• The CDC clinical criteria to guide evaluation of persons under investigation (PUI) for COVID-19 has been updated (02/27/2020), https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html
• Healthcare providers should immediately notify both infection control personnel at their healthcare facility and the Fairfax County Health Department at 703-409-8449 in the event of PUI for COVID-19.
• Obtain a detailed travel history for all patients being evaluated with fever and acute respiratory illness.
• Healthcare personnel caring for patients with confirmed or possible COVID-19 should adhere to CDC recommendations for infection prevention and control (IPC):
- Assess and triage patients with acute respiratory symptoms and risk factors for COVID-19 to minimize chances of exposure, including placing a facemask on the patient and isolating them in an Airborne Infection Isolation Room (AIIR), if available.
- Use Standard Precautions, Contact Precautions, and Airborne Precautions and eye protection when caring for patients with confirmed or possible COVID-19.
- Perform hand hygiene with alcohol-based hand rub before and after all patient contact, contact with potentially infectious material, and before putting on and upon removal of PPE, including gloves. Use soap and water if hands are visibly soiled.
- Practice how to properly don, use and doff PPE in a manner to prevent self-contamination.
- Perform aerosol-generating procedures, including collection of diagnostic respiratory specimens, in an AIIR, while following appropriate IPC practices, including use of appropriate PPE.
• If a patient with respiratory illness meets criteria for a PUI and for COVID-19 testing, contact FCHD (703-409-8449) to discuss the patient and obtain concurrence for specimen testing.
- Three specimens need be collected, stored and shipped at 4°C:
- lower respiratory tract specimen (Sputum [induced not indicated] or 2-3mL bronchoalveolar lavage or tracheal aspirate)
- upper respiratory tract specimen (nasopharyngeal (NP) swab and oropharyngeal (OP) swab in separate vials of VTM or 2-3 mL nasopharyngeal wash/aspirate or 2-3 mL nasal aspirate).
- combined NP/OP swab in VTM
• For more information on this rapidly evolving situation, call FCHD at 703-409-8449 and visit the CDC’s COVID-19 webpage https://www.cdc.gov/coronavirus/2019-nCoV.