HJAR May/Jun 2020

46 MAY / JUN 2020 I  HEALTHCARE JOURNAL OF ARKANSAS DIRECTOR’S DESK COVID-19, physicians should immediately implement recommended infection preven- tion and control practices and notify their facility’s infection control staff and the ADH that a person is now classified as a PUI. The ADH will consult on possible PUIs. Depend- ing on travel history or exposure to people with confirmed COVID-19, the ADH will in- struct some individuals to self-home quar- antine for 14 days. However, physicians are responsible for their patient’s testing for COVID-19. Specimens should be collected as soon as possible for testing once a PUI is identified. For initial diagnostic testing, the CDC recommends collecting and testing upper respiratory tract specimens (a naso- pharyngeal swab) as well as lower respira- tory tract specimens if available. If a patient develops a productive cough, collect and test sputum. The induction of sputum is not recommended. Patients who are clinically indicated, such as those receiving invasive mechanical ventilation, should have a lower respiratory tract aspirate or bronchoalveolar lavage sample collected and tested as a lower respiratory tract specimen. At this time, the ADH is giving priority to performing tests for Arkansans with high- risk exposure, including close contact with a person confirmed to have COVID-19; residents of institutional facilities, such as nursing homes; and hospitalized patients for whom isolation issues are a concern. ADH staff including local health units do not do specimen collection for patients. This is the responsibility of the clinic or hospital requesting the test. If a high-priority patient is not involved, then physicians should use COVID-19 testing that is available through private, commercial laboratories. To report, test, and collect specimen, remember to: • Immediately implement recommend- ed infection prevention and control practices, such as placing a surgical mask on the patient. • Notify infection control personnel at your facility. • For initial diagnostic testing, follow the directions provided by your commercial lab. • For testing high-priority patients, consult with theADHOutbreak Response staff at 1-800-803-7847. Collect a nasopharyn- geal swab and submit it to theADH along with a completed PUI form. The form can be found at www.healthy.arkansas.gov/ images/uploads/pdf/pui-form.pdf. There is additional guidance on the ADH’s COVID-19 webpages. The U.S. Food and Drug Administration also has a hotline (1-888-INFO-FDA) available 24 hours a day for labs to call if they have difficulties getting supplies for collecting patient samples for COVID-19 testing, including swabs, media needed for transport, and conservation of the samples. Labs may email CDRH-EUA- Templates@fda.hhs.gov with any questions related to diagnostic development. This is a high-risk environment for health care professionals, so they need to protect themselves. The CDC recommends a cautious approach to PUIs for COVID-19. Health care professionals can lower their risk of exposure by following CDC andADH guidance such as CDC recommendations for infection prevention and control. This means assess and triage patients with acute respiratory symptom and risk factors for COVID-19, including placing a facemask on the patient and using an Airborne Infection Isolation Room (AIIR), if available. Use standard precautions, contact precautions, airborne precautions, and eye protection. Practice hand hygiene with alcohol-based hand rub before and after all patient contact, contact with potentially infectious material, and before putting on and upon removing personal protective equipment. Use soap and water if hands are visibly soiled. Perform aerosol-generating procedures, including collection of diagnostic respiratory specimen, in an AIIR, while following appropriate infection prevention and control practices, including use of appropriate personal protective equipment. The best way to prevent the spread of infectious diseases is to wash your hands with soap and water or hand sanitizer; avoid close contact with sick people; avoid touching your eyes, nose, and mouth with unclean hands; stay home when you are sick; cover all coughs and sneezes with a tissue, then throw the tissue in the trash and wash your hands; cough and sneeze into your elbow instead of your hand; clean and disinfect frequently touched objects and surfaces with a regular household cleaning spray or wipe; and avoid shaking hands. People are also encouraged to prepare their families in the event of an emergency, whether it is for COVID-19 or a natural disaster. To prepare, families should have supplies like water and food on hand, along with prescription drugs, nonprescription drugs, and copies of your medical records. Aplan should also be made for your business, school, or other organization. Please visit https://www.healthy.arkansas . gov/programs-services/topics/novel- coronavirus for more guidance on COVID-19. An ADH call center is available to answer questions from health care providers and the public. For urgent and non-urgent calls during normal business hours (8 a.m. to 4:30 p.m.), please call 1-800-803-7847. After normal business hours, urgent calls needing immediate response should be made to 501- 661-2136. Health care providers may also contact the Physician Hotline at 1-844-930- 3023 or ADH.Covid19.Providers@arkansas. gov. n