Definition of Symptoms and COVID Suspected Patients

COVID Symptoms	Concerning Symptoms	Sustained cough Shortness of breath Difficulty breathing Loss of taste or smell
	Symptom Categories non-specific to COVID	Fever Fatigue Chills/rigors Headache Myalgia Sore throat Congestion/rhinorrhea Nausea Vomiting/diarrhea
COVID Suspected	≥ 1 Concerning Symptom or ≥ 2 Non-specific Symptom Category Without evidence of another explanatory non-respiratory or viral illness Examples: Cellulitis, classic Hand-foot-mouth, GAS pharyngitis, UTI Exceptions: Bronchiolitis, pneumonia

Exposure

Full Exposure Definition with Examples Prolonged (> 15 minutes), close (< 6 feet) contact with a person who is COVID-positive Spent 15 cumulative minutes close (< 6 feet) contact with a person who is COVID-positive

PPE Recommendations and Isolation and Don Personal Protective Equipment (PPE) Video

Asymptomatic, Non-specific symptoms	Standard Precautions Surgical Mask + Eye Protection + Hand Hygiene Don gloves when exposed to body fluid	Routine Care Process
Suspected COVID Concerning Symptoms or Exposed	Modified Expanded Hand Hygiene Gown + Gloves + Surgical Mask + Eye Protection	Expedite to Exam Room. Door closed. Use negative pressure as available. Buerger neg pressure rooms remain closed 30 minutes after AGP. Clean room with hospital-approved disinfectant while still in PPE. All other locations: Close room for 1 hour if AGP performed, such as nebulization treatment, Clean room with hospital-approved disinfectant while still in PPE.
Aerosol Generating Procedure (AGP) and Suspected COVID or Exposed	Expanded Precautions Hand Hygiene Gown + Gloves + N95 Mask + Eye Protection Aerosolized Generating Procedures

Testing Considerations for Patients Stable for Care at Home

SYMPTOMATIC Patients
Indications for Testing	Test Selection, Interpretation
Test ALL patients Consider influenza testing for high-risk patient populations meeting ILI definition Influenza-like Illness (ILI) Fever > 100.4°F and cough and/or sore throat During influenza season	Use Rapid Test as available POSITIVE Rapid Test: Assume COVID diagnosis NEGATIVE Rapid Test: Assume no COVID infection unless any of the following 3 exceptions are present. If any present, confirm results with PCR test. Exceptions: Any CONCERNING symptom present Documented exposure history, by exposure definition above Lives in a potential high-risk situation e.g. Immunocompromised family member Testing Guidance – Rapid COVID-19 Platforms in Outpatient Specialty Care and Primary Care Settings
ASYMPTOMATIC Patients
Indications for Testing	Test Selection, Interpretation
Results are needed for contact tracing of exposed patient Exposed patients can be tested on or after day 5-7 and end isolation if negative Required for admission to another facility such as shelters or residential facilities	PCR Test Rapid Antigen or PCR tests may be used at or after day 7. If a test is requested on day 5 or 6, it MAY be performed, but should be a PCR only. Quarantine must continue to day 7 in all circumstances. PCR Test required
Hospital admission, procedure, AGP scheduled within the next 72 hours Pre-Operative Screening	PCR test required

Clearance of Transmission-Based Precautions

Asymptomatic/SARS-CoV-2 positive	At least 10 days have passed since the date of the first positive test
Symptomatic/SARS-CoV-2 Positive or Suspected	At least 10 days has passed since symptoms first appeared and At least 24 hours have passed since last fever w/o use of fever medications and Symptoms are improved
No Symptoms and Exposed	Exposed patients quarantine for 10 days after last exposure as long as they remain asymptomatic This can be reduced to 7 days if they test negative day 7 and remain asymptomatic All patients, regardless of initial clearance date, should monitor for symptoms for 14 days
No symptoms, Vaccinated and Exposure	Vaccinated persons with exposure to suspected/confirmed COVID-19 do not need to quarantine if they: Are 2 weeks past their full vaccination series Are within 3 months following the last dose in the series Have remained asymptomatic since their COVID-19 exposure This is true for household exposures