Follow up for Positive COVID 19 Cases and their Close Contacts - - PowerPoint PPT Presentation
Follow up for Positive COVID 19 Cases and their Close Contacts Tools for LBOHs April 17, 2020 Hillary Johnson, Infectious Disease Epidemiologist Scott Troppy, Surveillance Epidemiologist Bureau of Infectious Disease and Laboratory
Hillary Johnson, Infectious Disease Epidemiologist Scott Troppy, Surveillance Epidemiologist Bureau of Infectious Disease and Laboratory Sciences MA Department of Public Health
April 17, 2020
Collaborative
Contacts is the goal until that strategy changes/evolves.
where you should document your work.
need your help.
create cluster events.
Now Tuesdays AND Fridays at 11am!!
Quarantine Period (if you have checked in at the end and they did not become a case themselves).
have attached to their event and their case status should be updated to CONFIRMED.
confirmed case before signing off on the event.
1. Once you have completed the interview, AND 2. The patient has exited isolation.
have to use a Test or Non‐Test based strategy.
resolve symptoms at different points.
days after symptom onset.
Even then, I would use some judgement based upon how sick they were when you first contacted and interviewed them.
weeks old (done with quarantine) can be signed off after a last check‐in.
Package
Completed
along.
be signed off when interview is complete & patient is out of isolation (need last check‐in).
Packages (from interview)
Package
Completed
these along.
covid‐19 and anyone who is clinically diagnosed with covid‐19 and not tested.
are in home isolation may discontinue home isolation under the following conditions:
the use of fever‐reducing medications AND improvement in respiratory symptoms – e.g., cough, shortness of breath) AND
symptoms) would be considered “day zero.”
should only discontinue isolation if at least 72 hours have also passed since “recovery.”
Guidance issued 3/16/2020
least 24 hours apart, resolution of fever without the use of fever‐reducing medications, and improvement in respiratory symptoms).
infection may discontinue home isolation when at least 7 days have passed since the date of their first positive covid‐19 diagnostic test and they have had no subsequent illness.
continue to limit contact (stay 6 feet away from others) and limit potential of dispersal of respiratory secretions by wearing a covering for their nose and mouth whenever they are in settings where other people are present.
bandana, scarf, or cloth mask. The covering does not refer to a medical mask or respirator.
providers or workplaces may request the test‐based strategy.
then had a positive test?
additional symptoms, they can exit isolation.
Use one of the below strategies to determine when HCP may return to work in healthcare settings
two consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of two negative specimens)[1]. See Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens for 2019 Novel Coronavirus (2019‐nCoV).
fever‐reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
influenza), criteria for return to work should be based on that diagnosis.
Diagnosis:
Collection.
are being reported to MDPH and MAVEN. Questions remain:
determine what role serology testing should play in COVID‐19 surveillance. Thus, Guidance is Pending.
dates.
Look in the Lab Tab of a MAVEN event. Call MDPH if you have questions.
CONFIRMED
Meets confirmatory laboratory evidence
Probable
Meets clinical criteria AND epidemiologic linkage with no confirmatory laboratory testing performed for COVID‐19 OR; Meets presumptive laboratory evidence AND clinical criteria OR Epidemiologic linkage. OR; Meets vital records criteria with no confirmatory laboratory testing performed for COVID19.
PCR Test (swab)
Clinical Criteria:
(measured or subjective), chills, rigors, myalgia, headache, sore throat, new olfactory and taste disorder(s); OR
shortness of breath, or difficulty breathing; OR
following: clinical or radiographic evidence of pneumonia
alternative more likely diagnosis.
Presumptive laboratory evidence:
infection* *serologic methods for diagnosis are currently being defined
(blood tests)
interviewed.
look at symptoms to establish all the timeframes for Isolation (case) and Quarantine (contacts).
1. If the Contact already has a COVID event, you don’t need to add them again, you just want to LINK your Index Case to the Contact’s COVID event. 2. Search for the contact to see if they already exist in MAVEN.
3. If you find a COVID event already exists for your contact – Write Down the MAVENID#. 4. Go back to your Index Case that named them.
Key Variables:
Follow‐up, Transfer, Other
Date
quarantine.
Monitoring
What are these Variables?
enter health checks. Not required.
What are these Variables?
hours?
days?
notification of I&Q requirements?
contact about their exposure? (MDPH I&Q guidance helpful)
probably no longer applicable for 90% of contacts.
might not show up in your town’s cases.
for tracking purposes.
SEARCH Update Type to “Outbreak” (from Normal)
Partners in Health Community Tracing Collaborative (CTC) and Harvard MHOA REDCap contact tracing groups/outreach
Direct all questions and comments to:
mailbox address to use for questions/comments around the Partners in Health Community Tracing Collaborative (CTC) and Harvard MHOA REDCap contact tracing groups/outreach.
individuals that are contacted directly by contact tracers from either the Harvard group or the CTC Partners in Health folks.
Gillian Haney, Director of Surveillance and Informatics Scott Troppy, Surveillance Epidemiologist Bureau of Infectious Disease and Laboratory Sciences MA Department of Public Health
April 17, 2020
What’s Ahead? |Roll‐Out Timeline
Academic Public Health Volunteer Corps
A partnership between MDPH, MHOA, and MA Academic Institutions Update to LBOH on April 17, 2020
1.
Boston University, School of Public Health
2.
Harvard University T.H Chan School of Public Health
3.
Holyoke Community College, Community Health Worker Program
4.
MCPHS University (Massachusetts College of Pharmacy and Health Sciences)
5.
Northeastern University, Program in Public Health
6.
Northern Essex Community College, Associates in Public Health
7.
Regis College
8.
Simmons University, Program in Public Health
9.
Tufts University, School of Public Health
10.
UMass Amherst, School of Public Health
11.
UMass Lowell, Public Health Program
12.
UMass Worcester, Medical School, Public Health Program
As of Friday, April 17
Component of Volunteer Assignment Process *Note that some neighboring LBOHs have chosen to share a team of volunteers Number of individuals or towns
# of volunteers 1,800 # of LBOH enrolled with APH Volunteer Corps (deployed or planning) 132 # of LBOH doing contact tracing with APH Volunteers 82 # of LBOH* with deployed APH Volunteers (includes 4 county‐ level assistance requests) 89 # of APH Volunteers deployed 554
Acushnet Ashland Avon Barnstable County Bedford Belchertown Bellingham Belmont Beverly Boston Bourne Brewster Brookline B li t Carver Chatham Chelsea Concord Danvers Dedham Dennis Dennis (county assistance) Dighton Eastham Easton Fairhaven F ll Ri Freetown Georgetown Gloucester Harwich Holyoke Hopedale Hudson Ipswich Kingston Lakeville Lawrence Lexington Lincoln Marion M hfi ld Mashpee Mattapoisett Maynard Medway Mendon Milford Nantucket Natick New Bedford Newbury North Reading Northboroug h N thb id Paxton Peabody Pelham Plympton Provincetow n Randolph Sandwich Saugus Sheffield Somerville Sudbury Taunton Tewksbury T Ware Watertown Wellfleet Wellfleet (county assistance) Wenham Westboroug h Westfield Westminster Westwood Wilbraham Yarmouth
Andover Attleboro Auburn Barnstable Clinton Cohasset Dover Dukes County Duxbury Framingham Gosnold Greenfield Hadley Haverhill Holbrook Lowell Lynn Lynnfield Mansfield Marion Rochester Regional Health District Medford Methuen Milton Nashoba Newburyport Newton Northhampt
Orange Palmer Plymouth Raynham Revere Rochester Sharon Shutesbury Springfield Swansea and Somerset Wales Webster Weymouth Whately Winthrop Worcester
Changes to Scope of Services from Student Volunteers
as of April 23
Contact Tracing Cases will no longer go to REDCap. LBOHs will begin work with Community Tracing Collaborative (CTC). Existing cases in REDCap will continue with student volunteers until they are closed out. Other Public Health Assistance The following services will continue to be available to LBOH: health communications, social media, data and policy analysis, translation assistance.
1.
Every LBOH is different. Volunteers can assist with health communications, data and policy, translation, and other needs. Please discuss with the Team Lead so we can assign a volunteer team for you.
2.
Team Lead acts as single point of contact/project manager with LBOH
Fill out MHOA Survey APHV will contact you for brief phone call Phone consult with your Team Lead Volunteers are assigned
We are open to feedback.
Package NOT the notes section
contact tracers – we normally don’t receive them
the Notes section. You need to email isishelp@state.ma.us with your request.
demographic question package (tip sheet in MAVEN help)
(Risk/Exposure QP#5) Employed at, admitted to, or visited a healthcare setting?
skilled nursing, rest homes and rehab facilities)
appropriate staff