COVID-19: How We Got Here An outbreak of novel coronavirus was confirmed on January 7, 2020 by the Chinese health authorities in Wuhan, China. Using the DNA sequence data provided by Chinese researchers, the earliest COVID-19 cases in the United States were confirmed on January 20, 2020 in Washington State. The Coronavirus (SARS-CoV-2) that is causing COVID-19 has unique and novel features compared to past viruses in the Coronavirus family (SARS-CoV, MERS-CoV). First, this Novel Coronavirus is unrecognizable by our immune systems, so viral infection is initially unchallenged by the body. Second, this Novel Coronavirus is spread more easily from person to person than SARS-CoV and MERS-CoV was, and can be spread by both infected persons showing symptoms (fatigue, fever, cough, respiratory distress) and uniquely, by persons infected but showing no symptoms. This fact makes it very difficult to isolate infected persons and protect the general population from infection.
Policies of personal distancing have been implemented throughout the world and seem to have had the desired effect of reducing transmission of SARS-CoV-2. Meanwhile insufficient testing for the virus, shortages of hospital beds, ventilators, and personal protection equipment have hampered healthcare workers and officials tasked with controlling the spread of the COVID-19 disease and caring for those who have been hospitalized. Vaccinations and treatments for COVID-19 are not available now but are projected to be available to all in 2021-2022.
COVID-19: Responses by the Fertility Industry The response by U.S. and International medical groups to the COVID-19 pandemic is best described as ‘fluid’. This is an unusual time we all find ourselves with rapidly evolving circumstances. This COVID-19 pandemic has resulted in a public health crisis that requires all medical practices to make adjustments for the general good. The American Association for Reproductive Medicine (ASRM) and most fertility practices in the U.S. are following the Center for Disease Control (CDC) recommendations as well as taking cues from physician groups, and experiences of other countries around the world.
ASRM Coronavirus/COVID-19 Task Force made the following recommendations (March 17,2020):
*Suspend initiation of new treatment cycles including ovulation induction, intrauterine inseminations (IUIs), in vitro fertilization (IVF), including retrievals and frozen embryo transfers, as well as non-urgent gamete cryopreservation
*Strongly consider cancellation of all embryo transfers whether fresh or frozen
*Continuing to care for patient who are currently “in-cycle” or who require urgent stimulation and cryopreservation
*Suspend elective surgeries and non-urgent diagnostic procedures
*Minimize in-person interactions and increase use of telehealth
There is a strong desire by both patients and fertility professionals to re-initiate care but most agree that the timing of the restart of infertility care must 1) prioritize the health and safety of the patients, physicians and staff and 2) must take into account the progression of the pandemic, 3) the availability of testing to determine infection and immunity status, 4) the time-sensitivity of patient diagnoses, and 5) what impact re-opening would have on the utilization of resources critically needed by local health systems on the frontlines of caring for COVID-19 patients. Lastly, 6) what are the Federal, State and Local government regulations which may impact reopening services (ASRM Coronavirus/COVID-19 Task Force, April 13, 2020).
COVID-19: Response by Viera Fertility Center Our Practice is currently open with limited service. Dr. Chamoun, via telemedicine, will continue to correspond with current and new patients in lieu of direct person to person consultation. We will continue to perform pelvic ultrasound as needed but have temporarily halted all IVF and Andrology procedures as per ASRM guidelines and Florida state rulings. Viera Fertility Center is expected to resume normal activities by June 1, 2020.
As always we appreciate you and are committed to providing all our patients with the best possible care with the ultimate goal of keeping everyone safe during these trying times.
Further information: www.whattoexpect.com/news , www.remembryo.com/coronavirus-covid19-pregnancy-ivf , www.asrm.org