At risk individuals include those who are:
• 65 years of age and older
• Who live in a nursing home or long-term care facility
• Who have an underlying medical condition
Healthcare providers must obtain a risk history for individuals
being evaluated who have fever and acute respiratory illness.
People with fever and symptoms of lower respiratory illness (cough
or shortness of breath) should be isolated if, within the past 14 days,
they have traveled to a high-risk area or have been in close contact
with a confirmed infection. Isolation precautions include:
• Placing a facemask on the patient
• Placing them in a private room or separate area
• Wearing appropriate personal protective equipment (PPE)
At risk patients should be immediately reported to both infection
control personnel and the local or state health department to
determine the need to obtain specimens to collect for COVID-19.
Testing is limited and health departments will provide the necessary
guidance for healthcare providers. Depending on the severity of the
illness, some patients may be advised to stay home and return for
re-evaluation (wearing a mask) if symptoms worsen (Centers for
Disease Control and Prevention, 2020). Recommendations for
reporting, testing and specimen collection can be found on the
Evaluating and Testing Persons for Coronavirus Disease 2019
(COVID-19) web page.
TESTING PRIORITIES
PRIORITY 1
all hospitalized patients
and symptomatic healthcare
workers
onset, they are at risk for infection and transmission, and should be
be evaluated as a person under investigation (PUI). This includes
healthcare workers (Centers for Disease Control and Prevention,
2020). Take note that “fever may not be present in some patients,
such as those who are very young, elderly, immunosuppressed, or
taking certain medications. Clinical judgement should be used to
guide testing of patients in such situations” (Centers for Disease
Control and Prevention, 2020).
The United States has declared COVID-19 as a public health
emergency and has focused on preventing transmission of the virus.
Most states have stay-at-home orders to mitigate this risk in
communities. Other measures include:
• Foreign nationals who have been in affected countries cannot
enter the U.S.
• United States citizens who have traveled to affected countries
are subject to health monitoring and possible quarantine.
• Cruise ship travel should be deferred and the CDC has
published Travel Guidance on their website.
INFECTION CONTROL AND
PREVENTION CONSIDERATIONS
Infection control and prevention means using evidenced-based
practices to prevent and contain infections. They include
administrative policies and procedures, environmental hygiene, work
practices, and appropriate use of PPE. All healthcare workers,
including those paid and unpaid, who work in a healthcare setting
PRIORITY 2
symptomatic high-risk
individuals (as noted above) and
symptomatic first responders
Clinicians are strongly encouraged to test for other causes of
respiratory illness.
Additional information is available in CDC’s Interim U.S. Guidance for
Risk Assessment and Public Health Management of Healthcare
Personnel with Potential Exposure in a Healthcare Setting to Patients
with Coronavirus Disease 2019 (COVID-19).
Furthermore, if a person has a fever OR signs and symptoms of
lower respiratory symptoms AND they have had close contact with
a laboratory confirmed case of COVID-19 within 14 days of symptom
HEALTHCARE PROVIDERS
MUST OBTAIN A DETAILED
TRAVEL HISTORY FOR
PATIENTS BEING EVALUATED
WHO HAVE FEVER AND ACUTE
RESPIRATORY ILLNESS.