COVID19 HCW exposure determinations within hospital setting

[Anonymous]

Hi All

What guidance are you aware of for potential HCW exposures to known COVID19 inpatients please?

I would sense we need fairly tight close contact definition as otherwise we will not have staff.

Would suggest that the approach to meningococcal disease might work?

Also what about patients who are inadvertently cohorted in the same room as a COVID19 patient? What length of time should represent significant exposure? We need some lines in the sand!
Kind regards
Dr John Ferguson MBBS DTM&H FRACP FRCPA
Director, Infection Prevention Service | Hunter New England Local Health District
John Hunter Hospital, Locked Bag 1, Newcastle Mail Centre, NSW 2310, Australia
T: 61 2 49214444 | F: 61 2 49214440 | M: +61(0)428 885573 (Speed Dial 67607) | Tw @mdjkf
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John

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[Anonymous]

And so, we are using the 15 min face to face and 2hr same room criteria below

Exposed patient cohort – individual patients go to single room (? standard precautions initially until test status of case clarified) or are discharged into public health monitored quarantine at home

A person in the same hospital room when an aerosol generating procedure is undertaken on the case, without recommended PPE.

This covers of HCW exposure category along with face to face consideration.

Any other thoughts ?

6. Contact management

As there remain gaps in the understanding of infectivity of COVID-19 cases and transmission modes, the definition of contacts and their public health management is based on available information on COVID-19 together with observations from similar serious coronaviruses SARS-CoV and MERS-CoV.

Identification of contacts

All persons categorised as close contacts (see definition of “close contacts” below) of a confirmed case should be followed-up, and monitored for the development of symptoms for 14 days after the last exposure to the case (i.e. the maximum incubation period).

Contacts of suspected cases should also be considered for contact management if there is likely to be a delay in confirming or excluding COVID-19 in the suspected case, such as delayed testing.

Close contact definition

A close contact is defined as requiring:

greater than 15 minutes face-to-face contact in any setting with a confirmed case in the period extending from 24 hours before onset of symptoms in the confirmed case, or

sharing of a closed space with a confirmed case for a prolonged period (e.g. more than 2 hours) in the period extending from 24 hours before onset of symptoms in the confirmed case.

For the purposes of surveillance, a close contact includes a person meeting any of the following criteria:

Living in the same household or household-like setting (e.g. in a boarding school or hostel).

Direct contact with the body fluids or laboratory specimens of a case without recommended PPE or failure of PPE.

A person who spent 2 hours or longer in the same room (such as a GP or ED waiting room; a school classroom; communal room in an aged care facility). See Special situations for further information specific to aged care facilities and schools.

A person in the same hospital room when an aerosol generating procedure is undertaken on the case, without recommended PPE.

John Ferguson
Infectious Diseases Physician, John Hunter Hospital, Newcastle, Hunter New England Health, Microbiologist, Pathology North, NSW
Conjoint Associate Professor, University of Newcastle
T: 61 2 49214444, F: 61 2 49214440, M: +61 (0)428 885573 @mdjkf idmic.net, aimed.net.au
________________________________

Hi All

What guidance are you aware of for potential HCW exposures to known COVID19 inpatients please?

I would sense we need fairly tight close contact definition as otherwise we will not have staff.

Would suggest that the approach to meningococcal disease might work?

Also what about patients who are inadvertently cohorted in the same room as a COVID19 patient? What length of time should represent significant exposure? We need some lines in the sand!
Kind regards
Dr John Ferguson MBBS DTM&H FRACP FRCPA
Director, Infection Prevention Service | Hunter New England Local Health District
John Hunter Hospital, Locked Bag 1, Newcastle Mail Centre, NSW 2310, Australia
T: 61 2 49214444 | F: 61 2 49214440 | M: +61(0)428 885573 (Speed Dial 67607) | Tw @mdjkf
Mon

Tues

Wed

Thurs

Fri

[cid:image005.png@01D41F3E.1B59CB50]

[cid:image005.png@01D41F3E.1B59CB50]

x

[cid:image005.png@01D41F3E.1B59CB50]

[cid:image005.png@01D41F3E.1B59CB50]

[cid:image002.png@01D5FAF1.31CB5850]

John

This message is intended for the addressee named and may contain confidential information. If you are not the intended recipient, please delete it and notify the sender.

Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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This message is intended for the addressee named and may contain confidential information. If you are not the intended recipient, please delete it and notify the sender.

Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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