Guidelines We’re Recommending to Hospitals and Medical Practices during COVID-19

Last updated: March 19, 2020, 5 pm ET

Coronavirus has caused an unprecedented challenge to the healthcare industry, including the supply chain and healthcare worker and patient safety.

Sitting at the connection point between providers, suppliers and the government, Premier is acting as an extra pair of hands to help our members – including more than 4,000 hospitals and health systems and 175,000 non-acute providers – access the supplies and medications they need to serve their communities, keep their workers safe and ensure high-quality care.

As we aim to maintain supply chain integrity with a data-driven approach, we are also partnering with the Administration and other private sector partners to create both short-term and long-term solutions

While we are keeping in touch with our members on a daily basis, we are committed to sharing our guidance, insights and expertise with the industry at large. Check out our newsroom and the additional resources listed at the bottom for ways to stay in touch with us for regular updates.

Our Guidance to Healthcare Providers

1. Consider ways to limit the spread within each care location. Public health officials estimate that the incubation period for COVID-19 is four days, but could range from between two and 14 days. During this time, patients may be asymptomatic, yet still contagious.
   
   As a result, Premier advises that providers, both acute and non-acute, follow recommended guidance for limiting the potential for COVID-19 to spread, including limiting points of entry to the facility, restricting visitor access, providing added signage about proper hand hygiene, and ensuring safe triage and isolation. Since screening and triaging of patients outside of the emergency department is allowed during surge demand and pandemics, facilities can begin screening and triaging patients prior to entering the emergency room.
   
   
2. Follow supply conservation protocols issued by the Centers for Disease Control & Prevention (CDC). The industry at large is now undertaking a national conservation approach, and we recommend all healthcare providers – acute and non-acute – follow conservation protocols to stretch PPE supplies as long as possible, regardless of whether they’re facing supply disruptions.
   
   Facilities with difficulty obtaining supplies should reach out to Premier for assistance. In certain cases, Premier has been able to work through the traditional channels to free up urgently needed supplies, particularly in the event of a confirmed COVID-19 case in the facility or community.
   
   More than 1,800 unique stock keeping units (SKUs) are on allocation from distributors. This means that in most cases, supply ordering is limited to historic levels. This underscores the importance of all providers following rigorous conservation protocols.
   
   As of March 11, the CDC has revised its guidance on masks and respirators. Personnel should continue to wear facemasks and eye protection while providing care to known or suspected COVID-19 patients. However, a respirator such as an N95 respirator, is only required during high-risk procedures. Industrial N95 masks that are NIOSH-approved and certain expired N95s are also allowed.
   
   To go along with the CDC’s revised stance, CMS has temporarily waived annual fit testing for respirators, which will avoid wasting masks used in the annual validation. Providers still need to fit test new employees and new types of masks.
   
   
3. Be judicious in the ordering of supplies and avoid panic buying and hoarding. While PPE supplies remain available, they are heavily backordered. While acute care providers indicated that they had at least two weeks of PPE supplies on hand in a survey that Premier fielded at the end of February, this will fluctuate as more cases spread.
   
   Luckily, some helpful steps are being taken. On March 11, the President issued an unprecedented Executive Order giving the government sweeping authorities to shift U.S. manufacturing resources to increase domestic supplies of respirators that may be needed to protect the public from COVID-19. The ultimate effect of this Order is still unclear, but we are hopeful that we can work with the Administration to funnel any added capacity to providers experiencing the most acute need.
   
   We continue to recommend judicious ordering and refraining from panic-buying in the pharmaceutical supply chain, as well, even though it has not experienced the same volatility as the PPE supply chain. Although most pharmaceutical suppliers contracted with Premier have told us they have four to six months of active pharmaceutical ingredients (APIs) on hand, we continue to closely monitor the supply chains for APIs sourced from overseas.
   
   
4. Be cautious of products being sold on the gray market, outside of authorized supply channels. A gray market is amassing around personal protective equipment (PPE), as unauthorized, third-party sellers hawk masks, gowns and other scarce supplies at a markup.
   
   We have seen gray market offers for fake N95 respirator masks marked up 50x, sold in fake packaging and more. At best, this means these respirators came from a questionable source, with no way to verify safe storage, handling and valid expiration dates. At worst, they could be out-and-out fakes. Either way, there is a risk that the offered products will not perform as marketed, increasing the risk to healthcare workers, as well as patient health and safety.
   
   If you are not sure of a product’s legitimacy, contact your GPO and have them vet the offer with the original manufacturer. Premier’s relationships with manufacturers allow us to investigate the authenticity of the origin of the products. If the product’s origin can’t be verified, we do not recommend that you proceed with the purchase.
   
   Premier has a blog post with additional advice for providers to avoid counterfeit products during coronavirus.
   
   
5. Don’t fall for hacker schemes. There has been a significant uptick in COVID-19-related fraud schemes, in which hackers impersonate a trusted healthcare source such as the World Health Organization or the CDC to enable account takeovers or spread of malware. To combat these scams, we recommend:
   
   - Verifying outside senders by checking their email address;
   - Checking any unfamiliar links before clicking on them;
   - Treating any messages asking for personal information or requesting document/attachment downloads as suspicious;
   - Reviewing the FTC warnings regarding Coronavirus scams; and
   - Reporting any scams to local law enforcement.
   
   Check out our blog post for more in-depth guidance on this issue.
   
   
6. Enable real-time alerts of current or suspected coronavirus cases through clinical surveillance technology.
   
   For healthcare workers managing current or suspected coronavirus cases, clinical surveillance technology can be used to deploy real-time alerts of probable coronavirus cases, initiate intervention protocols and track patients under investigation and exposures. Premier’s clinical surveillance technology has created a custom package of alerts to assist in identification of suspected and confirmed COVID-19 cases, and we also offer a remote surveillance program that leverages our infection prevention team to help staff routine surveillance activities.

Learn More

During COVID-19, Premier continues to act as a trusted connection point for healthcare providers, suppliers and the government. We are working 24/7 to address challenges as they occur and help our alliance of more than 4,000 hospitals and health systems and 175,000 non-acute providers access the supplies they need to serve their communities. We are also partnering with the Administration and private sector to create both short-term and long-term solutions, and sharing our insights to help inform the public understanding.

Access our COVID-19 resources and tools.