9/14/20 Allergy'&'Asthma'Network'News More*information*at*allergyasthmanetwork.org Advances)in)Allergy)&) Check)out)our)News) USAsthma Summit) Asthma)Webinar) for)this)&)more! 2020 • Disparities*in*Food* • Face*Masks* = Critical* • Friday,*November*13* Allergy:**Racial,* from*12:00*p.m.*to* for*People*with* Ethnic*&* 4:00*pm Asthma*and* Socioeconomic* • https://allergyasthm Allergies*During*the* Considerations anetwork.org/news/ COVIDL19*Pandemic • Thursday,*Sept.*24 th usasthmaLsummitL • https://allergyasthman – 4:00*PM*EDT advancesLguidelinesL etwork.org/newsL articles/ basedLasthmaLcare / Creative(Approaches(to(Routine( Asthma/Allergy(Care(during(COVID<19 Dr.$Jackie$Eghrari. Sabet Dr.$Purvi Parikh Tonya$Winders 1
9/14/20 Our$Speakers Dr.$Jackie$Eghrari.Sabet Dr.$Purvi Parikh Tonya$Winders President$&$CEO,$Allergy$&$Asthma$ Clinical$Assistant$Professor$of$ Clinical$Assistant$Professor$of$ Network Medicine,$George$Washington$ Medicine$NYU$Langone$School$of$ School$of$Medicine$&$Health$ Medicine &$Director,$Allergy$and$ President,$Global$Allergy$&$ Sciences Asthma$Association,$Murray$Hill Airways$Patient$Platform Medical$Director,$Telehealth,$ National$Spokesperson,$$$$$$$$$$ Allergy$&$Asthma$Network$ Allergy$&$Asthma$Network$ Outline ! Current*State*of*COVID*– 19 ! In5Office*Care*Strategies ! Asthma*&*Allergy*Care*– Creative*Approaches ! Latest*Facts*&*Myths*about* COVID519 2
9/14/20 Poll$Question • We’d%like%to%know%who%is%here%today. • What%“title”%best%describes%you? Current'State'of'COVID019 Tonya&Winders 3
9/14/20 Cases#in#the#last#7#days US#Data#Report#– CDC# 4
9/14/20 In#the#News • Astra#Zeneca#placed#COVID619#vaccine#trials#on#hold • One#volunteer#in#the#UK#developed#a#serious#neurological# issue • Not#unprecedented#action#in#vaccine#trials COVID&19)Cases)in)US)by)Date)Reported New)Cases)by)Day 70000 60000 50000 40000 30000 20000 10000 0 1 8 5 2 9 3 0 7 8 6 3 0 7 3 0 7 4 1 8 5 2 9 6 3 0 7 4 1 7 1 2 2 2 h ) 1 2 2 ) 1 1 2 ) ) 1 2 2 ) ) ) 1 2 2 ) 1 1 2 3 ) l y y e e y t r ) ) ) ) r i ) ) ) ) ) ) ) ) ) ) ) ) s ) ) ) ) e y c h h h l l l a a y y y n n e e e l y y y t t t t i i i u u s s s s b r r c c c p r r r M M a a a u u n n n l l l a a A J u u u g u u u u m r r r p p p M M M J J u u u u M a a a J J J u g g g g A A A J J J r M M M A e u u u u b A A A A t p e e F S Cases 5
9/14/20 In#the#News ! California#Governor#reports#lowest#daily#case#count#in# nearly#4#months ! CDC:#National#Forecasts: ! 3national#forecasts#predict#a#likely#increase#in#the#number#of#new# hospitalizations#per#day#over#the#next#four#weeks ! 3#forecasts#predict#a#likely#decline CDC:#The# ! 1#forecast#is#uncertain#about#the#trend effectiveness#of# ! For#October#5,#the#forecasts#estimate#1,600#to#6,000#new#COVIDI gaiters#and#face# 19#hospitalizations#per#day ! CDC#Mask#Update: shields#is# ! Wear#masks#in#public#settings#around#people#who#don't#live#in#your# "unknown#at#this# household#and#when#you#can't#stay#6#feet#away#from#others time" ! Wear#the#mask#over#your#nose#and#mouth#and#secure#it#under#your#chin COVID&19)Information)– Allergy)&)Asthma)Network) • COVID&19)Information)Center • FAQ’s • Mental)Health)Tools • Infographics • Much)more).).).) • COVID&19))School)Resources)) • National)recommendations • Network)Notes)for)Parents • Planning)Tools • Asthma)Care)Resources • Posters)for)School 6
9/14/20 Poll$Question • How$have$you$received$your$medical$care$ during$COVID819? In#Office#Care#Strategies Dr.$Purvi Parikh 7
9/14/20 The$Office$Environment$is$Changing The$Socially$Distanced$Medical$Office$ Experience • Staggered$appointments • Barriers • Signage • Masks$on$patients$&$staff Challenge:$$How$do$we$keep$things$ personal$when$we’re$trying$to$be$distant? Protecting*Office*Staff Need*to*have*appropriate*PPE Stringent*cleaning*protocols Precautions*for*staff • Separated*work*stations*for*social*distancing • Mandated*masks • Cleaning*of*patient*rooms*and*staff*work*space • Patient*screening • Questionnaires • Temp*checks 8
9/14/20 COVID& 19)& Task)Risk)Assessment https://education.aaaai.org/resources&for&a&i&clinicians/prepare&your&practice_covid&19 Low)Risk Medium)Risk High)Risk • Biologic)Therapy • Food)Challenge • Spirometry • Immunotherapy • Drug)Challenge • Nebulizer) Treatment • Skin)Testing • Skin)Testing)(Young) Children) • Exhaled)Nitric) • Patch)Testing Oxide • Peak)Flow)Meter) in&Office • Patients) Demonstrating) MDI)Technique When%COVID+19%Numbers%Rise,%Reduce%Office% Visits • Patients%receiving%a%biologic% Again,%if%running%a% Cancel% medication%injection%still% temperature,%no% “nonessential”% need%to%come%in%– office%visit appointments • Look%to%giving%it%less% frequently%if%appropriate Give%allergy%shots% every%2%weeks% . instead%of%weekly • Oral%immunotherapy%needs% special%consideration 9
9/14/20 Creative(Solutions Electronic(or(phone(check(in(upon(arrival(at(office • Wait(in(car(until(you(can(be(seen • Avoids(time(in(waiting(room Forms(or(payments(can(be(done(electronically(prior(to(arriving Some(allergists(are(giving(shots(in(the(parking(lot(and(having(patients(wait( in(the(car Opening(windows(if(possible(to(avoid(ventilation(&(airflow(near(spirometry The$only$thing$that$is$constant$during$this$ pandemic$is$that$everything$will$change! 10
9/14/20 Asthma'&'Allergy'Care'– Creative'Approaches Dr.$Jackie$Eghrari.Sabet Constants C alendars C ustoms C ontact 11
9/14/20 COVID&19)has)Made)Life) Unrecognizable • In)the)midst)of)the)virus& Touch) • Need)to)organize)our) Points thinking)towards)health • Need)to)be)reminded)to) Reminders stay)on)top)of)health C alendar Less*Exposure*in*2020: Days*away*from*the*official* • Youth*Athletes*F limited*or*no* start*of*Fall practices/games • Home*Office*Worker*– no*commute • Fall*allergies 2020*“Twist” More*Exposure*in*2020: • Students*in*outdoor*classrooms*or*near* • Ragweed*exposure*is*variable open*windows • People*dining*outdoors,*walking*more 12
9/14/20 Best%Way%to%Combat% Ragweed Filter%air%with%air%conditioning% Avoidance when%you%can Shower%&%rinse%pollen%off%at%least% before%you%go%to%bed If%you%have%allergic%asthma%from% ragweed%– Continue%maintenance% asthma%treatments C ustoms&– Old&&&New Back&to&School Home&Office • Back&to&school&looks&different • Minimize&allergens&as&work&at&home& continues • At&home&or&hybrid&settings • Wash&pets&– cut&down&on&dander • Students¬&exposed&to&dust&mites& • No&pets&in&sleeping&areas at&schools • Dust&mite&covers&on&beds • Exposed&at&home • HEPA&filters • Combined&with&pet&dander&&& household&allergens CONTINUE&ON&ALLERGY&&&ASTHMA& • Need&to&consider&“Back&to&School& Cleaning” MEDICATIONS&AS&PRESCRIBED 13
9/14/20 Contact'your'Healthcare' Provider Historically,'this'is'the'time'of'year'for'check8 ups • With'COVID819'concerns,'many'missed'their'annual' health'visit Unusual'times'call'for'innovation'– includes' healthcare • Telemedicine'is'well'accepted'and'in'widespread'use Regular'check8ups'can'be'done'in'a' traditional'way'or'through'telemedicine Benefits(of(Telemedicine • No(travel(time Efficient • No(waiting(time • Undivided(attention Focused • Time(for(patient(– and(family(; to(ask(questions • Care(provider(can(lead(you(to(web;based( Resources resources(for(follow;up 14
9/14/20 What%to%Expect%From%a%Telemedicine%Visit Full%medical%history • Report%your%symptoms%– concerns • What’s%really%bothering%you? Physical%exam • Assess%symptoms • Send%for%lab%work • Diagnose Share%decisions%on%treatment%plan Putting'it'All'Together Address'how'you'can' tackle'your'allergies'in' BE'PREPARED PLAN'AHEAD this'new'reality with' telemedicine'and' treatment'at'home. 15
9/14/20 What%was%once%done%in%the%office%can%now%be%done%with%telemedicine! Revisiting)Treatment)Risks Low)Risk)Treatments ! Biologic'therapy' — many)of)these)are)done)at)home)for) asthma)and)for)atopic)dermatitis.) You)can)have)your) follow)up)visits)via)telemedicine ! Immunotherapy — can)also)be)done)at)home)with)SLIT) (FDA)approved)tablets).) In)many)cases)you)already)have) your)testing)on)file)at)the)office)and)that)can)be)used)to) guide)your)decision)to)start)SLIT)allergy)tablets ! Allergy'assessment' — in)home)visits)to)“view”)/advise) on)avoidance)via)telemedicine)visit 16
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