COVID-19: Testing and Isolation/Quarantine Update

Posted March 20, 2020. Past health advisories and alerts are archived for historical purposes and are not maintained or updated.

Community transmission of COVID19 continues to occur in Washington, including Spokane County. Washington Department of Health (DOH) is maintaining current case counts by county.

 ACTIONS REQUESTED

  1. Prioritize testing individuals with compatible illness according to the following risk factors:
    1. Hospitalized with severe lower respiratory illness
    2. Work in healthcare setting (e.g., clinic, hospital, corrections, detention center, long-term care facility, mental/behavioral health clinic)
    3. Work in public safety (e.g., law enforcement, firefighter, EMS)
    4. Live or work in institutional or congregate setting
    5. Work in critical infrastructure (e.g., grocery, pharmacy, public utility, etc.)
  2. The following individuals should be tested if their symptoms worsen or their healthcare provider recommends testing:
    1. Patients ≥ than 60 years
    2. Patients with underlying medical conditions
    3. Pregnant women
  • Understand guidelines for isolation and quarantine of healthcare workers/first responders as well as members of the general community as written below.  With limited testing and slow turnaround time, patients should be advised to isolate per guidelines below if either they were tested or if COVID-19 is suspected.
  • For information on how to test (including which commercial labs are accepting specimens) and guidance on precautions, please see SRHD Alert from March 13, 2020 on our Alerts and Advisories for Healthcare Providers site.
  • Be aware Gov. Inslee has ordered halt to elective surgeries and dental services to reserve critical equipment for healthcare workers. This includes (but is not limited to) most joint replacements, most cataract and les surgeries, non-urgent cardiac procedures, cosmetic procedures, some endoscopy, non-emergent dental procedures and some interventional radiology services until May 18. Learn more here.

Isolation – Health Care Workers (HCW) and First Responders (FR):

Health Care Workers (HCW) and First Responders (FR) with confirmed COVID-19 should not return to work until at least 3 days (72 hours) have passed since recovery. Recovery is defined as:

  1. Resolution of fever without the use of fever-reducing medications AND improvement in respiratory symptoms (e.g., cough, shortness of breath)
    AND
  2. at least 7 days have passed since symptoms first appeared 

Healthcare workers and first responders can return to work provided they:

  • Adhere to respiratory hygiene, hand hygiene, and cough etiquette
  • Wear a facemask at all times while in the healthcare facility, if there is a sufficient supply of facemasks, until all symptoms are completely resolved or until 14 days after illness onset, whichever is longer.

Employers should consider reassigning recovered HCWs who work with severely immunocompromised patients, such as bone marrow transplant patients, to work in other areas.  

Guidance document for health care workers and first responders: doh.wa.gov/Portals/1/Documents/1600/coronavirus/HealthCareworkerReturn2Work.pdf  

Quarantine – Healthcare workers and First Responders:

Asymptomatic HCWs and FRs with High or Medium Risk Exposures to a known case of COVID-19 should actively monitor for symptoms consistent with COVID-19 infection but can return to work provided they:

  • Adhere to cough etiquette and hand hygiene
  • Wear a facemask at all times while in the healthcare facility, if there is a sufficient supply of facemasks, until the end of the 14-day monitoring period from date of exposure.

Guidance document: doh.wa.gov/Portals/1/Documents/1600/coronavirus/HealthCareworkerReturn2Work.pdf  

Isolation – General Public:

Consistent with CDC guidelines, WA DOH recommends persons with COVID-19 who have symptoms and were directed to care for themselves at home may discontinue home isolation under the following conditions:

  • 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.

Additionally, in an abundance of caution, SRHD recommends patients who have recovered from COVID-19 consider refraining from social gatherings of ≥ 10 persons and individuals at high risk of severe outcomes (people over the age of 60, people with underlying health issues) and continue social distancing and other appropriate non-pharmaceutical interventions (NPIs) for an additional 10-14 days beyond the recommended period of self-isolation.

Guidance document for general public:
doh.wa.gov/Portals/1/Documents/1600/coronavirus/COVIDcasepositive.pdf

Quarantine – General Public:

Individuals who have been in close contact with someone with COVID-19 should monitor their health for fever, cough and shortness of breath during the 14 days after the last day they were in close contact with the sick person with COVID-19.  They should not go to work or school and should avoid public places for 14 days. 

Guidance document: doh.wa.gov/Portals/1/Documents/1600/coronavirus/COVIDexposed.pdf  

ADDITIONAL RESOURCES

Washington State Department of Health and CDC have compiled additional guidance for healthcare providers, which is available on their website (this is a rapidly evolving situation and you should continue to check for updates to these documents): https://www.doh.wa.gov/Emergencies/NovelCoronavirusOutbreak2020/HealthcareProviders