Provider Responsibilities and Guidance

Isolation and Quarantine Protocols​ (PDF)

Cases

 

Symptomatic

Asymptomatic

Case
(all cases regardless of setting)

Isolation Period: Starts immediately. If case is symptomatic, isolation can be discontinued after:

  • At least 10 days since symptoms first appeared, AND

  • At least 24 hours with no fever (without the use of fever-reducing medications); AND

  • Improvement in other symptoms.

Testing: No additional testing needed after a positive test.

Isolation Period: Starts immediately and ends 10 days after collection date of positive test.

Testing: No additional testing needed after a positive test.

Case in high-risk, congregate setting (e.g., jails, shelters, SNFs/LTCFs, dormitories)

Follow the same guidelines as above.

Follow the same guidelines as above.

Case (severely ill or immunocompromised)

Discontinuation of isolation policies in hospital settings should be determined by the individual institution. NOTE: The timeframe from symptom onset could be extended to up to 20 days for individuals who are severely immunocompromised (e.g., currently receiving chemotherapy, or recent organ transplant), or who had critical illness (e.g., required intensive care).

 

Close Contacts

 

Symptomatic

Asymptomatic

Close Contact

Quarantine Period: Starts immediately and ends 10 days after last exposure to case AND until 24 hours after fever resolution and improvement in other symptoms, whichever is longer.

Close contacts who develop symptoms before Day 10, but who test negative, must remain in quarantine for at least 10 days AND until 24 hours after fever resolution and improvement of other symptoms.

Close contacts who develop symptoms between Days 11 – 14 must retest after symptoms began. Those who test negative must remain in quarantine until 24 hours after fever resolution and improvement in other symptoms.​

If close contact continues to be exposed to a case during their isolation, the Quarantine Period starts immediately and ends 10 days after case’s isolation period ends. This may last about 20 days.

Testing:

  • Test immediately because contact is symptomatic:

    • If positive, continue to follow Home Isolation Steps.

    • If negative and the test was earlier than 6 days after last exposure to case, repeat testing towards the end of the Quarantine Period.

    • If negative and the test was done after 6 days from the last exposure to the case, the close contact must remain in quarantine for a full 10 days.

Please note: all symptomatic close contacts must quarantine and get tested immediately, regardless of vaccination status.

​Quarantine Period1: Starts immediately and ends 10 days after last exposure to case.

Close contacts without symptoms may end quarantine after Day 10 from last exposure but should continue monitoring for symptoms for a full 14 days. If close contact continues to be exposed to a case during their isolation, the Quarantine Period starts immediately and ends 10 days after case’s isolation period ends. This may last 20-24 days.

Testing2:

  • Test at day 6 after last exposure to case.

  • Test immediately, if the close contact becomes symptomatic during quarantine.

  • If testing is done earlier than 6 days after the last exposure to case, repeat testing towards the end of the 10 day Quarantine Period.

Fully Vaccinated Individuals:

Vaccinated Close Contacts3,4 should follow CDC recommendations. In general, they are not required to quarantine if they meet all of the following criteria:

  • Are fully vaccinated (i.e., ≥14 days following receipt of the second dose in a 2-dose series, or ≥14 days following receipt of one dose of a single-dose vaccine),

  • Have remained asymptomatic since the current COVID-19 exposure.

  • Are not an inpatient or resident in a healthcare setting or facility

See section below on Quarantine Guidance for Fully Vaccinated People for more information.

 

1Workers with special quarantine considerations: Consult your employer if you are considered a first responder or healthcare worker and compliance with the Public Health Department’s isolation and quarantine guidance would compromise the continuity of service of your operation or department. If critical staffing shortages exist, healthcare workers may follow the recommendations outlined here​.

2The Public Health Department may provide alternative testing recommendations in congregate settings and during cluster investigations.

3Fully vaccinated healthcare workers who have been exposed to COVID-19 case are not required to quarantine outside of work if they meet the above criteria. For more information, see section on Managing Exposures Among Healthcare Workers.

4Inpatients and residents in healthcare settings should continue to follow CDPH quarantine guidance for healthcare settings following an exposure to someone with suspected or confirmed COVID-19.

 

See the Home Isolation and Quarantine Guidelines handout for patients with detailed instructions.
(PDF): | English​ | Chinese | Spanish | Vietnamese | Tagalog​ |

 

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Managing Exposures Among Healthcare Workers

Fully Vaccinated Healthcare Workers

Fully vaccinated Healthcare Workers (HCWs) should follow CDC guidance for healthcare settings, as well as their employer’s guidance. Fully vaccinated is defined as: ≥14 days following receipt of the second dose in a 2-dose series, or ≥14 days following receipt of one dose of a single-dose vaccine. In general, fully vaccinated HCWs who are asymptomatic do not need to be excluded from work or quarantine after a high-risk exposure. Some exceptions may apply. Work exclusion may still be considered for HCWs who have underlying immunocompromising conditions. HCWs who have traveled should follow CDC’s travel recommendations and requirements, including restrictions from work, when recommended for any traveler. HCWs who work in congregate settings (e.g. long-term care facilities) please see CDPH All Facilities Letter dated March 23, 2021.

Non-vaccinated or Partially Vaccinated Healthcare Workers

Non-vaccinated or partially vaccinated HCWs should continue to follow CDC guidance for Potential Exposure at Work, as well as CDPH All Facilities Letter dated March 23, 2021, which provides guidance for HCWs based on vaccination status.

Mitigation Strategies During Critical Staffing Shortages

HCWs who are not fully vaccinated after experiencing a higher risk exposure in the workplace or identified as a close contact in the community should continue to follow County guidance for quarantine. However, during times of critical staffing shortage, healthcare facilities are recommended to follow CDC staffing shortage mitigation strategies and guidance on Potential Exposure at Work, as well as CDPH guidance. In general, to alleviate critical staffing shortage, asymptomatic HCWs who are not fully vaccinated may return to work after Day 7 from date of last exposure if they received negative PCR test result from specimen collected after Day 5. See CDPH All Facilities Letter for more information.

The following recommendations may also be considered for HCWs who have not been fully vaccinated, in the context of returning them to work during their quarantine periods to mitigate critical staffing shortage.

  1. The HCW is asymptomatic (or symptoms are resolved per policy).
  2. The HCW undergoes the following testing regimen:
    1. A COVID-19 test is done immediately upon learning of exposure and the test result is negative.
    2. The HCW will remain off work until the COVID-19 test is resulted.
    3. Thereafter, during the remainder of the Quarantine Period, the HCW’s COVID-19 status shall be monitored with approximately daily rapid antigen tests or RT-PCR tests every 3 days. Test type and frequency will depend on testing availability and schedules.
  3. The HCW must wear an N95 respirator and all other required PPE at all times during the Quarantine Period.
  4. The HCW must not eat, drink, or be unmasked around others at any time, regardless of social distancing.
  5. The HCW continues to monitor COVID-19 symptoms daily. If the HCW develops symptoms, the HCW must leave work, contact their Manager/Employee Health, and be tested
  6. The HCW maximizes social distancing (even beyond 6 feet) wherever possible with both patients and co-workers, maintains excellent hand hygiene at all times.
  7. The HCW does not work with severely immunocompromised patients or individuals (e.g., cancer, organ transplants).
  8. The HCW’s work duties are assigned in a manner that minimizes the number of different patients cared for by the HCW.
  9. The HCW is still under home quarantine for 10 days after last exposure except to go to work. The HCW must not carpool, taxi , or rideshare.

Quarantine Guidance for Fully Vaccinated People

According to CDC’s definition, people are considered fully vaccinated:

  • ≥14 days following receipt of the second dose in a 2-dose vaccine series (such as Pfizer or Moderna), or
  • ≥14 days following receipt of one dose of a single-dose vaccine (such as Johnson & Johnson)

Fully vaccinated individuals are recommended to follow CDC guidance for travel, social gatherings, and other activities. In general, fully vaccinated individuals are allowed to gather in-doors with other fully vaccinated people of any age, travel domestically without the need to test before or after travel, and forego quarantine after either domestic or international travel. There are still other restrictions and considerations that may apply to fully vaccinated individuals. Please see CDC guidance for more information.

Persons who are not fully vaccinated should continue to follow current County guidance. Healthcare personnel please see section above on Managing Exposures Among Healthcare Workers for workplace specific guidance based on their vaccination status.

*Fully vaccinated inpatients and residents in healthcare settings should continue to follow CDPH quarantine guidance for healthcare settings following an exposure to someone with suspected or confirmed COVID-19; outpatients should be cared for using appropriate Transmission-Based Precautions.

For more information, see CDC webpage on COVID-19 Vaccines.

 

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Guidance for a Suspected COVID-19 Case

What to do if you suspect that your patient may have COVID-19:

  1. Call the Public Health Department (408-885-4214, ext. 3; ask for Provider Response Branch) immediately if your patient resides or recently resided (within the last two weeks) in any of the following facilities:
    1. ​Long-Term Care Facility (LTCF), including a skilled nursing facility (SNF)
    2. Other congregate residential setting, e.g., jail, homeless shelter or encampment, group home, board and care. We will call the facility to assess the situation and facilitate testing.
  2. ​​F​or p​atients who do not require a call to the Public Health Department, offer testing.
    1. ​​​​Unlike early in the pandemic, laboratory testing capacity has now increased significantly, as has the supply of nasopharyngeal swabs. Additionally, we are finding that many COVID-19 patients do not present with classic symptoms, and many are asymptomatic. Therefore, similar to the California Department of Public Health, we recommend broad expansion of testing immediately, guided by the criteria below. Testing should be performed even if the diagnosis of COVID-19 can be made on clinical and epidemiologic grounds.​ Additional testing resources can be found on Where to Get Tested.

      Healthcare providers must offer testing to the following individuals:

      1. All Symptomatic Persons*, regardless of age, hospitalization status, comorbidities, or other risk factors for COVID-19; 
      2. All persons, with or without COVID-19 Symptoms*, who report that they have been exposed to a confirmed case of COVID-19;
      3. All persons who are referred by the County Public Health Department to their provider for COVID-19 Diagnostic Testing; 
      4. All persons, with or without COVID-19 Symptoms, who are "Essential Workers" as defined by the COVID-19 Diagnostic Testing emergency regulation of the California Department of Managed Health Care, 28 C.C.R. § 1300.67.01(b)(5), also currently available at: https://wpso.dmhc.ca.gov/regulations/docs/regs/50/1594998444637.pdf

For more information, please see the September 16, 2020 Health Officer Testing Order

  1. ​If you decide that testing is indicated:
    1. ​Arrange for testing.​
      1. Each hospital and healthcare system in the area should now have a contract with a private lab for testing. Additional Santa Clara County testing resources can be found on Where to Get Tested.
    2. Review the Home Isolation and Quarantine Guidelines with the patient and give the patient a copy of the handout.
      1. ​It is your responsibility to tell the patient to self-isolate while awaiting test results and to follow the instructions on the handout.
    3. ​Inform the patient that you will contact them with the test results.
      1. ​If the result is positive:
        1. Inform the patient of the result and instruct the patient to follow the isolation instructions in the Home Isolation and Quarantine Guidelines. In addition, instruct the patient to notify their close contacts of their exposure and provide them with the handout for guidance on how to quarantine (also found at http://sccstayhome.org).
        2. Provide close contact information on the case report form whenever possible. If close contacts cannot be elicited from the patient, please be sure to include the contact information of next of kin.
          1. Please note, as of 3/17/2021, PHD reinstated requirement for providers to report ALL confirmed COVID-19 cases.
          2. NEW- Providers must also indicate in their report patients who tested positive after having been fully vaccinated (≥14 days following receipt of the second dose in a 2-dose series, or ≥14 days following receipt of one dose of a single-dose vaccine).
          3. Also, employers are still obligated to report employee and patron cases to Public Health in accordance with orders by the Public Health Officer. This requirement includes patients and visitors exposed at a healthcare facility or patient cases suspected to be part of a healthcare-associated outbreak. To report COVID-19 cases in employees and patrons, please go here​.
          4. We recommend prioritizing the following fields if unable to complete the entire form: Contact for next of kin, Resident of congregate setting, Symptom onset date, and Date of admission. If time allows, symptom and comorbidity information should also be completed.
      2. If the result is negative:​​
        1. ​Inform the patient of the result and instruct the patient to follow the instructions for negative tests in the "What To Do After You Get Your Results" section on the Home Isolation and Quarantine Guidelines.​

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​Guidance for Patients Leaving Against Medical Advice

Hospital providers should continue to follow their existing policies regarding patients leaving against medical advice, with additional processes noted below.

  1. If a patient who is suspected or confirmed to have COVID-19 desires to leave AMA, the Public Health Department does not need to be, and should not be, contacted.
  2. If the individual is suspected or confirmed COVID-19 case, the patient should be instructed to isolate for the following period:
    1. If symptomatic, at least 10 days from the date of symptom onset AND at least 24 hours from the date of symptom resolution (resolution of fever without the use of fever-reducing medication and substantial improvement in other symptoms).
    2. If asymptomatic or with an unclear date of symptom onset, at least 10 days from the date of specimen collection. 

​For information regarding supportive services for patients:

  1. Food delivery resources :
    1. If your patient is experiencing food insecurity, have them call 1-800-984-3663 to be screened and confirm the need for food delivery.
    2. If a need for food delivery is determined, a one-week supply of groceries will be delivered at the front door of the patient's address.​
    1. Isolation and quarantine support referrals for housed patients:
      1. If a patient is unable to self-isolate or quarantine (e.g., they share a room where they cannot adequately physically distance, or a bathroom or kitchen facility that they cannot adequately disinfect), call 408-808-7770 to obtain assistance with at-home isolation/qua​rantine or to determine placement eligibility at motels/hotels/inns. Staff are available to conduct screening of the referral 7 days a week from 8:00 a.m. to 5:00 p.m. If no staff member is available to take your call, please leave a message and it will be returned promptly. We are prioritizing housing accommodations for high risk and vulnerable individuals. 
         
    2. Homeless referrals including support for isolation and quarantine: 
      1. Mondays – Fridays (except holidays)
        Please call 408-278-6420 for all your referrals. Staff are available to conduct screening of the referral from 9:00 a.m. to 6:00 p.m. to determine placement eligibility at one of the shelters or motels/hotels/inns. If you are unable to reach us, please leave a detailed voicemail, including your name and phone number, and your call will be returned. 
      2. Saturdays – Sundays (including holidays)
        Please call 408-808-7770 for confirmed COVID patient referrals. Staff are available to conduct screening of the referral from 8:00 a.m. to 5:00 p.m. to determine placement eligibility at motels/hotels/inns. For any other referrals, please call 408-278-6420 and leave a detailed voicemail with your name and phone number for your call to be returned on the next business day.  
      3. If you have any questions about this process, please email [email protected] or call 408-808-7770. 

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    Reporting COVID-19 Cases:

    Providers must report to PHD in compliance with the following chart:

    Provider Responsibilities to Report COVID-19 Cases

    Class of Cases

    Who Must be Reported

    How to Report

    Patients with a positive COVID-19 test received by ordering healthcare provider

    As of 3/17/2021, PHD has reinstated the requirement for providers to submit a Case Report Form for ALL confirmed COVID-19 cases

    NEW- Providers must indicate in their report patients who tested positive after having been fully vaccinated (≥ 14 days following receipt of the second dose in a 2-dose series, or ≥14 days following receipt of one dose of a single-dose vaccine)

    NEW - complete an online COVID-19 Case Report Form (version 4.12.2021). Providers who wish to may still report using the PDF form and submit by email or fax. Form now includes option to report post-vaccinated cases.

    See section below on how to submit a Case Report Form to PHD.

    Healthcare facility outbreaks*

    Providers must report all employee or patient cases and contacts associated with a healthcare facility outbreak (3 or more epidemiologically linked* cases of any combination of: confirmed COVID-19 in a patient 7 or more days after admission for a non-COVID condition OR confirmed COVID-19 in a healthcare worker).

    Call PHD at 408-885-4214, ext. 3 

    (8:00 a.m. – 5:00 p.m.; 7 days a week)

    Congregate setting outbreaks*

    Providers must urgently report all confirmed COVID-19 cases among residents and staff in a congregate setting. In addition, providers must report any suspected congregate setting outbreak (3 or more suspected cases of acute illness compatible with COVID-19 in residents and/or staff of a congregate setting with onset within a 72-hour period).

    Call PHD at 408-885-4214, ext. 3 

    (8:00 a.m. – 5:00 p.m.; 7 days a week)

    Children

    Children with MIS-C (Multi-Inflammatory Syndrome in Children)

    NEW - complete an online COVID-19 Case Report Form (version 4.12.2021). Providers who wish to may still report using the PDF form and submit by email or fax. Also complete the MIS-C Form.

    Call PHD at 408-885-4214, ext. 3 

    (8:00 a.m. – 5:00 p.m.; 7 days a week)

    Healthcare facility employees

    Providers must report (1) all employees who test positive, regardless of location of exposure; and (2) all employees exposed at their healthcare facility or believed to be part of a healthcare facility outbreak.

    Report via PHD’s Worksite Case and Contact Reporting Portal.

    Healthcare facility patients and visitors

    Providers must report all patient and visitor cases and contacts  exposed at your healthcare facility or believed to be part of a healthcare facility outbreak.

    Report via PHD’s Worksite Case and Contact Reporting Portal.

    (Reporting of patient cases by case report form does NOT fulfill this requirement to notify the County of a potential healthcare acquired case.)

    *For definitions of “outbreak” and “epidemiological linkage,” please click here.

    How to submit a Case Report Form to the Public Health Department:

    NEW -there are now two options to report a case to Public Health. Providers are encouraged to use the online reporting method, but may use the old PDF fillable form method if they choose. 

    Online Reporting Method 

    1. Open the online form (version 4.12.2021)1,2 and complete all fields 3,4
    2. Attach supporting labs in form and submit.   


    PDF Fillable Form Method

    1. Download the fillable form here (updated 4/12/21)1,2
    2. Complete all fields3,4
    3. Scan
    4. Attach form and supporting labs to email
    5. Using a secure email account, send documents to [email protected]
    6. If you cannot send via secure email, please fax documents to (408) 224-7046

    Do NOT submit a Confidential Morbidity Report (CMR). Please use the Case Report Form instead.

    2 Do NOT submit a report to the Public Health Department if the patient’s residence is outside of Santa Clara County – refer to instructions from the patient’s respective county of residence.

    3 We recommend prioritizing the following fields if unable to complete the entire form: Contact for next of kin, Resident of congregate setting, Symptom onset date, and Date of admission. If time allows, symptom and comorbidity information should also be completed.

    Providers are also asked to provide close contact information on the case report form whenever possible. If close contacts cannot be elicited from the patient, please ensure that contact information of next of kin is included.

    Resources for Facilities without Infection Prevention/Occupational Health:

    Facilities without Infection Prevention/Occupational Health may consult the Healthcare Facilities (HCF) Isolation, Quarantine, and Testing Guidelines  and PHD’s Businesses and Workplaces page for managing exposures that occurred in their healthcare facility.

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    Reporting COVID-19 Deaths

    Healthcare providers are required to report all deaths of anyone who has ever tested positive for COVID-19 within 24 hours, including out of hospital deaths and deaths among residents of congregate residential facilities, by doing the following:

    1. Immediately call the Medical Examiner at (408) 793-1900, ext. 2.
    2. NEW - complete the online Death Report Form (version 1.28.2021)
    • Providers who do not wish to use the online form may still report using the PDF fillable form and submit via 1) secure email to [email protected] or 2) secure fax to (408) 224-7046. 

      1. If the decedent tested positive for COVID-19, please include their PCR or antigen test result with their Death Report Form. Do not report antibody test results because they are not adequate for diagnosing COVID-19.
      2. If you have additional questions, call the Public Health Department at (408) 885-4214, ext. 3 and ask for Provider Intake.
       

    *If the patient’s residence is outside Santa Clara County, please do not send a report to the County of Santa Clara Public Health Department. For contact information for other jurisdictions, please view the LHD Communicable Disease Contact Information List maintained by the California Public Health Department (CDPH).

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    Guidance for Congregate Care Settings

    Congregate Settings include but are not limited to long-term care facilities, jails/prisons, retirement communities, dormitories, and shelters/encampments.

    Additional guidance for Long-Term Care Facilities (LTCFs) is located here

    Letter from the Health Officer to healthcare workers and staff who work in congregate settings: Protecting Your Health as COVID-19 Cases Spike in Santa Clara County | English | Spanish | Tagalog |

    For Infection Prevention and Preparedness

    1. Provide supplies for recommended infection prevention and control practice
      1. ​Hand hygiene supplies: 
        1. ​Put alcohol-based hand sanitizer with 60–95% alcohol in every room (ideally both inside and outside of the room) and in other common areas. 
        2. ​​Make sure that sinks are well-stocked with soap and paper towels for handwashing.​
      2. ​Respiratory hygiene and cough etiquette: 
        1. ​Make tissues and facemasks available for people who are coughing. 
        2. Consider designating staff to steward those supplies and encourage appropriate use by residents, visitors, and staff. 
      3. ​Make necessary PPE available to staff members caring for persons with undiagnosed respiratory illness or COVID-19. Put a trash can near the exit inside the room to make it easy for staff to discard PPE prior to exiting the room, or before providing care for another patient in the same room. Facilities should have supplies of: 
        1. ​Facemasks, 
        2. respirators (if available and the facility has a respiratory protection program with trained, medically cleared, and fit-tested healthcare personnel), 
        3. gowns, 
        4. gloves, and 
        5. eye protection (i.e., face shield or goggles)

     ​COVID-19 Prevention and Mass Testing for Long-Term Care Facilities

    Please see below for important COVID-19 infection prevention information and testing tool kit for residents and staff at long-term care facilities.


    For Cases and Contacts

    Case Report Form & Worksite Case and Contact Reporting Portal 
    Certain long-term care facilities have two different requirements to report cases to the County:
     

    1. Case Report Form: California Health and Safety Code Title 17 requires healthcare providers to report diagnosed COVID-19 cases to the County via the Case Report Form. When applicable, also identify post-vaccination cases using the Case Report Form by completing the questions in the form about if and when the patient was fully vaccinated. See Report to Public Health patients who tested positive after being fully vaccinated’ section below.


      How to submit a Case Report Form to the Public Health Department:

      NEW - there are now two options to report a case to Public Health. Providers are encouraged to use the online reporting method, but may use the old PDF fillable form method if they choose. 

      Online Reporting Method 

      1. Open the online form (version 4.12.2021)1,2 and complete all fields 3,4
      2. Attach supporting labs in form and submit.  

      PDF Fillable Form Method

      1. Download the fillable form here (updated 4/12/21)1,2
      2. Complete all fields 3,4
      3. Scan
      4. Attach form and supporting labs to email
      5. Using a secure email account, send documents to [email protected]
      6. If you cannot send via secure email, please fax documents to (408) 224-7046

      1 Do NOT submit a Confidential Morbidity Report (CMR). Please use the Case Report Form instead.

      2 Do NOT submit a report to the Public Health Department if the patient’s residence is outside of Santa Clara County – refer to instructions from the patient’s respective county of residence.

      3 We recommend prioritizing the following fields if unable to complete the entire form: Contact for next of kin, Resident of congregate setting, Symptom onset date, and Date of admission. If time allows, symptom and comorbidity information should also be completed.

      4 Providers are also asked to provide close contact information on the case report form whenever possible. If close contacts cannot be elicited from the patient, please ensure that contact information of next of kin is included.

    1.  Worksite Case and Contact Reporting Portal: County Health Officer Directive requires certain employers and businesses, including all long-term care facilities, to report all staff, resident, and visitor COVID-19 cases and contacts exposed at your healthcare facility or believed to be part of a healthcare facility outbreak. Report via PHD’s Worksite Case and Contact Reporting Portal (reporting of resident cases by Case Report Form does NOT fulfill this requirement to notify the County of a potential healthcare-acquired case).

       

      Instructions for Completing the Worksite Case and Contact Form:

      Please complete the Worksite Case and Contact Form using the Worksite Case and Contact Reporting Portal to report all staff, resident, and visitor COVID-19 cases and contacts exposed at your healthcare facility or believed to be part of a healthcare facility outbreak. Please include as much information as you can. Under the Health Officer Order, certain employers and businesses, including all long-term care facilities, are legally required to submit this report within four hours after the facility learns of the positive case(s). If you do not have complete information within four hours, you must report the information that you have obtained. You may update the information you provide if you discover additional information after your initial report. The information you provide on this form will remain confidential and is not reported to law enforcement or immigration. Providing this information helps our local case investigation teams identify and slow the transmission of COVID-19 in our in-person education settings and the community. Thank you for your cooperation.

    Additional Reporting Requirements

    Congregate Setting Outbreaks:

    Providers must report any suspected congregate setting outbreak (3 or more suspected cases of acute illness compatible with COVID-19 in residents and/or staff of a congregate setting with onset within a 72-hour period).

    Report by calling PHD at 408-885-4214, ext. 3 (8:00 a.m. – 5:00 p.m.; 7 days a week).

     

    Report to Public Health patients who tested positive after being fully vaccinated:

    Providers must report patients who test positive for COVID-19 after being fully vaccinated. Fully vaccinated is defined as: ≥ 14 days following receipt of the second dose in a 2-dose series, or ≥14 days following receipt of one dose of a single-dose vaccine. Follow the same procedure as for reporting non-vaccinated patients by using the Case Report Form, see instructions above.

    LTCF-SNF Reporting Guidance Chart

    Use the chart below to identify when and how to report cases and contacts.

    Who Must be Reported  

    How to Report

    1) Any diagnosed COVID-19 case diagnosed by a facility such that they serve as the diagnosing provider, including patients who tested positive after being fully vaccinated

     

    NEW - complete an online COVID-19 Case Report Form (version 4.12.2021). Providers who wish to may still report using the PDF form and submit by email or fax.

    Note: When applicable, identify post-vaccination cases using the Case Report Form by completing the questions in the form about if and when the patient was fully vaccinated.

    2) All staff, resident, and visitor COVID-19 cases and contacts exposed at your healthcare facility or believed to be part of a healthcare facility outbreak

    Report via PHD’s Worksite Case and Contact Reporting Portal (reporting of patient cases by Case Report Form does NOT fulfill this requirement to notify the County of a potential healthcare-acquired case).

    Note: In addition to row ‘1)’ above, a separate submission to report resident case(s) and contact(s) using the Worksite Case and Contact Form is required.

    3) Any suspected congregate setting outbreak (3 or more suspected cases of acute illness compatible with COVID-19 in residents and/or staff of a congregate setting with onset within a 72-hour period).

    Report by calling PHD at 408-885-4214, ext. 3 (8:00 a.m. – 5:00 p.m.; 7 days a week).
     

    Note: In addition to rows ‘1)’ and ‘2)’ above, a separate submission to report any suspected congregate setting outbreak(s) via calling PHD at the number above is required.

     

    1. Isolating the case and cleaning the area:
      1. Isolate the patient and limit non-essential contact.
      2. Cleaning staff should clean and disinfect all areas (e.g., offices, bathrooms, and common areas) used by the ill persons, focusing especially on frequently touched surfaces. See the CDC's instructions on disinfecting community facilities.

     

    1. Begin to identify close contacts:
      1. Identify close contacts and be prepared to discuss with the Public Health Department regarding appropriate quarantine instructions. 

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    Guidance on Movement of Patients between Hospitals and Long-Term Care Facilities

    Hospitals do NOT need approval from the Public Health Department before discharging or releasing a suspected or confirmed COVID-19 patient to a Long-Term Care Facility.

    Guidance for Hospitals

    1. When receiving patients from LTCF:
      1. Hospitals should perform COVID-19 testing of all patients that reside or recently resided (within the last two weeks) in a LTCF who present with symptoms of COVID-19. Call the Public Health Department at 408-885-4214, ext. 3 (ask for Provider Branch) to inform of a confirmed or suspect COVID-19 case who resides or recently resided (within the last two weeks) in a LTCF.
      2. We will contact the facility to assess the situation.
    2. When proposing to discharge patients to a LTCF:
      1. For transfers (not related to COVID-19), testing should be done prior to discharge but does not need to be resulted prior to transfer, as the patient will be entering a 10-day Observation Unit (or quarantine in apartment) at the LTCF.
      2. The acute care hospital days may count towards the 10 days of quarantine if the following criterion is met: there is no evidence of ongoing COVID-19 transmission among patients or staff at the hospital. In this case, the first day of quarantine would be the hospital admission date rather than the date of the last test.

    Guidance for LTCFs

    1. When receiving transfers of patients with COVID-19:

      Testing and further isolation are not required for hospitalized patients who were positive and treated for COVID-19 and have met criteria for discontinuation of isolation precautions prior to transfer to LTCF.

      If the patient is deemed clinically stable for discharge prior to completion of isolation, the patient should be transferred to the COVID unit (or patient’s own apartment) of the facility for completion of their isolation.

    1. When receiving patients not known to be COVID-19 positive from the hospital:
      1. Patients should be tested prior to transfer and should be quarantined for 10 days and then retested before release into the general unit. Results do not need to be available prior to transfer. If the hospital does not test the patient within 72 hours of transfer, the LTCF should test and quarantine upon admission.
      2. The LTCF may consider acute care hospital days as part of the 10 day quarantine period if there is no evidence of ongoing COVID-19 transmission among patients or staff at the hospital. This would be determined by discussion with the hospital infection preventionist at the time of planned discharge. In this case, the first day of quarantine would be the hospital admission date rather than the date of the last test.
    1. When readmitting LTCF patients, who resided in a LTCF prior to hospitalization, from the hospital:

      Testing and quarantine are not required for patients readmitted after hospitalization if there is no evidence of ongoing COVID-19 transmission at the hospital.

    1. Patients who go to the Emergency Department, clinic visits or dialysis:

      Testing and quarantine are not required for patients who go to the Emergency Department, clinic visits, or regular dialysis appointments. It is recommended that patients who go out frequently to these facilities should undergo regular testing. 

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    Guidance for Mortuaries and Funeral Homes

    Please refer to the following resources for information on COVID-19 for mortuaries and funeral homes:

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    Request of Healthcare Facility Resources and Conservation of PPE

    PE and other Healthcare Facility Resources Requests

    Healthcare providers* who need PPE, antigen tests, or other resources to continue delivering healthcare services during this time can make a request through the County Emergency Operations Center (EOC).

    Please fill out the 213 Resource Request (213RR) form​, save and send as an attachment to: [email protected].

    Requests for PPE/Medical Supplies (Goods & Services)

    Requests for non-medical personnel/staff

    Requests for medical personnel/staff

     

    Please read "How to use the EOC Form 213RR" on page 1 of the request form:

    • Page 1 contains required information for all requests and must include signatures for "Approved By" (box 7).
    • Last page is completed by the OA EOC.​

    Providers from approved skilled nursing facilities requesting antigen tests please see this sample 213 RR form​ for guidance.​

    Please do not call the Public Health Department for PPE, as you will be routed to the above process.

    *The Santa Clara County Dental Society (SCCDS) will manage all PPE requests from dental providers in Santa Clara County. Please email the SCCDS at [email protected].
     

     

    PPE Use and Conservation Strategies

    Supply chains for respirators are not fully restored, however, the supply of respirators for hospitals and other employers involved with healthcare has improved. During PPE shortages with limited supply chain, refer to SCC PHD Resource Request Process. Submit a 213RR to [email protected].

    Conservation strategy for extended use of N95s refers to wearing N95s for an entire shift or during the care of more than one resident within the same respiratory pathogen cohort. Refer to Cal/OSHA August 6, 2020 interim guidance on COVID-19 for Healthcare Facilities.  PPE conservation measures also include cleaning and re-use of face-shields. The re-use of gowns is not recommended except in contingency or crisis mode​. See CDC’s Optimizing Supply of PPE and Other Equipment during Shortages and addendum for additional strategies to conserve specific PPE.


    These recommendations are not intended to replace your organization's policies regarding personal protective equipment. They are intended to supplement those policies to help reduce demand of existing limited supplies. 

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