Ongoing coronavirus (COVID-19) updates and resources for integrative healthcare professionals
Last Updated: March 27, 2020
The novel coronavirus disease (COVID-19) is impacting all communities and the situation is rapidly evolving. Healthcare practitioners are on the frontlines of combatting this pandemic.
COVID-19 can cause mild to severe illness, with the most severe illness occurring in older adults. Symptoms include fever, dry cough, and shortness of breath.
A pneumonia of unknown cause was detected in Wuhan, China and first reported to the World Health Organization (WHO) on December 31, 2019. The outbreak was declared a public health emergency of international concern by the WHO on January 30.
The U.S. Centers for Disease Control and Prevention (CDC) is responding to the respiratory disease spreading from person-to-person caused by COVID-19. The federal government is working closely with state and local government and public health partners to respond.
As concerns about the spread of coronavirus mount and efforts to contain it escalate, integrative practitioners should be aware of the latest advisories from public health agencies and credible organizations and be prepared to advise patients.
We at Integrative Practitioner are here to support all healthcare providers who are caring for patients and keeping medical facilities up and running. To that end, this page will serve as a source of:
- Official guidelines and recommendations
- News updates and statistics
- Informative and educational resources
- Opportunities to engage and connect with other practitioners
We will be providing regular updates on this page as they are available. Check back for the latest information.
Guidelines for prevention from the CDC
The best method for containing the virus is prevention. Practitioners should communicate social distancing and public health measuresto their patients, including:
- Stay home if you can and follow all executive orders given by state and local government.
- Wash your hands often, following proper technique, and avoid touching your eyes, nose, and mouth.
- Avoid close contact with people who are sick and stay home if you are sick.
- Cover coughs and sneezes with a tissue or use the inside of your elbow.
- Wear a facemask if you are sick; if you are not sick, you do not need to wear a facemask. Save facemasks for caregivers who need them.
- Practice social distancing, staying at least six feet away from others when you need to be in public spaces.
- Clean and disinfect frequently touched surfaces daily, including tables, doorknobs, light switches, countertops, desks, phones, keyboards, toilets, faucets, and sinks.
- Stay informed about the latest recommendations for your city or state, especially in regard to business or clinic closure, stay-at-home, or shelter-in-place mandates.
Recommendations for healthcare clinics
Integrative practitioners should develop a clinic protocol and follow CDC recommendations for caring for patients with confirmed or possible COVID-19 infection. This should include screening patients before, during, and after appointments and identifying how to care for patients who may be ill with a respiratory viral infection. Telemedicine consults are strongly recommended during this time.
Other office procedures and plans may include:
- Placing a STOP sign on the front door instructing patients with symptoms not to enter. Click here for the CDC template.
- Instruct patients to call ahead if they have symptoms.
- Develop a policy for face masks and understand when it's appropriate to wear a face mask or instruct a patient to do so.
- Assess and triage patients with possible or confirmed COVID-19 to minimize chances of exposure, including placing a facemask on the patient and placing them in an examination room with the door closed.
- Designate appointment times, examination rooms, or clinic entrances for COVID-19 patients, to minimize chances of exposure.
- Collect all specimens and perform clinical interventions in the exam room.
- Minimize the number of healthcare workers interacting with COVID-19 patients.
- Perform hand hygiene with alcohol-based hand rub before and after all patient contact, contact with potentially infectious material, and before putting on and upon removal of personal protective equipment (PPE), including gloves. Use soap and water if hands are visibly soiled.
- Practice how to properly don, use, and doff PPE in a manner to prevent self-contamination.
- Exam rooms should be left empty for as long as possible after the patient has left. Proper cleaning and disinfecting protocols should followed.
- Patients under evaluation for COVID-19 may stay at home if they are not sick enough to be admitted. Make a plan with the patient if symptoms worsen, referring to the CDC guidelines for home care.
- Do not send patients to the emergency room or hospital if there is no clinical need. Advise patients to avoid emergency rooms unless clinically necessary.
Integrative healthcare clinics should decide whether to test patients for COVID-19 or refer to other clinics in the community. Clinics who do offer testing should follow all safety precaution guidelines.
Testing resources include:
- Professional Co-Op Services/LabCorp
- Boston Heart Diagnostics
- CPT Medical
- CTK Biotech
- Abbott Labs
- RealTime Labs
Practice management considerations
For integrative healthcare professionals who manage clinics and other providers, there are basic steps practice managers should take, including updating leave policies to support employees who need to stay home if they are sick. Practice managers should instruct providers who become sick with a fever or other symptoms to stay home and return only after they are free of symptoms for at least 24 hours. Practice managers should also consider creating or updating policies for employees who must stay home to care for sick family members or children who cannot go to school.
Additionally, practice managers should plan for employee absences due to illness by identifying essential functions, creating plans for community operations, and cross-training employees to perform essential functions.
Communicating with patients
Integrative healthcare professionals should communicate facts, not fear, and encourage following public health guidelines. The American Association of Naturopathic Physicians suggests the following:
- Communicate only evidence-based, accurate information.
- Reassure patients and the public regarding fears and discourage biases.
- Reinforce the importance of social distancing.
- Reinforce their role in supporting the global and local community efforts of containment.
- Use social media to inform the public of what steps your clinic is taking to reduce the spread and accommodate patients.
- Whenever possible, include citations for public education materials.
- Refrain from posting medically inaccurate or unsubstantiated claims regarding any potential therapies with relation to COVID-19.
- If you see misinformation from other providers, assume best of intentions and reach out to the individual privately.
Supplements and Prescriptions
The CDC is urging patients to have a three-month supply of any prescription medications. Several insurance companies are waiving restrictions that prevent patients from refilling early. Practitioners should communicate and work with patients to refill prescriptions now in the event of shortages or strict shelter-in-place mandates.
Supplement companies are also facing supply challenges as a result of high demand for certain formulas, including immune support products. Practitioners are encouraged to research alternatives to their trusted products in the event a product is unavailable.
Latest news updates and statistics
The latest news updates include:
- U.S. tops China for highest number of cases in the world.
- American relief bill passage may be delayed.
- More than 1,000 deaths linked to COVID-19 in the U.S.
- Washington, Indiana, Massachusetts, Michigan, Wisconsin, West Virginia and Oregon became the latest states to announce directives aimed to keep people home and slow the virus.
- Tokyo Olympics delayed, according to Japan prime minister.
- U.S. borders with Mexico and Canada will close this weekend.
- New York governor ordered residents to stay indoors and nonessential businesses to keep all workers at home. Earlier this week, California’s made a similar order for residents to stay home.
- Critical supplies, including ventilators, are running low, and some officials are calling on Trump to use federal powers to speed production.
- Tax Day has been moved to July 15.
- Restrictions on travel tighten and job losses increase.
- Red Cross calls for blood donations, noting blood supply is short
The total number confirmed cases as press time, according to the John’s Hopkins University Coronavirus Resource Center, is 549,604, with the largest number of cases coming from the following countries:
- 85,996 in the U.S.
- 81,897 cases in China
- 80,589 cases in Italy
- 64,059 cases in Spain
- 47,278 cases in Germany
- 32,332 cases in Iran
- 29,581 cases in France
Click here for the latest statistics provided by Johns Hopkins University.
Helpful resources of integrative practitioners
- WHO Coronavirus disease (COVID-19) outbreak
- CDC Coronavirus (COVID-19)
- Contact Integrative Practitioner at [email protected] to provide state-specific information, including emergency declarations. Your contributions are much appreciated.
- CDC Clinical Care Guidance for COVID-19
- CDC Healthcare Personnel
- CDC Implementing Home Care
- CDC Evaluating and Testing
- CDC Steps for Prevention
- U.S. Department of Justice Drug Enforcement Administration COVID-19 guidelines
- CDC STOP Sign
- CDC Get Your Clinic Ready for Coronavirus Disease 2019 Poster
- CDC Symptoms of Coronavirus Disease 2019 Poster
- CDC Share Facts About COVID-19 Poster
- American Academy of Family Physicians (AAFP) Checklist to Prepare Physician Offices for COVID-19
- Sample COVID-19 Office Protocol
- HIPAA Guidelines on Telemedicine
- Medicare Telemedicine Health Care Provider Fact Sheet
- CDC Travel Notices
- U.S. Small Business Association Disaster Assistance
- Integrative perspectives on coronavirus (article)
- AACN Cross Training to Treat Patients with COVID-19 (free course for nurses)
- COVID-19 Support (Community Forum)
- Coming soon!
Boosting immune health and resiliency
While there is now known treatment or vaccine for COVID-19 (experimental vaccine testing in humans began in mid-March), integrative practitioners understand the importance of prevention through maintaining healthy lifestyle habits. The Institute for Functional Medicine recommends the following:
- Stress reduction: Chronic stress can negatively alter immune system responses, making you more likely to get sick. Identify your personal stress reduction strategies and practice them regularly.
- Sleep: Sleep has a big influence on immune function, so it is essential to get plenty of sleep. Practice good sleep hygiene and maintain consistent sleep hours—turn off screens, ensure the room is cool, quiet, and dark, and set a reminder to help yourself go to bed on time.
- Exercise: Moderate, regular physical activity helps to boost immune system function by raising levels of infection-fighting white blood cells and antibodies, increasing circulation, and decreasing stress hormones. Establish and follow an exercise program to not only help prevent respiratory infections but also to improve cognitive and physical resilience.
- Nutritious diet: Research indicates that brightly colored vegetables and fruits boost immunity better than most supplements. Eat plenty of fruits and vegetables—aim for 10 servings per day. Include fermented vegetables or other probiotic-containing foods.
- Self-care: When battling upper respiratory infections, top priorities are plentiful hydration and rest. Drink plenty of fluids. Homemade vegetable or bone broths are also extremely beneficial. Various herbal teas and hot drinks can help with hydration and reducing symptoms. Good choices include peppermint, ginger, eucalyptus, chamomile, and hot water with lemon, honey, and cinnamon.
Editor’s note: This article will be updated. Contact [email protected] to contribute.