Sunday, March 22, 2020 at 9:33:01 PM Pacific Daylight Time Subject: [EXTERNAL] RE: Media inquiry Date: Friday, March 20, 2020 at 3:21:48 PM Pacific Daylight Time From: Marc T Brown To: Farivar, Cyrus (NBCUniversal) There is a lot here: Kaiser Permanente has been working on confronTng highly infecTous diseases for years, and we are confident we can conTnue to safely treat paTents who have been infected with this virus, with limited risk to other paTents, members and employees. Experts and public health officials all over the world now have confirmed that the coronavirus is spread through respiratory droplets produced when an infected person coughs or sneezes and is transmiZed more easily than the flu. In line with CDC guidance, recommendaTons by the World Health OrganizaTon, and the pracTces of other health care providers in California and around the country, Kaiser Permanente is now treaTng paTents who may have or are confirmed to have COVID-19 using the appropriate droplet protecTons for screening and rouTne care. For paTent care procedures that would generate airborne parTcles, our care teams are using airborne protecTons. By shicing to the evidenced based protocols for droplet protecTon, we can help ensure that that we have the resources, capacity, and staff available to care for our members and the communiTes we serve, and conTnue working toward slowing the community spread of COVID-19. Kaiser Permanente, like other health care systems, has used droplet infecTon control protocols for decades to treat similar droplet-borne diseases such as influenza. ConTnuing to use unnecessary and increasingly scarce equipment, instead of the appropriate gear, will dramaTcally limit our health care system’s ability to deliver care to those who need it. The CDC has noted that preserving healthcare system funcToning is paramount, including concentrated efforts to mobilize all aspects of healthcare to reduce transmission of disease, direct people to the right level of care, and decrease the burden on the healthcare system. We would not be using droplet protecTon protocols if it were unsafe or put our care teams at greater risk. Q: Is the move to droplet protecTons supported by the state of California? • Most states around the country are evolving their care protocols to align with the updated guidance from the CDC defined specifically to preserving healthcare system funcToning in response to the community spread of the novel coronavirus. We, along with other California based healthcare providers, have been urging the state to adopt these protocols to ensure that we can protect healthcare personnel and non-COVID19 paTents, prepare for a potenTal surge in paTents with respiratory infecTon, and manage the risk of personal protecTve equipment supply and staff shortages. For these reasons, we have elected to follow the evidenced-based guidance and move to droplet protocols. Q: What is different with droplet protocols than airborne protocols? • This means that when caring for a paTent that meets the criteria for or has tested posiTve for COVID19, our care teams are protected by the use of a surgical or “isolaTon” mask rather than an N-95 respirator. • It also means that, consistent with CDC guidelines, we may place paTents in a single room, rather than solely using negaTve pressure rooms, to assess and care for paTents who meet the criteria for or have tested posiTve for COVID-19. Page 1 of 4 • Staff will conTnue to use the same disposable gowns, gloves, and eye wear (goggles or face shields) that they have been using and that also meet CDC guidelines. • For procedures such as intubaTon or bronchoscopy, where there is a risk of generaTng airborne parTcles, the appropriate airborne isolaTons and equipment are being used. This includes CAPR or PAPR (if not available, N95 can be used) and the use of negaTve pressure rooms. • Enhanced respiratory precauTons remain in place. This emphasizes using droplet plus contact precauTons plus eye protecTon for all paTents presenTng with infecTous respiratory syndromes. This is a method by which staff protect themselves from all respiratory viruses, including COVID 19. Q: If droplet precauTons are safe, why weren’t they used from the beginning? • COVID-19 is an emerging disease and our knowledge about the natural history, transmission, clinical course and treatment is constantly updated. When the CDC announced isolaTon precauTons with associated recommendaTons for personal protecTve equipment, they differed from the World Health OrganizaTon by adding airborne precauTons ‘out of an abundance of cauTon.’ Evidence now points to the droplet nature of transmission. Q: Why not conTnue to use airborne precauTons out of an abundance of cauTon? • This is an emerging disease and scienTfic evidence has confirmed the droplet nature of transmission. It is criTcally important that we use the appropriate protecTons in response to this and move to droplet protecTon immediately to ensure criTcal supplies such as N-95 masks, PAPRs and CAPRs remain available. Our PPE stewardship guidelines also ensure that PPE supplies remain available so that we can safety care for our paTents as the number of people who contract COVID-19 conTnues to increase. Response to CNA: We understand the concern and will conTnue to support and engage with our staff as the situaTon evolves. We engage with our labor leaders every week to keep them informed and make sure there is two-way dialogue as the situaTon conTnues to evolve. Our teams of nurses, respiratory therapists, environmental service workers, medical assistants and others have been trained and are properly equipped and prepared to safely care for paTents with any suspected or confirmed case, as well as any complicaTons that arise from the virus. We will conTnue to strive to keep our caregivers and all staff safe. We greatly value our care teams and staff, including our nurses, who are at the frontline of care. It is important that all health care systems protect staff and paTents based upon the science and evidence available. Mask Re-use We have asked staff that when pracTcal, they should conTnue to use masks that are not soiled. As the virus is now spreading quickly through our community, equipment and supply needs have increased dramaTcally. We are prudently managing our resources to ensure this equipment is available for our health care workforce for the duraTon of this pandemic. We are commiZed to the safety of our paTents and staff now and into the future. To conTnue to provide proper protecTon when caring for paTents with COVID-19, in some locaTons we have moved to using the CDC protocols for reuse of N95 respirators and have provided the necessary training for our health care workforce to be able to implement this. -------Marc Brown Manager, National PR and Media Relations Kaiser Permanente Page 2 of 4 Communications 1 Kaiser Plaza, 18 Lakeside Oakland, CA 94612 (510) 271-6328 (office) (510) 407-2592 (mobile phone) (510) 271-5953 (national media hotline) --------kp.org/thrive From: Farivar, Cyrus (NBCUniversal) Sent: Friday, March 20, 2020 2:44 PM To: Marc T Brown Subject: Re: Media inquiry Standby. Driving, let me pull over. Sent from my iPhone Cyrus Farivar +1 646 872 5369 (Signal/WhatsApp) InvesTgaTve Tech Reporter, NBC News From: Marc T Brown Sent: Friday, March 20, 2020 2:32:40 PM To: Farivar, Cyrus (NBCUniversal) Subject: [EXTERNAL] RE: Media inquiry My cell number is below if you want to call… -------Marc Brown Manager, National PR and Media Relations Kaiser Permanente Communications 1 Kaiser Plaza, 18 Lakeside Oakland, CA 94612 (510) 271-6328 (office) (510) 407-2592 (mobile phone) (510) 271-5953 (national media hotline) --------kp.org/thrive From: Farivar, Cyrus (NBCUniversal) Sent: Friday, March 20, 2020 2:24 PM To: Marc T Brown Subject: Re: Media inquiry Page 3 of 4 CauDon: This email came from outside Kaiser Permanente. Do not open aZachments or click on links if you do not recognize the sender. Yes please! I’m anxious to speak to someone ASAP. Thanks. Sent from my iPhone Cyrus Farivar +1 646 872 5369 (Signal/WhatsApp) InvesTgaTve Tech Reporter, NBC News From: Marc T Brown Sent: Friday, March 20, 2020 13:50 To: Farivar, Cyrus (NBCUniversal) Subject: [EXTERNAL] Media inquiry Hi, Cyrus, Sorry to be so tardy in gexng back to you. I emailed twice yesterday and got no response. That’s likely on my end. We are all working at home and I had some bandwidth issues with my home network yesterday. Comcast. Please let me know if you get this. I can help with what you are looking for. -------Marc Brown Manager, National PR and Media Relations Kaiser Permanente Communications 1 Kaiser Plaza, 18 Lakeside Oakland, CA 94612 (510) 271-6328 (office) (510) 407-2592 (mobile phone) (510) 271-5953 (national media hotline) --------kp.org/thrive NOTICE TO RECIPIENT: If you are not the intended recipient of this e-mail, you are prohibited from sharing, copying, or otherwise using or disclosing its contents. If you have received this e-mail in error, please notify the sender immediately by reply e-mail and permanently delete this e-mail and any attachments without reading, forwarding or saving them. Thank you. NOTICE TO RECIPIENT: If you are not the intended recipient of this e-mail, you are prohibited from sharing, copying, or otherwise using or disclosing its contents. If you have received this e-mail in error, please notify the sender immediately by reply e-mail and permanently delete this e-mail and any attachments without reading, forwarding or saving them. Thank you. NOTICE TO RECIPIENT: If you are not the intended recipient of this e-mail, you are prohibited from sharing, copying, or otherwise using or disclosing its contents. If you have received this e-mail in error, please notify the sender immediately by reply e-mail and permanently delete this e-mail and any attachments without reading, forwarding or saving them. Thank you. Page 4 of 4