Ongoing coronavirus (COVID-19) updates and resources for integrative healthcare professionals
Last Updated: September 17, 2020
Latest Updates Include:
- COVID-19 susceptibility linked with substance abuse; Researchers predict COVID-19 will eventually become seasonal virus; Exercise may not help stress enough during COVID-19; obesity may affect immune response to coronavirus; Proteins could prevent COVID-19 transmission through placenta; Children can have COVID-19 virus and antibodies in system at same time; and more news updates and statistics (pg. 2)
Vaccines currently being evaluated in clinical trials (pg. 2)
CDC recommendations on reopening clinics, businesses, workplaces (pg. 3)
FDA issues emergency authorization for two new antibody tests (pg. 4)
New articles, tips, resources for practitioners and practice managers available (pg. 5)
The novel coronavirus disease (COVID-19) continues to impact 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.
As the world begins to reopen with new guidelines and restrictions, and concerns about spread and containment continue, 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 an ongoing source of:
- News updates and statistics
- Official guidelines and recommendations
- Practice management information
- 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 regularly for new information.
Latest news updates and statistics
The latest news updates from Integrative Practitioner include:
- Study finds COVID-19 susceptibility for those with addiction. Click here for more information.
- Researchers predict COVID-19 will eventually become seasonal virus. Click here for more information.
- Exercise may not help stress enough during COVID-19, study finds. Click here for more information.
- Obesity may affect immune system response to coronavirus. Click here for more information.
- New research identifies proteins that could prevent COVID-19 transmission through placenta. Click here for more information.
- Children can have COVID-19 virus and antibodies in system at same time, research finds. Click here for more information.
- Study finds vitamin D deficiency may increase COVID-19 risk. Click here for more information.
- Face shields, masks with valves less effective than surgical masks. Click here for more information.
- CDC pushes states to prepare for COVID-19 vaccines. Click here for more information.
- Pregnant women with COVID-19 more likely to need intensive care, study finds. Click here for more information.
- Patients with anxiety, depression may delay medical care, study finds. Click here for more information.
- Integrative Healthcare Symposium postpones 2021 conference amid COVID-19. Click here for more information.
The total number confirmed cases as press time, according to the John’s Hopkins University Coronavirus Resource Center, is 29,917,428 with the largest number of cases coming from the following countries:
- 6,635,467 cases in the U.S.
- 5,118,253 cases in India
- 4,419,083 cases in Brazil
- 1,081,152 cases in Russia
- 744,400 cases in Peru
- 736,377 cases in Colombia
- 680,931 cases in Mexico
- 653,444 cases in South Africa
- 614,360 cases in Spain
- 589,012 cases in Argentina
- 443,869 cases in France
- 441,150 cases in Chile
- 413,149 cases in Iran
- 380,680 cases in United Kingdom
- 344,264 cases in Bangladesh
There are currently 201,631 deaths linked to COVID-19 in the U.S. and 4,120,577 have recovered. Click here for the latest statistics provided by Johns Hopkins University.
There are currently over 100 vaccine programs underway worldwide. The three front-runners are ChAdOx1 nCoV-19 developed by Oxford University and AstraZeneca, an mRNA vaccine developed by Moderna, and Ad5-nCoV developed by CanSino Biologics. All three produced promising immune responses in early clinical trials.
Johnson & Johnson's experimental vaccine was also found to protect against SARS-CoV-2 infection.
In July, the pharmaceutical giant Pfizer and German biotechnology company BioNTech received a $1.95 billion grant to produce 100 million doses of a coronavirus vaccine by December 2020.
Click here to track COVID-19 vaccine development in real time. Other promising vaccine trials include:
- Arcturus and Duke-NUS Medical School
- Johnson & Johnson
- Kentucky BioProcessing
- Gamaleya Research Institute
The National Institutes of Health announced July 23 it was preparing to launch several large clinical trials to test new approaches to treating COVID-19.
While there is currently no definitive treatment for COVID-19, a May 2020 report found remdesivir more effective than a placebo for shortening recovery times in adults hospitalized with the virus. Additionally, dexamethasone, a steroid, prolonged survival in the sickest patients in a study conducted in the U.K.
Guidelines for prevention from the CDC
As states begin to reopen, the CDC provides several recommendations for healthcare clinics and other businesses and workplaces to prevent COVID-19 transmission among employees. The best method for containing the virus is prevention. Practitioners should communicate social distancing and public health measures to their patients, including:
- The CDC recommends all Americans wear non-medical cloth face coverings in public settings. The agency continues to emphasize reserving surgical facemasks for caregivers who need them. Additionally, use of gloves is not recommended, as washing hands or using alcohol-based hand sanitizer is deemed more effective. Click here for the latest information.
- 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.
- 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.
The FDA has issued an unprecedented number of Emergency Use Authorizations to companies developing diagnostic tests for COVID-19, including the most recent authorization for an at-home saliva testing kit. Testing resources include:
- Laboratory Corporation of AmericaPixel by LabCorp COVID-19 Test home collection kit
- Professional Co-Op Services/LabCorp
- Boston Heart Diagnostics
- CPT Medical
- CTK Biotech
- RealTime Labs
While there is currently no definitive treatment for COVID-19, remdesivir and dexamethasone have been shown to effectively reduce symptoms and recovery time.
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.
Click here for more information on supporting your clinic staff.
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. Click here for more guidance on supplements and immune support.
Helpful resources of integrative practitioners
This list is updated daily. Check back regularly for new resources.
- WHO Coronavirus disease (COVID-19) outbreak
- CDC Coronavirus (COVID-19)
- The President's Coronavirus Guidelines for America
- New! HHS Coronavirus Data Hub
- Share your story. Help us document integrative healthcare in 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
- State-specific guidance for retired medical doctors
- Guidance for COVID-19 patients with IBD
- Preparing clinics, businesses, and workplaces for reopening (CDC)
- Caring for clinic support staff (article)
- Coronavirus Waivers & Flexibilities
- 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
- Coronavirus Response Toolkit (U.S. Chamber of Commerce)
- Coronavirus Emergency Loans Small Business Guide and Checklist (U.S. Chamber of Commerce)
- Rural health system response strategy
- New! An epidemic within the novel coronavirus pandemic (article)
- New! The sleep-trauma feedback loop (article)
- Finding opportunity in COVID-19 and beyond (article)
- Practitioners share lessons from front lines of COVID-19 (article)
- Video with Mark Hyman, MD
- Video with Jeffrey Bland, PhD
- Video with Robert Silverman, DC
- Video with David Perlmutter, MD
- Managing depression post-COVID-19 (article)
- Integrative perspectives on coronavirus (article)
- AACN Cross Training to Treat Patients with COVID-19 (free course for nurses)
- Integrative Approaches to COVID-19 (article by Andrew Weil Center for Integrative Medicine)
- Novel Corona Virus: A Physician’s Guide (American College of Physicians)
- Traditional Chinese Medicine and the immune system (article)
- How to have an integrative healthcare practice from a distance (article)
- COVID-19 Support (Community Forum)
- Share your COVID-19 stories and experiences (Integrative Practitioner)
- COVID-19 Support Registry (National University of Natural Medicine)
- COVID-19 Policy Call-to-Action (Integrative Health Policy Consortium)
- International practitioners share their COVID-19 perspectives (article)
- Strategies for boosting immune resilience
- Strategies for stress to optimize immune response
- Managing sleep and stress behaviors
- Weekly self-care tips for integrative practitioners
- Helping patients handle stress
- Coping with social isolation for practitioners and patients (article)
- Culinary herbs and teas for immune support
- Coping with stress (article)
- Boosting immune function with food-recipes included (article)
- Nutrient support and supplementation for immune function (article)
John’s Hopkins University (2020) Coronavirus COVID-19 Global Cases by Center for Systems Science and Engineering at Johns Hopkins University School of Medicine. Retrieved from: https://coronavirus.jhu.edu/map.html
U.S. Centers for Disease Control and Prevention (2020) Coronavirus (COVID-19). Retrieved from: https://www.cdc.gov/coronavirus/2019-nCoV/index.html
World Health Organization (2020) Rolling updates on coronavirus disease (COVID-19). Retrieved from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen
Editor’s note: This article will be updated. Contact [email protected] to contribute.