COVID-19 Update – April 6, 2020
Isolation and Quarantine Orders to Patients with Suspected COVID-19 and
Alameda County EMS Interaction and Transfer of Care Guidance

As of April 6, there are 588 confirmed cases of COVID-19 in Alameda County and 13 deaths (including City of Berkeley information). As of April 6, there are 417 confirmed cases of COVID-19 in Contra Costa County and 7 deaths. Please check  www.accma.org/COVID-19  for the latest updates.    
LOCAL UPDATES

Health Care Providers to Disseminate Isolation and Quarantine Orders to Patients with Suspected COVID-19 and Their Close Contacts 
  
On April 3, 2020, the Alameda and Contra Costa County Health Officers issued blanket isolation orders that will apply to all persons diagnosed with suspected or confirmed COVID-19 and blanket quarantine orders that will apply to close contacts of cases. Effective April 3, 2020, ACPHD and CCHS directs health care partners to disseminate blanket orders to all patients being tested for COVID-19 or who are presumptively diagnosed with COVID-19 without testing BEFORE they leave the health care facility. 

To view the full Alameda County Press Release, click here . To view the full Contra Costa County Press Release, click here .  
Alameda County – Actions Requested of Clinicians

1. Prioritize COVID-19 testing in persons meeting updated CDC and California Department of Public Health (CDPH) criteria regardless of which laboratory is performing testing. See the CDC Guidance for Prioritzation of Patients for Laboratory Testing for COVID-19.

2. Print out and give the ACPHD Health Officer Isolation and Quarantine Orders Packet to all patients being tested for COVID-19 or in whom you strongly suspect COVID-19 but will not be testing. The Orders Packet is posted on the ACPHD website and can be found in either English or Spanish . In addition to the orders, the packet contains home isolation and quarantine instructions.

3. Place a patient identification sticker or handwrite the patient’s name on the Health Officer Order of Isolation.

4. Instruct your patients to:
a) Self-isolate at home while waiting for the results of COVID-19 testing (if being tested);
b) Adhere to the Health Officer Order of Isolation if their COVID-19 test results are positive or if you diagnose
them with COVID-19 without laboratory testing;
c) Follow the ACPHD Home Isolation and Quarantine Instructions;
d) If diagnosed with COVID-19, inform their household members, intimate partners and in-home caregivers.

They must also provide those individuals with the Health Officer Order of Quarantine, and the Home Quarantine Instructions that are included in the packet.
Receiving Facility and EMS Interaction and Transfer of Care Guidance – Alameda County EMS

After surveying the different practices being employed by the receiving facilities, reviewing CDC guidance, consulting with Alameda County Public Health, and in accordance with the pre-hospital care guidance that Alameda County EMS has already distributed, we wanted to share best practices and guidance   relating to the interaction and transfer of care between receiving facilities and EMS.

Please keep in mind that these are not mandates, however we are trying to create an opportunity for consistency throughout the system in order to streamline this process as well as minimize confusion and frustration.

  • All healthcare providers should self-monitor for development of symptoms and it is encouraged that employers assist in these efforts. Take care of yourself, so that you can take care of others. If symptoms develop take the appropriate actions. Employers should consider touching base with their healthcare providers on a regular basis as well as other measures such as periodic temperature checks.

  • All healthcare providers should wear the appropriate level of personal protective equipment when interacting with patients or each other when a risk of exposure to COVID-19 exists. We have a duty to protect our patients and each other to the best of our abilities.

  • Prehospital providers should provide early notification to facilities, especially in cases where COVID-19 is suspected based upon their assessments or patient history. This provides the facility an opportunity to plan for the arrival and make the appropriate room types available if possible.

  • Prehospital providers should limit aerosol generating procedures as much as clinically possible and should terminate nebulizer treatments prior to entering facilities. Please refer to previously released guidance documents, available at https://ems.acgov.org/covid19, for additional information.

  • Facilities should have a process in place for their staff, wearing the appropriate PPE, to meet incoming ambulances and transfer patient care outside of the facility. This will allow facility staff to triage incoming patients and determine the correct patient movement pathway into the facility while also decreasing the number of people entering the facility which mitigates exposure risk.

  • Facilities should have at least one designated area and receptacle available outside of the facility for their staff and/or prehospital personnel to appropriately remove and dispose of worn PPE as well as accessibility to use a restroom and wash their hands within the facility. This process will centralize the collection of potentially contaminated materials outside the facility and provide access to proper hygiene efforts to reduce possible exposure risk.

Everyone’s efforts to work together, collaborate, and leverage best practices in as consistent a manner as possible is greatly appreciated. Healthcare providers are on the front line of this pandemic, and we all need to work together to mitigate exposure, reduce spread, and take care of each other while providing the highest level of care to our patients.
Upcoming Webinars
Presented by Schwartz Center for Compassionate Healthcare
Tuesday, April 7, 2020 | 10:00 - 11:00 AM | FREE
 
Join Richard Westphal, PhD and Patricia Watson, PhD as they discuss specific strategies health care leaders and managers can use to address the five essential human needs that support recovery from adversity and stress. They’ll also explain how to use the Stress First Aid framework for conducting a stress and coping assessment. Following their presentation, Schwartz Center Chief Medical Officer Beth Lown, MD, will moderate a brief Q&A session. To register for this webinar please click here . 
Wednesday, April 8, 2020 | 12:30 - 1:30 PM | FREE

Get practical tips on choosing a technology platform that is right for your practice. Learn about how the right telehealth technology can save you and your staff valuable time in set up, onboarding, and patient flow. Set the right expectations about what telehealth can and cannot do. Find out best practices for launching your telehealth service fast. To register for this webinar please click here .
 
This will be the first event in a Telehealth/Telemedicine series . Details and registration information for the rest of the series will be available soon.
Questions/Concerns?  

Please contact ACCMA at 510-654-5383 or   [email protected]   with any questions or concerns you have. Although we may not currently have an immediate answer to all questions, we want to know the information and resources that you need to continue to provide care for our community during this difficult time.  
 
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.