Disease Prevention and Control, San Francisco Department of Public Health

COVID-19 Info for SF Healthcare Providers

This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses.
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FAQ for Health Care Providers

Who is at higher risk for severe illness due to COVID-19? Which additional groups need to take extra precautions?

Updated May 20, 2020

SFDPH considers persons in the following groups or with the following conditions to be at higher risk for severe illness if they develop COVID-19 infection.  Except where noted, this list aligns with CDC guidance.

  • Age 60 years and older*
  • Staying in a nursing home or long-term care facility
  • Asthma (moderate-to-severe)
  • Chronic lung disease
  • Diabetes (type 1, type 2, or gestational)
  • Serious heart conditions (including heart failure, coronary artery disease, congenital heart disease, cardiomyopathies, and pulmonary hypertension)
  • Hypertension**
  • Chronic kidney disease being treated with dialysis
  • Severe obesity (body mass index of 40 or greater)
  • Immunocompromised (including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, HIV with a low CD4 cell count or not on HIV treatment, and prolonged use of corticosteroids and other immune weakening medications)
  • Chronic liver disease

Other groups of persons are recommended by CDC to take extra precautions, as emerging data indicate some populations bear disproportionate burden of COVID-19 disease and death, have higher prevalence of underlying conditions, or are experiencing conditions that may facilitate the spread of infection (see https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/other-at-risk-populations.html).

  • People with disabilities
  • People who are pregnant or breastfeeding
  • People experiencing homelessness
  • Racial and ethnic minority groups

*CDC states age 65 years and older.  However, recently published data on COVID-19 mortality in China find a gradient of increasing age associated with increasing fatality ratios. While the CDC currently classifies adults over age 65 years as at high-risk, the SF Department of Public Health bases their classification of over 60 years on the data from the above cited article and evidence of premature aging among other vulnerable populations, including persons experiencing homelessness.

**CDC does not specifically include hypertension, other than pulmonary hypertension.  In a recent published review, hypertension was cited as likely to be an independent risk factor for more severe disease and increased mortality.

Will existing respiratory virus panels, such as those manufactured by Biofire or Genmark, detect COVID-19?

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.

What should I do with my stock of N95 respirators that have passed their manufacturer-designated expiration date?

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.

Should medical waste or general waste from healthcare facilities treating Persons Under Investigation and patients with confirmed COVID-19 be handled any differently or need any additional disinfection?

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.

Are there special handling procedures for COVID-19 medical waste including disposal of used personal protective equipment (PPE), laundry, and food service utensils?

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.

See CDC FAQ for Health Care Professionals