Philadelphia Medicine Spring 2020 - 10

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Confronting COVID-19 in Philadelphia
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(active monitoring vs. self-monitoring with delegated supervision)
based on epidemiologic risk factors.5 PDPH is prepared to perform active symptom monitoring for all medium and high-risk
HCP exposures.
As we prepare for increasing community transmission, protection of our most vulnerable populations is paramount. Long-term
care facilities where many persons may be highly susceptible are of
particular concern. In Washington state, 19 residents have died in
just one nursing home. Industry leaders are recommending strict
limits on nursing home visits across the country.
The outcomes of a COVID-19 outbreak at any long-term
care facility could be devastating. To limit the introduction of
COVID-19 into long-term care facilities, recent CDC guidance
recommends: 1) posting signs at the entrance instructing visitors
not to visit if they have symptoms of respiratory infection; 2) ensuring that sick leave policies allow employees to stay home if they
have symptoms of respiratory infection; and 3) assessing residents
for symptoms of respiratory infection upon admission to the facility and implementing appropriate infection prevention practices
for incoming symptomatic residents.6
As we begin to shift from containment to community mitigation strategies, public messaging is critical to empowering
the public to take appropriate protective measures. Given the
constant media coverage, the public is understandably concerned.
While the risk of getting COVID-19 in Philadelphia is still low,
this could change any day, so it is important to communicate consistent information to patients about what they can do to prepare.
Key messages include the following:
* Stay home when sick
* Avoid contact with sick people
* Practice good hand hygiene and respiratory etiquette
* Do not travel to affected areas
* Consider avoiding large crowds
* Use disinfectant wipes on shared surfaces

Additional information for the public is available on the City
of Philadelphia website: www.phila.gov/covid-19.
By the time of publication, much of the information presented here is likely to be outdated, but our tools for disease
containment and community mitigation are tried and true and
will continue to serve us as COVID-19 evolves over the coming
weeks and months. *
Dr. Alles is director of the Division of Disease Control at PDPH,
and Jessica Caum is Public Health Preparedness program manager at
PDPH.
Reference list
1. World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). February 2020.
2. Wu Z, McGoogan JM. Characteristics of and Important Lessons
From the Coronavirus Disease 2019 (COVID-19) Outbreak in
China: Summary of a Report of 72 314 Cases From the Chinese
Center for Disease Control and Prevention. JAMA. Published online
February 24, 2020. doi:10.1001/jama.2020.2648
3. Zhang S, Diao M, Yu W, Pei L, Lin Z, Chen D. Estimation of
the reproductive number of Novel Coronavirus (COVID-19) and
the probable outbreak size on the Diamond Princess cruise ship: A
data-driven analysis. International Journal of Infectious Diseases.
2020. doi:10.1016/j.ijid.2020.02.033
4. Interim Guidance: Evaluating and Reporting Persons Under
Investigation (PUI). Centers for Disease Control and Prevention.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html.
Published March 4, 2020. Accessed March 4, 2020.
5. Interim U.S. Guidance for Risk Assessment and Public Health
Management of Healthcare Personnel with Potential Exposure in
a Healthcare Setting to Patients with Coronavirus Disease 2019
(COVID-19). Centers for Disease Control and Prevention. https://
www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.
html. Published March 4, 2020. Accessed March 5, 2020.

* Maintain a two-week supply of water, food, and essential
household items, such as diapers, pet food, and cleaning 6. Strategies to Prevent Spread in LTCF. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/
products
healthcare-facilities/prevent-spread-in-long-term-care-facilities.html.
Published March 1, 2020. Accessed March 4, 2020.
* Maintain a month-long supply of prescription medications,
as well as over the counter products, such as fever-reducing
medications
* Seek information from credible sources, such as the CDC
and PDPH

10 Philadelphia Medicine : Spring 2020

http://www.phila.gov/covid-19 https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html http://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp. html https://www.cdc.gov/coronavirus/2019-ncov/ healthcare-facilities/prevent-spread-in-long-term-care-facilities.html

Philadelphia Medicine Spring 2020

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