Global Guidance and Operational Considerations for Management of - PowerPoint PPT Presentation

National Center for Emerging and Zoonotic Infectious Diseases Global Guidance and Operational Considerations for Management of Healthcare Workers Exposed to COVID-19 Amber Vasquez, MD, MPH Medical Officer US Centers for Disease Control and Prevention International Infection Control Program Global Webinar Series 5.28.20

Disclosures  I have no financial relationships with commercial entities producing healthcare related products and/or services

Objectives  Review existing global guidance on management of healthcare workers exposed to COVID-19  Review key elements involved in exposed healthcare worker public health management  Discuss operational considerations when resources are limited

Goals of Healthcare Worker Management  Allow for early identification of healthcare workers at risk of developing infection after an exposure to someone with COVID-19  Reinforce the need for healthcare workers to self- monitor for fever and other symptoms and avoid work when ill  Limit introduction and spread of COVID-19 within healthcare facilities by healthcare workers

Risk Assessment  Interview of each healthcare worker  Review of exposure risks during the interaction – Community or healthcare setting? – Degree of interaction (e.g., time, proximity)? – Providing direct patient care? – Contact with the patient’s surrounding environment? – Performing an aerosol-generating procedure? – Elements of personal protective equipment (PPE)? – Hand hygiene performed?  Determination of high-risk vs. low-risk interaction

Work Restriction  Recommended for high-risk exposure – Exclusion from work – Self-quarantine – Active monitoring for symptoms of COVID-19 for 14 days after the date of last exposure  Recommended for low-risk exposure – Self-monitor for symptoms while continuing to work – Reinforce importance of IPC fundamentals while continuing to work (e.g., physical distancing, respiratory and cough etiquette, hand hygiene, use of PPE)

Symptom Monitoring (14 days) Active Monitoring (High-Risk) Self-Monitoring (Low-Risk)   Healthcare facility or public Healthcare workers monitor health authority establishes themselves for fever a minimum of daily  Healthcare workers remain communication for exposed alert for symptoms of healthcare workers COVID-19  Remote or in-person contact  Point of contact provided if  Assess for presence of fever fever or symptoms develop or symptoms consistent with during the monitoring COVID-19 period *Testing for COVID-19 if fever or symptoms develop

Challenges with Resource Limitation  Limited public health staff to perform contact tracing  Challenges in performing individual healthcare worker risk assessments  Healthcare staffing shortages  Limited testing availability  Widespread community transmission

References  Centers for Disease Control and Prevention (CDC). Interim Operational Considerations for Public Health Management of Healthcare Workers Exposed to or with Suspected or Confirmed COVID-19: non-U.S. Healthcare Settings. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/non-us- settings/public-health-management-hcw-exposed.html  European Centre for Disease Prevention and Control (ECDC). Public health management of persons, including health care workers, having had contact with COVID-19 cases in the European Union – first update. Available from: https://www.ecdc.europa.eu/en/publications-data/public-health-management- persons-including-health-care-workers-having-had-contact  Pan American Health Organization (PAHO). Care for health workers exposed to the new coronavirus (COVID-19) in health facilities. Available from: https://www.paho.org/en/documents/care-health-workers- exposed-new-coronavirus-covid-19-health-facilities  World Health Organization (WHO). Health workers exposure risk assessment and management in the context of COVID-19 virus. Available from: https://www.who.int/news-room/detail/09-03-2020-covid-19- for-health-workers

For more information, contact CDC 1-800-CDC-INFO (232-4636) TTY: 1-888-232-6348 www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.