At this point the Orange County Health Care Agency (OCHCA) will only be conducting investigations of cases identified in hospitalized patients, health care workers, and residents of congregate living facilities. Providers should inform their patients of test results and give them education on disease prevention and monitoring for worsening disease (see below for more details). Providers should inform their outpatients who test positive of their results and deliver the following messages:
- Duration of isolation: self-isolate for at least 7 days after illness onset; must have no fever (without use of antipyretics) for at least 72 hours AND have symptom improvement to be released from isolation. Clearance testing is no longer recommended. Instruct patient to not leave the house during this time, except for urgently needed medical care (call ahead to alert facility of COVID+ status); have friends or family members run errands as needed.
- Prevent transmission in the household: separate from family members as much as possible; stay in a separate bedroom and use a separate bathroom, have meals delivered to the bedroom and do not spend time in same room as family members without a mask. Open windows (weather permitting) to increase ventilation. Do not allow visitors to come into the home.
- Monitor for severe disease: warning signs of more severe disease include shortness of breath, chest pain, weakness and confusion. Clinical decompensation tends to occur in second or third week of illness. Help patient decide where he/she would go for further evaluation if needed.
- Management of household members: household members with close contact to the patient while symptomatic should be quarantined at home for 10 days beyond last unprotected contact with patient (i.e, since admission to hospital or separation into a different room). People on quarantine can leave the house on errands to get food, medicines or other essentials, or to exercise, but should avoid close contact with others as much as possible. They also should monitor themselves for fever, cough, body aches or other symptoms, and isolate themselves if such symptoms occur.
- Inform contacts: ask patients to notify people they have had prolonged close contact with while they were having symptoms.