Public Health Advisories

Public Health Advisories ( Disaster/Emergency Issues )

Provider: CORONAVIRUS HEALTHCARE - GUIDANCE FOR PROVIDERS

L A County Department of Public Health: Information for Healthcare Providers
Please read these instructions carefully as issues with specimens, forms, and labeling can lead to specimen rejection or testing delays. DO NOT collect or send specimens to the Public Health Lab (PHL) until instructed to by DPH. When contacting DPH, please be prepared to provide a call-back number and to wait for 10-15 minutes for a call-back. Once approved by DPH, follow all instructions below under Public Health Lab Specimen Collection and Transport.

PHL aims to result tests within 2 business days of receipt of specimen, but delays could occur based on volume and capacity.

Current Situation and Updates
http://publichealth.lacounty.gov/acd/ncorona2019/

Press Release and Case Count
http://publichealth.lacounty.gov/media/Coronavirus/#press-release

3-19-20: LAC DPH Health Advisory: COVID-19 Testing, Isolation and Quarantine, and Health Care Worker Monitoring Recommendations. Health care providers are encouraged to join the Los Angeles Health Alert Network (LAHAN) to receive DPH email notifications on COVID-19.

View our press releases for the information about new cases.

3-19-20: Interfacility Transfer Rules for Patients with Laboratory Confirmed COVID-19

3-18-20: COVID-19 Surveillance Data for Los Angeles County.

3-17-20: LAC Health Officer Letter to Healthcare Executives and Chief Medical Officers on COVID-19 Surge Planning

3-17-20: LAC DPH guidance for Monitoring Healthcare Personnel released

On-demand webinar with free CME- LAC DPH Clinical Update II on COVID-19.

CDC infection control guidance (3-10-20).

Clinical Presentation

Identifying and Managing Suspect Patients

Clinician Checklist for COVID-19
http://publichealth.lacounty.gov/acd/ncorona2019/checklist.htm

Laboratory Testing

For all patients: Collect TWO upper respiratory specimens - one oropharyngeal (OP) swab and one nasal specimen (either nasopharyngeal (NP) swab, nasopharyngeal wash/aspirate or nasal aspirate swab)

For patients with a productive cough: collect one lower respiratory specimen (sputum, bronchoalveolar lavage or tracheal aspirate) in addition to the upper respiratory specimens.

Outpatient settings should only collect an NP and an OP swab.

Information for Patients Managed at Home and Their Caregivers

Non-hospitalized patients being tested for COVID-19 should be instructed to self-isolate. Patients should follow home isolation instructions until their test result is negative or until they are told by LAC DPH or their healthcare provider that they are no longer infectious.

Home Isolation Information
http://publichealth.lacounty.gov/acd/ncorona2019/index.htm#Homeisolation

Reporting
Provider Report Form

http://publichealth.lacounty.gov/acd/Diseases/EpiForms/COVID19NotifFromMedProvResult_fillable.pdf

Infection Prevention Including Personal Protective Equipment

Updated 3-7-20: Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19)

Exposures: Geographic Risk and Contacts of Laboratory-confirmed Cases.

On 3-10-20, the CDC published revised guidance, Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. Below is a summary of important changes to PPE and patient isolation.

For more information please visit:

https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html

CDC guidance recommends the following changes in personal protective equipment (PPE) for healthcare workers caring for patients with suspected or confirmed COVID-19. Facemasks are an acceptable alternative to respirators in the setting of shortages of respirators.

N95 respirators should be prioritized for procedures that are likely to generate a high concentration of respiratory aerosols (e.g., intubation, cardiopulmonary resuscitation).

Eye protection is still recommended for use during patient care.

Gowns and gloves are recommended for clinical care, but if gowns are in short supply, they should be prioritized for procedures that are likely to generate respiratory aerosols.

Assure Adequate Supplies of N95 Respirators

In the setting of a respirator or mask shortage, healthcare facilities can apply for additional supplies through the mechanisms below.

Facilities that are part of the Reddinet should send requests through that system.

Healthcare facilities and clinics not part of Reddinet can complete the request form Resource Request Medical and Health (2018) and email it to LAEMSADutyOfficer@dhs.lacounty.gov.

Healthcare Facilities

Guidance for Monitoring Healthcare Personnel
http://publichealth.lacounty.gov/acd/docs/HCWMonitoring.pdf

Long Term Care Facilities

Guidance for Managing COVID-19 in Long Term Care Facilities
http://publichealth.lacounty.gov/acd/docs/nCoVLTCGuide.pdf

Checklist for preparing for potential COVID-19 patient
http://publichealth.lacounty.gov/acd/docs/LTCFPreparednessAssessment.pdf

EMERGENCY MEDICAL SERVICES

FAQ's for EMS Personnel
http://publichealth.lacounty.gov/acd/docs/nCoV_EMS_FAQ.pdf

Additional COVID-19 Resources
http://publichealth.lacounty.gov/acd/ncorona2019/

For DPH Clinical Consults on Communicable Disease:

All services by this agency

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