INFECTION CONTROL AT THE
FEDERAL LEVEL
The United States has declared COVID-19 as a public health
emergency and has focused on preventing transmission of the virus.
Although most states have re-opened by easing up on stay-at-home
orders, certain CDC guidelines remain intact and include:
• Social distancing of 6 feet or more
• Wearing face masks in public settings, especially when social
distancing is difficult to maintain
• Frequent hand hygiene and avoidance of touching your eyes,
nose, and mouth with unwashed hands
The following restrictions remain for those who must travel outside
of the United States:
• 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
and who encounter patients during admission, assessment, care,
housekeeping, specimen collection, and triage, for instance, must
implement infection control precautions. Identification and
isolation are essential in preventing unnecessary exposure among
patients, healthcare workers, and visitors. Detailed
recommendations can be found on the CDC website, Interim
Infection Prevention and Control Recommendations for Healthcare
Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic.
At this point in time, scientists continue to study disease severity,
transmission efficiency, and shedding duration of COVID-19.
Considering what we know about SARs, MERs, and other viruses
such as influenza, transmission risk is more likely when symptoms
are present because shedding is more common during that time
with most viruses. What we do know now is that the virus spreads
easily from person to person, in fact, more efficiently than influenza
but not as efficiently as the measles. Some people without
symptoms may be able to spread the virus. This is why the
CDC has strongly advised social distancing. Those who go out in
public should wear a cloth mask to protect others.
It is important to be mindful of the fact that when droplets of
various sizes enter the air through coughing or sneezing, they can
land in the mouths and noses of people nearby (within 6 feet) and
can then be inhaled. They can also land on surfaces and it may be
possible that a person can get COVID-19 from touching a
contaminated surface, then touch their eyes, nose or mouth.
Thus, hand hygiene is extremely important. This is also why
recommendations for PPE include the use of N95 respirators,
gloves, eye shields and gowns.
Follow these important steps throughout the continuum of care
for infection control and prevention:
� Screen everyone who enters a healthcare facility, including
patients, visitors, and healthcare personnel, for symptoms and
exposure to others upon entry into your facility. Although
asymptomatic or pre-symptomatic individuals cannot be
identified, screening remains an important infection control step
because it can identify those who have COVID-19 so
appropriate precautions can be implemented. Ideally, screening
stations should be set up outside of the facility.
� Persons who call a healthcare facility with symptoms of
respiratory illness should be advised to wear a mask prior to
arrival. If emergency medical services are transporting a patient
with respiratory illness, they should take appropriate protective
precautions and alert the receiving facility prior to arrival so they
can prepare.
� Limit and monitor points of entry, and install barriers to limit
contact with patients at triage.
� Upon arrival at any facility, make sure the patient complies with
respiratory hygiene precautions, including cough etiquette and
hand hygiene. If the patient does not have symptoms and is
admitted for a non-COVID-19 reason, then assess them
daily for symptoms.
� Patients with symptoms of suspected COVID-19 should not wait
among other patients in the waiting area and should be placed in
a well-ventilated space with the door closed. They should be
provided with respiratory hygiene supplies. It is appropriate to
ask them to wait in their vehicle during the waiting time if they
can be contacted by phone when they are ready to be seen.
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