The COVID-19 pandemic has been devastating for kidney patients and challenging for nephrologists, nurses, and other caregivers. However, in the kidney community, it has led to collaborations that reduced the impact of COVID-19—collaborations that promise to serve kidney patients and professionals long into the future.
In March 2020, ASN formed the COVID-19 Response Team as a forum to gather accurate, unbiased information from reliable sources and to share it broadly with the kidney community, nationally, and regionally. The pandemic's ever-changing realities required continuous refinement, underscored the need to learn from one another's experience, and offered the opportunity to build on existing relationships among dialysis providers. The COVID-19 Response Team brought together knowledge and experience from the Centers for Disease Control and Prevention (CDC), dialysis providers, industry, patients, and government to deliver the best care possible to kidney disease patients. These efforts were spearheaded by four subcommittees: Outpatient Hemodialysis, Home Dialysis, Transplantation, and Acute Kidney Care. The Response Team's work was supported at every turn by the dedicated staff of ASN's Excellence in Patient Care Team, Policy and Government Affairs Team, and society leadership.
To keep the kidney community informed, Response Team nephrologists, infectious disease specialists, transplant physicians, nurses, social workers, and psychologists hosted more than 20 webinars yielding more than 50,000 views. ASN's COVID-19 resource portal has had more than 100,000 downloads. Response Team leaders were quoted in leading publications including The New York Times, The Washington Post, and The Philadelphia Inquirer; hosted appearances on the PBS NewsHour as well as several other television outlets; and authored more than 20 manuscripts published in national and international journals including JASN, CJASN, Kidney International, and AJKD.
On March 11, 2020, ASN began hosting national meetings of chief medical officers (CMOs) of US dialysis companies to share guidance about caring for kidney patients infected with COVID-19. Experts from the CDC participated with CMOs to share US and international experience about the evolution of the pandemic. Weekly meetings with the CMOs have continued and serve as a forum for open sharing of critical information. Discussions allow these leaders to learn from one another, collaborate, and develop strategies to improve patient outcomes while managing all aspects of the pandemic. These meetings also provide a support network for the leaders of these dialysis companies.
In April 2020, ASN focused on a regional crisis after receiving reports of shortages of acute dialysis supplies in New York City hospitals. Response Team leaders immediately convened a meeting of clinical leaders from nine area hospital organizations to determine the extent of the shortages. Meetings were held with manufacturers of dialysis solutions, the Assistant Secretary for Preparedness and Response (ASPR), and representatives of the Department of Defense. Hospital leaders contributed data to ASN documenting rates of utilization of dialysis solutions and equipment. Response Team leaders shared the data with manufacturers and government officials and provided a clear picture of the precise shortages and critical needs. Manufacturers were able to quickly adjust supply deliveries to all hospital organizations that week. Together with local hospital creativity and ingenuity, these efforts allowed all patients requiring kidney replacement therapy to receive this life-saving treatment.
ASN and the Response Team recognized early on that the key to reducing the impact of COVID-19 on kidney patients is to prevent or ameliorate the effects of SARS-CoV-2 infection with vaccines. The initial recommendation by the Advisory Committee on Immunization Practices (ACIP) released in December 2020 placed kidney patients in category 1C, meaning that many would not have priority access to receive vaccination. ASN, understanding that dialysis and transplant patients were at particularly high risk for complications and death from COVID-19, joined dialysis providers to advocate for kidney patients to receive higher priority. On March 25, 2021, following many meetings with dialysis organizations, ASN, the Department of Health and Human Services, and the CDC, the White House announced a priority vaccine delivery plan for dialysis patients, the Network Administrator Model. Larger dialysis providers served as a hub for delivery of vaccine to patients receiving care at all dialysis facilities in the United States. At the time, only 25% of dialysis patients had been vaccinated. After successful deployment of this Network Administrator Model, almost 80% of patients have been vaccinated.
The COVID-19 pandemic has changed many of the ways we work to keep dialysis and transplant patients safe. Perhaps the silver linings are the lessons we learned: 1) collaboration among competing dialysis companies improves outcomes for all, and 2) information sharing among professionals, industry, and government facilitates emergency planning, product delivery, and patient care. Throughout the pandemic ASN has served as a convening body to facilitate the best care for people with kidney disease.