Innovations and Lessons Learned from IsoCare August 5, 2020

1. Connecting Vulnerable Populations with
Resources to Support Self-Isolation:
Innovations and Lessons Learned from IsoCare
August 5, 2020

2. CME Credit
• Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State
Medical Society to sponsor continuing medical education for physicians. The
Bridgeport Hospital Yale New Haven Health designates this live activity for a
maximum of one (1) AMA PRA Category 1 CreditsTM. Physicians should claim only
credits commensurate with the extent of their participation in the various
activities.
• This activity has been planned and implemented in accordance with the Essential
Areas and policies of the Accreditation Council for Continuing Medical Education
through the joint sponsorship of Bridgeport Hospital Yale New Haven Health and
the Weitzman Institute. Bridgeport Hospital Yale New Haven Health is accredited
by the Connecticut State Medical Society to provide continuing medical education
for physicians.
• The content of this activity is not related to products or services of an ACCME-
defined commercial interest; therefore, no one in control of content has a relevant
financial relationship to disclose and there is no potential for conflicts of interest.
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3. Connecting Vulnerable Populations with
Resources to Support Self-Isolation
www.careinnovations.org/

4. 4,771,080 cases on 8/5/20 up from 4,341,201 cases on 7/28/20
156,801 deaths https://coronavirus.jhu.edu/map.html
COVID-19 by population- US & World

5. Daily New Cases per 100k people
Data shown from 1/22/20 to 8/4/20
https://coronavirus.jhu.edu/data/new-cases-50-states
LAST week:

6. A Tale of Two States: FL and CT
Florida
Connecticut
250+ cases/day
end of July
7166 cases Aug 2nd;
decline from 10,145 July 26th

7. USA trends: New cases by Day
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html

8. News updates
• Israeli school openings – May 17th
– “They definitely should not do what we have
done” – Dr. Waxman
– Take strict precautions when reopening schools:
• Smaller classes
• Mask wearing
• Keeping desks six feet apart
• Providing adequate ventilation

9. News updates
• Developing world:
Collateral damage: reduced availability of
drugs for HIV, TB and malaria
– interrupting supply chains
– diverting manufacturing capacity
– physical barriers for patients
• travel to clinics to obtain medications

10. News updates
• Vaccine progress
– Novavax’s Covid-19 vaccine - promising immune
response
• Protein based – adjuvant vaccine (Spike protein)
• Scientists: Improved understanding of
inflammation in COVID-19

11. Resources
• Isocare: https://disastercrashcart.org/isocare.php
• Nuvance
health:https://spark.adobe.com/page/LPYqVcgQFwqqh/
• CDC:
https://www.cdc.gov/coronavirus/2019-ncov/index.html
https://emergency.cdc.gov/coca/calls/2020/
• WHO:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
• Johns Hopkins:
https://coronavirus.jhu.edu/map.html
• Others
https://www.thelancet.com/coronavirus
https://covidactnow.org/

12. Supporting Isolation
Panna Lossy, MD; Family
Medicine Physician, Santa Rosa
Family Medicine Residency; Co-
founder, IsoCare
Deirdre Bernard-Pearl, MD;
Pediatric Medical Director, Santa
Rosa Community Health Center;
Co-founder, IsoCare

13. How It Started

14. Gaps Identified
• Lag time from symptom
onset to test result
• Need for timely support
for many to actually
isolate/quarantine

15. Test turn around is longer than
infectious period!
• Peak Infectious period is
likely 2 days before
symptoms until ~ 5 days
after symptoms.
• To stop spread we need
to intervene quickly
after someone gets
symptoms!
How-Yuen Chen et al, JAMA Internal Medicine,
May 2020

16. • Community Health Centers refer
patients who must isolate or
quarantine while awaiting test
results
• Provides telephone health
education, resources and
support for people who have
been told to home isolate or
quarantine
• Has trained over 150 volunteers
and supported over 1300 clients
since April 2, 2020
• Partnered with Petaluma People
Services Center as Fiscal Agent

17. What Does
• Education on how to
prevent spreading Covid
to close contacts and
community.
• Problem solving for
individual situations
• Emotional support
• Link client to resources
like food, masks, $, etc.
• Safety net for people who
can’t isolate safely

18. What Is NOT
Their doctor Law Enforcement

19. Are and PH doing the same
thing?
• Public Health is focused on tracking known positive
cases and tracing contacts (Who, Where, When)
• IsoCare supports people in isolating and quarantining
when they don’t yet have a positive test – 5-15 days
before they get a call from PH
• IsoCare is focused on helping people understand what
it really means to home isolate and how to protect the
rest of their household and the larger community
• IsoCare deploys community resources to help people
stay home

20. Sirius Activist Phone Bank

21. Over 1500 people supported

22. Easy to learn about clients

24. Slightly more English Speakers Leave
the House

25. But almost all the Spanish Speakers who leave are
going to work!

26. Some things we have learned
• You can’t wait until the
positive test result to engage
patients in stopping Covid
spread!
• Isolation and Quarantine are
really hard to do!
• Most people don’t read the
handouts
• If you want people not to go
to work, you need to give
them a work excuse
• Financial support would
make a big difference in
compliance

27. Strategies that are Key to Success
• Train Community Health Workers (CHWs) to use a Case Management
model to provide support, increase connection, and build trust
• Utilize interactive scripts (on-line) to support and guide community
health workers
• IT platform that easily collects data can be used to inform the model
and future interventions
• Comprehensive, initial Training for CHWs in Isolation/Quarantine,
resources, motivational interviewing
• Minimum weekly collaboration/update meetings for CHWs
• IsoCare staff available for CHWs so they can get questions answered
real time and support for complex patient needs
• Close collaboration with other Community Based Organizations –
partnerships for client resources

28. Where could we go from here?
• Spread it - Other areas
could create an IsoCare
Collaborative
• Integrate It – Use the
information from Intake to
prioritize case investigation
and potentially do case
investigation or contact
tracing with people in the
program
• Need financial
sustainability!

29. Community
County Health Dept
Test
Order Isolation
Contact Trace
Release Isolation
Patient Needing
Home
Isolation
For
Covid
Medical
Care
Test
Triage
Sx Control
Mental Health
Community
Resources
Food Bank
Financial
assistance
Laundry
Supplies
Phone support for
home isolation &
linkage to
resources

30. People Behind

31. Organizations Behind

32. Join Us!
www.disastercrashcart.org/isocare.php

33. 33 * This initiative is supported by 33

34. Thank You!
www.weitzmaninstitute.org/coronavirus
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