� All visitors should be monitored, managed, restricted, and
trained. Because of asymptomatic or pre-symptomatic
transmission, source control must be implemented for everyone
entering a healthcare facility, regardless of their symptoms. This
includes healthcare personnel, patients, and visitors. Source
control involves the following:
• Visitors and patients should wear cloth masks. A facemask
may be used if available.
• Anyone entering the facility should be screened for fever
and symptoms.
� Discontinuation of transmission-based precautions must be
determined in collaboration with the local, state, and federal
health authorities on a case-by-case basis.
� If discharged to home because it is both medically and socially
appropriate to do so, follow the health department’s
recommendations for infection control in the home setting.
Patients should be instructed to maintain isolation at home if
they still require transmission-based precautions. They can
discontinue isolation if:
• It has been at least 3 days since they had a fever (without the
use of fever-reducing medications, AND
• They have an improvement in respiratory symptoms, AND
• It has been 7 days since symptoms first appeared OR they
have negative test results from at least 2 nasopharyngeal
swabs taken at least 24 hours apart.
As with any emerging infection, make sure that you become familiar
with the resources available on the CDC website. The CDC
updates information there as they learn it so checking in daily and
setting up an email notification for updates is strongly
recommended. The references below will provide you with detailed
information that you need should you suspect COVID-19 or have
to manage confirmed cases.
This is an ever-evolving disaster due to new findings and data and availability of resources, so refer to the CDC website for detailed
information when you need it.
REFERENCES
Centers for Disease Contol and Prevention. (n.d.). Coronavirus Disease 2019 (COVID-19) Cases in the U.S. Retrieved April 13, 2020, from https://
www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html#cumulative
Centers for Disease Control and Prevention. (2020, April 13). Coronavirus Disease 2019 (COVID-19) Cases in the U.S. Retrieved April 14, 2020,
from CDC: https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html
Centers for Disease Control and Prevention. (2020, April 7). Coronavirus Disease 2019 (COVID-2019) Infection Control. Retrieved April 14, 2020,
from CDC: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/infection-control.html
Centers for Disease Control and Prevention. (2020, April 10). Discontinuation of Isolation for Persons with COVID-19 Not in Healthcare Settings
(Interim Guidance). Retrieved April 14, 2020, from CDC: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html
Centers for Disease Control and Prevention. (2020, March 24). Evaluating and Testing Persons for Coronavirus Disease 2019 (COVID-19) Summary
of Recent Changes. Retrieved April 14, 2020, from CDC: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html
Centers for Disease Control and Prevention. (2020, January). Flowchart to Identify and Assess 2019 Novel Coronavirus. Retrieved April 14, 2020,
from CDC: https://www.cdc.gov/coronavirus/2019-ncov/hcp/2019-nCoV-identify-assess-flowchart-508.pdf
Centers for Disease Control and Prevention. (2020, April 13). How COVID-19 Spreads. Retrieved April 13, 2020, from CDC: https://www.
cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavi-
rus%2F2019-ncov%2Fprepare%2Ftransmission.html
Centers for Disease Control and Prevention. (2020, April 8). Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Patients
Under Investigation (PUIs) for 2019 Novel Coronavirus (2019-nCoV). Retrieved April 14, 2020, from CDC: https://www.cdc.gov/coronavi- rus/2019-
nCoV/lab/guidelines-clinical-specimens.html
Centers for Disease Control and Prevention. (2020, April 13). Interim Infection Prevention and Control Recommendations for Patients with Suspect-
ed or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. Retrieved April 14, 2020, from CDC: https://www.cdc.gov/coronavi-
rus/2019-ncov/hcp/infection-control-recommendations.html
Clinical management of severe acute respiratory infection when novel coronavirus nCoV infection is suspected: Interim Guidance. (2020, January 12).
Retrieved from World Health Organization: https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf?sfvrsn=bc-
7da517_2
Joshua P. Metlay, G. W. (2019, October 1). Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice
Guideline of the American Thoracic Society and Infectious Diseases Society of America. Retrieved from Infectious Disease Society of America: https://
www.idsociety.org/practice-guideline/community-acquired-pneumonia-cap-in-adults/
NIOSH. (n.d.).Three Key Factors Required for a Respirator to be Effective. Retrieved from Centers for Disease Control and Prevention: https://www.
cdc.gov/niosh/npptl/pdfs/KeyFactorsRequiedResp01042018-508.pdf
WHO. (2020, February 11). Novel Coronavirus(2019-nCoV) Situation Report - 22. Retrieved February 12, 2020, from World Health Organization:
https://www.who.int/docs/default-source/coronaviruse/situation-repor ts/20200211-sitrep-22-ncov.pdf?sfvrsn=fb6d49b1_2
World Health Organization. (2020, April 13). Situation Report - 84. Retrieved April 14, 2020, from World Health Organization: https://www.who.int/
docs/default-source/coronaviruse/situation-reports/20200413-sitrep-84-covid-19.pdf?sfvrsn=44f511ab_2
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