CAHAN Coronavirus call 11 am PST 1/28/2020
Personal notes from the meeting
Over half of new cases occurring outside Hubei. Youngest case is 9 months old.
Continue to suspect underreporting due to asymptomatic cases.
Testing 36 requested in California.
26 negative.
13 pending.
Prioritization based on level of risk.
Flight investigations occurring for at risk at flight. Contacts share with local health departments for appropriate monitoring.
CDC has not updated PUI definition at this time. However anticipate in next several days update. Continue contacting local Health Department regarding guidance for at risk patients.
Tests continue to be done only at CDC.
Local Health departments are responsible for updating local results PUI to health facilities/providers.
Specimens that are recommended:
1. NP, OP swabs
2. Lower respiratory specimens with BAL, Sputum (DO NOT INDUCE)
3. Serum
Continue standard biosafety lab safety when processing PUI specimens however for possible aerosols should be done in a class 2 biological safety cabinet.
Serum testing should follow standard laboratory procedures. Available in CDC website.
Continue PPE when handling specimens.
Healthcare Facility Guidance: AFL (all facilities letter) sent out last night. (CAHAN email at bottom of these notes to join list serve)
Voluntary survey on capacity to treat Novel coronavirus. Capacity for isolation, supplies of PPE.
Facility survey request to be complete by end of 1/29/2020.
Checklist available to help address any gaps in triage, procedures for rapid identification with use of Signage, Fit testing up to date, negative pressure rooms up to date, Disinfecting procedure. Screening and work restriction policies for exposed HCW. Surge evaluation capacity
EMS Has met to review with EMS administrators to review. Sacramento county has developed a novel coronavirus policy that has been shared with other state EMS.
Questions:
How long should a room be empty if not negative pressure for PUI? Guidance is in AFL. 1 hour is the rule of thumb.
Will any of the Health Departments be able to obtain specimens for testing? Will local health departments do any screening at the Health department? Work out case by case with local health department.
Employee health portion- will they need 14 day off work if exposed? There is a framework for Health Care workers that assess by level of risk (High with no PPE and confirmed case and low risk with PPE). Motoring for 14 days for symptoms. Right now no restriction if no symptoms. Local Health department can ask for more conservative.
Will there be a designated hospital treatment list like for Ebola? No, all Healthcare facilities need to be prepared for new threats including novel coronavirus. Follow-up asking about 14 days? Longest time to get symptoms
Standard contact precautions, N95 + Eye protection for PPE is recommended. Full suit not needed. Correct donning and doffing most important. Again recommendation not to do a sputum induction due to creating aerosols.
Regarding family members recently return from China, OK to stop visiting other patients? Check with local health department, no restrictions though for asymptomatic. Only concern would be within 14 days and symptomatic.
Is CDPH monitoring PPE? Notified of shortages with recent order. We are aware of issue around PPE one of key roles at CDPH is a good snapshot of needs so please reply to survey. If you are a HCF and anticipate issues please email the norovirus email below to let CDPH know.
Is there a point we would recommend full-time masking of frontline HCW? At this point CDC has not seen evidence yet that this is needed. Monitoring close contacts of US cases to see risk level. Asymptomatic carriers have not in past lead to full blown epidemics.
Expanding travel history question to expand to China in general rather than just Wuhan? Risk is considering all of china so we anticipate a change in PUI criteria. Posters were already updated.
If we have a patient that has PUI and the room is not negative pressure how long? Yes still 1 hour to turn over room air with door closed then standard environmental cleaning.
Ontario airport has flight coming in today or tomorrow from China? US state department and HHS have been learning efforts, CDPH is ready to welcome. We will share more details as they become available.
Private providers are seeing providers and are sending to hospital and this is overwhelming nearby medical centers. CDPH is working on reaching out to individual providers. Also encourage to work with your local health department to engage and provide additional guidance.
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