LAC DPH Health Advisory: Revised Evaluation Criteria for Coronavirus Disease 2019 (COVID-19) March 2, 2020 Coronavirus, Health Alert, LAHAN, Public Health, Virus 1225 Key Messages The Centers for Disease Control and Prevention (CDC) have updated their criteria for evaluation of persons with suspected coronavirus disease-19 (COVID-19). Based on the CDC criteria, the Los Angeles County Department of Public Health (LAC DPH) has updated the local evaluation criteria for COVID-19. Healthcare providers should immediately report to LAC DPH any patients that meet LAC DPH criteria for evaluation for COVID-19 (see below). Healthcare facilities should review their infection control procedures and infectious disease surge plans to ensure that they are ready for implementation in the event of widespread COVID-19 transmission in LAC. Situation To date, Los Angeles County has only had one confirmed case of COVID-19 in a non-resident traveler from China. A patient in Northern California with no known travel links or contact to a known case has recently been diagnosed with COVID-19. This patient is hospitalized and requiring ICU care. In light of this case, CDC released updated evaluation criteria. The LAC DPH COVID-19 evaluation criteria differ from the CDC’s and are intended to prioritize SARS-CoV-2 testing in a setting of limited local testing capacity. Providers should keep in mind that these evaluation criteria were developed to identify patients at highest risk for COVID-19. Health care providers are advised to check the LAC DPH COVID-19 Healthcare Providers website for the most up to date local guidance and resources. Actions Requested of Providers Work with Facility Administrators to: Place signage requesting visitors with a fever and respiratory symptoms and recent international travel to immediately notify healthcare staff. Screen patients at triage for any signs or symptoms of febrile respiratory illness. If signs or symptoms are present, the healthcare worker should don a surgical mask. The patient should also be instructed to wear a surgical mask and be placed in a private room with the door closed or separated from others by at least 6 feet. Assess if the patient meets criteria for COVID-19 evaluation. Patients with milder presentations who do not meet COVID-19 evaluation criteria should be instructed to isolate at home until 24 hours after the resolution of fever and/or improvement of respiratory symptoms. Patients should contact their provider if symptoms worsen. If patient meets COVID-19 evaluation criteria Implement additional infection control procedures for healthcare workers entering the room. These include standard precautions, contact precautions (gloves, gown), airborne precautions (N95 mask or PAPR), and the use of eye protection. Follow the LAC DPH Provider Checklist for evaluating patients who may have COVID-19. Promptly contact and report patient to LAC DPH. LAC DPH will advise on next steps, including patient testing and specimen collection, if indicated. Approval from LAC DPH is required before specimens can be submitted to the LAC Public Health Laboratory (PHL) for testing. Learn more about the Revised Evaluation Criteria for Coronavirus Disease 2019 (COVID-19) Here