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Rhode Island Releases COVID-19 Crisis Standards of Care Guidelines for Hospitals

The Rhode Island Department of Health (RIDOH) issued Crisis Standards of Care Guidelines for acute care hospitals today, which are intended to ensure an equitable and just allocation of patient-care resources, should a scarcity arise. (See link below.)

These Guidelines, which could be implemented during any public health emergency, are not currently in effect. Rhode Island hospitals are currently below capacity and are not experiencing any shortages that would trigger the implementation of these Guidelines. These Guidelines would only be implemented when all other surge strategies are exhausted and no other regional resources are available. The swift construction of temporary surge or "alternate hospital sites" in Rhode Island as a part of the State's coronavirus disease 2019 (COVID-19) response provide another buffer from the need to implement these plans, should Rhode Island experience a surge in the near future. The Crisis Standards of Care Guidelines would only be implemented in a hospital in Rhode Island at the direction of RIDOH.

The Crisis Standards of Care Guidelines are supported by several key medical ethical principles, including duty to care, duty to steward resources, and distributive justice. Using these principles, clinical judgment, clinical information, and objective triage tools, facilities would be empowered to make patient care decisions based on medical status and likely outcome.

These Crisis Standards of Care Guidelines were developed in partnership with the acute care hospitals throughout the state, the Hospital Association of Rhode Island, and many other partners throughout the state and the region.

COVID-19 Data Update Rhode Island has 374 new cases of COVID-19. This brings Rhode Island's count to 8,621. Rhode Island also has 15 new fatalities to announce. Rhode Island's number of COVID-19 associated fatalities is now 266. A full data summary for Rhode Island is posted online.

RIDOH and hospitals are now using an updated COVID-19 reporting tool. This allows for more streamlined, systematic, electronic submissions. The prior reporting system was developed in the first days of the pandemic in Rhode Island was very labor intensive. It focused on reports and reviews of medical records for patients who are hospitalized because of COVID-19 like illness. The new reporting system will bring consistency to hospitals' reports. Rhode Island is continuing to develop its systems for tracking and responding to COVID-19, including its data systems, as the scope of the public health emergency has broadened.

Using this new system, there are 339 patients with COVID-19 currently hospitalized in Rhode Island. The historical numbers will be adjusted to fit this new system.

In addition to the data shift resulting from the reporting change, RIDOH is looking closely at hospitalization data to determine whether activity from around the holidays or enhanced screening at hospitals are impacting the numbers.

Key messages for the public Anyone who is sick should stay home and self-isolate (unless going out for testing or healthcare). The people who live with that person and who have been in direct close contact with that person should self-quarantine for 14 days after the last day that that person was in isolation. Direct close contact means being within approximately 6 feet of a person for a prolonged period. Help is available for people living in quarantine or isolation due to COVID-19. Visit www.RIDelivers.com [ridelivers.com] for connections to groceries, home supplies, restaurants, and mutual aid groups. People can also call 2-1-1. When people are in public, they should wear a cloth face covering. A cloth face covering is a material that covers the nose and mouth. It could be sewn by hand or improvised from household items such as scarves, T-shirts, or bandanas. Groups of more than five people should not be gathering. Always avoid close personal contact with other people in public. Healthcare workers should not be going to work if they are sick (even with mild symptoms). People who think they have COVID-19 should call their healthcare provider. Do not go directly to a healthcare facility without first calling a healthcare provider (unless you are experiencing a medical emergency). People with general, non-medical questions about COVID-19 can visit www.health.ri.gov/covid, write to RIDOH.COVID19Questions@health.ri.gov, or call 401-222-8022. This is the COVID-19 Hotline that RIDOH has available to the public. Everyone can help stop the spread of viruses in Rhode Island. o Wash your hands often throughout the day. Use warm water and soap. If soap and water are not available, use hand sanitizer with at least 60% alcohol. o Cough or sneeze into your elbow. o Stay home and do not leave your house if you are sick, unless it is for emergency medical care. o Avoid touching your eyes, nose, or mouth. Germs spread this way.

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