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615. A Year with COVID19 – Experience from the Front Line in a Large Infectious Disease (ID) Clinical Practice
BACKGROUND: ID Care (IDC) is a large, 43 physician, 74 provider, practice that treats patients in 16 acute care hospitals (ACH) and 120 skilled nursing facilities (SNF) in NJ. March 4, 2021 was the first day a patient with COVID19 seen by IDC. Over the subsequent year IDC evaluated, treated, and tes...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8644621/ http://dx.doi.org/10.1093/ofid/ofab466.813 |
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author | Nahass, Ronald G Giordano, Angelo McManus, Edward J |
author_facet | Nahass, Ronald G Giordano, Angelo McManus, Edward J |
author_sort | Nahass, Ronald G |
collection | PubMed |
description | BACKGROUND: ID Care (IDC) is a large, 43 physician, 74 provider, practice that treats patients in 16 acute care hospitals (ACH) and 120 skilled nursing facilities (SNF) in NJ. March 4, 2021 was the first day a patient with COVID19 seen by IDC. Over the subsequent year IDC evaluated, treated, and tested over 23,000 persons for COVID19. Patients were seen in 2 distinct times - wave 1 (W1) March 5-August 31 and wave 2 (W2) September 1 to March 4. We compare the experience of these 2 waves and report on the year of COVID19 at IDC. METHODS: The administrative data base for IDC was queried for demographic, visit and testing information. A survey of providers was performed to capture incidence of COVID19 and vaccination rates. Daily census logs were used to create epi curves. Comparisons between waves were performed using student T Test or X(2). RESULTS: Table 1 provides the comparisons between waves. More patients were seen in W2, however, the number of visits per patient was less, consistent with a shorter length of stay. Fewer patients were seen in SNF in W2 compared to W1. The age and sex distribution between the waves were the same. A total of 8741 molecular tests were performed. Test positivity peaked the week of December 31 at 6.99% and dropped to 0% by May 1 consistent with vaccination and the NJ epidemic curve. During the year of COVID19, 6/74 (8%) clinicians were infected with SARSCoV2. All recovered. Infections in providers were not clearly work-related exposures. 73/74 clinicians were vaccinated. [Image: see text] Table 1. Demographics For the Year in COVID19 at ID Care [Image: see text] Figure 1. Test Positivity Rate for ID Care CONCLUSION: The year of COVID19 occurred in 2 distinct waves. W1 was short and intense. The age and gender distributions were the same between the waves. Even though wave 2 was numerically greater, the cases in SNF were statistically less than the first wave likely from improved IP practice initiated in W1. The numbers of visits per patient, a surrogate for LOS, was statistically less in W2. The decline in test positivity paralleled deployment of vaccination. Despite an intensity of exposure of 158 patients/provider or 1198 visits/provider to SARSCoV2 infected persons only 8% of the clinician staff were infected. ID clinical practice can use electronic databases to help describe regional outbreaks of transmissible disease giving additional perspective across the care continuum. A more usable standard tool would enhance this capacity. DISCLOSURES: Ronald G. Nahass, MD, Abbvie (Grant/Research Support, Speaker's Bureau)Alkermes (Grant/Research Support)Gilead (Grant/Research Support, Speaker's Bureau)Merck (Grant/Research Support, Speaker's Bureau) |
format | Online Article Text |
id | pubmed-8644621 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-86446212021-12-06 615. A Year with COVID19 – Experience from the Front Line in a Large Infectious Disease (ID) Clinical Practice Nahass, Ronald G Giordano, Angelo McManus, Edward J Open Forum Infect Dis Poster Abstracts BACKGROUND: ID Care (IDC) is a large, 43 physician, 74 provider, practice that treats patients in 16 acute care hospitals (ACH) and 120 skilled nursing facilities (SNF) in NJ. March 4, 2021 was the first day a patient with COVID19 seen by IDC. Over the subsequent year IDC evaluated, treated, and tested over 23,000 persons for COVID19. Patients were seen in 2 distinct times - wave 1 (W1) March 5-August 31 and wave 2 (W2) September 1 to March 4. We compare the experience of these 2 waves and report on the year of COVID19 at IDC. METHODS: The administrative data base for IDC was queried for demographic, visit and testing information. A survey of providers was performed to capture incidence of COVID19 and vaccination rates. Daily census logs were used to create epi curves. Comparisons between waves were performed using student T Test or X(2). RESULTS: Table 1 provides the comparisons between waves. More patients were seen in W2, however, the number of visits per patient was less, consistent with a shorter length of stay. Fewer patients were seen in SNF in W2 compared to W1. The age and sex distribution between the waves were the same. A total of 8741 molecular tests were performed. Test positivity peaked the week of December 31 at 6.99% and dropped to 0% by May 1 consistent with vaccination and the NJ epidemic curve. During the year of COVID19, 6/74 (8%) clinicians were infected with SARSCoV2. All recovered. Infections in providers were not clearly work-related exposures. 73/74 clinicians were vaccinated. [Image: see text] Table 1. Demographics For the Year in COVID19 at ID Care [Image: see text] Figure 1. Test Positivity Rate for ID Care CONCLUSION: The year of COVID19 occurred in 2 distinct waves. W1 was short and intense. The age and gender distributions were the same between the waves. Even though wave 2 was numerically greater, the cases in SNF were statistically less than the first wave likely from improved IP practice initiated in W1. The numbers of visits per patient, a surrogate for LOS, was statistically less in W2. The decline in test positivity paralleled deployment of vaccination. Despite an intensity of exposure of 158 patients/provider or 1198 visits/provider to SARSCoV2 infected persons only 8% of the clinician staff were infected. ID clinical practice can use electronic databases to help describe regional outbreaks of transmissible disease giving additional perspective across the care continuum. A more usable standard tool would enhance this capacity. DISCLOSURES: Ronald G. Nahass, MD, Abbvie (Grant/Research Support, Speaker's Bureau)Alkermes (Grant/Research Support)Gilead (Grant/Research Support, Speaker's Bureau)Merck (Grant/Research Support, Speaker's Bureau) Oxford University Press 2021-12-04 /pmc/articles/PMC8644621/ http://dx.doi.org/10.1093/ofid/ofab466.813 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Poster Abstracts Nahass, Ronald G Giordano, Angelo McManus, Edward J 615. A Year with COVID19 – Experience from the Front Line in a Large Infectious Disease (ID) Clinical Practice |
title | 615. A Year with COVID19 – Experience from the Front Line in a Large Infectious Disease (ID) Clinical Practice |
title_full | 615. A Year with COVID19 – Experience from the Front Line in a Large Infectious Disease (ID) Clinical Practice |
title_fullStr | 615. A Year with COVID19 – Experience from the Front Line in a Large Infectious Disease (ID) Clinical Practice |
title_full_unstemmed | 615. A Year with COVID19 – Experience from the Front Line in a Large Infectious Disease (ID) Clinical Practice |
title_short | 615. A Year with COVID19 – Experience from the Front Line in a Large Infectious Disease (ID) Clinical Practice |
title_sort | 615. a year with covid19 – experience from the front line in a large infectious disease (id) clinical practice |
topic | Poster Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8644621/ http://dx.doi.org/10.1093/ofid/ofab466.813 |
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