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Posted on: April 13, 2020

COVID-19 Update for Clinicians: April 13, 2020

COVID-19 Update for Clinicians
April 13, 2020

Contents

  • Isolation & Quarantine Site Update
  • Syndromic Management of STD during COVID-19
  • COVID-19 Data
  • Isolation and Quarantine Supplemental Materials

Isolation & Quarantine Site Update

Requested Actions:

  • Please see attached materials at the end of this transmission providing additional guidance regarding Snohomish County’s Isolation & Quarantine (I&Q) facility.
  • Review information in the health advisory from April 7, 2020 regarding the I&Q facility, AND please note the following updates intended to streamline the I&Q referral process and your role in it.
    • Continue to contact the Snohomish Health District’s (SHD’s) Communicable Disease Program at 425-339-5278 to make referrals for individuals meeting criteria (i.e., COVID-19 suspects, cases, and contacts who are unsheltered or not appropriate for home I&Q).
    • Most individuals meeting eligibility criteria likely will be admitted on a voluntary basis at the discretion of the Health District.
    • Health officer’s orders will only be issued if deemed necessary by SHD based on features of the individual, present circumstances, and input from the referring clinician or facility. When a health officer’s order is issued, it will be served by the I&Q staff after arrival at Angel of the Winds Arena. Clinicians and facilities no longer need to be involved in serving the health officer’s order.
    • After getting approval from the Health District, be sure to complete an I&Q Intake Form, give a copy to the individual, and fax it to the I&Q facility at 425-322-2762
    • The mechanism for transporting individuals to the facility is via cabulance through Northwest Ambulance, 9AM-6PM. After receiving approval from the Health District, call 425-328-7651 and ask for “COVID-19 cabulance transport to Angel of the Winds Arena.”
  • Ensure that the Isolation & Quarantine Flyer (page 6 of this document) is posted in a visible location in emergency departments and other areas where staff interact directly with patients who may meet criteria for the Isolation & Quarantine site.
  • Review the Frequently Asked Questions (pages 7-10 of this document) about the Isolation & Quarantine site, as well as the direct referral form (page 11).

Syndromic Management of STD during COVID-19 Event

Requested actions:

Background

As the need for social distancing changes the ability to see patients face-to-face, telemedicine visits and presumptive treatment are acceptable practices for uncomplicated symptomatic infections and exposures. If a patient reports symptoms or exposure to someone with STD such as gonorrhea, chlamydia, or syphilis, clinicians may choose to treat them without having laboratory test results available (this includes not having collected a specimen at all for testing). The Washington State Department of Health (DOH) recommends that clinicians advise all presumptively treated patients to be tested as soon as practicable, and to seek further medical attention if symptoms persist.

Please find attached guidance from the CDC on management of STD during this challenging time. It is focused on syndromic management of patients based on symptoms when laboratory services are not available, or treating with oral medications when injectable medications are not feasible due to reduced clinical resources or clinic closures.

While it is ideal to collect specimens for HIV and STD testing concurrently with presumptive treatment, we understand that due to requirements for social distancing and redirection of clinical resources and space to attend to patients during the COVID-19 event, the ability to collect specimens from patients may be reduced or eliminated.

One practice that may assist providers in collecting specimens for testing is that patients may self-collect specimens (like urine, vaginal, rectal) for chlamydia and gonorrhea testing. This practice can reduce face-to-face time with a patient. Please remember that expedited partner therapy (EPT) is an option for some partners to persons diagnosed with chlamydia or gonorrhea. This strategy may be helpful for exposed partners who cannot be seen in a clinical environment. These medications can be prescribed to patients or to their partners to be picked up at pharmacies and covered by their insurance payer.

Please continue to report clinically suspected cases of primary and secondary syphilis, as well as laboratory confirmed cases of HIV and other notifiable STD to the Health District (Tel 425- 339-5261, Fax 425-339-8707). Telephone consultation on STD diagnosis and treatment is also available through this line. STD screening and treatment guidelines can be located on the CDC website.

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