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THE ADVOCATE

Volume 1, Issue 2
May 2020

Dear FPA Members and Friends,

We are hope you are staying safe as we continue to bring you resources on COVID 19, which hopefully are of assistance to you during this time.

PROTECTIVE PERSONAL EQUIPMENT

Advice from Margarita Cancio, MD, Infectious Disease, on Proper PPE for Blood Drawing in the Office

  • All office staff, including phlebotomists, need to use a surgical mask. A 3 level mask that has a face shield is preferable. The mask stays on all day and only comes off for lunch.  If using a regular surgical mask, add a pair of goggles. Goggles can be labeled and issued to each phlebotomist, which can then be disinfected and reused. No need to  be disposable. To draw blood, use gloves – and wash hands in between each patient.
  • All patients need to wear a mask or any kind of facial cover.

Update on Face Masks, Face Shields, Protective Masks
As you aware, in the FPA Newsletter last month, we informed you of a company through which we could obtain the above items.  Due to unforeseen circumstances with the Chinese government confiscating all N95s, our vendor was no longer able to obtain them, but could obtain KN95s.  We would have had to order a very large volume for best pricing.  At the same time, FPA became aware of the availability of PPE (at no cost) through the Florida Department of Emergency Management, which received N95s, face shields and procedure masks from the federal government.  The state provided and distributed these items to the various counties. Thus, for those of you who wanted the items, FPA submitted your requests for these items for a 10 day supply.  The county has since notified us that no further PPE will be provided to physicians due to the fact that “local buyers have realized greater efficiency as supply channels have reopened for sourcing.” The county has provided the below list of sources that have the capacity to fill orders for PPE:

NEW…KN95s, Protective Masks & Thermometers Available through Chagrin Safety Supply.
FPA was also able to obtain special pricing package with this vendor who has KN95s, surgical masks and Infrared non-contact Thermometers available for sale. Cost is all inclusive (no credit card processing fee or shipping fees). The price is the same regardless of how many masks/thermometers you order.  Once you sign off on the order, it is shipped.  You will receive KN95s within 3-5 days and the protective masks and/or thermometers within 2 days Federal Express, with invoice to be paid within 14 days of delivery.  If interested, please contact, Nanak Saran, at 330-990-1259.  You must identify yourself as a FPA member in order to obtain the below pricing.

  • KN95 – 30 masks/box, 40 boxes/case – $3.95 per mask
  • Surgical masks – 50 masks/box, 6 boxes/case – $.80 per mask
  • Infrared non-contact Thermometers – $80.00 each

NOTE:  If any FPA member is in dire need of KN95s until their supply arrives, FPA member, Dr. Joel Rose has 100 available for sale (at his cost) for $4.25 each.  If interested, please contact his Office Manager, Dayara, at 813-882-3331.

Hand Sanitzer, Gloves, Hand Wash, Disinfectant
As with the other PPE noted above, the county will not provide these PPE items to physicians. We informed you in last month’s newsletter that Buckeye International, which has earned its reputation as a leader in the industry with its products, has hand sanitizer (foaming), gloves, hand soap (foaming), and disinfectant spray for purchase.  Buckeye has provided FPA with a discount on these items. Please (click here) for pricing.  You can purchase only the products you need. You do not have to purchase all products. If you are interested in purchasing these items, please contact Ryan Bowne, Sales Rep, at 813-240-5680. You must identify yourself as a FPA member in order to obtain the group discount.  Orders will take approximately 2 weeks to arrive.  NOTE:  Buckeye also has surgical masks available for $.80 each.

PPE Available through HCMA
If you are a current HCMA member, you would have received a communication regarding PPE which you are able to purchase through them.  You must be a member of HCMA to take advantage of their offer.  You are able to be a member even if you live in a county outside of Hillsborough as long as your are an Active member (or the equivalent) of another county medical society in Florida.  As an Affiliate member, you will receive any and all benefits as regular HCMA members receive.  Affiliate membership cost is $250.00 per year.  If you are interested, please contact Kay Mills at 813-253-0471.

PPE Available through Amazon’s Business 
Amazon Business has given priority access to its COVID-19 Supplies store to individual physicians. FPA has verified the items are available to all independent providers of any specialty.  Click on the attached link for further information. https://www.aafp.org/news/practice-professional-issues/20200515amazonbiz.html?cmpid=em_AP_20200514

COVID 19 TESTING SITES
Advent Health – According to the Advent Health website, all events are full at this time – both for Adventure Island and Wesley Chapel

BayCare  (Weekdays – 8-11 a.m.)

  • BayCare Urgent Care, 900 Carillon Parkway, #106, St. Petersburg
  • Gulf High School, 5355 School Road, Port Richey

TGH-Fast Track   (7 days per week – 8 a.m. – 8 p.m.) (813-925-1904)

  • 2 testing centers – Brandon & Carrollwood – will remain the high risk test sites. They will continue doing the PCR nasopharyngeal swabs for COVID 19 testing.
  • The 8 remaining sites that have been doing the IgG antibody testing for COVID 19 to date will continue to draw blood for this.  BREAKING NEWS… in addition, per Dr. Diecidue, these 8 sites will now be doing the 15 minute nasal swab point of care testing for COVID 19 starting on Monday (Quidel’s Sofia 2 SARS Antigen FIA rapid point of care test).

Hillsborough County  (Weekdays – 8 a.m. – 5 p.m.)

  • Raymond James Stadium, 4201 N. Dale Mabry Highway, Tampa
  • Lee Davis Community Resource Center, 3402 N. 22nd Street, Tampa
  • Plant City Community Resource Center, 307 N. Michigan Avenue, Plant City
  • SouthShore Community Resource Center, 201 14th Avenue, SE, Ruskin

CVS Drive-Thru Testing  (Restricted to those in need only as testing supplies are limited.  Those interested need to go to MinuteClinic.com and complete a questionnaire.)

  • Lutz
  • Largo
  • Tarpon Springs
CONVALESCENT PLASMA

Plasma Donors – As you are aware, the FDA approved COVID-19 convalescent plasma for emergency treatment to assist critically ill coronavirus patients.   (Click here) for a letter you can provide to all of your recovered patients.  If describes what COVID-19 convalescent plasma is as well as how the patient can help in this matter.

Plasma Donor Information for Physicians – Dr. Martha Price provided us with this information for physicians on the convalescent plasma and the donation process.  Please  (click here) for the details.

FOUR ALGORITHMS THAT ANSWER KEY QUESTIONS ON COVID-19

FPM/AAFP published a very informative article regarding virtual visits, COVID-19 patients isolation/return to work, scheduling/rescheduling patient appointment during COVID-19, and staffing strategy practices to be adopted during COVID-19, especially if a staff member becomes infected. Click on this link for the full article including four algorithms useful for practices:
https://www.aafp.org/journals/fpm/blogs/inpractice/entry/covid_algorithms.html
TELEBUDDIES

Dr. Cheryl Reed provided us with information on trained volunteers who provide support to isolated older adults during the COVID-19 crisis and beyond. If interested, please contact Caroldene Diaz-Fernandez, health  Buddies Coordinator, Seniors in Service Tampa Bay, Inc., at 813-932-5228 ext. 222 or via email at cdfernandez@seniorsinservice.org. Please view the attached flyer for more information (click here).  

TAMPA AMEET CHAPTER OF HADASSAH ZOOM MEETING HONORING JUDY TAWIL
The Tampa Ameet Chapter of Hadassah is holding a Zoom Meeting event on Tuesday, June 23, 2020, 7:00 p.m. in memory of our FPA member Dr. Albert Tawil’s wife, Judy Tawil, who was their past president.  FPA member, Dr. Martha Price, and FPA Vice-Chair, Dr. Cheryl Reed, are honored to be invited at speakers at this event. Dr. Price’s topic will be COVID 19: Myths vs. Truths, and Dr. Reed will present on the Patient/Doctor Relationship During a Pandemic. If anyone is interested in listening to this event, please contact Dr. Martha Price at (813) 879-3334 or Dr. Cheryl Reed at (813) 997-4240.

FPA COVID 19 TOWN HALL MEETING WEBINAR

FPA received very positive feedback from the providers on the FPA COVID 19 Town Hall Meeting Webinar which was held on April 29th, with requests for future meetings and suggested topics. Our thanks goes out to all who participated as well to our speakers and presenters, including the Honorable Jane Castor, Tampa Mayor.  Our plan is to hold another webinar soon with Dr. Holt, Hillsborough County Health Department Medical Director, who graciously accepted to do another presentation. Dr. Margarita Cancio, Infectious Disease, was also requested to be brought back. Once the date is set, you will receive an email with a registration link.

FLORIDA ACADEMY OF FAMILY PHYSICIANS – WEEKLY THURSDAY WEBINARS

The FAFP holds weekly COVID 19 Webinars on Thursdays from 8-9 p.m.  To listen to these and other FAFP COVID-19 webinars (click here).
AMERICAN ACADEMY OF FAMILY PRACTICE
The AAFP has a webinar series on Friday evenings from 7-8 p.m., as well as opportunities for CME credits.  (Click here) for an article which provides information on the webinars as well as a wealth of other information including Testing Resources, Financial Relief and Practice Management, Audio-only E/M visit payment and much more.
FPA NEWSLETTERS

We would like to spotlight some of our independent practices front line responders of COVID 19 in our next newsletter.  If there is there is anyone you would like to recognize, please send us the information to place in our next edition.  Also, if there is anything in particular you would like to see in the FPA newsletters, or any comments or suggestions, please let us know.  Please send all information to: admin@floridaphysiciansalliance.com

Thank you for your participation in and support of FPA!  We will continue to keep you updated.

Sincerely,

Erfan Albakri, MD, FAHA
Chairman, Florida Physicians Alliance Board

Florida Physicians Alliance
5 Tampa General Circle, Suite 200
Tampa, FL 33606
Office (813) 250-9101
Fax (813) 844-4952
www.FLPhysiciansAlliance.com

Excelsior (“Ever Upward”)!   
E plurivus unum (“Out of Many, One”)!

THE ADVOCATE

Volume 1, Issue 1
April 2020

Dear FPA Members and Friends,

We are pleased to bring you our first issue of Florida Physicians Alliance (FPA) newsletter,  “The Advocate.”  Although we had planned to introduce the FPA board, along with other FPA information, it has been placed on the back burner as information on the COVID-19 is more important at this time.  This issue is devoted solely to this critical information.

We have collected information in many areas, which we feel would help assist you in your practices.

Hand Sanitizer, Gloves, Hand Wash, Disinfectant  – Many of you may be in short supply of these items. Buckeye International, has earned its reputation as a leader in the industry with its products.  If you are interesting in purchasing these items, please contact Ryan Bowne, Sales Rep, at 813-240-5680, who has provided FPA with a discount on these items.  Please (click here) for pricing.  You can purchase only the products you need. You do not need to purchase all 4 products.  You must identify yourself as an FPA member in order to obtain the group’s discount. Please place your order by Friday 4/10/20. Please (click here) for information on the hand sanitizer, (click here) for information on the disinfectant and (click here) for information on the hand wash.  Orders will take approximately 2-4 weeks to arrive.

Face Masks – If you are in short supply of face masks (N95 or KN95 or surgical) and/or face shields, we as a group can purchase through Tiger Packaging, which is a licensed and credentialed importer of these products and is headquartered out of Boca Raton.  Please click here for an email from Dr. Steven Horwitz for further information.  For an article regarding FDA allowing use of KN95 Masks approved by China, go to this website https://www.nytimes.com/2020/04/03/health/coronavirus-n95-kn95-masks.html. A minimum bulk order is required in order to obtain discounted pricing and payment in advance.  If you are interested, please contact admin@floridaphysiciansalliance.com by Friday, 4/10/20.  For information on the N95 specs (click here), and for image of the mask (click here)  For the spec sheet on the KN95 (click here) and for images (click here).
For N95 and KN95 and the various surgical masks pricing (click here).  For the face shield and pricing (click here).  Orders will take approximately 3-5 weeks to arrive.

Article on Facemasks helping to “Flatten the Curve” – written by Vikram Baliga, son of our newest board member, Dr. Rajendra Baliga.  Please (click here) to read this very insightful article.

BayCare Testing Sites – (Click here) for the BayCare Screening form and testing sites as provided to us by Dr. Martha Price.. They tested last Thursday and Friday, from 9-noon, however, please listen to local news for additional testing they may have upcoming..

TGH Admission Process and PPE information – the below information was provided to Dr. Albakri by Tallee Williams, Manager, Physician Wellness and Special Project, TGH.

      Admission Process:

  • If you have a COVID-19 positive patient that you want to admit, please use the normal admission process and identify them as a COVID-19 positive patient. They are asking screening questions upon admission to TGH.
  • If you have a COVID-19 rule out patient that needs to be screened and potentially admitted, please have them go to the parking area under the TGH ER for screening.
  • (I have included Dr. Chang in case you have more questions on this process or if I misunderstood something.)

Alternative Screening Sites:

  • TGH Urgent Care Powered by Fast Track has 2 locations for screening: Carrollwood location (4505 Gunn Hwy) and Brandon location (799 W. Lumsden Rd).  Individuals can call (813) 925-1903 to be screened over the phone and directed to a clinic or visit fasttrackurgentcare.com to make an online appointment. Patients will be assessed and if meets the testing requirements, a sample will be collected and sent to a commercial lab. Clinics are open 8 a.m. – 8 p.m. seven days a week.
  • We have not set up a screening site in S. Tampa.

PPE:

  • As of right now, we do not have plans to distribute hospital PPE to PCPs.
  • We are adding this discussion topic to our Supplies and Distribution work group agenda and will loop back around if that changes.

Raymond James Stadium Testing – testing reopened Wednesday, 4/1/10. Appointments will be scheduled from 8-11 a.m.  Individuals must call (813) 272-5900 to register. Health officials are also working with hotels individuals can go to for isolation and quarantine. Check local news as testing is being done sporadically depending on availability of test kits.

Plasma Donors – As you are aware, the FDA approved COVID-19 convalescent plasma for emergency treatment to assist critically ill coronavirus patients.  (Click here) for a letter you can provide to all of your recovered patients.  If describes what COVID-19 convalescent plasma is as well as how the patient can help in this matter.

Plasma Donor Information for Physicians – Dr. Martha Price provided us with this information for physicians on the convalescent plasma and the donation process.  Please (click here) for the details.

COVID-19 Provider Liability Concerns – Dr. Mark Smith  has written to the Governor, his Florida State Representative and Senator regarding his concern of medical malpractice as well as potential criminal charges and attached two JAMA articles which outlines the concerns and the potential intervention the State could take.  He asked FPA board to make you aware of this concern.  Please (click here) for the article on “Potential Legal Liability for Withdrawing or Withholding Ventilators During COVID-19. (Click here) for the article on “A Framework for Rationing Ventilators and Critical Care Beds During the COVID-19 Pandemic.”.  Your review and consideration to contact the Governor, your State Representative and State Senator would be appreciated.

Covid-19 Disaster Relief Options for Practices and Small Business Owners –  Below are some SBA resources that you might qualify for:

FPA is working with Bank of America financial advisors Palmer Ogden and Douglas Ressler. Please (click here) for a letter to small business owners from David Ressler. (Click here) for a flyer on the Paycheck Protection Program.

Application link: https://www.bankofamerica.com/smallbusiness/business-financing/
Information on applying link: www.bankofamerica.com/sbresources

Medicare Accelerated and Advance Payments – Dr. Cheryl Reed as provided the following information from AAFP regarding this topic.  For an overview, please go to https://www.aafp.org/news/government-medicine/20200330covidpayment.html and for the information on how to apply, go to https://www.aafp.org/patient-care/emergency/2019-coronavirus/financial-relief/mac.html

Essential Travel to Work In a Stay at Home Order State – With the 30 day stay-at-home order, healthcare workers are permitted to travel to/from work. They should have a copy of the Essential Worker letter (click here) with them, in their car, as verification they are essential healthcare workers.

HCA Caregiver Hotel Accommodations – HCA is providing complimentary hotel accommodations for bedside caregivers treating patients who have or are suspected to have COVID-19. This applies during the pandemic period, through May 16, unless the national emergency ends sooner.  It is available on the days the caregiver is working at the hospital and for up to 5 days following their shift.  Hotel request need to be submitted by the prior Wednesday for hotel arrangements in the upcoming week. Please click on this link to take you to the form. https://forms.office.com/Pages/ResponsePage.aspx?id=dW1aM-vDGkusCNSTOIFsoL9ld2_zhoxDgFbgt8P64rlUNjRETDRDVkZQTDBRVUtJUUhQNUNONzRKMS4u&j=42046716&sfmc_sub=644133687&l=5162575_HTML&u=580276437&mid=10986293&jb=0

Generic Drug Protease Inhibitor – Camostat Mesilate, NI-03 –  Dr. Eric Harrison is involved in a possible study involving this drug and is looking for investigators in the Tampa area.  This information was provided by Dr. Harrison: Per Dr. Harrision, this drug is licensed to Sagent Pharmaceuticals and being researched by Kangen pharmaceuticals. It has been used in Japan for years for chronic pancreatitis and is in phase II clinical trials in the USA, by the FDA, for chronic pancreatitis with 2 centers in Florida.  The COVID-19 virus cannot enter a person’s cells without the protease TMPRSS2 which is blocked by Camostat.  BARDA of HHS has classified this drug as a lower tier after the application was submitted 3/5/20.  Dr. Harrison feels that holding up this inexpensive/harmless drug to allow other expensive drugs with more complications and complexity is wrong.  If anyone has interest in helping with this study, please contact Dr. Eric Harrison.

FAFP COVID-19 Webinar “Best Practices and Perspectives from Florida Family Physicians” – This insightful YouTube webinar discuss changes occuring in practices during the crisis we are in, how to handle the challenges, and motivation techniques. Click on this link:  https://www.youtube.com/watch?v=VV1XYg11iss&feature=youtu.be

TeleHealth Buddies – Dr. Cheryl Reed provided us with information on trained volunteers who provide support to isolated older adults during the COVID-19 crisis and beyond. If interested, please contact Caroldene Diaz-Fernandez, health  Buddies Coordinator, Seniors in Service Tampa Bay, Inc., at 813-932-5228 ext. 222 or via email at cdfernandez@seniorsinservice.org. Please view the attached flyer for more information (click here).  

During these trying times, we thank all of you who are on the front lines battling our mutual enemy COVID-19.  Special thanks to Dr. Margarita Cancio, one of our FPA board members and FPA appointee to the Hillsborough County COVID-19 Emergency Task Force, for her tireless efforts on behalf of us all.  We pray for our community and will only win this fight by standing together!

If you have any questions, please text/call Dr. Reed on her cell at 813-997-4240.

Thank you for your participation in and support of FPA!  We will continue to keep you updated.

Sincerely,

Erfan Albakri, MD, FAHA
Chairman, Florida Physicians Alliance Board

Florida Physicians Alliance
5 Tampa General Circle, Suite 200
Tampa, FL 33606
Office (813) 250-9101
Fax (813) 844-4952
www.FLPhysiciansAlliance.com Excelsior (“Ever Upward”)!   
E plurivus unum (“Out of Many, One”)!