Healthcare FAQs

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• What should providers do regarding personal protective equipment (PPE)?
  • Providers should use standard, contact, and droplet precautions.
  • Facemasks are an acceptable alternative when respirators (i.e., N95) are not available and respirators should be conserved for procedures with high risk of aerosol-generation (i.e., sputum induction or bronchoscopy) when in short supply.
  • Eye protection, gown, and gloves continue to be recommended. If there are shortages of gowns, they should be prioritized for procedures with high risk of aerosol-generation.
  • Patients with suspected or known COVID-19 can be cared for in a single-person room. Airborne Infection Isolation Rooms should be reserved for patients undergoing for procedures with high risk of aerosol-generation.

  CalOSHA has developed guidance regarding the use of PPE:

  • Guidance for hospital and laboratory workers on preventing exposure to coronavirus
  • Guidance for health care facilities on the efficient use of respirator supplies

   

• Should my patient get tested?

  Testing should be considered for any person with a fever and cough who belong to any of the following populations:

  • Evidence of lower respiratory disease without alternative diagnosis, especially if hospitalized
  • Any resident of a senior living facility, including skilled nursing facilities or assisted living facilities
  • Persons who care for the elderly
  • Persons living in congregate settings (homeless shelters, etc.)
  • Health care workers, first responders, and other emergency workers

   

• How should my practice submit positive and negative test results?

  Send your positive and negative test results to the Epidemiology fax line: (858) 715-6458. For positive results, please also include the progress notes and patient demographics.

   

• When should I lift isolation for a patient?

  The CDC has developed guidance on lifting home isolation for patients suspected or confirmed to be infected with COVID-19, as well as guidance on lifting home isolation specific to immunocompromised patients suspected or confirmed to be infected with COVID-19.

   

• When can infected healthcare personnel return to work?

  The CDC has developed guidance for when healthcare personnel can return to work. If tests are unavailable, infected individuals should be excluded from work until:

  • At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
  • At least 7 days have passed since symptoms first appeared.

   

• Can Medi-Cal providers see their patients using telehealth?

  Yes, the California Department of Health Care Services has issued guidance on how Medi-Cal providers can use telehealth to deliver services.

   

• What should be done with potential cases at long-term care facilities?
  • Test for flu and other respiratory viruses.
  • Send those with severe symptoms to the hospital.
  • Staff and healthcare workers should use personal protective equipment when working with the suspected cases.
  • Cases should be cohorted per usual flu protocol.
  • Utilize available resources for rapid testing.

  Additional guidance for SNFs and long-term care facilities can be found here:

  • www.sdcms.org
  • www.PALTC.org

   

• What should I do if a healthcare organization is not complying with the PHO’s orders or CDC guidance?

  Per California Executive Order N-27-20, the California Department of Public Health (CDPH) is responsible for enforcement. Please file your complaint with CDPH here:

  https://www.cdph.ca.gov/Pages/contact_us.aspx

   

• Are there any emergency funds/grants available for healthcare providers to pay staff as they telework and keep their business open?

  Please see the Centers for Medicare and Medicaid Fact Sheet on telemedicine and temporary expansions as well as The San Diego Medical Society’s website (with a section dedicated to telemedicine) with other resources which we believe answer your question.

  If the business to which you are referring is a small business, please visit the following links below from the U.S. Small Business Administration (SBA):

  • Disaster Assistance in Response to the Coronavirus
  • Economic Injury Disaster Loan Program Information
  • News Release: San Diego Among CA Counties Declared Disaster Areas for SBA Assistance

  Another potential option might be the SAN DIEGO COVID-19 COMMUNITY RESPONSE FUND , hosted by The San Diego Foundation, offering no-interest loans for nonprofit organizations to provide business and community service continuity.

   

• How can healthcare workers reduce the risk of exposing their families to COVID-19?
  • 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 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.