CDC COCA Issues Update on COVID-19 for Clinicians & Healthcare Facilities

On March 5, 2020, the CDC Clinician Outreach and Communication Activity (COCA), a resource for emergency health professionals, hosted a call updating clinicians on preparing for COVID-19, or coronavirus. Healthcare settings, including skilled nursing and long-term care facilities, are some of the areas of greatest concern. Below is a summary of COCA’s best practices when addressing COVID-19 in a healthcare setting:

1) Identifying persons under investigation

As of yesterday, the criteria for evaluation of persons under investigation was expanded to a wider group of symptomatic patients. Clinicians should look to possible symptoms of COVID-19, such as fever, cough, and difficulty breathing, in determining if the patient should then be tested. Influenza should also be considered during testing and co-infection is possible. Testing of healthcare personnel should be considered if they have been exposed to an individual with a suspected case of COVID-19 or they exhibit even mild symptoms of COVID-19.

2) Applying infection prevention and control measures

While the CDC has learned a lot about COVID-19, there is still a great deal that is unknown. The best way to protect residents, visitors, and staff is to rely on the infection control measures already in place. This includes standard precautions, such as washing hands and disinfecting surfaces. Facilities should also take an aggressive approach to diagnosing individuals showing signs of any respiratory infection and place them in isolation where possible.

3) Assessing risks for exposures

It is currently optional, not mandatory, for facilities to verify absence of fever and respiratory symptoms when healthcare personnel report to work. Risk exposure should focus on source control, use of personal protective equipment (PPE), and the degree of contact with the resident. Healthcare providers are also advised to inform their employers if they have travel or community related exposure.

4) Optimizing the use of personal protective equipment supplies

The CDC anticipates an increased demand for N95 masks. Facilities should optimize the use of these masks by, for example, limiting them to use in symptomatic residents and using expired masks during training. The FDA has also issued an emergency use authorization for the use of certain other masks in healthcare settings. See Letter of Authorization and NIOSH-approved FFRs.

5) Managing and caring for patients (inpatient and at home)

If a resident is either a person under investigation or a confirmed case, provide supplies and a garbage bin outside the door of the resident’s room. Post signage on the door clearly describing the infection control precautions to be taken. A facility may also limit exposure by designating and training certain individuals, or a team, to care for persons under investigation or confirmed cases.

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Looking for information related to a specific state? Contact the authors for more information.

See also: CDC Issues Update on COVID-19 Response: Precautions in Healthcare Facilities (March 4, 2020)

CDC Issues Update on COVID-19 Response

On March 3, 2020, Nancy Messonnier, MD, Director for the National Center for Immunization and Respiratory Diseases at the Center for Disease Control (“CDC”), held a medical telebriefing on COVID-19, commonly known as coronavirus disease. She reported confirmed cases in 12 states. While the CDC, at a national level, and state health departments, on a local level, are taking steps to contain and reduce the spread of COVID-19, she highlighted the importance of informed clinicians in batting the spread of the virus. Here are some recommended actions to prevent the spread of the virus.

Precautions in Healthcare Facilities:

  1. Review Infection Control Policies with Employees and Visitors
    Strictly adhere to all facility policies concerning minimizing exposure to respiratory pathogens. For example, wearing personal protective equipment, such as masks, gloves and eyewear, utilizing airborne infection isolation rooms when possible, and isolating patients when necessary.
  2. Employee and Visitor Screening and Access
    Strictly adhere to all facility policies concerning monitoring who is entering the facility. Including asking family members about travel, cold symptoms, maintaining an accurate sign-in log, and restricting certain visitors. While public health facilities are required by regulations to accept visitors, there are generally exceptions to this when it comes to the health and safety of patients. Be sure to discuss changes to visitor polices with patients as part of their service and care plans. Facilitate alternatives to in-person visitations, such as phone calls, Facetime, and text messaging. Consider blanket prohibitions on visitors if the facility is located in an area with known cases of COVID-19.
  3. Supply Items for Basic Hygiene
    Ensure there are tissues, hand sanitizer, soap, and respiratory masks for the residents, staff, providers, and visitors throughout the facility.
  4. Educate
    Educate residents, staff, providers, and visitors on the individual actions to reduce spread and impact. Posting signs with these recommendations is encouraged. Provide advance warning that access to the facility may be restricted on short notice.
  5. Stay Informed and Communicate
    It is important for providers to be in close contact with state and local health department to understand the precautions being taken at the local level. This also includes reporting any cases to the local health departments as necessary. Consider reaching out to state and local regulatory agencies to inquire whether they have more specific guidance.

Stay Informed