Novel Coronavirus (COVID-19) Guidance for Health Care Providers

Last Updated: April 3, 2020

The Public Health Department is working to limit transmission of novel coronavirus (COVID-19) in our community and to help ensure our county maintains an adequate and healthy health care workforce. 

See the latest news about SLO Public Health response to COVID-19 

For general updates on COVID-19 in SLO County, please see ReadySLO.org

Keep reading for guidance specific to health care providers:

Medical Reserve Corps

We need as many people as possible to respond to the forthcoming surge of our friends, family and neighbors who are going to get sick. Whether it's manning a hot line or on the front lines, we need you now. Together, our community will work to overcome this challenge. Apply at ReadySLO.org.

Infection Prevention and Control / Personal Protective Equipment (PPE)

Protect yourself: Minimum personal protective equipment (PPE) recommendations for health care providers caring for suspect or confirmed COVID-19 patients:

Situation

Minimum PPE Recommendations

Performing Aerosol-Generating Procedures

  • N95 or higher-level respirator
  • eye protection
  • gloves
  • gown

Prolonged close contact with a COVID-19 patient NOT wearing a face mask

  • face mask
  • eye protection
  • gloves required only if collecting swab specimen from patient or conducting physical exam
  • gown required only if extensive body contact with patient (e.g., rolling a patient)

Prolonged close contact with a COVID-19 patient wearing a face mask

  • face mask

See CDC guidance for detailed guidance on Sequence for Putting On and Safely Removing PPE

If you are exposed without adequate PPE: Health care workers who have been exposed to a suspect or confirmed COVID-19 patient without the minimum recommended PPE should be excluded from work for 14 days after exposure.  However, if the health care worker is asymptomatic, they may continue to work if options to improve staffing have been exhausted and their occupational health program has been consulted. In such a case, the post-exposure, asymptomatic health care worker must wear a face mask while at work for 14 days after the exposure. If the worker develops even mild fever or respiratory symptoms, they must cease patient care activities and notify their supervisor or occupational health program.

This guidance may be modified as conditions change.

Testing

The Public Health Department asks clinicians to evaluate patients for COVID-19 based on the clinical criteria. Clinicians do not need to consult the Public Health Department before gathering and submitting specimens.

Clinical criteria 

Clinical criteria for COVID-19 testing include:

  • Patients with fever (T > 100.4 F) and symptoms (cough and/or shortness of breath and/or fatigue)
  • History of sick contact consistent with COVID-19 signs and symptoms
  • Incubation period consistent with COVID-19 (typically 5-7 days)
  • Hospitalized patients in whom other likely diagnoses have been ruled out (e.g., Respiratory Pathogen Panel is negative)
  • Nature of disease onset – COVID-19 typically has prodrome vs. flu, which has rapid onset
  • Chest X-ray with bilateral infiltrates/ground-glass opacities
  • History of international travel or travel to locale in US with community transmission
  • No alternative diagnosis 

Specimen collection

If you are collecting the specimen

  • If you are collecting swab specimen from patient, the minimum recommended PPE is a face mask (any face mask - does not need to be N95), eye protection, and gloves. See PPE section above for detail. 
  • Only one nasopharyngeal swab specimen is required to test for COVID-19. An oropharyngeal swab is no longer required. (If you run out of nasopharyngeal swabs and are unable to obtain more, you may use and submit an oropharyngeal swab instead.)  
  • Use only synthetic fiber swabs with plastic shafts. Do not use calcium alginate swabs or swabs with wooden shafts as they may contain substances that inhibit PCR testing.
  • Place nasopharyngeal swab immediately into sterile tube containing 2-3 ml of viral transport media.
  • Refrigerate specimens at 2-8°C and ship overnight to testing lab on ice pack. 
  • See complete specimen collection and transport instructions at: www.slocounty.ca.gov/Corona-sars-Cov2-PCR

If you are not collecting the specimen

If you determine that a patient needs to be tested for COVID-19 and you wish to have the Public Health Department collect the specimen and test, you must contact the Public Health Department before the patient comes in for testing. When contacting the Public Health Department to refer for testing, you may phone (805-781-5500) or fax (805-781-5543) the following information:

  • Provider name
  • Provider contact information 
  • Patient name 
  • Patient DOB
  • Patient contact information
  • Symptoms (must include fever AND signs/symptoms of lower respiratory illness such as cough or shortness of breath)

In all cases, the Public Health Department must be contacted prior to sending patients or specimens for testing.  We are unable at this time to accommodate specimen collection after hours or on weekends.

Send specimens to appropriate lab

  • For outpatients who have health insurance or other proof of payment: Send specimens to WestPac Labs, Quest Diagnostics, Pacific Diagnostic Laboratories, or LabCorp. These commercial labs are accepting swab specimens for COVID-19 testing as long as the specimens are accompanied by documentation of health insurance or other proof of payment.
  • For inpatients and symptomatic close contacts of confirmed cases: Send specimens to the SLO Public Health Laboratory. The Public Health Laboratory is currently accepting specimens for COVID-19 testing only for symptomatic close or household contacts of confirmed cases of COVID-19 as well as hospital inpatients who meet clinical criteria for testing. We must limit testing to these groups because our testing supplies are limited. 

If submitting specimens to SLO Public Health Laboratory

Fax a referral for testing to 805-781-5543, preferably on the SLO Public Health Laboratory requisition form. (You may use a standard prescription or referral form if needed.) Referral must include:

  • Provider name
  • Provider contact information (including 24/7 phone number and fax number for results)
  • Patient name 
  • Patient DOB
  • Patient contact information
  • Signs and symptoms that support testing 
  • Travel history
  • Indicate if patient has had any other testing (e.g., Flu, Respiratory Pathogen Panel, Chest X-ray)
  • Indicate if provider is sending swab specimen with courier, or if patient will require Public Health Department to perform swab
  • Indicate if you want Respiratory Pathogen Panel and COVID-19 testing, or just COVID-19 testing

See complete specimen collection and transport instructions at: www.slocounty.ca.gov/Corona-sars-Cov2-PCR

Results from SLO Public Health Laboratory

Results for most COVID-19 testing performed in the County of San Luis Obispo Public Health Laboratory will be returned via fax and/or phone within 24 hours of receipt of the nasopharyngeal swab specimen. However, given the rapidly increasing volume of testing and the transportation of specimens to the Public Health Lab, please allow 48 hours for receipt of results from the time the specimen leaves your facility.

If more than 48 hours have passed and you wish to call to obtain COVID-19 test results for your patient, please call 805-781-4843 between the hours of 8 a.m. – 5 p.m. Monday-Friday. If leaving a message, please speak clearly and leave the following information:

  • Your name
  • Your practice name (if applicable)
  • Your call back number
  • Your FAX back number
  • Patient’s Last name, First name, Date of Birth

Report all cases immediately by phone

The County of San Luis Obispo Public Health Department requires that any and all positive laboratory test results for COVID-19 for individuals residing in San Luis Obispo County be reported immediately to the Public Health Department. The diagnosis or laboratory test in question may refer to COVID-19 or SARS-CoV-2. 

Clinicians must report a positive test result immediately by calling the County of San Luis Obispo Public Health Department at 805-781-5500. In addition, clinicians must complete a Confidential Morbidity Report (CMR Form A) and transmit the CMR to the Public Health Department by one of three ways:

  • Via Fax at (805)781-5543 
  • Via Phone at (805)781-5500
  • Through CalREDIE

Questions? 

For additional questions, please call the Public Health Department at 805-781-5500.

Additional Resources 

Provider Health Advisories for San Luis Obispo County 

California Department of Public Health (CDPH) Guidance for Health Care Facilities

Centers for Disease Control and Prevention (CDC) Guidance for Health Care Providers

 

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