Infection Mitigation Compliance
What are the temperature screening requirements for staff and patients?
The County’s Safe Reopening Plan requires that all County of San Diego essential and reopened businesses conduct temperature screenings and symptom questionnaires for all employees every workday prior to entering the workplace. Employees with a temperature of 100 ºF (37.8 ºC) or more shall be prohibited from entering the workplace.
CDC has also released guidelines on infection prevention and control (IPC) that include conducting temperature screening for individuals entering healthcare facilities. See the “Screen and Triage Everyone Entering a Healthcare Facility for Signs and Symptoms of COVID-19” section on the Interim Infection Prevention and Control webpage for detailed information on these practices.
What are the face covering requirements for staff and patients?
The CDPH’s Guidance for the Use of Face Coverings mandates that all residents must wear cloth face coverings that fully cover the nose and mouth in public, especially when social distancing is not possible. Certain individuals, including children under 2 years old and those with certain medical conditions are not required to wear face coverings. The County PHO's Order requires that all residents wear a cloth face covering whenever they are outside, in businesses and healthcare facilities, and within 6 feet of someone who is not from their household.
What kinds of face coverings are recommended?
Outside of a clinical setting, simple cloth face coverings are recommended. Face coverings should have at least two layers of washable fabric and should not contain exhalation valves which could allow viral particles escape. CDC does not recommend the use of face shields at this time as their effectiveness has not yet been determined nor the use of single-layered neck gaiters. For detailed guidance on how to select an appropriate face covering, wear it properly, and care for it, see visit the How to Select, Wear, and Clean Your Mask webpage from CDC, or the CDPH Face Covering Guidance.
What should I do if a business or healthcare facility/provider is not
complying with the County PHO’s Orders or CDC guidance, such as refusing
to wear a face covering or practice social distancing?
If you would like to report an employee of a business, such as a grocery store, pharmacy/drug store, restaurant or food establishment, convenience store, or gas station who is not wearing a face covering as required by the County PHO, please report it by filing a report with the San Diego Healthy Compliance Call Center by calling (858) 694-2900 or contacting the Safe Reopening Compliance Team via email at SafeReopeningComplianceTeam@sdcounty.ca.gov.
If you would like to file a complaint regarding a healthcare facility or provider, you may do so through the CDPH.
What should I do if a patient is not complying with the County PHO’s
Orders or CDC guidance, such as refusing to wear a face covering or
practice social distancing?
You may provide healthcare workers with N95 masks for additional protection if the patient is not following infection mitigation practices. Notify the patient that compliance with the County PHO’s orders is required by the State of California in healthcare settings and that non-compliance may result in future appointments being conducted remotely. If a patient refuses to be compliant, consider accommodating as much as possible by conducting a virtual visit, conducting an outdoor visit in a private area, scheduling in an well-ventilated room at end of the day or room with negative pressure, or minimizing the time of the in-person part of the visit. Non-compliance may be grounds for refusal of patient admission by healthcare facilities. If considering to refuse service, please consult your internal protocols first.
COVID-19 Testing and Reporting
Should my patient get tested for COVID-19?
Individuals who present with signs and symptoms characteristic of COVID-19 should be tested immediately. CDC has confirmed that pre-symptomatic and asymptomatic disease transmission are also possible. By testing individuals early on, public health authorities will be better able to conduct contact tracing and quarantine exposed individuals. Cumulative efforts from healthcare providers to identify symptomatic individuals and test them will help reduce the rate of transmissions in the community. For detailed information, including testing prioritization and locations in the County, please visit the Testing in San Diego County webpage.
The County of San Diego is also aware of the disproportionate impacts of COVID-19 in certain racial and ethnic populations that may be, in part, exacerbated by delayed testing after symptoms first appear. Efforts are underway to actively address these disparities and improve testing availability for these populations. For more information on the impact of COVID-19 on specific racial and ethnic groups in California, visit the CDPH’s COVID-19 Race and Ethnicity Data webpage.
What should providers do if they encounter patients sent home from
childcare, K-12 school, or an institution of higher learning and told to
contact their primary care providers?
Providers are asked to follow the appropriate County COVID-19 Symptom Decision Tree for childcare (narrated; Español), K-12 (Español), and institutes of higher education, trade, and vocational schools. If you are not able to offer testing at your office or medical group, refer the patient for testing to www.211sandiego.org as Rady can test young children and County-coordinated testing sites can test down to 6 months of age. For more information, see CAHAN update #18.
How can patients get tested if they are unable to reach or schedule an
appointment with their usual healthcare providers?
For patients seeking a COVID-19 test who are unable to be tested through their usual healthcare provider, please refer them to the 211 San Diego COVID-19 Testing website to locate a free county testing site and schedule an appointment. Before visiting a county testing site, individuals who meet the following criteria should attempt to be tested elsewhere first.
· Parents and caretakers of children should contact Rady’s Children Hospital for youth testing information by emailing firstname.lastname@example.org. If unable to be tested at a Rady’s site, County sites can accommodate patients as young as 6 months old.
· Employees of K-12 educational institutions may contact their school district for information on preferred testing sites.
· Youth and caretakers with Kaiser Permanente health insurance should seek testing directly through their healthcare provider.
County tests results are usually ready within three days. Alternatively, patients can be tested at a state site by visiting the California State Testing website or calling (888) 634-1123.
Patients with COVID-19-related questions or more complicated COVID-19 testing needs should call 2-1-1 so that the County’s trained nurses can receive and coordinate their treatment ahead of time.
Is re-testing of patients who test positive for COVID-19 recommended?
No. Providers should refer to CDC’s updated, symptom-based strategy for Ending Home Isolation and for discontinuation of transmission-based precautions for hospitalized patients. CDC’s Duration of Isolation Guidance does not recommend re-testing within 3 months for persons previously diagnosed with symptomatic COVID-19 who remain asymptomatic after recovery. For individuals who tested positive and subsequently develop symptoms associated with COVID-19 within 3 months of first symptom onset, CDC recommends possible re-testing, isolation, and consultation with an infection-control expert.
In addition, the CDPH Updated COVID-19 Testing Guidance advises against requiring re-testing before employees can return to work. Patients should instead be screened using symptom- or criteria-based guidelines.
What are the reporting requirements for COVID-19 cases or deaths?
The reporting of COVID-19 cases and deaths, caused directly or indirectly by COVID-19, is a critical component of the County of San Diego’s public health response to the pandemic and is required by law. All positive and non-positive SARS-CoV-2 test results (including point of care antigen tests and serology tests that have an Emergency Use Authorization from the U.S. Food and Drug Administration) must be reported by laboratories and include required fields such as address and race/ethnicity. All laboratory-confirmed COVID-19 cases must be reported by healthcare providers within 8 hours. Healthcare providers reporting positive COVID-19 results must complete all sections of the COVID-19 Confidential Morbidity Report Form and submit it to the County of San Diego Epidemiology Unit by fax to (858) 715-6458. For positive results, also include the progress notes and patient demographic information.
For more information, view the CAHAN announcement on COVID-19 reporting guidance or visit the County of San Diego Reporting Guidelines for COVID-19 webpage. The County Epidemiology Data Reporting Unit can be reached for questions at Epi-CDReporting.HHSA@sdcounty.ca.gov.
How should my practice submit positive and non-positive COVID-19
laboratory test results?
All positive and non-positive antigen and serology tests, including those under Emergency Use Authorization from the U.S. Food and Drug Administration (FDA), must be reported by laboratories. In addition, all laboratory-confirmed COVID-19 cases and COVID-19-associated deaths must be reported by healthcare providers by law. Healthcare providers reporting positive COVID-19 results must complete all sections of the COVID-19 Confidential Morbidity Report Form and submit it to the County of San Diego Epidemiology Unit by fax to (858) 715-6458. For positive results, also include the progress notes and patient demographic information.
What should I do if one of my employees is diagnosed with COVID-19?
Cooperate with the County Department of Public Health’s COVID-19 response team to identify and provide the contact information of any persons exposed by the employee at the workplace.
In addition, provide notice of the exposure to any employees and/or contractors who may have been exposed. Please see the County of San Diego Responding to COVID-19 in the Workplace webpage for more information. If you are unsure of the next steps in the healthcare reporting process, see this flowchart available in English and Español.
Employees who are unable to isolate or quarantine at home may be eligible for the Hotels for Healthcare Workers program through the State. To verify eligibility, call (877) 454-8785.
Per CDC guidance, employers should not require COVID-19-positive employees to provide a HCP’s note or test result to confirm illness, return to work, or take sick leave. This information may not be immediately available as many facilities are extremely busy at this time.
What specific instructions should healthcare providers provide to
patients who test positive for COVID-19?
Providers should provide patients with a copy of the following documents:
Patients who are unable to safely isolate or quarantine at home and do not require a higher level of care may be eligible for the County’s Temporary Lodging Program (English/Español) through their healthcare provider. Certain individuals experiencing homelessness or who are at higher risk may also be eligible for temporary lodging through the County. For more information and guidance from CDC on home care, refer patients to the Home Care of People Not Requiring Hospitalization for COVID-19 webpage.
Healthcare personnel who are unable to isolate or quarantine at home may be eligible for the Hotels for Healthcare Workers program through the State. To verify eligibility, call (877) 454-8785.
When can employees infected with COVID-19 return to work?
Persons infected with COVID-19 are isolated, even if they are asymptomatic. The County has released Home Isolation Instructions for COVID-19 that includes guidance on returning to work or school. In addition, CDC has developed Return-to-Work Criteria outlining when confirmed infected or suspected infected healthcare personnel (HCP) may return to work and what precautions they should take when returning. A test-based strategy is no longer recommended, and all decisions should be made in the context of other relevant information. In addition, the CDPH Updated COVID-19 Testing Guidance advises against requiring re-testing before employees can return to work due to the risk of false positive PCR tests. Patients should instead be screened using symptom- or criteria-based guidelines.
Upon returning to work, HCPs should self-monitor for symptoms and don a facemask in healthcare facilities until their symptoms are completely resolved or return to baseline.
When can employees exposed to a positive COVID-19 person return to work?
Healthcare workers, first responders, and other critical infrastructure workers should refer to their employer and CDC’s Critical Infrastructure Response Planning webpage for further guidance. Essential healthcare personnel who have had unprotected exposures (as defined by CDC) to a COVID-19-positive individual, but have tested negative themselves and continue to be asymptomatic, are advised to quarantine for 10 days before returning to work. If staffing is limited, they can return at 7 days with a PCR test conducted at or after 5 days. Alternatively, if staffing is critically low, then CDC guidance can be followed where asymptomatic healthcare workers with a negative test result may return to work under quarantine, if they meet the following criteria:
· their employer is aware of the worker’s exposure and approves of their return to work,
· they wear the appropriate PPE (facemask),
· they wash their hands, and
· they socially distance at least 6 feet away from others
· they monitor themselves for COVID-19 symptoms.
CDC continues to recommend that exposed individuals quarantine for the full 14-day period, if possible. For more information on quarantine guidelines, visit the When to Quarantine and Home Quarantine Guidance for COVID-19 Close Contacts webpages on CDC’s website and the COVID-19 Quarantine Guidance from the CDPH.
Once a COVID-19 vaccine is available, how is the County planning to
Once a vaccine is available in quantities suitable for distribution, the County will adhere to the distribution plan developed by the California Department of Public Health. The CDPH plan consists of a three-phased approach:
· Phases 1A, 1B, and 1C: Potentially Limited Doses Available;
· Phase 2: Larger Number of Doses Available; and
· Phase 3: Continued Vaccination, Shift to Routine Strategy.
Persons in healthcare settings who have direct exposure to patients (1A) and long-term care facility residents (1A); essential workers (1B); and increased-risk individuals (1C), including the elderly, will be prioritized in the event doses are limited. As supplies of the vaccine increase, the remainder of the population will be vaccinated in Phases 2 and 3.
In the meantime, the County recommends that HCPs register for the California Reportable Disease Information Exchange (CalREDIE) and San Diego Regional Immunization Registry (SDIR). These services will be used for disease reporting, disease surveillance, and vaccine distribution monitoring.
Do employees still need to wear a mask and practice social distancing
after getting a COVID-19 vaccine?
Yes, individuals who receive a COVID-19 vaccine must continue to adhere to social distancing and masking practices until advised otherwise by health officials. These practices, regardless of vaccination status, will continue to aid in reducing the virus’ spread among the general population. It is unclear whether the vaccine will prevent transmission of the virus to others. Herd immunity may be achieved eventually but is not possible until a majority of the population is vaccinated or develops natural immunity (estimated to be approximately 60-70% of the population).
If an employee tested positive for COVID-19 and has since recovered,
does he or she still need to get the vaccine?
Yes, recovered persons should still get a COVID-19 vaccination. While there is likely some degree of immunity lasting for weeks after an infection resolves, this natural immunity duration and the degree to which someone is protected after recovery are unclear at this time. A history of confirmed SARS-CoV-2 infection – symptomatic or asymptomatic – is not a contraindication for vaccination. In addition, serologic testing for antibodies is not recommended before vaccination.
Will individuals who get vaccinated for COVID-19 be able to infect others?
Current data suggest that COVID-19 vaccines are effective at preventing individuals from becoming ill. While these results are encouraging, they do not necessarily mean that vaccination will prevent people from becoming infected and subsequently transmitting SARS-CoV-2 to others. Until more is known about post-vaccination infection and transmissibility, it is recommended that vaccinated individuals continue to adhere to non-pharmaceutical interventions, including masking and social distancing, and continue to avoid contact with higher-risk individuals.
Should employees get a flu shot this season?
Yes, it is extremely important to get an influenza vaccination this season. While cases of influenza have thus far been low, CDC has increased the vaccine’s availability and strongly recommends getting vaccinated. In addition to protecting you from infection and severe illness, flu vaccination will help prevent you from infecting vulnerable populations, which is possible prior to you becoming symptomatic.
Importantly, getting a flu vaccine will help preserve already limited healthcare resources during the COVID-19 pandemic. It is challenging to distinguish influenza from COVID-19 or other respiratory illnesses. In addition, co-infections can further strain our testing, PPE supplies, and other healthcare resources.
Why should I get the COVID-19 vaccine?
Public health experts have determined that COVID-19 vaccine is safe and highly effective. Vaccination greatly reduces the risk of getting sick with COVID-19. If you do contract COVID-19 after vaccination, the course of illness will likely be less severe. Avoiding contracting COVID-19 also prevents long-lasting effects that have been reported. COVID-19 infection has been reported to cause long-term symptoms such as fatigue, shortness of breath, cough, joint pain, chest pain, difficulty thinking and concentrating (“brain fog”), depression, muscle pain, headache, and intermittent fever. In addition, some people have reported ongoing post-infection complications related to their heart, lung, kidney, skin, and nervous system. It is currently unclear whether vaccination prevents infection and the potential to transmit the virus to others, as described in "Do employees still need to wear a mask and practice social distancing after getting a COVID-19 vaccine?"
Is the vaccine required for healthcare personnel?
No. The vaccine is voluntary, but highly recommended.
What is the difference between Emergency Use Authorization (EUA) status
and full Food and Drug Administration (FDA) approval for a vaccine?
When a vaccine’s efficacy and safety has been demonstrated through rigorous testing, its manufacturer can apply for an EUA with 2 months of post-vaccine safety data. In order to apply for full approval, post-vaccine safety data over longer periods must be provided. The FDA is encouraging companies who receive EUA status to apply for full approval as soon as possible. Both EUA-approved vaccine manufacturers have reported outstanding safety data with only rare serious side effects (see Vaccination Question 24). In addition, California (with other western states) have formed their own safety review panel prior to distributing these vaccines; the review workgroup recommendations are available at the CDPH website.
What COVID-19 vaccines are currently available?
Two vaccines are available under EUA: Pfizer and Moderna vaccines.
• EUA issued on December 11, 2020
• Large-scale trial (44,000 participants) showed 95% efficacy
• Two-dose vaccine, requires ultra-cold storage (-70 oC)
• First shipments to specific cold storage-capable facilities
• 50 million doses to the world by end 2020 (6.5 million to US)
• 1.3 billion doses to the world in 2021
• EUA issued on December 18, 2020
• Large-scale trial (30,000 participants) showed 94% efficacy
• Two-dose vaccine, requires standard cold storage (-20 ºC)
• 20 million doses to the world by end 2020
• 500 million to 1 billion doses to the world in 2021
What is an mRNA vaccine?
The two EUA-approved vaccines are both mRNA vaccines. There is no live virus in mRNA vaccines. These COVID-19 vaccines are not the first mRNA vaccines to be studied: mRNA vaccines have been explored for influenza, rabies, CMV (cytomegalovirus), and Zika viruses. While mRNA technology has been under development for decades, the COVID-19 vaccines represent the first large-scale distribution of mRNA vaccines. Cancer research is also exploring using mRNA technology to trigger the immune system to target cancer cells.
How well does the vaccine work?
Both EUA-approved vaccines are effective at preventing symptomatic illness from COVID-19. The Pfizer and Moderna COVID-19 vaccines have both been tested in large trials involving tens of thousands of participants. In studies, the vaccine group had only 5% of the cases seen in the placebo (non-vaccine) group, a 95% efficacy at preventing COVID-19. For example, if the placebo (non-vaccine) group had 100 cases of COVID-19, the vaccine group would only have 5. Importantly, the vaccine not only prevented COVID-19 cases overall, but also prevented severe COVID-19 symptoms.
• COVID-19 vaccine Phase 3 trial (~44,000 participants)
• 95% efficacy (protection)
• All COVID-19 cases: 162 in placebo group vs. 8 in vaccine group
• Severe COVID-19 cases: 9 in placebo group vs. 1 in vaccine group
• COVID-19 vaccine Phase 3 trial (~30,000 participants)
• 94% efficacy (protection)
• All COVID-19 cases: 185 in placebo group vs. 11 in vaccine group
• Severe COVID-19 cases: 11 in placebo group vs. 0 in vaccine group
How many doses of the vaccine are required and how far apart are they administered?
Both the Pfizer and Moderna vaccines require 2 doses. Both doses are necessary to achieve the 94-95% protection that was observed in the trials. The second dose of the Pfizer vaccine is given 21 days after the first. Similarly, the second dose of the Moderna vaccine is given 28 days after the first. The same manufacturer’s vaccine should be administered at both visits; mixing vaccines from different manufacturers have not been studied.
What side effects do the vaccines have? What should I expect prior to
receiving the vaccine?
Thus far, vaccine trials have shown that COVID-19 mRNA vaccines are highly protective and generate a strong immune response. There may be side effects that feel like the flu, but do not signify infection. Instead, these symptoms are simply a sign that an immune response is generated. Below is some general guidance to consider before getting vaccinated.
Expect some symptoms after vaccination
• Both mRNA COVID-19 vaccines commonly cause mild-to-moderate, non- infectious, “flu-like” symptoms.
• While most people can continue regular activities after vaccination, some experience side effects that may inhibit their return to work for a day or two.
• Staff on the same shift or division should not all receive the vaccine on the same day.
• Staff should plan to receive the vaccine on the last day of a go-round or first day off shift.
• Staggering vaccinations by at least 3 days will ensure that agencies do not have a shortages of certain skill sets if employees are absent from work because of vaccine-related side effects.
Do not take anti-inflammatory medication prior to vaccination
• In general, use of over-the-counter medications such as aspirin, acetaminophen (e.g., Tylenol) and ibuprofen (e.g., Motrin, Advil) before receiving a vaccine can blunt the immune response. These medications may be used to treat discomfort after vaccination.
What if I missed my second dose? Can I get it late?
Data on vaccine benefit were based upon a fixed number of weeks between doses (3 weeks between Pfizer doses; 4 weeks between Moderna doses). The second dose should be administered, even if delayed. As of now, there remains no maximum allowable interval recommended by the CDC between the first and second dose. Any delay in receiving the second dose should be resolved as soon as possible without restarting the series.
Where can HCPs find additional information on COVID-19 vaccination?
Providers can consult the following resources from CDC:
· What to Expect After Getting a COVID-19 Vaccine (for distribution to patients) and
What PPE should providers utilize when contacting patients who are
confirmed or suspected to be COVID-19 positive?
Providers should don appropriate PPE and observe universal precautions when contacting patients who are confirmed or suspected to be COVID-19 positive. Standard, contact, and droplet precautions should also be observed to mitigate risk of exposure especially during aerosol-generating procedures (AGPs). Respirators and gowns should be conserved for procedures with a high risk of aerosol-generation (i.e., sputum induction or bronchoscopy) should they be in short supply.
Patients with suspected or known COVID-19 can be cared for in a single-person room. Airborne infection isolation rooms (AIIR) should be reserved for patients undergoing for procedures with a high risk of aerosol generation. In addition, patients should adhere to source-control practices by wearing a facemask while receiving medical treatment.
Depending on the prevalence of COVID-19 in the community, universal precautions may be recommended when initially caring for all patients.
What should providers do to minimize the risk of contracting SARS-CoV-2
while performing AGPs?
CDC has put forth specific Infection Prevention and Control guidance focusing on minimizing the risk of contracting SARS-CoV-2 during aerosol-generating procedures. Such procedures should be performed with the utmost caution or be avoided altogether, if possible. To minimize exposure, CDC recommends:
· wearing appropriate PPE including N95 mask (or equivalent) or respirator (without exhalation valves), eye protection, gloves, and gown;
· minimizing the number of HCPs in the room;
· implementing source-control measures such as placing masks on patients;
· utilizing engineering controls such as smoke-evacuation devices;
· performing procedures in an airborne infection isolation room (AIIR); and
· disinfecting room surfaces promptly in accordance with environmental infection control guidelines.
For detailed information and considerations related to AGPs, visit CDC’s Infection Control FAQs.
When can patients discontinue their home isolation?
Quarantine is for individuals who are asymptomatic and have been exposed to the virus. Isolation is for symptomatic or otherwise infectious individuals. Persons infected with COVID-19 must isolate per the California Health and Safety Code, even if they are asymptomatic. For detailed guidance by the County on isolation procedures, refer to the PHO’s order.
CDC released symptom-based guidance regarding the Discontinuation of Home Isolation for Persons with COVID-19 Not in Healthcare Settings. The update contains information to help providers determine the appropriate amount of time patients should be isolated and what additional precautions should be taken during that time. In addition, the County of San Diego has also released Home Isolation Instructions for COVID-19 for people with confirmed or clinically suspected COVID-19.
What should be done with potential cases at long-term care facilities
(e.g., skilled nursing facilities, intermediate care facilities,
residential care facilities for the elderly, etc.)?
Outbreaks in these facilities are associated with high morbidity due to patients’ advanced age and congregate living conditions. The CDPH’s All Facilities Letter (AFL) 20-53.3 details the following information for SNFs:
· general testing guidance,
· arrangements with laboratories to process tests,
· plans to utilize test results, and
· procedures for residents and HCPs who test positive.
The County of San Diego also issued Congregate Facilities Guidance for COVID-19 elaborating on the CDPH order. Additional guidance can be found on the County’s Long-Term Care and Residential Facilities webpage.
Is additional expert clinical guidance available regarding questions on
the clinical management of patients with COVID-19?
CDC has partnered with the Infectious Diseases Society of America (IDSA) to offer a new service to clinicians treating COVID-19 patients. Clinicians who have questions about the clinical management of patients with COVID-19 can call the main CDC information line at (800) 232-4636. Calls from clinicians will be triaged by CDC to a group of IDSA volunteer clinicians for peer-to-peer support.
What is the guidance for healthcare organizations in the event of a
While there are still respirator shortages in some sectors, California healthcare providers are no longer experiencing an extreme respirator shortage. Manufacturers are increasing respirator production and many distributors are making respirators available to employers through allocation protocols. In addition, state and local governments are procuring respirators to support healthcare facilities.
Cal/OSHA issued interim guidance in the event of Severe Respirator Supply Shortages. Each method below, or a combination thereof, may be used to extend supplies of N95 respirators provided higher-level protections are implemented first. Surgical masks cannot be used where a respirator is required, such as during AGPs on a suspected or confirmed COVID-19 patient. Acceptable optimization strategies to preserve respirators include:
· using reusable NIOSH-certified respirators instead of disposable filtering facepiece respirators,
· using NIOSH-certified industrial filtering facepiece respirators,
· allowing employees to wear their own respirators if it complies with Cal/OSHA requirements,
· using fit-testing methods that maximize respirator supplies and fit-testing efficiency,
· using certain expired NIOSH-certified filtering facepiece respirators,
· using methods to preserve existing stocks of filtering facepiece respirators,
· extending the use of the same respirator under certain circumstances, and
· storing disinfected filtering facepiece respirators in case of future shortages.
To request respirators and other PPE from the County, HCPs and offices should contact MOC.LOGS.HHSA@sdcounty.ca.gov.
Resources for Providers
Can healthcare providers be reimbursed for COVID-19 patient counseling?
Yes, the Center for Medicare and Medicaid Services (CMS) and CDC announced that providers can be reimbursed for patient counseling at the time of COVID-19 testing, using existing evaluation and management (E/M) payment codes. For general information on telemedicine, visit the County’s Telemedicine – Quick Guides & Fact Sheet webpage.
Can Medi-Cal providers see their patients using telehealth?
Yes, the California Department of Health Care Service’s Telehealth Provider Manual provides detailed information on how providers can deliver services virtually. In addition, the Federal Communications Commission’s COVID-19 Telehealth Program offers reimbursements for eligible healthcare providers utilizing telehealth services. For general information on telemedicine, visit the County’s Telemedicine – Quick Guides & Fact Sheet webpage.
Are there any emergency funds/grants available for healthcare providers
to pay staff as they telework and keep their business open?
Yes, there are multiple opportunities for funding. For a full listing, visit the County’s Financial Assistance webpage. For information pertaining to small businesses, please visit the following links from the US Small Business Administration (SBA) below:
The San Diego Foundation has multiple funding opportunities for small business and non-profit organizations, including the COVID-19 Community Response Fund, to facilitate business and community service continuity.
How can healthcare workers reduce the risk of exposing their families to COVID-19?
: Providers can mitigate the risk of exposing their families by adhering to the following practices.
· Remove Work Shoes. If possible, shoes that have been worn in a clinical location should be removed before entering your home. Shoes can be disinfected with a household disinfectant or alcohol spray.
· Remove Work Clothes and Wash Immediately. Work clothes should be removed when you get home before coming in contact with family members or household surfaces (i.e. couches, beds, tables, etc.). It’s preferable to wash clinical work attire with a hot water wash cycle (ideally with bleach) followed by a cycle in the dryer.
· Shower/Bathe Prior to Greeting Your Family. Explain this routine to your family/children so that they understand why you may not immediately greet them upon arrival. If it is not possible to shower/bathe, make sure that areas of skin not covered by your work attire are washed properly with soap and water.
· Wipe Down Personal Items. Wipe down any personal items such as purses and cell phones with disinfectant or cleaning wipes.
· Continue to Monitor for Symptoms of Illness. Everyone should continue to monitor for any symptoms of illness or fever. If you are sick or have a fever, you should isolate yourself and seek further medical advice before going to work or out in public.
Are there behavioral health resources available to healthcare
professionals during the COVID-19 pandemic?
The County has released a one-page flyer with information on free resources on maintaining mental health and wellness during the COVID-19 outbreak for healthcare professionals, first responders, and emergency workers. The flyer contains recommendations for self-care, common signs of distress, and where to seek help. Healthcare workers looking for additional behavioral health resources can visit following webpages:
· Behavioral Health Services Flyer (English/Español), and
· How to Manage Your Mental Health and Cope During COVID-19 (available in multiple languages).
For immediate, confidential assistance, call the San Diego Access and Crisis Line at (888) 724-7240. The service connects callers with an experienced counselor 24 hours a day, 7 days a week.
Are there behavioral health resources available to share with patients?
Providers can refer their patients to the following resources:
· Behavioral Health Services Flyer (English/Español), and
· How to Manage Your Mental Health and Cope During COVID-19 (available in multiple languages).
For immediate, confidential assistance, call the San Diego Access and Crisis Line at (888) 724-7240. The service connects callers with an experienced counselor 24 hours a day, 7 days a week.
What steps can parents and caregivers take to keep children healthy
during influenza season (and during the pandemic in general)?
The CDPH released a Health Update on November 12, 2020 detailing the importance of maximizing routine immunizations, especially for children, during the pandemic. Obtaining vaccination against influenza, in particular, will not only reduce the risk of concurrent respiratory illnesses, but also help preserve valuable healthcare resources. For more information and weekly flu surveillance updates, visit CDC’s Influenza webpage.
Parents of children who are due for immunizations and/or a well child check-up should contact their provider’s office for further guidance. The County also has related resources on well-child check-ups and immunizations in its Pediatric Provider Toolkit.
Does the county have informational materials such as flyers and posters
for distribution to the general public and around the workplace?
Yes, the County has created many general-purpose, free resources such as fact sheets, flyers, and videos in multiple languages. Visit the County’s Resources and Materials webpage to browse the available content. The Health Professionals Clinical Toolbox – Resources and Materials for Practices and Clinics has additional resources specifically for clinical practice including information on face coverings, contact tracing, and general operations. The County also has related resources on well-child check-ups and immunizations in its Pediatric Provider Toolkit.
Where can Medi-Cal beneficiaries find more information about their
healthcare choices to select a Medi-Cal managed care plan?
The County’s Healthy San Diego program informs patients of the different Medi-Cal healthcare options available to them. For a full listing of all important contact information, see this Healthy San Diego informational brochure (available in multiple languages).
Where can patients without private transportation find updated
information on public transportation schedules and shuttle services
during the pandemic?
Many transportation schedules and operations have disrupted by the ongoing pandemic. For residents, including seniors, persons with disabilities, and veterans, who need transportation for essential needs, the San Diego Find Access to Coordinated Transport (FACT) program is providing free rides. To schedule an appointment, call (888) 924-3228 Monday through Friday between 8:00 AM and 3:00 PM or visit the San Diego FACT webpage. Older residents using the San Diego Ride Well to Age Well Program should consult the updated COVID-19 guidance on the County’s website. For guidance on minimizing the risk of exposure while using public transportation, visit CDC’s Using Transportation webpage. Medi-Cal beneficiaries who have selected a managed care Medi-Cal Plan should contact their Plan’s customer service, in order to learn how to access covered transportation services.
Are there any available childcare services available for employees
during the pandemic?
The local YMCA Child Care Resource Services agency can assist with childcare through its enhanced referral for healthcare workers, first responders, law enforcement, and military personnel. Call the hotline at (619) 952-0242 between Monday to Friday from 8:00 AM - 5:00 PM, and their specialists will help locate a provider that matches your family’s immediate needs.
Are there opportunities for California emergency medical technicians,
paramedics, nurses, and doctors to volunteer?
Yes, healthcare workers can sign up on the California Health Corps website for emergency medical staffing roles. On the California Health Corps registration form, they will be asked to choose one or both of these two programs: the San Diego Medical Reserve Corps (MRC) and the California Medical Assistance Team (CAL-MAT).
Providers who would like to volunteer locally can e-mail MRC-VOLCOORD.HHSA@sdcounty.ca.gov with their name, certification level, and contact information. These volunteers may be used for other specific missions within San Diego County.
What opportunities are there for medical and nursing students interested
Students can sign up through the California Health Corps website for emergency medical staffing roles.
Can recovered COVID-19 patients donate blood?
Yes, recovered individuals may donate convalescent plasma provided they meet the standard blood donation guidelines. For more information and FAQs, visit the San Diego Blood Bank COVID-19 and Convalescent Plasma Donation webpage (English/Español). In addition, patients can donate blood through the American Red Cross. Visit the Red Cross Plasma Donations from Recovered COVID-19 Patients webpage for more details.
For additional questions and resources, please email: MCSDCallCenter.HHSA@sdcounty.ca.gov