 capped at three cups per day in general, and most people with high blood pressure should avoid it.

Herbs and food combinations.

“Natural” supplements and home remedies might not be safe. Some herbal supplements, such as licorice, can raise blood pressure.

Connecting with health care providers and pharmacist.

• Patients should ensure they have

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Austin Medical Times

Legal Matters

Continued from page 3 instance of exposure to enable an epidemiological investigation.

Additionally, employers should notify any employees of their potential exposure to the virus.

In doing so, employers should be careful to avoid identifying any infected employee (or providing information from which the employee could be readily identified), and instead disclose only sufficient information to enable employees to assess and address their own exposure risk to protect themselves, their family and community. If an employer suspects that COVID-19 was transmitted in the workplace, additional notice may be required to OSHA, workers’ compensation

or others.

• Review Exposure Controls: Health care employers are generally expected to maintain appropriate exposure controls, including engineering controls, administrative controls, safe work practices and PPE. However, when an employee reports an incident of exposure, employers should review these controls and ensure that all appropriate precautions are in place and operating properly.

Health care providers should also train workers with reasonably anticipated occupational exposure to COVID-19 about appropriate workplace protocols in place to prevent or reduce the likelihood of exposure.

Although these steps should serve as a helpful checklist to guide an employer’s immediate response to a case of COVID-19 in their workplace, they must be considered in conjunction with the employer’s obligations under all applicable OSHA regulations. Given the unprecedented circumstances presented by COVID-19, employers should consult legal counsel and OSHA’s Guidance on Preparing Workplaces for COVID-19 [https://www.osha.gov/Publications/ OSHA3990.pdf] to ensure compliance with the quickly evolving standards and expectations placed on employers.

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Match 2020

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Continued from page 8 Main Residency Match system of the National Resident Matching Program (NRMP) connects more than 43,000 applicants and 31,000 training positions every year.

Based on a computerized mathematical algorithm, the system considers preferences of both applicants and program directors to produce the best possible outcome for filling training positions available at U.S. teaching hospitals, according to the NRMP. All participants follow the same rules and adhere to the same deadlines. Applicants and programs get to consider all options before making

decisions. Not everyone matches, but for those who do, match results are binding.

Continuing a Year of Memorable Firsts

As Dell Med sends off its graduating students to institutions across the country, it will also welcome new physicians pursuing medical residencies. Future Dell Med residents coming to campus this fall hail from medical schools including Stanford, North Carolina, Baylor, UT Southwestern, the University of Virginia, the UT Health Science Centers at Houston and San Antonio,

the University of Pennsylvania, Minnesota, UCSF, Yale, Duke and Harvard.

Match Day marks the second medical education milestone for Dell Med this year. In February, it became one of 172 medical school programs fully accredited by the Liaison Committee on Medical Education. The next celebration is set for May when fourth-year students will graduate.

worn or used incorrectly, actually causes more harm than good, Weston explains. For example, wearing the same gloves from place to place only spreads germs that much farther. The germs you pick up in one store remain on the gloves and pass to each surface you touch after that, increasing the likelihood of spreading the virus. It is much more efficient, reasonable and responsible to wash your hands between each visit to reduce the spread of the COVID-19.

“Gloves were never meant to be reused or worn from place to place,” Weston said. “When used improperly, they can provide a false sense of protection when someone continues to touch their face or other objects and unknowingly increase the spread of the virus.”

Fast Facts

Continued from page 12 water—and use a tissue when you sneeze or cough. It is also important to avoid touching your face, especially your eyes, nose and mouth, even if you wash your hands often.

“Touching facial mucous membranes in the nose, eyes and mouth gives the virus a source of entry,” Weston said.

Should I wear a mask or gloves when I have to leave my home?

Wearing a mask and gloves only protects you to a point and, if April 2020

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Our Profound Debt of Gratitude to all our Healthcare Professionals and First Responders

#StayHomeSaveLives

#SocialDistancing

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#FlattenTheCurve

April 2020

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