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Updated Guidance

Published:  July 24, 2020

To:Health Care Providers
From:Sundari Mase, MD, Health Officer
Date:July 22, 2020
CC:Please share with all Medical Staff

Actions requested of all clinicians:

  • Follow updated guidance on:
    • Discontinuing Isolation for Persons with COVID-19 notin Health Care Settings
    • Returning-to-Work Criteria for Health Care Personnel (HCP) with SARS-CoV-2 Infection (Sonoma County COVID-19 Management of HCP)
    • Prioritizing COVID-19 Testing for Sonoma County Residents
    • Managing Persons Under Investigation (PUIs)
    • Submitting a Confidential Morbidity Report (CMR) and Laboratory Report for All COVID-19 Cases

Updated Guidance:  Discontinuing Isolation Criteria for Persons with COVID-19 not in Health Care Settings.

On July 20, 2020, the Centers for Disease Control and Prevention (CDC) issued updated guidance on the discontinuation of isolation for persons with COVID-19 who are convalescing in non-health care settings ( Criteria for Discontinuing Home Isolation of Individuals with COVID-19). On July 22, 2020, the Health Officer issued a new Blanket Isolation Order (C19-16) to align the County’s Blanket Isolation Order with the new CDC guidance. The new Order and isolation instructions can be found at: Updated Public Health Emergency Isolation Order for COVID-19.

HCP should now convey to their COVID-19 positive patients to isolate at their residence, another residence, or alternate care site as described below.

  • Persons infected with SARS-CoV-2 who develop COVID-19 symptoms should isolate until:
    • At least 10 days* have passed since symptom onset and
    • At least 24 hours have passed since resolution of fever without the use of fever-reducing medications and
    • Other symptoms have improved.
  • Persons infected with SARS-CoV-2 who never develop COVID-19 symptoms may discontinue isolation and other precautions
    • 10 days after the date of their first positive RT-PCR test for SARS-CoV-2 RNA (the date of their first positive is the date the test specimen was collected).

*A limited number of persons with severe illness may produce replication-competent virus beyond 10 days, that may warrant extending duration of isolation for up to 20 days after symptom onset. Consider consultation with Public Health. See Discontinuation of Transmission-Based Precautions and Disposition of Patients with COVID-19 in Healthcare Settings (Interim Guidance).

As a service to our providers, this guidance incorporates the latest information/guidance from CDC as well as other sources. As the situation evolves, this guidance may change.

Updated Guidance: Return-to-Work Criteria for Health Care Personnel (HCP)

Sonoma County Public Health continues to work closely with local, state and federal agencies and healthcare partners to monitor COVID-19.  On July 17, 2020, the CDC issued updated guidance on the return-to-work criteria for healthcare personnel (HCP) with SARS-CoV-2 infection.  The following symptoms-based criteria were modified as follows:

  • For HCP with severe-to-critical illness or who are severely immunocompromised, the recommended duration for work exclusion was extended to 20 days after symptom onset.
  • For asymptomatic severely immunocompromised HCP, the recommended duration for work exclusion was extended to 20 days after their initial positive SARS-CoV-2 diagnostic test. 
  • For all other HCP, the recommended duration for work exclusion was:
    • Decreased from “at least 72 hours” to “at least 24 hours” have passed since last fever without the use of fever-reducing medications.
    • Changed from “improvement in respiratory symptoms” to “improvement in symptoms” to address the expanding list of symptoms associated with COVID-19.

As a service to our providers, this guidance incorporates the latest information/guidance from CDC as well as other sources. As the situation evolves, this guidance may change. Criteria for Return to Work for Healthcare Personnel with SARS-CoV-2 Infection (Interim Guidance).

Updated Guidance: Prioritizing COVID-19 Testing for Sonoma County Residents

Sonoma County Public Health is now prioritizing testing for the following groups of people:

  • Individuals with signs and symptoms (fever not always present) compatible with COVID-19 and hospitalized and significantly ill; or
  • Healthcare personnel, including first responders with direct contact with patients; or
  • All other first responders (i.e., fire and law enforcement); or
  • Individuals who live in or work at a long-term care facility, skilled nursing facility, residential care facility for the elderly; or
  • Individuals experiencing homelessness; or
  • Individuals who are incarcerated or who work in a jail or prison; or
  • Individuals identified as contacts of persons with laboratory-confirmed COVID-19.   

Contact Sonoma Public Health at (707) 565-4566 for testing consultation regarding individuals that meet the above criteria.

Updated Guidance: Managing Persons Under Investigation (PUIs)

The Sonoma County Department of Health Services no longer requires assignment of a PUI number to PUIs. Providers may discontinue contacting Public Health to request a PUI number.  As a reminder, Department of Health Services, in consultation with clinicians, will determine whether a patient is a PUI for COVID-2019 per current CDC guidance.

Updated Guidance: Submitting a Confidential Morbidity Report (CMR) and Laboratory Report for All COVID-19 Cases

Sonoma County Public Health relies on medical providers, school officials and other community partners to notify us when they encounter cases or suspected cases of certain diseases or conditions. Reporting allows local health departments to track diseases in the community and take action to prevent diseases from spreading.
As with other reportable diseases such as syphilis and tuberculosis, health care staff should report COVID-19 cases by completing and submitting to Sonoma County Public Health a Confidential Morbidity Report (CMR) as well as a laboratory report. 

The  COVID-19 CMR  form (PDF: 388kb) should be submitted either directly by entering the information into CalRedie (the preferred method), or by faxing the paper form to (707) 565-4565

Contact Information

Public Health Division

County of Sonoma

Contact us by Phone
Monday – Friday
8:00 AM – 5:00 PM
Address

Public Health Administration

625 5th Street

Santa Rosa, CA 95404