COVID-19 In Setting of Community Transmission

To: All Catholic Health Associates and Medical Staff

From: Kevin Shiley, MD, Medical Director of Infection Prevention & Control
Date: March 16, 2020
RE: Screening, Testing and Isolation for COVID-19 in setting of community transmission
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Due to the presence of community-wide COVID-19 infections, screening and testing criteria are broadened to include many more patients presenting with acute respiratory illnesses, regardless of travel or exposure history. Please remove and disregard prior acute care screening and testing algorithms distributed at your sites dated before 3-16-20. Importantly, acute care providers with suspected cases of COVID-19 infection may order testing at their discretion without infectious disease approval, but must follow isolation and notification rules outlined in the attached document, “COVID-19 testing and PPE 3.16.20.”

The attached guidance document advises on testing scenarios for acute care sites to follow when evaluating patients with an acute respiratory tract infection complaint. Presently, the fastest turnaround times for testing are through the Erie County Department of Health. In situations where turnaround time is crucial (such as inpatient admissions), use of the county lab is advised. In situations where turnaround time is less crucial, such as uncomplicated outpatient scenarios, the order should reflect direction to send to Quest in the request (see attached table). The COVID-19 internal hotline (923-0670) remains available to help with decision making and guidance on testing.

In addition, PPE requirements for COVID-19 have been updated to align with updated guidance from public health authorities. Please review the attached table to familiarize yourself and staff with PPE requirements for suspected and confirmed COVID-19.

Lastly, during this unprecedented surge in requirements for PPE, Catholic Health is updating its isolation policy to conserve gowns and gloves for certain lower risk contact isolation situations. Specifically, patients without draining wounds that have a diagnosis of MRSA, ESBL and VRE will no longer require contact isolation. Other multidrug resistant organisms, including C. difficile and CRE must be placed in contact isolation. The updated policy will be available on the intranet policy site.