Cases and their Close Contacts Tools for LBOHs June 30, 2020 - - PowerPoint PPT Presentation
Follow-up for Positive COVID-19 Cases and their Close Contacts Tools for LBOHs June 30, 2020 Hillary Johnson, MHS, Infectious Disease Epidemiologist Scott Troppy, MPH, PMP, CIC, Surveillance Epidemiologist Bureau of Infectious Disease and
Hillary Johnson, MHS, Infectious Disease Epidemiologist Scott Troppy, MPH, PMP, CIC, Surveillance Epidemiologist Bureau of Infectious Disease and Laboratory Sciences MA Department of Public Health
June 30, 2020
webinars!
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your jurisdiction.
Step 1- LBOH Notification to “Yes” to clear out this workflow.
(Investigation Started) & 3 (LBOH Investigator (name, lboh, phone number)
(Final Review)
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non-COVID-19 cases that are still pending. Please review this workflow and complete or close out any older events/cases.
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the goal until that strategy changes/evolves.
you should document your work.
Facility
your help.
Tuesdays @ 11am will continue in July
MAVEN Help has Guidance Documents and Previous Webinars: http://www.maventrainingsite.com/maven-help/toc.html
MDPH Epi Program: 617-983-6800 MDPH MAVEN Help Desk: isishelp@state.ma.us MDPH Food Protection Program: 617-983-6712 CTC Help Desk: 857-305-2828 COVID19CommunityTracingCollaborativeQuestions@mass.gov 8
foot separation and close contacts?
while the two colleagues were in close contact, but the contact is still a close contact.
case wearing a cloth mask could still expose others through close contact.
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mask and more than 15 minutes and closer than 6 ft, etc.?
individual to give us a starting point to work with.
need to quarantine – but hopefully they have reduced their chances of developing illness by wearing those masks.
who sits next to a case for 4 hours is at a greater risk of infection than the person who sat next to the case for 20 minutes, but we would consider them both close contacts that need to quarantine.
person is at greater risk of exposure than the person who is 8 feet away. Remember, all these elements are “and” components of risk reduction not “or.” Nothing replaces anything else. They all help, and together help more in reducing risk.
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cutoff, and we need guidance to help people reduce risk, which is why we say 6 feet. (Data supports using this metric.)
greatest risk.
consider them exposed.
by wearing masks and other things)
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complete Question Package 6 (contact monitoring)?
last day of quarantine, and the Contact Monitoring Status (and if you do additional check-in assessments, you can track the contact’s symptoms here – but not required).
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6 Question Packages Confirmed/Probable/Suspect/Contact What’s linked? Go here to see/link to contacts or a cluster event. Lab Tab to see lab tests View Wizard Patient Person Details (address, phone) Electronic Trail for this event. Who has entered data? Where did this case come from? This View of a COVID event looks the same for cases and contacts. They all have the same Question Packages Available. 13
Confirmed/Probable/Suspect/Contact What’s linked? Go here to see/link to contacts or a cluster event. Lab Tab to see lab tests View Wizard Patient Person Details (address, phone) Electronic Trail for this event. Who has entered data? Where did this case come from? CONTACTS: Fill Out
Confirmed/Probable Cases: Fill Out
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clear the contact from the CONTACT workflow.
to quarantine and for how long.
contacting their provider if symptoms develop.
and update and sign off on case. If you are creating a contact for another town, make sure to give them your contact info and SHARE the index case. 15
How do you sign off on CONTACTS after 14 days? Is there a Wizard for Contacts?
after a last check-in.
the appropriate variables in the Wizard View as well.
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Data Entry in MAVEN
elsewhere (not at facility)).
residents, etc.)
Setting?”
facility name & full address?)
=COMPLETED.
monitoring status: “completed” by LBOH once patient is no longer in isolation and no longer under Transmission Based Precautions.
Responders Reports until this variable is completed, indicating the patient is no longer infectious to others.
Most of this can be completed in Wizard 17
help/pdf/Serology%20Interpretation%20for%20LBOH_ver3.0_June1.pdf
last 14 days. If not, they do not need to isolate. If they HAVE had recent symptoms, we would follow-up accordingly.
a HCW tests positive, they do not get to continue working. Also, symptomatic HCWs should isolate (even if pending test results). No one with symptoms should be working.
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Maven when they have long recoveries at long term care facilities.
pending sign off are the Admin QP steps 4 & 5 (completing the CRF (Case Report Form)), and the Contact Monitoring Status=Complete in Risk QP6. These should occur when a patient comes off transmission based precautions.
residents at some facilities, you can finish most of the data entry and set yourself a calendar reminder to check in with the facility every few days. 19
address is out of state? Do we need to email ISIS?
interview it needs to be updated to an official address out of state, update all the information/notes in the MAVEN event and update the official address.
1. Edit address in the Participant’s Tab 2. “Select Official Address” hyperlink in the Demographic QP
health department. If you have any issues or are not sure you correctly updated an address, email isishelp@state.ma.us. 20
cases are complete but still in workflow?
lots of functions – like supervisors assigning different follow-up activities.
an event).
workflow if cases were assigned to your LBOH User Groups.
remove that event from your workflows.
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Task Tab shows any tasks for an
“assignment.” You can update the task status to Completed and it will exit your tasks workflow. 23
that originally tested PCR positive & recovered >6-8 weeks ago?
however if you identify them and have questions on follow-up, please let us know.
617-983-6800 if you have any questions on case management.
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get tested and how long should they quarantine?
their 14 day quarantine period).
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associated with COVID-19, should be tested as soon as possible after they are notified of their exposure to COVID-19.
molecular test from a nasopharyngeal, nasal, or
(antibody) testing is not appropriate for this use.
days, even following a negative test result.
negative test) and retest if someone starts to show illness during the rest of quarantine.
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date? Should they test again?
symptoms, even if they initially obtained testing and were negative shortly after being identified as a contact but before symptoms developed.
the rest of their quarantine. But if they end up developing symptoms, the recommendation is to be tested again.
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because of their age. What should we do?
recommended even for children. That being said, we are also hearing it is difficult for children to obtain testing.
period, they could return to normal activities, even if we didn’t get them tested in the interim.
quarantine and having a low threshold for identifying symptoms should they develop.
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COVID-19 Cases can bring to provider office to
(particularly if asymptomatic).
add your town contact info/seal.
Tools Folder
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same or different?
asymptomatic people, etc. but the Table for Discontinuing Isolation and Returning to work is the same in both documents here:
Work Guidance
Work Guidance
Strategy to discontinue isolation.
Strategy.
Current List of Essential Services: https://www.mass.gov/info-details/covid-19-essential-services
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Based Strategy?
ALL of the following criteria:
❑ 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 10 days have passed since symptoms first appeared.
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Revised May 7, 2020 32
❑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 10 days have passed since symptoms first appeared. ❑ resolution of fever without the use of fever-reducing medications, and ❑ improvement in respiratory symptoms (e.g., cough, shortness of breath);
and ❑ Negative PCR results from at least 2 specimens collected >24 hours apart
Symptom-Based Strategy Test -Based Strategy
If Patient Ever Had Symptoms: OR
Symptoms need to have resolved before starting testing Use Symptom Onset Date
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❑ At least 10 days have passed since the date of their first positive COVID-19 diagnostic test.
❑ Assumes no symptoms ever developed.
Note, because symptoms cannot be used to gauge where these individuals are in the course of their illness, it is possible that the duration of viral shedding could be longer or shorter than 10 days after their first positive test.
❑ Negative PCR results from at least 2 specimens collected >24 hours apart
❑ Assumes no symptoms ever developed.
Time-Based Strategy Test -Based Strategy
If Patient NEVER Had Symptoms:
Use Test Collection Date
OR
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their contacts quarantined. Serology positive but no recent symptoms do not require further public health follow-up at this time.
COVID‐19 Cases
https://www.mass.gov/doc/covid-19-testing- guidance/download https://www.mass.gov/doc/notification-to-test-contacts-regardless-of-symptoms-0/download
http://www.maventrainingsite.com/maven-help/pdf/Serology%20Interpretation%20for%20LBOH_ver3.0_June1.pdf https://www.mass.gov/doc/healthcare-personnel-occupational-exposure-return-to-work- guidance/download https://www.mass.gov/doc/non-healthcare-workers-occupational-exposure-return-to-work-guidance/download
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