General Health Care Practitioner (HCP) Questions

Frequently Asked Inpatient Questions Microchapter
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General Health Care Practitioner (HCP) Questions

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Nuha Al-Howthi, MD[2]Gurmandeep Singh Sandhu,M.B.B.S.[3]Sara Haddadi, M.D.[4] Aisha Adigun, B.Sc., M.D.[5]

Sources of content- CDC, WHO, and FDA.

General Health Care Practitioner (HCP) questions

Is post-exposure prophylaxis currently available, and when can it be used?

• Any duration of exposure should be considered prolonged if the exposure occurred during a performance an aerosol-generating procedure.
• The time period that should be used for contact tracing after exposure to asymptomatic individuals who test positive for SARS-CoV-2 was shortened.
  • The time period was changed from 10 days before obtaining the specimen that tested positive for COVID-19 to 2 days to accommodate pragmatic and operational considerations for the implementation of case investigation and contact tracing programs.
  • Recent data suggest that asymptomatic persons may have a lower viral burden at diagnosis than symptomatic persons.  Thus, the longer contact elicitation window (10 days) may have a limited impact on identifying new COVID-19 cases.
  • The recommendation for the shorter contact elicitation window (2 days) will help focus case investigation and contact tracing resources toward activities most likely to interrupt ongoing transmission.
  • This time period is also now in alignment with recommendations from the World Health Organization, the European CDC, and Public Health Canada.

Can routine vaccinations still be administered to patients?

• Yes. Continue to administer these vaccines if an in-person visit must be scheduled for some other purpose and the clinical preventive service can be delivered during that visit with no additional risk, or an individual patient and their clinician believe that there is a compelling need to receive the service based on an assessment that the potential benefit outweighs the risk of exposure to SARS-CoV-2 virus

Should I use face mask/respirator while taking care of pregnant patients with known/suspected COVID-19 infection?

• When available, respirators (or face masks if a respirator is not available), eye protection, gloves, and gowns should be used for the care of pregnant patients with known or suspected COVID-19 infection.

I am a Health Care Practitioner living with someone who is at a higher risk of severe illness from COVID-19 infection. What precautions should I take?

• There are no additional precautions for the Health Care Practitioner. Some Health Care practitioners may choose to implement extra measures when arriving home from providing healthcare, such as removing any clothing worn during the delivery of healthcare, taking off shoes, washing clothing, and immediately showering. However, these are optional personal practices because there is insufficient evidence on whether they are effective. People at higher risk of severe illness from COVID-19 should take the general precautions recommended for them which include washing hands often, taking everyday precautions to keep space between them and others (stay 6 feet away, which is about two arm lengths), staying away from people who are sick, cleaning and disinfecting frequently touched services.

I am pregnant and a health care worker. Can I work with patients who are potentially infected with COVID-19?

• Information on COVID-19 in pregnancy is limited. Pregnant women are not currently considered at increased risk for severe illness from COVID-19. However, pregnant women have had a higher risk of severe illness when infected with viruses from the same family as COVID-19 and other viral respiratory infections, such as influenza.

Are there work restrictions recommended for HCP with underlying health conditions who may care for COVID-19 patients?

• Adherence to recommended infection prevention and control practices is an important part of protecting HCP and patients in healthcare settings. All HCP who care for confirmed or suspected COVID-19 patients should adhere to the standard and transmission-based precautions.
• To the extent feasible, healthcare facilities could consider prioritizing HCP who are not at higher risk of developing severe illness from COVID-19 or who are not pregnant to care for confirmed or suspected COVID-19 patients.
• If staffing shortages make this challenging, facilities could consider restricting HCP at higher risk for severe illness from COVID-19 or who are pregnant from being present for higher-risk procedures (e.g., aerosol-generating procedures) on COVID-19 patients.
• HCP who are concerned about their individual risk for severe illness from COVID-19 due to underlying medical conditions while caring for COVID-19 patients can discuss their concerns with their supervisor or occupational health services.
• People 65 years and older and people of all ages with serious underlying health conditions — like serious heart conditions, chronic lung disease, and diabetes — seem to be at higher risk of developing severe illness from COVID-19.

Whom should healthcare providers notify if they suspect a patient has COVID-19? Healthcare providers should immediately notify infection control personnel at their facility if they suspect COVID-19 in a patient. If a patient tests positive, providers should report positive results to their local/state health department.

If I have patients with asthma, do I need to make any changes to their daily asthma preventive management regimens to reduce their risk of getting sick with COVID-19?

• People with moderate to severe asthma, particularly if not well controlled, might be at higher risk of getting very sick from COVID-19.
• Based on what we currently know about COVID-19, the selection of therapeutic options through the guideline-recommended treatment of asthma has not been affected.
• Continuation of inhaled corticosteroids is particularly important for patients already using these medications because there is no evidence of increased risk of COVID-19 morbidity with the use of inhaled corticosteroids and an abundance of data showing reduced risk of asthma exacerbation with the maintenance of asthma controller therapy.
• Patients with asthma but without symptoms or a diagnosis of COVID-19 should continue any required nebulizer treatments.

What are the guidelines regarding face shields for HCP?

• CDC recommends that eye protection should be used in areas with moderate to substantial community transmission. For areas with minimal to no community transmission, eye protection is considered optional, unless otherwise indicated as part of standard precautions.
  

What is COVID-19 Surge?

• COVID-19Surge is a spreadsheet-based tool that hospital administrators and public health officials can use to estimate the surge in demand for hospital-based services during the COVID-19 pandemic. A user of COVID-19Surge can produce estimates of the number of COVID-19 patients that need to be hospitalized, the number requiring ICU care, and the number requiring ventilator support. The user can then compare those estimates with hospital capacity, using either existing capacity or estimates of expanded capacity.
  • Can COVID-19Surge be used to accurately estimate the impact of COVID-19?
    The numbers generated through COVID-19Surge are estimates. They DO NOT reflect what will actually occur during the pandemic. Rather, they are estimates for a given set of scenarios. COVID-19Surge should be used to plan and prepare a response to a surge in demand for hospital-based resources due to the COVID-19 pandemic.
  • Can users change the input variables?
    Yes. When you download and open the COVID-19Surge, all inputs are pre-populated with numbers and estimates based on published sources. Users can change the values in the tool that best illustrates the situation in their jurisdiction. Further, the CDC encourages users to change input values and explore the impact of various scenarios. Explanations are provided in the accompanying manual.

Are there any antibody tests for COVID-19?

• The FDA has approved COVID-19 blood tests to estimate the levels of antibodies in an individual's blood.
• The two tests, the ADVIA Centaur COV2G and Atellica IM COV2G were developed by Siemens Healthineers and have been reported to be 100% specific and 99.8% sensitive.