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COVID-19

Updates

To Our Patients, Caregivers, and Families:

As COVID-19, a respiratory illness caused by a coronavirus, continues to spread through our local communities, Assisteo Home Health is committed to providing the timely resources, care and support our patients need to stay well. Since our patients are among the most vulnerable to this viral infection, we are making every effort to protect them from potential exposure, while continuing to provide the highest quality of home health care.

We understand the uncertainty surrounding COVID-19, and it is our goal to alleviate your concerns by taking immediate action to protect you and your loved ones. As your home healthcare provider, you can count on Assisteo Home Health staff to be vigilant to address this situation and providing the extra layer of protection and support you need.

Duration of Isolation and Precautions for Adults with COVID-19

New CDC Guidelines for COVID-19 discontinuation of isolation: Updated July 17, 2020

Accumulating evidence supports ending isolation and precautions for persons with COVID-19 using a symptom-based strategy. This update incorporates recent evidence to inform the duration of isolation and precautions recommended to prevent transmission of SARS-CoV-2 to others, while limiting unnecessary prolonged isolation and unnecessary use of laboratory testing resources.

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Recommendations

1. Duration of isolation and precautions

  • For most persons with COVID-19 illness, isolation and precautions can generally be discontinued 10 days after symptom onset1 and resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with improvement of other symptoms.

  • A limited number of persons with severe illness may produce replication-competent virus beyond 10 days that may warrant extending duration of isolation and precautions for up to 20 days after symptom onset; consider consultation with infection control experts.

  • For persons who never develop symptoms, isolation and other precautions can be discontinued 10 days after the date of their first positive RT-PCR test for SARS-CoV-2 RNA.

2. Role of PCR testing after discontinuation of isolation or precautions

  • For persons previously diagnosed with symptomatic COVID-19 who remain asymptomatic after recovery, retesting is not recommended within 3 months after the date of symptom onset for the initial COVID-19 infection. In addition,  quarantine is not recommended in the event of close contact with an infected person.

  • For persons who develop new symptoms consistent with COVID-19 during the 3 months after the date of initial symptom onset, if an alternative etiology cannot be identified by a provider, then the person may warrant retesting; consultation with infectious disease or infection control experts is recommended. Quarantine may be considered during this evaluation based on consultation with an infection control expert, especially in the event symptoms develop within 14 days after close contact with an infected person.

  • For persons who never developed symptoms, the date of first positive RT-PCR test for SARS-CoV-2 RNA should be used in place of the date of symptom onset.

3. Role of serologic testing

  • Serologic testing should not be used to establish the presence or absence of SARS-CoV-2 infection or reinfection.

Summary of Changes to the Guidance

Except for rare situations, a test-based strategy is no longer recommended to determine when to discontinue Transmission-Based Precautions.

For patients with severe to critical illness or who are severely immunocompromised 1, the recommended duration for Transmission-Based Precautions was extended to 20 days after symptom onset (or, for asymptomatic severely immunocompromised 1 patients, 20 days after their initial positive SARS-CoV-2 diagnostic test).

Other symptom-based criteria were modified as follows:

  • Changed from “at least 72 hours” to “at least 24 hours” have passed since last fever without the use of fever-reducing medications.

  • Changed from “improvement in respiratory symptoms” to “improvement in symptoms” to address expanding list of symptoms associated with COVID-19.

Here are the studies, if you would like to read the evidence behind the CDC’s decisions:

https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html#definitions

COVID-19 Illness Severity Criteria


Mild Illness: Individuals who have any of the various signs and symptoms of COVID-19 (e.g., fever, cough, sore throat, malaise, headache, muscle pain) without shortness of breath, dyspnea, or abnormal chest imaging. (10 days of isolation from when symptoms began and no fever for 24 hours without use of fever reducing medication, unless severely immunocompromised)

Moderate Illness:

Individuals who have evidence of lower respiratory disease by clinical assessment or imaging, and a saturation of oxygen (SpO2) ≥94% on room air at sea level. (10 days of isolation from when symptoms began and no fever for 24 hours without use of fever reducing medication, unless severely immunocompromised)

Severe Illness: Individuals who have respiratory frequency >30 breaths per minute, SpO2 <94% on room air at sea level (or, for patients with chronic hypoxemia, a decrease from baseline of >3%), ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2) <300 mmHg, or lung infiltrates >50%. (20 days of isolation from when symptoms began)

Critical Illness: Individuals who have respiratory failure, septic shock, and/or multiple organ dysfunction. (20 days of isolation from when symptoms began)

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Steps we are taking to protect our patients:

  • Constant training to our home care employees on COVID-19 and infection control

  • Communicating our Emergency Preparedness Plan to employees

  • Increasing handwashing and hand-sanitizing protocols: upon arrival, before/after direct contact and at regular intervals throughout the day

  • Wearing the appropriate personal protective equipment (PPE) when exposure to a known or potential case of COVID-19 is suspected

  • Responding quickly to any patient symptoms of COVID-19 (fever, cough, and shortness of breath, decreased senses)

  • Staying current with the latest news on COVID-19, released by the Centers for Disease Control and Prevention (CDC), and sharing relevant information with you

  • Complying with all COVID-19 guidelines from the CDC, AZDHS and all applicable federal, state, and local requirements

Tips to stay healthy and prevent the spread of the virus:

  • Wash your hands often with soap and water for at least 20 seconds, especially after using the bathroom, before eating and after blowing your nose, coughing or sneezing (If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol).

  • Avoid touching your mouth, nose, and eyes

  • Cover your cough using a tissue or into your elbow.

  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe

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Healthcare workers

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Click here for more information from the Centers for Disease Control and Prevention (CDC) on using Personal Protective Equipment (PPE).

Steps to help prevent the spread of COVID-19 if you are sick

Follow the steps below:  If you are sick with COVID-19 or think you might have COVID-19, follow the steps below to care for yourself and to help protect other people in your home and community.

Stay home except to get medical care

  • Stay home. Most people with COVID-19 have mild illness and can recover at home without medical care. Do not leave your home, except to get medical care. Do not visit public areas.

  • Take care of yourself. Get rest and stay hydrated.

  • Stay in touch with your doctor. Call before you get medical care. Be sure to get care if you have trouble breathing, or have any other emergency warning signs, or if you think it is an emergency.

  • Avoid public transportation, ride-sharing, or taxis.

  • Separate yourself from other people

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Watch for Symptoms of the virus:

(Symptoms may appear 2-14 days after exposure)

  • Fever

  • Cough

  • Shortness of Breath

  • Decrease in sensory to loss of taste and/or smell

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For more information on the virus and the prevention:

As this situation evolves, we will continue to take proactive measures to ensure the safety and well-being of our patients. Please reference the CDC’s website for more information about COVID-19, and check this web page regularly for the latest updates from Assisteo Home Health. From our families to yours, stay safe.

For more information on the virus and the prevention, see the links below.

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.azdhs.gov/preparedness/epidemiology-disease-control/infectious-disease-epidemiology/index.php#novel-coronavirus-home

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