COVID-19 TOWN HALL

APRIL 21, 2020

Questions & Answers

From the April 21, 2020 Town Hall on COVID-19 & HIV

BHIV and the COVID-19 Response

Download a copy of the NYC DOHMH Bureau of HIV's presentation from the town hall.

Download the presentation

If someone tested positive for COVID-19 and is HIV+ can they donate their plasma for those who are not doing well and are also HIV+?

FDA guidelines have long recommended barring people with HIV from donating blood products.
TBD – hope to have more data in next few weeks
Dr. Blackstock mentioned this case series on first cases of COVID-19 among PLWH

Are those mental health apps really helpful?

Mental health apps, can be very helpful. NYC has curated resources to help support emotional well-being through the crisis.

How do we help those consumers that live alone and not near stores or have mobility problems? They cannot access public transportation and cannot access Medicaid transportation?

Members of vulnerable populations can sign up here to get food.
Find resources for people with disabilities here.
More COVID-19 resources can be found here.
All Ryan White Part A agencies that are contracted for food services have shifted to delivery or grab and go foods.
We will continue to seek out resources for people who belong to vulnerable populations.

Are there any numbers available on how many people who have died from COVID-19 were people who had HIV or AIDS? Is there any data on what their percentage is compared to the overall deaths here in New York City, or even the United States?

The New York City Health Department’s HIV Epidemiology Program is analyzing how many people in New York City who have probable or suspected COVID-19 and have died also had diagnosed HIV. A study in JAMA found that 43 or 0.8% of 5700 patients who tested positive for COVID-19 and receive care at 11 Northwell Health hospitals in New York City, Long Island, and Westchester County also have been diagnosed with HIV. This is roughly similar to the prevalence of HIV in the population of the New York City and the surrounding counties.

Are pharmacies aware of the 90 medication supply? Medicaid is denying 90-day supplies of medications. Isn't this suppose to be authorized? Who should someone contact in order to resolve this issue?

Pharmacies have all received guidance on distributing 90 day prescription supplies (found here). For questions on this policy providers may e-mail the pharmacy mailbox at: ppno@health.ny.gov or call (518) 486-3209.
People should have access to a 90 day supply in Medicaid and among insurers.
ADAP is doing 90 day supplies

Tri-county/submitting Westchester is mailing food vouchers?

Staff capacity to conduct surveys and conduct data analysis is limited. Any surveys that are conducted would not yield results in a timely enough fashion to address current issues.

Were the people that were hospitalized asked question concerning whether or not they wore masks all the time? Where they smokers, and where they in constant crowded places? Who is most at risk?

From New York City: Who is at higher risk of getting COVID-19 or of having severe illness. People who are at most risk of severe illness are people 50 years of age or older and people who have other health conditions, including:

Lung disease
Hear disease
A weakened immune system
Obesity
Diabetes
Kidney disease
Liver disease
Cancer

While currently there are no data to suggest pregnant people are more likely to be infected by the virus that causes COVID-19, they should be monitored closely. Pregnant people can get very sick if infected by some viruses. People with regular close contact with someone who has or could have COVID-19 are also at higher risk of getting COVID-19, such as people who live in the same home, caretakers who work in the home, or current sexual partners.

As we know masks are to prevent transmission, with so many people not wearing make and not knowing how they may be a potential health threat, has any form of aggressive education been discussed to let people know how their not wearing a mask, or maintaining distance is dangerous to others?

People can purchase masks or other face coverings online or at local stores, or through New York City’s distribution of free face coverings in parks occurring May 2-5, 2020. All New Yorkers are required to wear a mask or face covering when out in public and in situations where a six-foot distance from others cannot be maintained. New York City issued an FAQ on face coverings for essential retail businesses and customers.

Masks are worn to protect others, not yourself.
Guidance on Face Coverings
Face covering FAQ

Is the prevention workflow will be extended to May 15 2020?

NY on Pause – health department has established public health milestones to help inform the lifting of social distancing guidelines. The lifting will be gradual.

Have surveys been mailed to clients to find out whom has been affected in the HIV population density?

Staff capacity to conduct surveys and conduct data analysis is limited. Any surveys that are conducted would not yield results in a timely enough fashion to address current issues.

HASA Questions (will be answered shortly):

How is sanitation/distancing guidelines in 50:50 apartments being handled

HASA routinely receives guidance (Congregate Care Checklist ; NYC COVID-19 Guidance for Congregate Settings; NYS Guidance for Congregate and Shared Housing) from the State DOH and DOHMH on best practices to be utilized during this COVID emergency. We forward them to our permanent supportive housing and emergency housing providers and discuss them during conference calls. Any client residing in a private market apartment who is concerned about sanitation or social distancing issues is encouraged to call 311 and file a complaint

Individuals whose households have been affected and died, who's going into quarantine (time for apartments to be re-rented? Have the landlords been notified that the clients have died from corona/natural death to prep?

Due to confidentiality concerns, to the extent that HRA becomes aware of a particular person's cause of death, we are not authorized to share this information except as provided by law.
While HASA cannot confirm the cause of death of any staff member, at the appropriate time, HRA pay due respect and honor to all staff who we have unfortunately lost during this time period.

Is walk-in testing available?

NYC Health + Hospitals now has community walk-in COVID-19 testing sites with no referrals needed.

What are the testing policies when it comes to the MTA in particular the subway system? My concern is that the subway goes cross borough, but It seems the focus is on antibody testing at locations but if people are using the subways and have not been antibody tested, is this not a major concern? (homeless, compromised immune system, etc) how will people be social distancing during the first 1-2 weeks of reopening on each subway line at each stop, just seems the antibody test procedure should be at subways! curious about the re-entry policies*

Milestones have been established to inform plans for re-opening the city and state. These data driven measures will be used to help guide policy.

Are there any updates on Rikers Island?

At the moment those living with HIV and in Rikers are working with case managers to release people and ensuring that the discharge planning is thorough 

Comment

Legal Services is open and taking referrals. PLWH may contact me, Eleanor Sciannella, directly for referrals at 914-402-2192 x. 192 or esciannella@lshv.org. We have also been using this time to organize virtual legal education sessions via Skype and Zoom about the new federal and state laws regarding unemployment, sick leave, etc. If you are interested in getting together on video conference with our attorneys for a presentation and Q&A, please let me know!

For people who have self-quarantined but have no official diagnose – after the 14 days of self-isolation/quarantine - can those people be re-infected?

We currently do not know if exposure to SARS-CoV-2 or COVID-19 illness protects people from a new infection and illness, or for how long. Degree and length of immunity varies widely for other coronaviruses.
FDA has waived some requirements – which means a lot of tests that are not reliable on the market currently. Having had the infection should provide some level of immunity – but does not guarantee or ensure full immunity.
Antibody tests are not yet accurate or useful enough to determine population immunity.

What is happening in city lock up correctional facilities to protect staff and those incarcerated. Formerly incarcerated people cannot go to NYCHA housing – where are they to go? And what kind of tracking is happening in assisted living facilities, adult care centers and nursing homes?

The New York State Department of Corrections and Community Supervision issues daily reports on COVID-19 cases and deaths among incarcerated populations, parolees, and staff statewide, as well as information on its COVID-19 preparedness efforts and new protocols.
Nursing homes and other long-term care facilities have been hit hard by COVID-19 and require compliance with safety and care regulations and staffing of experienced medical personnel. The New York State Department of Health and New York City Health Department are working to support nursing homes in several ways, including ensuring sufficient personal protective equipment (PPE) and staffing and helping to manage infection control and implement testing.
To prevent outbreaks and severe illness among vulnerable residents, New York City and New York State currently recommend that people with COVID-19 in nursing homes, adult care homes, and other congregate settings with vulnerable residents be isolated and subject to infection control precautions for a longer period of time than others with COVID-19.

What is correlation between HIV and the protease inhibitors – something with effect on replication?

There were some preliminary studies that found an association between protease inhibitors – these were kind of “hail mary” treatments for people who had COVID-19 and were very sick. The treatment was not found to be useful, but more info can be found here.

Where do dental emergencies go? To the ER?

Avoid ERs if possible – many dentists are still delivering services on an emergency basis and that’s the best route to access oral health care.

I’m a PLWH with symptoms of COVID-19. I called the health department and reported my symptoms, and no one has called back.

Testing is largely only available for people who are very sick – we anticipate that testing will slowly become available on a large scale
If the symptoms are over 2 weeks old and you are doing ok – a test will not be very useful

If I have a chronic, non-HIV related illness- and my physician wants me to go into the ER and get a long series of tests and explanations – and so I will just stay with my pain – are a lot of people doing this?