Physician Advisory

Materials selected from multiple websites, mainly from CDC, IDPH and CDPH (MR)

Report suspect COVID-19 cases to CDPH immediately (within 3 hours) by calling 312-746-SICK (7425) Monday through Friday during business hours or 311 during evenings, weekends, and holidays.

Co powinni robić lekarze czy inne jednostki opieki zdrowotnej?

Lekarze, i inni Health Care Providers powinni niezwłocznie zgłaszać podejrzane przypadki COVID-19 (w ciągu 3 godzin) do Chicago Dept. of Public Health lokalnego oddziału zdrowia, który powinien zgłosić przypadki do IDPH w tym samym czasie. Zalecenia i wskazówki można znaleźć na stronie Coronavirus IDPH lub na stronie internetowej CDC Novel Coronavirus 2019.

 

Co wydziały zdrowia publicznego w Illinois robią z tą sytuacją?

IDPH i lokalne oddziały zdrowia wdrożyły wzmożony nadzór w celu zidentyfikowania i przetestowania pacjentów, u których istnieje prawdopodobieństwo wystąpienia COVID-19. Eksperci ds. Zdrowia publicznego komunikują się i edukują świadczeniodawców oraz innych partnerów zdrowia publicznego na temat obecnej sytuacji. Opracowywane są środki zapobiegające rozprzestrzenianiu się choroby w Illinois. Częsta komunikacja ze społeczeństwem będzie dostępna za pośrednictwem strony IDPH Coronavirus.

 

https://www.cdc.gov/coronavirus/2019-ncov/php/guidance-evaluating-pui.html

Interim Guidance for Public Health Personnel Evaluating Persons Under Investigation (PUIs) and Asymptomatic Close Contacts of Confirmed Cases at Their Home or Non-Home Residential Settings

As part of the risk assessment and public health management of persons with potential COVID-19, public health personnel will typically conduct interviews and assess these individuals for fever or other symptoms of COVID-19. In certain circumstances they will also obtain respiratory specimens. This guidance is intended to address recommended infection prevention and control practices when these activities are performed at a home or non-home residential settings, which warrant additional considerations beyond those described for healthcare settings.

For recommendations on the evaluation of PUIs in healthcare settings refer to the Interim Infection Prevention and Control Recommendations for Patients with Confirmed Coronavirus Disease 2019 (COVID-19) or Persons Under Investigation for COVID-19 in Healthcare Settings.

Interviewing and assessing persons with symptoms (PUIs for COVID-19):

  • Make every effort to interview the PUI by telephone, text monitoring system, or video conference.
    • Temperature monitoring could be reported by phone or shown to a provider via video conferencing.
  • If public health personnel must interview a PUI in their home, the public health personnel should wear recommended personal protective equipment (PPE), including a gown, gloves, eye protection (e.g., goggles, a disposable face shield that covers the front and sides of the face), and respiratory protection that is at least as protective as a NIOSH-approved N95 filtering facepiece respirator, as recommended in the Interim Infection Prevention and Control Recommendations for Patients with Confirmed Coronavirus Disease 2019 (COVID-19) or Persons Under Investigation for COVID-19 in Healthcare Settings.
    • Hand hygiene should be performed before putting on and after removing PPE using alcohol-based hand sanitizer that contains 60 to 95% alcohol.
    • PPE should ideally be put on outside of the home prior to entry into the home.
      • If unable to put on all PPE outside of the home, it is still preferred that face protection (i.e., respirator and eye protection) be put on before entering the home. Alert persons within the home that the public health personnel will be entering the home and ask them to move to a different room, if possible, or keep a 6-foot distance in the same room. Once the entry area is clear, enter the home and put on a gown and gloves.
    • Ask PUI if an external trash can is present at the home, or if one can be left outside for the disposal of PPE.
    • PPE should ideally be removed outside of the home and discarded by placing in external trash can before departing location. PPE should not be taken from the PUI’s home in public health personnel’s vehicle.
      • If unable to remove all PPE outside of the home, it is still preferred that face protection (i.e., respirator and eye protection) be removed after exiting the home. If gown and gloves must be removed in the home, ask persons within the home to move to a different room, if possible, or keep a 6-foot distance in the same room. Once the entry area is clear, remove gown and gloves and exit the home. Once outside the home, perform hand hygiene with alcohol-based hand sanitizer that contains 60 to 95% alcohol, remove face protection and discard PPE by placing in external trash can before departing location. Perform hand hygiene again.

Interviewing and assessing persons without symptoms (asymptomatic close contacts who have been exposed to a lab-confirmed case of COVID-19):

  • Make every effort to interview the asymptomatic close contact by telephone, text monitoring system, or video conference.
    • Temperature monitoring could be reported by phone or shown to a provider via video conferencing.
  • If public health personnel must interview the asymptomatic close contact in person, the public health personnel should stay at least 6 feet away from the asymptomatic close contact and ask them if they have had fevers or respiratory symptoms. If the interview and assessment is occurring in the home environment, the public health personnel should not enter the home until these questions have been asked and the asymptomatic close contact has been determined to be afebrile by temperature measurement.
    • If the asymptomatic close contact reports fever or symptoms, they should be considered a PUI and referred for further medical evaluation as appropriate. Public health personnel should document temperature measurement and description of symptoms.
  • If the asymptomatic close contact does not report fever or symptoms, they should be instructed to take their own temperature and report the result. If the asymptomatic close contact denies symptoms and fever is not detected, it remains appropriate to stay at least 6 feet away during further interactions even if entering the home environment. If they are not able to take their own temperature, the public health personnel should:
    • Perform hand hygiene
    • Put on a facemask and eye protection (consider adding gloves if entering the asymptomatic close contact’s home)
    • Proceed with checking the asymptomatic close contact’s temperature
    • Remove and discard PPE
    • Perform hand hygiene using alcohol-based hand sanitizer that contains 60 to 95% alcohol

Diagnostic respiratory specimen collection for all individuals (i.e., PUIs for COVID-19 or asymptomatic) at home:

  • Testing for the virus that causes COVID-19 should be conducted outdoors if climate allows. If conducted in the home, specimen collection should be performed in the area of the house where the individual being tested self-isolates.
    • Only the public health personnel and individual being tested should be in the room when testing is performed.
    • Collecting diagnostic respiratory specimens (e.g., nasopharyngeal swab) is likely to induce cough or sneezing.
    • Non-aerosol-generating procedures should be performed before aerosol-generating procedures. Aerosol-generating procedures should be the last activity performed just before leaving the home.
  • Public health personnel collecting specimens should wear recommended PPE, including a gown, gloves, eye protection, and respiratory protection that is at least as protective as a NIOSH-approved N95 filtering facepiece respirator, as recommended in the Interim Infection Prevention and Control Recommendations for Patients with Confirmed Coronavirus Disease 2019 (COVID-19) or Persons Under Investigation for COVID-19 in Healthcare Settings.
    • Hand hygiene should be performed before putting on and after removing PPE using alcohol-based hand sanitizer that contains 60 to 95% alcohol.
    • PPE should ideally be put on outside of the home prior to entry into the home
      • If unable to put on all PPE outside of the home, it is still preferred that face protection (i.e., respirator and eye protection) be put on before entering the home. Alert persons within the home that the public health personnel will be entering the home and ask them to move to a different room, if possible, or keep a 6-foot distance in the same room. Once the entry area is clear, enter the home and put on a gown and gloves.
    • Ask person being tested if an external trash can is present at the home, or if one can be left outside for the disposal of PPE.
    • PPE should ideally be removed outside of the home and discarded by placing in external trash can before departing location. PPE should not be taken from the home of the person being tested in public health personnel’s vehicle.
      • If unable to remove all PPE outside of the home, it is still preferred that face protection (i.e., respirator and eye protection) be removed after exiting the home. If gown and gloves must be removed in the home, ask persons within the home to move to a different room, if possible, or keep a 6-foot distance in the same room. Once the entry area is clear, remove gown and gloves and exit the home. Once outside the home, perform hand hygiene with alcohol-based hand sanitizer that contains 60 to 95% alcohol, remove face protection and discard PPE by placing in external trash can before departing location. Perform hand hygiene again.

Page last reviewed: February 24, 2020

Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Disease

 

 

March 4, 2020

Criteria to Guide Evaluation of PUI for COVID-19

As availability of diagnostic testing for COVID-19 increases, clinicians will be able to access laboratory tests for diagnosing COVID-19 through clinical laboratories performing tests authorized by FDA under an Emergency Use Authorization (EUA). Clinicians will also be able to access laboratory testing through public health laboratories in their jurisdictions.

This expands testing to a wider group of symptomatic patients. Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Decisions on which patients receive testing should be based on the local epidemiology of COVID-19, as well as the clinical course of illness. Most patients with confirmed COVID-19 have developed fever1 and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing). Clinicians are strongly encouraged to test for other causes of respiratory illness, including infections such as influenza.

Epidemiologic factors that may help guide decisions on whether to test include: any persons, including healthcare workers2, who have had close contact3 with a laboratory-confirmed4 COVID-19 patient within 14 days of symptom onset, or a history of travel from affected geographic areas5 (see below) within 14 days of symptom onset.

 

 

Chicago Department of Public Health

https://www.chicago.gov/city/en/depts/cdph/provdrs/health_protection_and_response/svcs/2019-novel-coronavirus–2019-ncov-.html

 

The Chicago Department of Public Health (CDPH) continues to work closely with the U.S. Centers for Disease Control and Prevention and other federal, state and local partners to monitor and respond to the Coronavirus Disease 2019 (COVID-19) outbreak. There have been five Illinois residents who have so far tested positive for COVID-19 and current information suggests that person-to-person spread will continue to occur and more cases might be identified in the United States, including in Chicago. CDPH’s goal is to reduce the impact of COVID-19 in Chicago by detecting new cases quickly, minimizing transmission and developing guidance to prepare communities to respond.

The virus is NOT currently spreading widely in the U.S. and the immediate health risk to the general public from the virus causing COVID-19 remains low both in the U.S. and in Chicago. However, there are steps individuals and communities can take to help minimize the risk of COVID-19 spread:

  • Practice everyday preventive actions such as performing frequent hand hygiene, washing your hands with soap and water for at least 20 seconds (especially when hands are visibly soiled) or using an alcohol-based hand sanitizer that contains 60%–95% alcohol; covering your cough and sneeze; avoiding ill people; and staying home when sick (except to seek medical care). These simple actions can prevent the spread of many illnesses, including COVID-19. For more information, see CDPH’s Guidance for Individuals and Households.
  • It’s currently flu and respiratory disease season and CDPH recommends getting a flu vaccine and taking everyday preventive actions to help stop the spread of illness. Go to your doctor, pharmacy, or www.ChicagoFluShots.org to learn where to get a flu shot.
  • Healthcare providers should continue to ask patients with fever and respiratory symptoms about their travel history. Refer to CDC’s Guidance for Healthcare Professionals for more information on screening and evaluating Persons Under Investigation.
  • Childcare facilities, K-12 schools and colleges/universities should review their emergency operations plans, including strategies for social distancing and online learning. Schools should consider postponing or canceling student foreign exchange programs. See CDPH’s COVID-19 Guidance for Childcare Programs and COVID-19 Guidance for Schools and Institutions of Higher Education.
  • Businesses and employers should actively encourage all employees to stay home when sick, perform hand hygiene, and cover coughs and sneezes. Businesses should review their emergency operations plan, including identification of essential business functions, teleworking and flexible sick leave policies. For more information, see CDPH’s COVID-19 Guidance for Businesses and Employers.
  • Community- and faith-based organizations should review existing emergency operations plans, including strategies for social distancing and modifying large gatherings such as concerts and festivals. See CDPH’s COVID-19 Guidance for Community- and Faith-based Organizations and CDC’s Interim Guidance: Get Your Mass Gatherings or Large Community Events Ready for COVID-19.
  • Help reduce the spread of rumors. Let people know that viruses cannot target people from specific populations, ethnicities, or racial backgrounds. Being of Asian descent does not increase the chance of getting or spreading COVID-19.
  • Fight stigma and fear by supporting people who may be coming back to school or work after traveling internationally or completing a quarantine or isolation period for COVID-19.

Travelers returning from any country with a Travel Alert Level 3 should stay home and monitor their health for up to 14 days. Please follow instructions during this time. Your cooperation is integral to the ongoing public health response to try to slow the spread of this virus.

  • Do not go to school or work. Absences for this purpose should be excused and alternate arrangements should be made for teleworking and online school assignments.
  • Take your temperature with a thermometer 2 times a day and watch your health.
  • If you develop a fever (100.4F/38C) or cough, seek medical care right away. Call ahead before going to a doctor’s office or emergency room. Tell them your symptoms and that you were in an affected area. You could also call CDPH at 312-746-7425 (SICK) during business hours, after hours call 311 and request to speak to the Medical Director on call. In the case of a medical emergency, call 911.

Travelers returning from any country with a Travel Alert Level 2 are also encouraged to monitor their health but do not need to limit their movement or activity. If you develop COVID-19 symptoms, contact your healthcare provider, and tell them about your symptoms and your recent travel to an area with community spread of COVID-19.

If you are a healthcare provider, report suspect COVID-19 cases immediately (within 3 hours) to CDPH by calling 312-746-SICK (7425) Monday through Friday during business hours or 311 during evenings, weekends, and holidays. For more information, see Interim Guidance for Healthcare Professionals.

 

Frequently Asked Questions

What is Coronavirus Disease 2019 (COVID-19)?

Coronavirus disease 2019 (COVID-19) is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified during an investigation into an outbreak in Wuhan, China. Coronaviruses are a large family of viruses that are common in many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS-CoV, SARS-CoV, and now with SARS-CoV-2.

Cases of COVID-19 have now been detected in 60 locations internationally, including in the U.S. During the week of February 23, CDC reported community spread of the virus that causes COVID-19 in California (in two places), Oregon and Washington. Community spread in Washington resulted in the first death in the United States from COVID-19, as well as the first reported case of COVID-19 in a health care worker, and the first potential outbreak in a long-term care facility. The latest situation summary updates are available on CDC’s web page Coronavirus Disease 2019 (COVID-19).

What is the current risk assessment?

  • For the general American public, who are unlikely to be exposed to this virus at this time, the immediate health risk from COVID-19 is considered low.
  • People in communities where ongoing community spread with the virus that causes COVID-19 has been reported are at elevated though still relatively low risk of exposure.
  • Healthcare workers caring for patients with COVID-19 are at elevated risk of exposure.
  • Close contacts of persons with COVID-19 also are at elevated risk of exposure.
  • Travelers returning from affected international locations where community spread is occurring also are at elevated risk of exposure.

What are the symptoms?

Patients who get sick with COVID-19 develop mild to severe respiratory illness with symptoms of:

  • fever
  • cough
  • difficulty breathing

CDC believes at this time that symptoms of COVID-19 may appear in as few as 2 days or as long as 14 days after exposure.

How does it spread?

Although the virus that causes COVID-19 probably emerged from an animal source, it is thought to spread mainly from person-to-person via respiratory droplets produced when an infected person coughs or sneezes. People are thought to be most contagious when they are most symptomatic (the sickest).

How is it treated?

There is no specific medicine to treat COVID-19 infection at this time, though studies are underway. People sick with COVID-19 should receive supportive care from a health care professional. Supportive care means care to help relieve symptoms; for example, medicine to bring down fevers, or oxygen if a patient’s oxygen level is low.

How is COVID-19 diagnosed?

Diagnosis occurs through laboratory testing of respiratory specimens and serum (blood). Some coronavirus strains cause the common cold and patients tested by their health care provider may test positive for these types. The COVID-19 strain can only be detected at a public health laboratory.

How can I protect myself and my family?

As with any respiratory virus, you can protect yourself and others by taking everyday common sense actions:

  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.

Remember that it is also flu season and CDPH recommends getting vaccinated, taking everyday preventive actions to stop the spread of germs, and taking flu antivirals if prescribed. For more information, see www.chicago.gov/flu.

Do I need to wear a mask?

CDPH does not recommend that people who are well wear a face mask to protect themselves from respiratory diseases, including COVID-19. Face masks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).

What can travelers do to protect themselves and others?

CDPH strongly recommends avoiding travel to countries with level 3 travel notices, including layovers at airports, because there is widespread sustained transmission of COVID-19 in these countries and the risk of acquiring the virus is high. Because COVID-19 can be more serious in older adults and those with chronic medical conditions, people in these groups should also consider postponing travel to destinations with level 2 travel notices. CDPH does not recommend canceling or postponing travel to destinations with level 1 travel notices because the risk of COVID-19 is thought to be low. If you travel, take the following routine precautions:

  • Avoid contact with sick people.
  • Avoid touching your eyes, nose, or mouth with unwashed hands.
  • Clean your hands often by washing them with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer that contains 60%–95% alcohol. Soap and water should be used if hands are visibly dirty.
    • It is especially important to clean hands after going to the bathroom; before eating; and after coughing, sneezing or blowing your nose.

The latest travel updates are available on CDC’s COVID-19 web page for travelers.

What if I recently traveled to an area affected by COVID-19 and got sick?

If you were in a country with a COVID-19 outbreak and feel sick with fever, cough, or difficulty breathing, within 14 days after you left, you should

  • Seek medical advice – Call ahead before you go to a doctor’s office or emergency room. Tell them about your recent travel and your symptoms.
  • Avoid contact with others.
  • Not travel on public transportation while sick.
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
  • Wash hands often with soap and water for at least 20 seconds to avoid spreading the virus to others.
  • Wash your hands with soap and water immediately after coughing, sneezing or blowing your nose.
  • If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains 60%–95% alcohol. Always wash hands with soap and water if hands are visibly dirty.

What are the recommendations for healthcare providers?

If you are a healthcare provider, be on the look-out for:

  • People who recently traveled from China or another affected area and who have symptoms associated with COVID-19, and
  • People who have been in close contact with someone with COVID-19 or pneumonia of unknown cause. (Consult the most recent definition for patients under investigation [PUIs].)

Report suspect COVID-19 cases to CDPH immediately (within 3 hours) by calling 312-746-SICK (7425) Monday through Friday during business hours or 311 during evenings, weekends, and holidays.

If you are a healthcare provider caring for a COVID-19 patient, please take care of yourself and follow recommended infection control procedures. For more information, see CDC’s Interim Guidance for Healthcare Professionals.

 

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