News Flash

SUMMARY: See this health alert for

• Brief Epidemiologic Update
• Updated Guidance from the Washington State Department of Health
• Requested Action
• Background
• Isolation – Healthcare Workers and First Responders
• Quarantine – Healthcare Workers and First Responders
• Isolation – General Public
• Quarantine – General Public

Brief
Epidemiologic Update

UpdatedGuidance from the Washington State Department of Health (DOH)

DOH has provided the following guidance for COVID-19 isolation and quarantine for health care workers and first responders that is new since our last update
on March 19. It also reiterates prior guidance forcases and contacts in the community. This transmission does NOT include DOH
updates on testing and PPE that were already covered in that March 19 update. Pleasereview topics relevant to your area(s) of care and responsibility.

Requested Action:

• Be aware of current guidance from CDC and DOH for COVID-19 including PPE, isolation, quarantine, and testing.
  • Isolation & Quarantine – Health Care Workers and First Responders – Return to Work Guidance for Healthcare Workers (HCWs) and First Responders (FRs) Who Have Confirmed COVID-19 Infection or Are Asymptomatic with High or Medium Risk Exposures* to a Known Case of COVID-19 (3/19/2020)
  • Isolation – General Public – What to do if you have confirmed or suspected coronavirus disease (COVID-19) (3/17/2020)
  • Quarantine – General Public - What to do if you were potentially exposed to someone with confirmed coronavirus disease (COVID-19) (3/17/2020)
• Deliver clear and consistent messaging with patients and community members regarding isolation, quarantine and adherence to social distancing recommendations and requirements. Your support in public health directives and education can make a difference.
  • https://www.snohd.org/500/Info-for-people-with-COVID-19
  • Health Officer’s Order from March 17, 2020
  • Governor’s Proclamation on Statewide Limits: Food and Beverage Services, Areas of Congregation

Background: 
COVID-19 disease should be considered in patients with fever, cough, or shortness of breath without other explanation.
 
As the COVID-19 outbreak continues to rapidly evolve, it is important to ensure local health jurisdictions and clinical partners are aware of current operational guidance on: testing, personal protective equipment, isolation, and quarantine. A summary of current recommendations is provided below. In addition, links are provided to documents for more detailed guidance on each topic.
 
Isolation –
Health Care Workers and First Responders: 
Health Care Workers (HCW) and First Responders (FR) with confirmed COVID-19 should not return to work until at least 3 days (72 hours) have passed since recovery. Recovery is defined as:
 
1.    Resolution of fever without the use of fever-reducing medications AND improvement in respiratory symptoms (e.g., cough, shortness of breath)
       AND
2.    at least 7 days have passed since symptoms first appeared
 
Healthcare workers and first responders can return to work provided they: 

• Adhere to respiratory hygiene, hand hygiene, and cough etiquette
  Wear a facemask at all times while in the healthcare facility, if there is a sufficient supply of facemasks, until all symptoms are completely resolved or until 14 days after illness onset, whichever is longer.
   
  Employers should consider reassigning HCWs who work with severely immunocompromised patients, such as bone marrow transplant patients, to work in other areas. Governor’s Proclamation Restrictions on Non Urgent Medical Procedures

Guidance document for health care workers and first responders: https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/HealthCareworkerReturn2Work.pdf

 Quarantine– Healthcare workers and First Responders:

Asymptomatic HCWs and FRs with High or
Medium Risk Exposures to a known case of COVID-19 should actively monitor forsymptoms consistent with COVID-19 infection but can return to work provided
they: 

• Adhere to cough etiquette and hand hygiene 
• Wear a facemask at all times while in the healthcare facility, if there is a sufficient supply of facemasks, until the end of the 14-day monitoring period from date of exposure.

Guidance document: https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/HealthCareworkerReturn2Work.pdf

Isolation –General Public:

Consistent
with CDC guidelines, WA DOH recommends persons with COVID-19 who have symptoms and were directed to care for themselvesat home may discontinue home isolation under the following conditions:

• At least 3 days (72 hours) have     passed since recovery     defined as resolution of fever without the use of fever-reducing     medications and     improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
• At least 7 days have passed since symptoms first appeared.

Guidance document for general public: 

https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/COVIDcasepositive.pdf

Quarantine
– General Public:

Individuals who have been in closecontact with someone with COVID-19 should monitor their health for fever, cough
and shortness of breath during the 14 days after the last day they were inclose contact with the sick person with COVID-19. They should not go to work or
school, and should avoid public places for 14 days.

Guidance document: https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/COVIDexposed.pdf

Resources:

• Washington State Department of Health: https://www.doh.wa.gov/Emergencies/Coronavirus
• Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-nCoV/index.html
• Infection control (CDC): https://www.cdc.gov/coronavirus/2019-ncov/infection-control/index.html
• Snohomish Health District: https://www.snohd.org/ncov2019