COVID-19 Health Alert # 1:
Activation of the Health Alert Network for Urgent Updates about COVID-19 from the Wisconsin Department of Health Services
Bureau of Communicable Diseases, March 17, 2020
- Wisconsin medical providers, public health officials and preparedness personnel are encouraged to subscribe to the HAN for rapidly changing guidance and alerts related to COVID-19
- Return to Work Criteria for Health Care Personnel with Confirmed or Suspected COVID-19
- Return to Work Criteria for Health Care Personnel with Exposure to COVID-19 related to patient care or travel
DHS Health Alert Network (HAN) is now activated
Wisconsin Department of Health Services (DHS) has established the HAN to facilitate dissemination of frequently changing guidance and recommendations, and to provide critical COVID-19 updates to health care, public health, and other governmental partners. The HAN will be the primary method for sharing time-sensitive public health information with partners during the COVID-19 response. Health care providers and other officials engaged in the COVID-19 response have been automatically subscribed to the HAN. Individuals can subscribe and unsubscribe using their preferred email address at the DHS COVID-19 website.
New CDC Guidance about Return to Work for Health Care Personnel with Confirmed or Suspected COVID-19
CDC has issued updated interim guidance describing two strategies for determining when health care personnel may return to work when they have laboratory confirmed COVID-19, or who have suspected COVID-19 (e.g., developed symptoms of a respiratory infection but did not get tested for COVID-19). The two strategies are:
1.Test-based strategy. Exclude from work until
- Resolution of fever without the use of fever-reducing medications and
- Improvement in respiratory symptoms (e.g., cough, shortness of breath), and
- Negative results of an FDA Emergency Use Authorized molecular assay for COVID-19 from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of two negative specimens)
2. Non-test-based strategy. Exclude from work until
- At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
- At least 7 days have passed since symptoms first appeared
When Should Health Care Workers be Excluded from Work Because of Potential Exposure to COVID-19?
CDC published interim guidance on March 7, 2019, providing a framework for assessing the risk of COVID-19 based on different types of exposures in health care settings. Recommendations for excluding staff from work depend on whether the exposure is considered high, medium, or low-risk. In general, HCP with medium and high-risk exposure should be excluded from work for 14 days during which they should monitor for symptoms and/or fever in coordination with their local health department. However, for hospitals that would suffer significant staffing shortages that would compromise their ability to adequately care for patients, HCP with medium-risk exposures may continue to see patients if wearing appropriate personal protective equipment (PPE) and completing a daily check of symptoms in coordination with their employee health department. DHS does not recommend requiring a negative COVID-19 test prior to returning to work for asymptomatic HCP.
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Exposure Risk Level
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Recommended exclusion
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Recommended exclusion during staffing shortage
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Monitoring
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High
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14 days
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14 days if feasible
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Daily monitoring by LHD
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Medium
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14 days
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None, but must wear PPE during patient care activities
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Daily monitoring by LHD or self-monitoring with delegated supervision if working
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Low
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None
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None
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Self-monitoring with delegated supervision
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*Delegated supervision: HCP should report daily symptom and/or temperature checks to occupational health to be cleared for work
Should Health Care Workers be Excluded from Work Because of Travel to Areas with known Community Transmission?
At this time, health care organizations are encouraged to enact policies to restrict work-related travel for essential clinical staff, to reduce potential exposure to COVID-19. Clinical staff who have traveled to areas with Level 3 Travel Health Notices should be advised to follow recommendations to stay home from work, practice social distancing, and monitor symptoms for 14 days. Travelers returned from specific U.S. States known to have high levels of community transmission (e.g., Washington, New York, Florida) may also be assumed to have high risk of exposure, and should receive similar recommendations for social distancing, as staffing resources allow. If health care organizations determine that staffing shortages are present, asymptomatic health care workers with travel related exposure may return to work with similar precautions to those with medium or high-risk exposures to laboratory-confirmed COVID-19 patients. These precautions include:
- Wear a facemask at all times while in the healthcare facility for 14 days after exposure occurred
- Be restricted from contact with severely immunocompromised patients (e.g., transplant, hematology-oncology) until 14 days after exposure
- Adhere to hand hygiene, respiratory hygiene, and cough etiquette in CDC’s interim infection control guidance(e.g., cover nose and mouth when coughing or sneezing, dispose of tissues in waste receptacles)
- Self-monitor for symptoms, and seek evaluation from occupational health if any respiratory symptoms occur
For More Information
Please contact DHSResponse@dhs.wisconsin.gov with questions regarding this update. A team of DHS staff is monitoring the inbox. We will use the incoming questions to update our FAQs and guidance.
The content of this message is intended for public health and health care personnel and response partners who have a need to know the information to perform their duties.
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