Eyeworld Daily News

DAILY NEWS ASCRS VIRTUAL ANNUAL MEETING ASCRS TWITTER @EyeWorldMag LINKEDIN EyeWorld Magazine INSTAGRAM eyeworldmagazine EDITORIAL CO-DIRECTOR Ellen Stodola EDITORIAL CO-DIRECTOR Liz Hillman GRAPHIC DESIGNER Susan Steury GRAPHIC DESIGNER Katherine Beutner PRODUCTION MANAGER Cathy Stern SALES, SPONSORSHIPS, AND SPECIAL EVENTS Jessica Donohoe Joe Dooley Cathy Stern ASCRS EXECUTIVE DIRECTOR Steve Speares EYEWORLD MANAGING DIRECTOR Stacy Jablonski Find EyeWorld on social media 4 | EYEWORLD DAILY NEWS | MAY 17, 2020 and "extra housekeeping." There is also safety in process- ing patient flow and volume. Patients should be informed about practice re- opening and safety protocols via text messages, email noti- fications, and on the practice websites and social platforms. When patients arrive at the clinic, Mr. Chambers showed how a curbside check-in could look, with patients being asked from their car about travel his- tory, contact with patients who might have COVID-19, health status, and living situation. Mr. Chambers also described a "parking lot waiting room," where patients would wait with their family until admitted to the clinic. Some routine vis- its could be performed curbside with a follow-up call or tele- health visit with the doctor. For practices that are ad- mitting patients to a waiting room, Mr. Chambers suggest- ed, in addition to sanitation procedures, put up signage that advises patients to leave at least one seat between them and others. Some additional content from the presentations was added later in the day. For full footage as well as the Q&A with moderators and faculty, see SS-1. Editors' note: The sources have no financial interests related to their presentations. with patients, colleagues, and strategic partners, and respon- sibly managing your team to the "other side." Mr. Maller provided details as to how to accomplish each of these goals in his presentation. Financial relief Nancey McCann, ASCRS direc- tor of Government Relations, Fairfax, Virginia, gave an up- date on the many efforts being enacted to help preserve the viability of physician practices. Restarting an ASC Regina Boore, MS, RN, Pro- gressive Surgical Solutions, San Diego area, California, spoke on considerations for reopening an ASC. She listed several sources of essential guidance, including CMS, CDC, OSHA, the Ambulatory Surgery Association, and state health departments. She also noted the importance of having an adequate supply of PPE and disinfectants. For administrators Dan Chambers, COE, Dallas, Texas, spoke on an administra- tor's perspective. He stressed the importance of policies, procedures, and updates while people are still working from home. He addressed the im- portance of staff and patient concerns, noting the CDC's guidance for infection control severe inflammatory response syndrome, and cardiac failure. There would be elevated levels of inflammatory markers, tro- ponin, and NT-proBNP. Potential therapies from the start of this disease course include remdesivir, chloro- quine, hydroxychloroquine, and convalescent plasma transfusions. Clinical trials are underway to evaluate these options. In the early phase, Dr. Niederman's presentation noted a recommendation to reduce immunosuppression, avoiding excess steroids. In the second and third stage, careful corticosteroids, statins, human immunoglobulin, and some inflammatory inhibitors are being evaluated. These pro- posed therapies have different sites of action, Dr. Niederman noted in his presentation. Dr. Niederman emphasized a point about corticosteroids: Data, albeit weak with cau- tious conclusions, suggests that corticosteroids might increase mortality in patients with pneumonia. Guidance from medical organizations differs on the use of systemic cortico- steroids with COVID-positive patients. At this point, the focus is on supportive care for patients with COVID-19, Dr. Niederman said. Prevention The conversation transitioned to what ophthalmologists should be doing to prevent infections in their offices with a presentation from Francis Mah, MD, La Jolla, California. Reopening challenges, Dr. Mah said, include protection for patients, staff, and doc- tors, and projecting that the environment is safe, all while providing excellent eyecare. He spoke in-depth about masking for patients, staff, and doctors. Patients should be encouraged to wear even a cloth face cov- ering, if a surgical mask is not available. "The reason we're wearing face masks and while it's good practice … is because it does reduce spread," Dr. Mah said, noting that 20–30% of people with COVID-19 are asymptom- atic. Wearing the mask doesn't protect one from getting infect- ed, Dr. Mah continued, rather it helps reduce efficient spread of the disease. Leadership Bruce Maller, BSM Consult- ing, Incline Village, Nevada, tackled the topic of being a leader in a time of crisis. Qualities of leadership in a crisis include remaining calm, getting educated, act- ing the part of a leader, being decisive, selfless, hopeful, clear/concise, and demon- strating empathy. He broke crisis leadership into three buckets: protecting business integrity, staying connected continued from page 1

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