Sharing a few key points presented on March 17th’s CDC Clinician Outreach and Communication Activity (COCA) Webinar:
Additional resources, recording of this call and upcoming webinar (Monday) announcements at coca@cdc.gov
Ongoing updates and resources: https://www.cms.gov/outreach-education/partner-resources/coronavirus-covid-19-partner-toolkit
Presenters:
Dr Brendan Jackson
Medical Epidemiologist
CDC COVID-19 Response Clinical Team (CDC)
LCDR Kara M Jacobs Slifka, MD
Medical Officer
CDC COVI -19 Infection Prevention and Control Response Team
Recognizing COVID-19:
Incubation period on average is 4-5 days but can be as little as 2 and as long as 14 days
Signs and Symptoms:
Fever, cough, fatigue, diarrhea, nausea, respiratory symptoms
80% experience mild symptoms
Most do not experience a runny nose
Often conditions take a quick decline after a week or so when the lungs begin to fill with fluid – may not have had shortness of breath prior to the downturn
20-30% require ICU for respiratory support
Often combined with influenza and may present with a normal chest x-ray early on
Mortality Rate: (worsened by underlying chronic health conditions and obesity)
- 30 y.o. – 1/500
- 60 y.o. – 1/12
- 80 y.o. – 1/7
Long Term Care Special Considerations:
Higher mortality rate
Not all present with fever – may experience confusion and malaise
Educate all team members on signs and symptoms, Vital Signs and Pulse Oximetry
Check all residents upon admission and at least twice daily for signs and symptoms – check temp, Pulse Oximetry and signs/symptoms
Infection control KEY
If COVID-19 is found in the building – increase frequency of checks for all residents
Management and Treatment:
There are no treatments specific to COVID-19
Use caution with IV fluids – do not want to overload system and end up with increased fluid on the lungs
Watch for secondary infections which may be present
Strategies to Decrease Risk (utilize CDC Preparedness checklist on the CDC webpage):
Restrict visitation of all Non-Essential personnel
Immediate restriction of all visitation
Screening at the door – no one ill allowed in. Temp Check and Questionnaire Required.
Template letter available from CDC explaining actions to be taken for family and visitors
Post notification outside of the building
Group Distancing – 6’ apart - communal dining and activities cancelled
Staff health a priority – stay home if ill. Regularly monitor for fever and symptoms.
Staff health - avoid groupings of 10 or more people, eliminate unnecessary travel
If symptoms arise for staff members: mask, notify facility and go home
PPE Shortage is real: Assess inventory now, Know health department and coalition contact #’s
Clean between patients: blood pressure cuffs, hoyer lifts, pulse oximeters… any multi pt devices used
Preserve supply of PPE – check the CDC website for tips – mentioned, utilizing same face mask and eye wear per caregiver -do not touch – sanitize hands before and after putting on and taking off
If symptoms arise in patients:
Isolate in single room with private bath if possible – close the door
All staff mask, gown and glove, eye protection & sanitize
Decision to Hospitalize determined based on clinical assessment - if needs can be met - care for in place
Airborne Infection Isolation rooms are not required to care for COVID-19 cases
Let's Get to the Point:
Thank you for caring for our highest risk population!
Information is continually being updated. Please keep your questions and helpful ideas coming!