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Global Health Outbreaks and Updates

COVID19 Infection Control

COVID 19 Infection Control and Prevention

  • The best way to prevent the virus is to avoid being exposed[1]
  • Stay away from sick people
  • Avoid touching your eyes, noes and mouth
  • Cover your cough and sneezes, throw tissues into the trash
  • Clean frequently touched surfaces (door knobs, counter tops, banisters) with a common household cleaning spray or wipe.
  • Handwashing with soap and water for 20 seconds or alcohol (60%) based hand sanitizers
  • There are current efforts for vaccine creation and prophylactic medications (see below)
  • The virus is spread via respiratory droplets from nose of mouth of infected people[2]
  • Droplets can land on surfaces
  • Other people can touch these surfaces and infect themselves by touching their face, eyes, nose or mouth
  • Healthy people in the general public have no benefit from wearing masks[3]
  • Infection control for healthcare workers[4]
  • Take steps to ensure all persons with symptoms of suspected COVID-19 or other respiratory infection (e.g., fever, cough) adhere to respiratory hygiene and cough etiquette, hand hygiene, and triage procedures throughout the duration of the visit.
  • Ensure that patients with symptoms of suspected COVID-19 or other respiratory infection (e.g., fever, cough) are not allowed to wait among other patients seeking care.  Identify a separate, well-ventilated space that allows waiting patients to be separated by 6 or more feet, with easy access to respiratory hygiene supplies.
  • Identify patients at risk for having COVID-19 infection before or immediately upon arrival to the healthcare facility.
  • Inform infection prevention and control services, local and state public health authorities, and other healthcare facility staff as appropriate about the presence of a person under investigation for COVID-19
  • Place a patient with known or suspected COVID-19 in an Airborne infection isolation room (AIIR) that has been constructed and maintained in accordance with current guidelines.
  • AIIRs are single patient rooms at negative pressure relative to the surrounding areas, and with a minimum of 6 air changes per hour (12 air changes per hour are recommended for new construction or renovation). Air from these rooms should be exhausted directly to the outside or be filtered through a high-efficiency particulate air (HEPA) filter before recirculation. Room doors should be kept closed except when entering or leaving the room, and entry and exit should be minimized. Facilities should monitor and document the proper negative-pressure function of these rooms.
  • If an AIIR is not available, patients who require hospitalization should be transferred as soon as is feasible to a facility where an AIIR is available. If the patient does not require hospitalization they can be discharged to home (in consultation with state or local public health authorities) if deemed medically and socially appropriate. Pending transfer or discharge, place a facemask on the patient and isolate him/her in an examination room with the door closed. Ideally, the patient should not be placed in any room where room exhaust is recirculated within the building without HEPA filtration.
  • Once in an AIIR, the patient’s facemask may be removed. Limit transport and movement of the patient outside of the AIIR to medically-essential purposes. When not in an AIIR (e.g., during transport or if an AIIR is not available), patients should wear a facemask to contain secretions.
    • Facilities should keep a log of all persons who care for or enter the rooms or care area of these patients.
  • Gloves
    • Perform hand hygiene, then put on clean, non-sterile gloves upon entry into the patient room or care area. Change gloves if they become torn or heavily contaminated.
    • Remove and discard gloves when leaving the patient room or care area, and immediately perform hand hygiene.
  • Gowns
    • Put on a clean isolation gown upon entry into the patient room or area. Change the gown if it becomes soiled. Remove and discard the gown in a dedicated container for waste or linen before leaving the patient room or care area. Disposable gowns should be discarded after use. Cloth gowns should be laundered after each use.
  • Respiratory Protection
    • Use respiratory protection (i.e., a respirator) that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator before entry into the patient room or care area. See appendix for respirator definition.
    • Disposable respirators should be removed and discarded after exiting the patient’s room or care area and closing the door. Perform hand hygiene after discarding the respirator.
    • If reusable respirators (e.g., powered air purifying respirator/PAPR) are used, they must be cleaned and disinfected according to manufacturer’s reprocessing instructions prior to re-use.
    • Respirator use must be in the context of a complete respiratory protection program in accordance with Occupational Safety and Health Administration (OSHA) Respiratory Protection standard (29 CFR 1910.134external icon). Staff should be medically cleared and fit-tested if using respirators with tight-fitting facepieces (e.g., a NIOSH-certified disposable N95) and trained in the proper use of respirators, safe removal and disposal, and medical contraindications to respirator use.
  • Eye Protection
    • Put on eye protection (e.g., goggles, a disposable face shield that covers the front and sides of the face) upon entry to the patient room or care area. Remove eye protection before leaving the patient room or care area. Reusable eye protection (e.g., goggles) must be cleaned and disinfected according to manufacturer’s reprocessing instructions prior to re-use.  Disposable eye protection should be discarded after use.
  • Healthcare workers should revisit their procedures for donning, doffing and disposing their PPE[5]
  • Assume every person is potentially infected or colonized with a pathogen that could be transmitted in the health care setting.
  • Strict contact, airborne and eye protection should be used for healthcare workers

 

[1] https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html

[2] https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

[3] https://www.ama-assn.org/delivering-care/public-health/covid-19-6-key-points-physicians-should-share-patients

[4] https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Finfection-control.html

[5] https://www.ama-assn.org/delivering-care/public-health/8-ways-protect-doctors-caring-patients-covid-19

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