We invite ACS-member surgical residents and associate fellows to submit ONE case worthy of a discussion at the annual Spectacular Cases panel at Clinical Congress 2020. 

Seven selected spectacular cases will be selected.  This is an opportunity for residents and associate fellows to present a case with spectacular significance (hint: because of a multidisciplinary approach in how the case was managed).  Cases will be presented in an M & M style of case discussion.  Selected spectacular cases (NOT case reports) will be presented to a group of expert panel members, followed by an interactive discussion. 

The discussion will be held on Tuesday, October 6, 2020, from 8:00 – 11:15 am at the American College of Surgeons Clinical Congress 2020, in Chicago, IL.

Submissions are due by 5:00 pm CST on May 3, 2020.    No exceptions for late entries. 

You will need for your application:

1. Name
2. Title
3. Institution you are working at/training at
4. City, state
5. PGY level
6. Phone number, preferably cell phone
7. Email address
8. Twitter handle
9. One-page, 300 words (or less) abstract that includes the title and description of the case.   Pictures and/or graphs are permitted.  The references included can be outside of the 300-word limit.

Submit your ONE case here:  https://www.surveymonkey.com/r/MY8HLJN

Contact Alison Powers at apowers@facs.org with any questions.

Governor Cuomo has issued an executive order giving the state the power to seize and redistribute medical equipment, including ventilators and PPE, from all private sector companies, medical practices, ASCs and hospitals with lower needs, in response to the number of COVID-19 patients flooding New York City hospitals.

The order calls for all office-based and ASC facilities to immediately inventory and surrender their ventilators and PPE (N95 masks, surgical masks, sterile gloves, surgical gowns and face shields). The order is expected to take effect this weekend.

The move is in response to Lenox Hill and other New York City hospitals, which have reached a crisis point in the need for ventilators to treat COVID-19 patients. New York now has more than 100,000 confirmed cases and its death toll is nearly 3,000 after its largest one-day increase. The state's death toll has nearly doubled in the last three days.

https://www.governor.ny.gov/news/amid-ongoing-covid-19-pandemic-governor-cuomo-announces-executive-order-allowing-state

Access the advisory

Healthcare entities should continue to submit requests for PPE through their local Office of Emergency Management. New York State continues to fulfill requests for PPE, as available. However, NYSDOH has become aware of instances in which healthcare providers, facilities, or practices are using or considering alternative means to manage PPE shortages,such as:

• Use of dubious means to attempt to disinfect N95 respirators or facemasks (e.g. putting them in the dishwasher).
• Use of a ventilator circuit filter attached to a disposable anesthesia facemask and strapped to the face in place of an N95 respirator.
• Use of homemade cloth masks.

If all efforts to obtain PPE through vendors and local Office of Emergency Management are exhausted or unsuccessful, healthcare providers should refer to the CDC guidance entitled “Strategies for Optimizing the Supply of PPE” 

Conventional, then contingency, then crisis capacity strategies should be used in that order, as feasible.

Many of the options from the CDC guidance document are summarized in the advisory.

For general guidance on the use of PPE in healthcare settings, please refer to CDC guidance entitled “Healthcare Supply of Personal Protective Equipment”

> Read the complete advisory

"As we all know the growing coronavirus cases are threatening the capacity of our hospital system. The state-owned Javits Center has been turned into a 2,500-bed emergency medical facility being run by the US Army. The original plan for Javits was that it be used to take non-COVID patients from hospitals to open up hospital beds. However, the number of COVID positive patients has increased so dramatically that it would be beneficial to the state if Javits could accept COVID positive patients. 

"I asked President Trump this morning to consider the request and the urgency of the matter, and the President has just informed me that he granted New York's request. I thank the President for his cooperation in this pressing matter and his expeditious decision making."

- Governor Cuomo

https://www.governor.ny.gov/news/governor-andrew-m-cuomo-announces-temporary-hospital-facility-javits-convention-center-will

The Governor announced that, through June 1, 2020, consumers and businesses experiencing financial hardship due to COVID-19 may defer paying premiums under individual and small group health insurance policies. DFS shall consider any liquidity or solvency concerns of the health plans. During this period, health plans will be required to continue to pay claims, not to report late payments to credit rating agencies, and to work with individuals to help them transition to new coverage, if appropriate. In addition, insurers are reminded that they cannot impose late payment fees. Governor Cuomo thanked Connecticut Governor Ned Lamont for his collaboration on this initiative.

Access the complete release
(Information found on page 2)

The NYS Department of Health is hosting weekly provider calls to update the medical community on outbreak.  The calls take place on Thursday afternoons from 1-2pm. 

Recordings of the weekly healthcare provider COVID-19 calls are posted within a few days of the initial presentation.

> Recordings can be found here

Loans Expected to be Exhausted Quickly: Prepare Your Materials Now

Surgeons in private practices impacted by the COVID-19 outbreak are advised to begin preparing necessary materials now to apply for assistance from the U.S. Department of the Treasury’s Paycheck Protection Program (PPP) – a key portion of the CARES federal economic stimulus package that authorizes up to $349 billion toward job retention and certain other expenses.

The Treasury Department and U.S. Small Business Administration (SBA) expect to have this program operational as early as Friday, April 3, with loan applications approved the same day.  Most banks are expected to require a pre-existing banking relationship with the applicant for a PPP loan; therefore, it is strongly recommended to first apply for a loan at a bank where you already have an account.

Surgeons should immediately begin preparations to finalize their PPP applications and remain in contact with their lenders to identify the earliest opportunity to make their loan available.

All loan payments will be deferred for six months. Most importantly, the SBA will forgive the portion of the loan proceeds that are used to cover the first eight weeks of payroll costs, rent, utilities and mortgage interest. Small businesses and individuals who are self-employed or independent contractors – including plastic surgeons – are eligible if they also meet program size standards.

Applications will be accepted through June 30, but many experts believe the funds will be exhausted in a very short time period.

• Overview of the Program
• PPP Application
  

This advisory supersedes specimen collection and handling guidance from NYSDOH, released originally on March 25, 2020.

This update further extends previous recommendations that nasal and oropharyngeal swab specimen collection is an acceptable alternative, with recommendations for the collection of one (1) nasal swab AND one (1) saliva specimen through healthcare personnel (HCP) observed patient self-collection for specimens submitted to Wadsworth Center,if nasopharyngeal (NP) supplies are unavailable.

If you are using a laboratory other than the Wadsworth Center, follow the laboratory’s guidance for all specimen collection, handling, and transport processes, including whether nasal swab AND saliva specimen, or nasal swab AND OP swab specimen collection methods are acceptable alternatives to an NP swab.

• For any suspected COVID-19 cases, ensure appropriate infection control precautions are in place and immediately notify the infection control lead at your facility and the local health department (LHD).
  
  
• Review local testing options for those who do not require clinical outpatient/inpatient medical care

> Read the complete advisory

This advisory supersedes guidance from the New York State Department of Health issued on March 28, 2020, to clarify that this guidance applies to essential personnel who have been exposed to a confirmed OR suspected case of COVID-19.

Public and private sector organizations that provide essential services or functions where personnel are needed to perform critical functions, including infrastructure, public safety, and other essential operations, may allow personnel who were exposed to or are recovering from COVID-19 to work in the workplace setting,if needed to maintain essential operations.

Essential services or functions include but are not limited to public health personnel, utility and water operators, skilled manufacturers and supporting supply chains, transportation infrastructure, law enforcement, and emergency response personnel.

Essential personnel who have been exposed to a confirmed or suspected case of COVID-19 can return if the following conditions are met.

This advisory supersedes guidance from the New York State Department of Health to Hospitals, Nursing Homes (NHs) and Adult Care Facilities (ACFs) pertaining to the COVID-19 outbreak, released on March 16, 2020, and further clarifies the updated guidance issued on March 28, 2020.

Entities may allow healthcare personnel (HCP) who are confirmed with COVID-19 or  have been exposed to a confirmed or suspected case of COVID-19, or who have traveled internationally in the past 14 days, whether healthcare providers or other facility staff, to work if all of the following conditions are met.