Monday, April 06, 2020 Coronavirus Update: April 6, 2020 HIPAA enforcement relaxed, PTs and PTAs among the health care workers who could be "exempted" from expanded sick leave, COVID-19's link to CVD, and more. HIPAA April 2: HHS Allows Disclosure of Some Protected Information The U.S. Department of Health and Human Services has issued notification that it is "exercising discretion" in how it applies HIPAA privacy rules during the COVID-19 national health emergency. HHS says it won't impose penalties against covered entity or business associate disclosure of private health information if the disclosure was made in "good faith" by the business associate as a part of public health efforts, and if the business associate notifies the covered entity of the disclosure within 10 days. Those "good faith" disclosures include information shared with the CDC "for purposes of preventing or controlling the spread of COVID-19," or with CMS in efforts to provide "assistance for the health care system." From CMS April 3: New CMS Nursing Home Recommendations Stress Collaboration, Consistent Staffing Assignment The U.S. Centers for Medicare & Medicaid Services issued new recommendations for nursing homes around the COVID-19 pandemic that urge states to attend to the personal protection equipment needs of long-term care facilities, and press nursing homes to establish separate staff teams for COVID-19-positive residents. The recommendations also include universal testing in the facilities and use of PPE "to the extent PPE is available." From the U.S. Department of Labor April 3: PTs, PTAs Could be "Exempted" From Receiving Additional COVID-19 Leave Emergency paid sick leave and expanded family and medical leave provisions will be implemented broadly in response to the COVID-19 pandemic, but PTs, PTAs, and other health care providers employed in certain settings can be prevented from receiving the additional relief if their employers say so: That's how the U.S. Department of Labor has laid out its plans for implementing the Families First Coronavirus Response Act signed into law on March 18. The exemption provisions could also be applied to first responders. April 3: OSHA Issues Guidelines to Permit Extended Use and Reuse of Respirators In a memorandum to its compliance safety and health officers, OSHA announced that it is seeking greater "enforcement discretion" that would allow for extended use and reuse of respirators. In the case of N95 masks, the same worker is now permitted to continue using the respirator "as long as the respirator maintains its structural and functional integrity" and the filter remains undamaged. The relaxed requirements also allow for use of N95 respirators that have passed their expiration dates—although the agency does not recommend the use of expired N95s when performing surgery on patients with diagnosed or suspected COVID-19, or when procedures are likely to create poorly controlled respiratory secretions. In the Media April 6: COVID-19 Virus May Damage Heart From Kaiser Health News: “As more data comes in from China and Italy, as well as Washington state and New York, more cardiac experts are coming to believe the COVID-19 virus can infect the heart muscle. An initial study found cardiac damage in as many as 1 in 5 patients, leading to heart failure and death even among those who show no signs of respiratory distress." Some cardiac specialists think that the virus could damage the heart in multiple ways. April 5: Researchers Investigating Links Between COVID-19 and Neurologic Effects According to Medscape, U.S. neurologists "are now reporting that COVID-19 symptoms may also include encephalopathy, ataxia, and other neurologic signs." In late March, doctors in Michigan reported on the first case of encephalitis linked to COVID-19, while researchers in China linked the development of Guillain-Barre syndrome to COVID-19 in a 61-year-old woman in China. Visit APTA's Coronavirus webpage for more information and updates.