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Q: What do you need from us during an outbreak?
A: An outbreak usually starts when a facility has two (2) or more cases of an illness. The health department will send you forms, a link to our online reporting form, or you can print them from this website and send them back to the health department for review.
- The Outbreak Reporting Form: This form needs to be completed and sent to the health department at the beginning of the outbreak and again at the end of the outbreak. There are two columns on the form "initial" and "final." Fill out the "initial" column when the outbreak starts and the "final" column at the end of the outbreak.
- The Line List: This form needs to be filled out and sent to the health department weekly reporting all positive cases within the facility, differentiating between "staff" or "resident," and noting if the person had an 'outside' exposure.
Q: Do I include every positive case on the outbreak paperwork?
A: The Michigan State and Local Public Health COVID-19 Standard Operating Procedures, which was updated in November 2022, states the following:
Local Facilities: In addition to individuals cases, long-term care facilities (including skilled nursing, assisted-living, adult foster care), jails, juvenile detention centers, shelters, schools, day cares, and camps must report all clusters of confirmed or suspected COVID-19 cases to the LHD. LHD authorities should investigate to determine if the cases meet the definition of an outbreak and how to proceed.
In summary, any new cases that have an "outside" epi link (spouse is sick/positive for Covid, friend has Covid) should be INCLUDED in the paperwork and line lists that you send to us weekly. However, when reporting these cases, they should be CLEARLY identified, and you should let us know so we can help determine if that case will be part of the outbreak or not.
Q: How long does a COVID-19 outbreak last?
A: Outbreaks are kept open until there have been 28 days with no new cases. That count re-starts with each new case that arises.
- Per CSTE: "Outbreak Resolution: No new symptomatic/asymptomatic probable or confirmed COVID-19 cases after 28 days (two incubation periods) have passed since the last case's onset date or specimen collection date (whichever is later)."
Q: Does staff need to wear face shields?
A: According to CDC, staff do not have to wear face shields; however, you should double-check your facility's policies and with your licensing agency. Face shields may be necessary if/when doing certain procedures.
Q: Who do facilities report their respiratory illness cases to?
A: It may be required by the facilities governing body (CMS) to report to and records in NHSN. Facilities should also reach out to the Health Department if the case is a resident or multiple staff members to determine if there is a cluster or outbreak to monitor.
Q: Is Source Control required at this time in facilities?
A: Source control is recommended for individuals in healthcare settings who:
- Have suspected or confirmed SARS-CoV-2 infection or other respiratory infection (e.g., those with runny nose, cough, sneezing)
- Had close contact (patients and visitors) or a higher-risk exposure (Healthcare Provider) with someone with SARS-CoV-2 infection.
- For 10 days after their exposure, source control is recommended more broadly as described in CDC’s Core IPC Practices in the following circumstances: By those residing or working on a unit or area of the facility experiencing a SARS-CoV-2 or other outbreak of respiratory infection:
- Universal use of source control could be discontinued as a mitigation measure once the outbreak is over (e.g., no new cases of SARS-CoV-2 infection have been identified for 14 days)
- Facility-wide or, based on a facility risk assessment, targeted toward higher risk areas (e.g., emergency departments, urgent care) or patient populations (e.g., when caring for patients with moderate to severe immunocompromise) during periods of higher levels of community SARS-CoV-2 or other respiratory virus transmission.
- Have otherwise had source control recommended by public health authorities (e.g., in guidance for the community when COVID-19 hospital admission levels are high).
- Source: https//www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html
Q: With the end of the PHE, what is the guidance?
A: In addition to your local health department, Hospitals and Nursing Homes will need to observe Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services (CMS) for guidance and requirements which will continue to mandate reporting.
Q: Is there any information out on the ending of the PHE?
A: A helpful video that explains a lot of the changes is located at: https://edhub.ama-assn.org/cdc-project-firstline/video-player/18780695#. You may also check out our Facebook and Instagram accounts that have previously posted information available in an easy to read graphic format.