Latest Updates:Due to the rapidly changing information available on COVID-19, this page is updated frequently. The latest updates include:
- Northeastern University Hospital Surge Capacity Planning Modelopens in a new tab (added 5/20/2020)
- Strategies to Optimize the Supply of PPE and Equipmentopens in a new tab (added 5/20/2020)
- Toolkit for Nursing Homes links to content within the page (added 5/14/2020)
COVID-19 (formerly 2019-nCoV)
- Coronaviruses are common around the world and cause a range of illnesses in humans, from the common cold to SARS and MERS. Viruses of this family also cause disease in animals. CDC confirmed person-to-person transmission in the U.S on Jan. 30. opens in a new tab On Feb. 26, they confirmed a possible instance of community-spread opens in a new tab of the virus that causes COVID-19.
- Complete CDC information and recommendations to date are available here opens in a new tab . The situation is unfolding dynamically; guidance will evolve.
- CDC COVIDView opens in a new tab (April 5). A weekly COVID-19 surveillance report of U.S. cases. The report summarizes and interprets key indicators including information related to COVID-19 outpatient visits, emergency department visits, hospitalizations and deaths, as well as laboratory data.
- CDC Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission opens in a new tab (April 3).Given what is now known about asymptomatic transmission, CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission. The cloth face coverings recommended are not surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders.
- CDC Coronavirus “Self-Checker”. opens in a new tab The purpose of the Coronavirus Self-Checker is to help you make decisions about seeking appropriate medical care. This system does not replace the judgment of healthcare professionals or the performance of any clinical assessment.
- The WHO COVID-19 opens in a new tab outbreak website contains excellent videos on topics, such as, proper use, removal and disposal of PPE, and infographics for download. It also houses up-to-date facts and global statistics on the disease.
- The U.S. Environmental Protection Agency (EPA) released a list of EPA-registered disinfectants that are qualified for use against COVID-19 opens in a new tab on March 5. The SARS-CoV-2, is a coronavirus that causes COVID-19. Coronaviruses are enveloped viruses, meaning they are one of the easiest types of viruses to kill with the appropriate disinfectant product. Follow manufacturer’s direction for use of the product; pay close attention to the contact time (how long product must remain on the surface). Disinfect high touch surface areas frequently.
- The Centers for Medicare and Medicaid Services (CMS) just released a memoon CMS website opens in a new tab stating, effective immediately, that all hospital inspections will focus solely on infection prevention and control procedures. This is a call to action for HCWs to ensure they are actively implementing comprehensive infection prevention and control practices. CMS provided a checklist PDF opens in a new tab to guide facilities how to prepare for potential inspection.
Recommendations for Healthcare Providers
opens in a new tab(March 31, 2020)
Decontamination and reuse of disposable filtering facepiece respirators (FFRs) may be considered as a crisis capacity strategy. Based on the limited research available, ultraviolet germicidal irradiation, vaporous hydrogen peroxide and moist heat showed the most promise as potential methods to decontaminate FFRs.
Recent topics include: Updates for Infection Prevention and Control; Long Term Care Facilities; and Caring for Children and Pregnant Women.
Protection of healthcare workers is a priority. This revised interim guidance prioritizes the use of N-95 respirators and other respiratory protection devices during high-risk procedures while still protecting healthcare personnel with facemasks and eye protection during other routine patient care activities in the setting of temporary respirator shortages.
In a March 10 memo issued to State Survey Agencies, CMS is expanding the allowable types of facemasks healthcare workers may use in situations involving COVID-19 and other respiratory infection. CMS also alerted state surveyors they are not required – on a temporary basis – to validate the date of a facility’s last annual test of the fit of N95 masks worn by workers in Medicare- and Medicaid-certified facilities. CMS took this step to minimize the discarded masks associated with such testing. Only annual fit testing validation is being waived.
This site includes clinical/technical, coding/billing and survey/certification guidance. Recent updates:
- Guidance to hospitals with emergency departments (EDs) on patient screening, treatment and transfer requirements opens in a new tab to prevent the spread of infectious disease and illness, including COVID-19, and remain in compliance with Emergency Medical Treatment and Labor Act (EMTALA) requirements. CMS has issued a frequently asked questions and answers on EMTALA opens in a new tab.
- Protecting patients, residents and healthcare workers in home health agencies opens in a new tab and dialysis facilities. opens in a new tab
On March 5, CDC held a Clinician Outreach and Communication Activity (COCA) webinar: Coronavirus Disease 2019 (COVID-19) Update – What Clinicians Need to Know to Prepare for COVID-19 in the United States. Listen here opens in a new tab
- At present, there is no vaccine or specific treatment for COVID-19 infection; care is supportive. CDC’s current interim recommendations are available here. opens in a new tab
- Given the evolving nature of COVID-19 in the U.S., CDC now recommends clinicians use best judgment to make testing decisions. Priority for testing includes hospitalized patients with lower respiratory illness symptoms and fever, older adults, those with underlying co-morbidities/pre-existing conditions, and HCWs with symptoms.
- Symptomatic patients should wear a surgical mask and be placed in a single occupancy room; the ideal location is an airborne infection isolation room.
- Healthcare workers should adhere to standard precautions, contact precautions and use eye protection, e.g., goggles or face shield.
- CDC has provided updated strategies to optimize the supply of N95 respirators opens in a new tab on Feb. 29, in brief:
- Know your current N95 inventory.
- Understand your N95 utilization rate.
- Ensure compliance with robust policies and procedures for appropriate use, proper fit testing and demonstrated competencies in putting on and taking off (sometimes referred to as “donning and doffing”) respirators and other PPE.
- CDC and FDA opens in a new tab took actions to increase access to respirators, i.e., N95s for HCWs on March 2.
- CDC updated its interim guidance for risk assessment and public health management of HCWs with potential COVID-19 exposure opens in a new tab on March 4.
- If you are sick, stay home; do not go to work. Reach out to your employer for guidance on options and resources.
- As always, hand hygiene and cough etiquette (cover the cough – not with your hand) are invaluable prevention tactics.
- For the Americans, in general, be prepared for the possibility of a COVID-19 outbreak in your community. Take measures to reduce the spread of COVID-19. CDC has made resources, guidance and communication materials available for individuals and communities, opens in a new tab including nonpharmaceutical interventions (NPIs).
Long-Term Care Facilities (LTCFs)
- CDC’s Clinician Outreach and Communication (COCA) webinar: Coronavirus Disease 2019 (COVID-19) Update and Information for Long-term Care Facilities (March 17, 2020) opens in a new tab
- CDC’s Morbidity and Mortality Weekly Report (MMWR) COVID-19 in a Long-Term Care Facility — King County, Washington, February 27–March 9, 2020 opens in a new tab
- Guidance for Retirement Communities and Independent Living opens in a new tab. Plan, prepare and respond to coronavirus disease 2019
- Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes opens in a new tab (May 2020)
- CMS Announces New Measures to Protect Nursing Home Residents from COVID-19 opens in a new tab (March 13, 2020):
- Restricting all visitors, effective immediately, with exceptions for compassionate care, such as end-of-life situations.
- Restricting all volunteers and nonessential healthcare personnel and other personnel (i.e., barbers).
- Cancelling all group activities and communal dining.
- Implementing active screening of residents and health care personnel for fever and respiratory symptoms.
- COVID-19 – Long Term Care Facilities Guidance opens in a new tab
- IDPH Long Term Care COVID-19 Guidance
- Visitor Restriction Guidance
- Checklist for Long Term Care Facilities opens in a new tab
- Sample Long Term Care Facility Letter
- Employee Monitoring Tool opens in a new tab
- Coronavirus Resources opens in a new tab: Practical information and resources for providers; friends and family; and residents and patients.
- AMDA Update on COVID-19 site opens in a new tab, includes guidance, resources and tools.
Surge: Capacity and Capabilities
Surge capacity, meaning a facility’s or healthcare systems’ ability to handle a sudden increase in volume or demand, is fundamental to disaster preparedness. Surge capability is focused on meeting specialized needs, i.e., need for ICU care or specific care need, such as, isolation. Preparation is key.
- AHRQ – Northeastern University Hospital Surge Capacity Planning Model: Bed, Ventilator, and PPE 1-30 Day Demand (May 2020) opens in a new tab
- ASPR – Enhancing Medical Surge Capacity (April, 27, 2018) opens in a new tab
- ASPR – Hospital Preparedness Program (HPP): Hospital Surge Evaluation Tool opens in a new tab
- CDC – Steps Healthcare Facilities Can Take Now to Prepare for Coronavirus Disease 2019 (COVID-19) opens in a new tab
- NEW: CDC COVID19Surge opens in a new tab (April 21) – A spreadsheet-based tool that can be used to estimate surge in demand for services during the pandemic. A user can generate estimates of needs for hospitalized COVID-19 patients, including the number requiring ICU level care and ventilatory support and compare to current capacity.
- HHS – Medical Surge Capacity Handbook opens in a new tab
- Wisconsin Department of Health Services – Guidelines for Managing Hospital Surge Capacity opens in a new tab. Wisconsin Healthcare Emergency Preparedness Program. Expert Panel on Medical Surge Capacity. (Rev. March 2015)
Communities also have a key role to play as active participants in planning for and responding to local health care crises, such as COVID-19.
Laboratory Specimen Collection, Testing and Reporting
- CDC updated its interim guidelines opens in a new tab for clinical lab specimens of Persons Under Investigation (PUIs) opens in a new tab and lab biosafety on Feb. 14. Providers should contact their local/state health department immediately to notify them of patients with fever and lower respiratory illness who live in or have traveled to an area with sustained transmission OR who have been in close contact (within six feet for at least 10 minutes) with a confirmed COVID-19 patient.
- Organizations with Premier® Clinical Surveillance technology and services opens in a new tab, powered by TheraDoc®, can deploy real-time alerts or set population flags to identify and track patients with suspected or confirmed illness, giving Infection Preventionists back precious time they need to stem the spread of COVID-19.
- CDC’s diagnostic test has been authorized by the FDA under the Emergency Use Authorization (EUA) opens in a new tab and the International Reagent Resources (IRR) has begun to distribute the test to requesting, certified labs, predominately local and state public health departments.
- CDC released official diagnosis coding guidance for encounters and deaths related to COVID-19 opens in a new tab on Feb.20. Information and guidance will likely be updates as new clinical information about COVID-19 becomes available.