Outbreak
or pandemic
readiness is
multi-layered
and requires
effort at the
federal, state,
local and
individual
facility levels,
as evidenced
by Ebola.
Pandemic Preparation for COVID-19
Outbreak or pandemic readiness is multi-layered
and requires effort at the federal, state, local and
individual facility levels, as evidenced by Ebola.
Pandemic preparation guidance for COVID-19
is changing daily as the experts learn more about
this evolving illness. CDC continues to provide
ongoing updates to healthcare professionals. These
guidelines are extensive, and many resources are
available for healthcare professionals in acute-care
hospitals and for emergency medical service (EMS)
personnel. Guidance for outpatient care and other
inpatient facilities has not been provided at this
juncture; however, the CDC does recommend
that all healthcare providers and facilities refer to
the guidelines to keep updated on the evolving
situation. Key components to effective containment
of this emerging virus include the following:
Evaluating and Reporting Persons Under
Investigation (PUI)
The CDC clinical criteria for a 2019-nCoV person
under investigation (PUI) have been developed
based on what is known about MERS-CoV and
SARS-CoV and are subject to change as additional
information becomes available. Healthcare providers
should obtain a detailed travel history for patients
being evaluated with fever and acute respiratory
illness. The CDC’s guidance for evaluating and
reporting a PUI for MERS-CoV remains unchanged.
Criteria to Guide Evaluation of Persons Under
Investigation (PUI) for 2019-nCoV
For any patient meeting criteria for evaluation
for COVID-19, clinicians are encouraged to contact
and collaborate with their state or local health
department. For patients that are severely ill,
evaluation for COVID-19 may be considered even if
a known source of exposure has not been identified
Recommendations for Reporting, Testing and
Specimen Collection
Healthcare providers should immediately notify
both infection control personnel at their healthcare
facility and their local or state health department
in the event of a PUI for 2019-nCoV. State health
departments that have identified a PUI should
immediately contact CDC’s Emergency Operations
Center (EOC)
12
Interim Healthcare Infection Prevention and
Control Recommendations for Persons Under
Investigation for 2019-nCoV
This section of the guidance is extensive and
includes but is not limited to the “Guideline for
Isolation Precautions: Preventing Transmission of
Infectious Agents in Health Care Settings.”
PPE for Healthcare Personnel
As the guidance states, “Healthcare personnel
can protect themselves when caring for patients
by adhering to infection prevention and control
practices, which includes the appropriate use of
engineering controls, administrative controls, and
personal protective equipment (PPE). The CDC
has issued guidance recommending the use of
PPE for healthcare personnel caring for patients
with confirmed or possible 2019-nCoV infection.”
In summary, emerging pathogens capable of
spreading easily from person to person create a
vulnerable and potentially dangerous situation
worldwide, with the threat of outbreaks at any
time. Immunity is usually absent, resulting in
potentially severe repercussions for infected
patients. History has shown that four influenza
pandemics have occurred between 1918 and
2009. In addition, Ebola, the first hemorrhagic
viral disease arrived in 2014.
Government, state and local agencies are
working diligently to ensure that guidelines and
resources are available for healthcare professionals,
including those working in acute-care facilities,
to prepare for an isolated patient or an influx of
patients. It is the responsibility of these facilities to
ensure that action plans for pandemic preparedness
are developed, implemented, enforced and tested
by performing drills at various times, to ensure
that at any moment in time, they are prepared
for the inevitable.
Phenelle Segal, RN, CIC, FAPIC, is the founder
and president of Infection Control Consulting
Services (ICCS). She has more than 30 years’
experience and leads a team of highly skilled
infection preventionists who assist ICCS in
providing customized comprehensive infection
control and prevention services to healthcare
facilities nationwide.
march 2020 • www.healthcarehygienemagazine.com