COVID-19 Info for SF Healthcare Providers

• Prioritizing Testing for COVID-19 Novel Coronavirus Infection (SFDPH, 3/27/2020)
• COVID19 Specimen Collection & Handling (SFDPH, 3/15/2020)
• COVID-19 Guidance for EMS Providers
• Preparing Your Clinic for Potential COVID-19 Patients (SFDPH, 2/14/20)
• COVID-19 Clinical Intake Form and Worksheet (SFDPH, 2/18/20)

• Instructions for Patients Awaiting COVID-19 Test Results (SFDPH, 3/6/2020)   [Spanish]   [Chinese]   [Tagalog]   [Vietnamese]   [Russian]
• After-Visit Instructions for Patients with Confirmed or Suspected COVID-19 Infection (SFDPH, 3/31/2020) [Word Version]
• Ending Home Isolation and Returning to Work after Suspected or Confirmed COVID-19 (SFDPH, 3/23/2020)   [Spanish]   [Chinese]   [Tagalog]

• Interim Guidance: Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with COVID-19 In the Setting of Community Transmission (SFDPH, 3/13/20)

• Use of Expired Hand Sanitizer (SFDPH, 3/14/2020)

• Interim Guidance for Providers: Addressing Needs of People Who Use Alcohol, Tobacco, or Other Drugs Requiring Isolation or Quarantine Related to COVID-19 (SFDPH, 3/16/2020)

• Interim Guidance: Preventing Spread of COVID-19 Among Persons Experiencing Homelessness (SFDPH, 3/11/20)

• Preliminary Guidance for Long Term Care Facilities (SFDPH, Updated 3/19/2020)
• Guidance for Adult Elder and Residential Care Facilities Licensed by CA Department of Social Services (CDSS, 3/5/2020)

• Interim Guidance: Prevention, Screening, and Management of Possible COVID-19 Patients at Outpatient Hemodialysis Centers (SFDPH, 3/15/20)
• COVID-19 Outpatient Dialysis Facility Preparedness Assessment Tool (CDC, 3/24/2020)

• Interim Guidance: Protecting Home Care Providers and Clients from COVID-19 (SFDPH, 3/19/2020)

• CDPH COVID-19 Prevention Graphics [English] [Spanish]

SFDPH aims to utilize testing to prevent morbidity and mortality particularly in vulnerable populations, preserve valuable health care resources, and slow transmission within the community. As such, SFDPH recommends the following testing priorities for all San Francisco providers.

Testing at the San Francisco Public Health Laboratory will be prioritized for persons with signs and symptoms compatible with COVID-19 who are:

• Hospitalized patients
• Residents and staff in skilled nursing or long-term care facilities
• Persons experiencing homelessness
• Persons living in congregate settings such as shelters, navigation centers, single-room occupancy hotels (SRO), or correctional facilities
• Outpatient hemodialysis patients
• Healthcare personnel and first responders
• Part of a cluster of cases of pneumonia in a congregate setting that may not be listed above
• Fatal cases with unexplained pneumonia
• Close contacts to confirmed cases of COVID-19 infection

Contact SFDPH Communicable Disease Control & Prevention by phone at 415-554-2830 7 days a week from 8am-8pm to request a case number to send specimens to SFPHL.

If testing through commercial and hospital laboratories, in addition to the priority groups above, the following additional persons with signs and symptoms compatible with COVID-19 may be prioritized for testing:

• Aged 60 years and above
• Immunocompromised, including patients with HIV or following organ transplantation

If resources further allow:

• Other symptomatic persons

There is no need to contact SFDPH when arranging testing via non-public health laboratories.

Persons with mild respiratory symptoms who do not otherwise need medical care and who are not in one of the above groups should be lowest priority for COVID-19 testing in the current environment of limited personal protective equipment (PPE) and testing resources. However, testing could be considered for these individuals as testing access improves and alternative testing sites are available (such as drive-through testing models) that conserve PPE. Ill persons should stay home and away from others until there has been no fever without the use of fever-reducing medications, there has been an improvement in respiratory symptoms for at least 3 days, AND at least 7 days have passed since symptoms first appeared. Individuals who still have a cough after this period should continue to wear a facemask when in contact with others.

Asymptomatic persons should not be tested for COVID-19. Current testing for COVID-19 cannot detect prior infection. Testing a person without symptoms does not rule out the possibility that person may become ill in the future.

No. These multi-pathogen molecular assays can detect a number of human respiratory viruses, including other coronaviruses that can cause acute respiratory illness, but they do not detect COVID-19.

Do not discard unused, expired N95 respirators.  Instead, contact your Infection Control or Health & Safety office. Per CDC, in times of shortage, consideration can be made to use N95 respirators beyond the manufacturer-designated expiration date.  See details here: Strategies for Optimizing the Supply of N95 Respirators and Release of Stockpiled N95 Filtering Facepiece Respirators Beyond the Manufacturer-Designated Shelf Life: Considerations for the COVID-19 Response.  Please note that CDC does not recommend using N95s beyond the manufacturer-designated shelf life in surgical settings.

Medical waste (trash) coming from healthcare facilities treating COVID-2019 patients is no different than waste coming from facilities without COVID-19 patients. CDC guidance states that management of laundry, food service utensils, and medical waste should be performed in accordance with routine procedures. There is no evidence to suggest that facility waste needs any additional disinfection.

Providers should use standard operating procedures for the containment and disposal of used PPE and medical waste. Anything that has been contaminated with liquid blood or body fluids should be placed in red boxes or red bags and disposed of as medical waste. PPE not contaminated with fluid blood or body fluids can be placed in garbage bags, sealed, and placed with the regular garbage. Management of laundry and food service utensils should also be performed in accordance with routine procedures.