March 4, 2020

TO: ACCMA Members

East Bay physicians should be advised that local public health officials are preparing for COVID-19 to become more widespread in the coming days and weeks:

  • Contra Costa County - Yesterday (3/3/20), local health officials confirmed that an adult male patient tested positive for COVID-19. The county’s public health lab conducted the test, which is expected to be confirmed by the CDC in the coming days. According to public health officials, the patient has no known travel history and no known contact with anyone else confirmed to have COVID-19. In a letter issued Monday, Contra Costa County officials indicated that they are “shifting from actions to contain the COVID-19 virus to preparing for a sustained response, including future measures to limit and slow the spread of the disease in our community.”

  • Alameda County - Yesterday (3/3/20), local health officials announced that a presumptive case of COVID-19 was detected in an Alameda County resident who had contact with a case in another jurisdiction. The announcement also stated that “cases of COVID-19 in the Bay Area indicate local community transmission, and warrant public health and healthcare providers in Alameda County to continue preparing for increasing numbers of identified cases and a surge of patients.” In a letter issued last Friday, Alameda County officials asked businesses and employers “to plan now for how best to decrease the spread of illness and lower the impact of COVID-19.” 

In addition, the California Medical Association (CMA) released a letter today calling on Governor Newsom to implement a range of mitigation strategies, including asking the Governor to immediately declare a state of emergency. CMA concluded that “containment of COVID-19 is no longer possible given clear evidence of community transmission outside of the hospital containment zones.” 

In an effort to assist ACCMA members with efforts to prepare for increased community transmission of COVID-19, the ACCMA has compiled the following resources for ACCMA members and their practices. 

This information will also be posted online at www.accma.org/COVID-19   and will be updated frequently. Please check the ACCMA website regularly for updates.  
CDC Guidance for Providers Treating People Under Investigation (PUI) for COVID-19

CDC updated their Criteria to Guide Evaluation of PUI for COVID-19 today (3/4/20): “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 fever 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 workers, who have had close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset, or a history of travel from affected geographic areas within 14 days of symptom onset.”

Physicians should regularly consult the CDC website for the latest criteria.
Providers with a patient who is suspected of meeting screening criteria should contact their local public health department to coordinate specimen collection and testing:

Alameda County Public Health Department Communicable Disease Section at (510) 267-3250 from 8:30 AM - 5:00 PM on weekdays. After hours calls should be directed to (925) 422-7595 and ask for the public health duty officer on call.
 
Contra Costa Public Health Department : (925) 313-6740. After hours calls should be directed to the Sherrif's Dispatch at (925) 646-2441. 

City of Berkeley Public Health:  (510) 981-5300.
This information will also be posted online at   www.accma.org/COVID-19  and will be updated frequently. Please check the ACCMA website regularly for updates. 

If you have any additional questions, please contact the ACCMA at (510) 654-5383.