July 13, 2020 (Update #4)

Using the recommendations and guidance from the Centers for Disease Control and Prevention (“CDC”), American Congress of Obstetrics and Gynecology (“ACOG”), and American Society for Reproductive Medicine (“ASRM”), the Center of Reproductive Medicine (“CORM”) is committed to mitigating the risk of Coronavirus amongst staff and patients. The guidelines delineated below represent CORM’s comprehensive plan to achieve this end.

 

PROCEDURE

CORM Staff/Employees:

  • Required to check temperature each day prior to coming to work
  • Required to report fever (temperature >100.4 ° F) to their supervisor and not come to work
  • Required to report symptoms of COVID-19 (i.e. cough, fever, shortness of breath, sore throat, loss of smell, muscle aches, confusion) to their supervisor and not come to work
  • Required to report exposures to persons diagnosed with or under investigation for COVID-19 to their supervisor
  • Required to wash or sanitize hands before and after every patient encounter and every time they leave or return to their work station
  • Required to wear gloves during any task that requires direct patient physical contact and while cleaning/disinfecting consultation or exam rooms
  • Required to wear a cloth or medical-grade mask at all times
  • Required to wear a medical-grade mask, which will be made available by CORM, when performing the following tasks/procedures:, oocyte retrieval, embryo transfer, hysteroscopy
  • Required to practice social distancing by staying more than 6 feet from other employees
  • Required to coordinate an alternative workstation with their supervisor, if the private work station does not accommodate social distancing
  • Required to avoid congregating in public areas (i.e. lunch room, hallways)
  • Employees may eat lunch in private (i.e. not visible by a patient) personal work spaces
  • Employees that do not have private work spaces may continue to utilize the lunch room
  • Required to clean and sanitize their work station daily
  • Return to work guidelines for an employee that tests positive for COVID-19:
    • Symptom-based strategy for the symptomatic healthcare provider (HCP) with suspected or confirmed COVID-19. Exclude from work until:
      • At least 3 days (72 hours) have passed since recovery, defined as resolution of fever without the use of fever-reducing medications, and
      • Improvement in respiratory symptoms (i.e. cough, shortness of breath), and
      • At least 10 days have passed since symptoms first appeared.
    • Time-based strategy for the asymptomatic HCP with laboratory-confirmed COVID-19. Exclude from work until:
      • 10 days have passed since the date of their first positive COVID-19 diagnostic test assuming they have not subsequently developed symptoms since their positive test.
      • If they develop symptoms, then the symptom-based strategy should be used.

Patients:

  • Required to report exposures to persons diagnosed with or under investigation for COVID-19
  • Required to self-screen for symptoms of COVID-19 or fever prior to commuting to any CORM facility
  • Will be screened for symptoms and potential exposures and have temperature checked at the front desk
  • Required to wear a cloth or medical-grade mask, brought by the patient, at all times
  • If the patient does not have a mask, one will be provided by CORM
  • When appropriate, telemedicine will be encouraged
  • Examples of appropriate clinic visits: new patient visits and restarts (by patient preference), OB visits, study visits, any encounter that requires an ultrasound, SIS, HSG, treatment cycle monitoring
  • Examples of appropriate telemedicine visits: new patient visits and restarts (by patient preference), lab reviews, follow-ups, post-treatment (i.e. OI, IUI, IVF, FET) visits, consent signing
  • Return to clinic guidelines for a patient that tests positive for COVID-19:
    • Test-based strategy for the symptomatic patient with suspected or confirmed COVID-19. Exclude from clinic until:
      • 14 days have passed, and
      • Resolution of fever without the use of fever-reducing medications, and
      • Improvement in respiratory symptoms (i.e. cough, shortness of breath); and
      • Negative result of one FDA Emergency Use Authorized (EUA) COVID-19 molecular assay for detection of SARS-CoV-2 RNA; a copy of the negative result must be provided.
    • Test-based strategy for the asymptomatic patient with laboratory-confirmed COVID-19. Exclude from clinic until:
      • 14 days have passed, and
      • Negative result of one FDA EUA COVID-19 molecular assay for detection of SARS-CoV-2 RNA; a copy of the negative result must be provided.
  • All patients will be provided with the contact information of the CORM in-house psychologist Dr. Kristen Chambliss and encouraged to contact her regarding coping with infertility during the COVID-19 pandemic

Visitors:

  • Required to report exposures to persons diagnosed with or under investigation for COVID-19
  • Required to self-screen for symptoms of COVID-19 or fever prior to commuting to any CORM facility
  • Will be screened for symptoms and potential exposures and have temperature checked at the front desk
  • Required to wear a cloth or medical-grade mask, brought by the patient, at all times
  • If the visitor does not have a mask, one will be provided by CORM
  • Patients having an obstetrical visit or embryo transfer are allowed to have ONE visitor (e.g. spouse, partner, or support person)
  • No patient visitors are otherwise allowed, but a patient may communicate with a partner or support person via FaceTime, telephone, or another method during the consult
  • Visits by study monitors are allowed
  • Visits by sales representatives continue to be suspended until further notice
  • Return to clinic guidelines for a visitor that tests positive for COVID-19 are the same as for patients (see above)

Clinical, Laboratory, and other Facilities:

  • Consultation and examination rooms will be cleaned with a CDC-approved cleaner/sanitizer (e.g. Sani-Cloth Plus) after each patient encounter
  • The entire facility will receive a daily terminal disinfecting with a CDC-approved disinfectant (e.g. Lysol with H2O2, CaviCide)
  • These policies will be posted in public areas visible by staff, patients, and visitors
  • Coronavirus (SARS-CoV-2) gene testing via RT-PCR or next-generation sequencing (“NGS”) and/or antibody testing will be offered to or required for staff or patients when deemed necessary and appropriate

 

Reviewed and approved by:
Vicki L. Schnell, M.D.

 

 

 

March 18, 2020 (Update #3)

 

To our valued patients:

What a time this is for all of us globally. The Center of Reproductive Medicine remains committed to protecting the health of our team and patient community. We are prioritizing the responsible management of the ongoing COVID-19 pandemic. We have been, and will continue to, actively monitor and comply with the recommendations of local, state, and federal health departments, the CDC, ACOG, and ASRM.

Given the rapid evolvement of the pandemic and subsequent recommendations, it is impractical to impart generalized patient care instructions. In order to continue our core value of providing individualized care to each of our patients, we advise that our patients (with ongoing or planned evaluation or treatment) reach out to confirm their next steps. We will utilize telehealth to continue our conversation and your care. Reach out to: 281-332-0073.

Thank you,

Vicki L. Schnell, M.D.

 


 

March 16, 2020 (Update #2)

 

To our valued patients and community:

Given the rapidly changing nature of this pandemic, our goal is to provide frequent updates regarding our plan. As the novel coronavirus disease (COVID-19) spreads around the world and USA, our patients may have questions about our approach to minimizing the spread of disease. Our patients’ safety is of utmost importance to us and we are actively monitoring the situation as it develops.

As mentioned in our previous update, the CDC, local health departments, ASRM, ACOG, and experts in the field, have not recommended that asymptomatic patients cancel, delay, or postpone planned infertility treatments. Again, there appears to be no cause for alarm for those already pregnant. However, it has been suggested that individuals with confirmed or presumed COVID-19 avoid pregnancy. We want to reiterate that individuals with symptoms suggesting possible COVID-19 infection (i.e. fever, dry cough, shortness of breath, sore throat, body aches, rash, or nasal congestion) that have presented for an elective visit will be redirected to the appropriate facilities for evaluation.

ASRM has recommended that symptomatic individuals currently in an IVF cycle consider oocyte or embryo freezing, but it has not been recommended that asymptomatic individuals discontinue or postpone fertility treatments.  As such, we have heightened our screening and management of patients to include the following:

  • All patients will continue to be assessed for symptoms of COVID-19;
  • All patients will be assessed for travel-related risks (i.e. travel to Europe or Asia, or travel via air or cruise ship) in the last 14 days;
  • All patients that test positive for COVID-19 or that have a true fever (100.4°F twice or 101°F once) during treatment will have the ongoing treatment cancelled;
  • All patients for all visit types will have a temperature taken;
  • Patients will have the entirety of their visit within one room in the clinic, and that room will be cleaned and disinfected in the standard fashion after the encounter;
  • Non-patient visitors and patient guests will be limited; and
  • Telemedicine via phone and secure video will be encouraged for certain visit types.

We also ask that employees with symptoms suggestive of COVID-19 stay home from work and be evaluated. Outside vendor and sales representative visits will not be allowed. Hospitals and certain medical clinics may have engaged in a more stringent visitation policy, as these entities have a more at-risk patient population. As a reminder, we have a low-risk, young, and healthy patient population and team. We all should be practicing good hygiene, such as frequent hand washing, cleaning/disinfecting our workspaces, and avoiding ill or at-risk individuals. Many experts are pointing to social distancing as an effective tool for flattening the curve of infection; this includes:

  • Avoiding crowds or groups of more than 10 people; and
  • Keeping a distance of 6-feet between yourself and others while in confined spaces.

We want to emphasize that we are taking strong measures to ensure the health of our patients and employees. In an effort to save resources for patients infected with COVID-19, the CDC has recommended postponement of certain elective procedures. As CORM is completely an outpatient facility and not associated with a hospital, we will not be using the resources of those in need and feel comfortable in proceeding as outlined above. We appreciate everyone’s understanding as we all navigate this stressful and rapidly evolving time. Please feel free to reach out to us if you have any comments or questions.

Thank you,

Vicki L. Schnell, M.D.

 


 

March 13, 2020 (Update #1)

 

To our valued patients and community:

As the novel coronavirus disease (COVID-19) spreads around the world and USA, our patients may have questions about our approach to minimizing the spread of disease. The Center of Reproductive Medicine’s management team is actively monitoring the situation as it develops.

In careful review of the information disseminated by the CDC, local health departments, and ASRM, it has not been recommended that asymptomatic patients cancel, delay, or postpone planned elective medical visits or treatments, including those to address infertility. Individuals with symptoms suggesting possible COVID-19 (e.g. fever, cough, shortness of breath, sore throat, body aches, rash, or nasal congestion) that have presented for an elective visit will be redirected to the appropriate facilities for evaluation. We also ask that employees with symptoms suggestive of COVID-19 stay home from work and be evaluated.

It has been suggested that individuals with confirmed or presumed COVID-19 avoid pregnancy, but there appears to be no cause for alarm for those already pregnant or undergoing fertility treatment. ASRM has recommended that symptomatic individuals currently in an IVF cycle consider oocyte or embryo freezing, but it has not been recommended that asymptomatic individuals discontinue or postpone treatment. If a patient develops symptoms while in treatment and wishes to continue, they may do so, but will be required to wear a provided mask in our facilities. The facility will undergo a deep cleaning after caring for any patient with symptoms. Standard cleaning and sanitation for each location will continue as scheduled.

At this time, we will continue to welcome patients and their guests at our clinics (Texas Medical Center, Memorial City, Beaumont, Clear Lake). In an overabundance of caution, outside vendor and sales representative visits will not be allowed as of Monday March 16th, 2020. Hospitals and certain clinics may have employed a more stringent visitation policy, as these entities have a more at-risk patient population. As a reminder, we have a low-risk, young, and healthy patient population and team. Nevertheless, we all should practice good hygiene, such as frequent hand washing, cleaning/disinfecting our personal and work spaces, and avoiding ill or at-risk individuals. All visitors will continue to be screened for travel history and the symptoms listed above.

We will accommodate on-location patient rescheduling, as well as secure video consultations, as they are requested. The fees for these services have been adjusted. We will also not charge patients for cancelling or rescheduling an appointment. We ask that you give us a minimum of 24-hour notice so we can adjust our schedule.

We are committed to the health of our patients and employees and responsible management of this issue. This is a dynamic situation and we will continue to share updates as they come. We appreciate everyone’s understanding during this stressful time. Please let us know if you have any comments or questions.

 

Thank you,

Vicki L. Schnell, M.D.