The general quarantine guidance above applies to healthcare workers under normal circumstances, and HCWs who have routine workplace exposures that are not high risk should continue to follow their employer’s guidance for returning to work. However, if critical staffing shortages exist, healthcare workers may follow the recommendations outlined below. For organizations that do not have an Infection Prevention or Occupational Health Department, please follow the guidance below:
Healthcare Workers (HCWs) who have been exposed to a COVID-19 positive person in the household or in the community, or a high-risk exposure in the workplace (e.g., not wearing required PPE), may continue to work, or return to work, under the following conditions during the Quarantine Period (defined as 10 days from the date of last exposure to the COVID+ person):
Hospital providers should continue to follow their
existing policies regarding patients leaving against medical advice, with additional processes noted below.
Please note, as of 12/22/20, due to the current surge in COVID-19 cases in the county, we are TEMPORARILY suspending case reporting requirements for all living non-hospitalized patients and individuals not living or working in congregate residential settings. You must continue to submit Case Report Forms for all deceased patients, hospitalized patients and individuals living or working in congregate residential settings (i.e. jails, shelters, long-term care facilities).
Also, employers are still obligated to report employee and patron cases to Public Health in accordance with orders by the Public Health Officer. This requirement includes patients and visitors exposed at a healthcare facility or patient cases suspected to be part of a healthcare-associated outbreak. To report COVID-19 cases in employees and patrons, please go here.
We recommend prioritizing the following fields if unable to complete the entire form: Contact for next of kin, Resident of congregate setting, Symptom onset date, and Date of admission. If time allows, symptom and comorbidity information should also be completed.
For confirmed COVID-19 cases fitting the criteria above, please report by secure EMAIL (firstname.lastname@example.org) or FAX (408-224-7046), by sending in a completed Case Report Form within 24 hours.
- Do NOT submit a Confidential Morbidity Report (CMR). Please use the Case Report Form instead.
- Do NOT submit a report to the Public Health Department if the patient’s residence is outside of Santa Clara County – refer to instructions from the patient’s respective county of residence.
How to submit a Case Report Form to the Public Health Department:
- Download the fillable form here
- Complete all fields1
- Attach form and supporting labs to email
- Using a secure email account, send documents to email@example.com
- If you cannot send via secure email, please fax documents to (408) 224-7046
1Providers are also asked to provide close contact information on the case report form whenever possible. If close contacts cannot be elicited from the patient, please ensure that contact information of next of kin is included.
Additionally, some confirmed or suspected COVID-19 cases ALSO require a CALL to the Public Health
(408-885-4214, ext. 3):
- The following confirmed or suspected cases in congregate residential settings (e.g., SNFs/LTCFs, jails, shelters) should be reported immediately (24 hours a day; 7 days a week):
- One (1) or more confirmed COVID-19 cases OR
- Three (3) or more suspected cases of acute illness compatible with COVID-19 in residents with onset within a 72 hour period.
- The following confirmed or suspected cases should be reported during daytime hours (8:00 a.m. – 5:00 p.m.; 7 days a week):
- fatal cases,
- cases with MIS-C (Multi-Inflammatory Syndrome in Children),
- three (3) or more epi-linked cases in an acute care hospital of any combination of: confirmed COVID-19 in a patient 7 or more days after admission for a non-COVID condition OR confirmed COVID-19 in a healthcare worker.
Special Considerations for Healthcare Worker Exposures in Facilities without Infection Prevention/Occupational Health
Facilities should undertake the following steps:
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Reporting the Death of a Confirmed or Suspected COVID-19 Case
The death of a confirmed or suspected COVID-19 case*:
Healthcare providers are required to report all deaths associated with COVID-19 within 24 hours, including out of hospital deaths and deaths among residents of congregate residential facilities, by doing the following:
- Immediately call the Medical Examiner at (408) 793-1900, ext. 2.
- Complete the Public Health Death Reporting Form (Note: ALL fields must be completed). If the decedent tests positive for COVID-19, include a copy of the lab result.
- Send the Death Reporting Form and the patient's medical records (g., H&P, discharge summary, medication list), to the Public Health Department. Send all documents by secure email to firstname.lastname@example.org by fax to (408) 224-7046
- Call the Public Health Department at (408) 885-4214, ext. 3; ask for Provider Branch. They will review any outstanding questions about the Death Reporting Form.
*If the patient’s residence is outside Santa Clara County, please do not send a report to the County of Santa Clara Public Health Department. For contact information for other jurisdictions, please view the LHD Communicable Disease Contact Information List maintained by the California Public Health Department (CDPH).
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Guidance for Congregate Care Settings
Congregate Settings include but are not limited to long-term care facilities, jails/prisons, retirement
communities, dormitories, and shelters/encampments.
Letter from the Health Officer to healthcare workers and staff who work in congregate settings: Protecting Your Health as COVID-19 Cases Spike in Santa Clara County | English | Spanish | Tagalog |
For Infection Prevention and Preparedness
- Provide supplies for recommended infection prevention and control practice
- Hand hygiene supplies:
- Put alcohol-based hand sanitizer with 60–95% alcohol in every room (ideally both inside and outside
of the room) and in other common areas.
- Make sure that sinks are well-stocked with soap and paper towels for handwashing.
- Respiratory hygiene and cough etiquette:
- Make tissues and facemasks available for people who are coughing.
- Consider designating staff to steward those supplies and encourage appropriate use by residents,
visitors, and staff.
- Make necessary PPE available to staff members caring for persons with undiagnosed respiratory illness
or COVID-19. Put a trash can near the exit inside the room to make it easy for staff to discard PPE
prior to exiting the room, or before providing care for another patient in the same room. Facilities
should have supplies of:
- respirators (if available and the facility has a respiratory protection program with trained,
medically cleared, and fit-tested healthcare personnel),
- gloves, and
- eye protection (i.e., face shield or goggles).
COVID-19 Prevention and Mass Testing for Long-Term Care Facilities
Please see below for important COVID-19 infection prevention information and testing tool kit for residents and staff at long-term care facilities.
For Case and Contacts
- Reporting a case to Public Health Department:
- Promptly notify the Health Department about the case by calling (408) 885-4214, ext. 3; ask for
- Isolating the case and cleaning the area:
- Isolate the patient and limit non-essential contact.
- Cleaning staff should clean and disinfect all areas (e.g., offices, bathrooms, and common areas) used by
the ill persons, focusing especially on frequently touched surfaces. See the CDC's instructions
on disinfecting community facilities.
- Begin to identify close contacts
- Identify close contacts and be prepared to discuss with the Public Health Department regarding appropriate
New Directive for Long-term Care Facilities
On November 20th, 2020, Santa Clara County Health Officer issued new directive for long-term care facilities in the County. The danger of COVID-19 transmission in long-term care facilities is particularly high due to facility residents generally being at higher risk of severe illness or death from COVID-19. Visitors to long-term care facility residents and residents returning to long-term care facilities after visits to friends or family in the community increase the risk of introducing and transmitting COVID-19 among residents and staff in the facility. The Health Officer therefore issued this new directive to provide guidance for visitation of, and by, residents of long-term care facilities.
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Guidance on Movement of Patients between Hospitals and Long-Term Care
Hospitals do NOT need approval from the Public Health Department before discharging or releasing a suspected or confirmed COVID-19 patient to a Long-Term Care Facility.
Guidance for Hospitals
- When receiving patients from LTCF:
- Hospitals should perform COVID-19 testing of all patients that reside or recently resided (within the last two
weeks) in a LTCF who present with symptoms of COVID-19. Call the Public Health Department at 408-885-4214, ext. 3 (ask for
Provider Branch) to inform of a confirmed or suspect COVID-19 case who resides or recently resided (within the last two
weeks) in a LTCF.
- We will contact the facility to assess the situation.
- When proposing to discharge patients to a LTCF:
- For transfers (not related to COVID-19), testing should be done prior to discharge but does not need to be resulted prior to transfer, as the patient will be entering a 10-day Observation Unit (or quarantine in apartment) at the LTCF.
- The acute care hospital days may count towards the 10 days of quarantine if the following criterion is met: there is no evidence of ongoing COVID-19 transmission among patients or staff at the hospital. In this case, the first day of quarantine would be the hospital admission date rather than the date of the last test.
Guidance for LTCFs
When receiving transfers of patients with COVID-19:
Testing and further isolation are not required for hospitalized patients who were positive and treated for COVID-19 and have met criteria for discontinuation of isolation precautions prior to transfer to LTCF.
If the patient is deemed clinically stable for discharge prior to completion of isolation, the patient should be transferred to the COVID unit (or patient’s own apartment) of the facility for completion of their isolation.
- When receiving patients not known to be COVID-19 positive from the hospital:
- Patients should be tested prior to transfer and should be quarantined for 10 days and then retested before release into the general unit. Results do not need to be available prior to transfer. If the hospital does not test the patient within 72 hours of transfer, the LTCF should test and quarantine upon admission.
- The LTCF may consider acute care hospital days as part of the 10 day quarantine period if there is no evidence of ongoing COVID-19 transmission among patients or staff at the hospital. This would be determined by discussion with the hospital infection preventionist at the time of planned discharge. In this case, the first day of quarantine would be the hospital admission date rather than the date of the last test.
When readmitting LTCF patients, who resided in a LTCF prior to hospitalization, from the hospital:
Testing and quarantine are not required for patients readmitted after hospitalization if there is no evidence of ongoing COVID-19 transmission at the hospital.
Patients who go to the Emergency Department, clinic visits or dialysis:
Testing and quarantine are not required for patients who go to the Emergency Department, clinic visits, or regular dialysis appointments. It is recommended that patients who go out frequently to these facilities should undergo regular testing.
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Guidance for Mortuaries and Funeral Homes
Please refer to the following resources for information on COVID-19 for mortuaries and funeral homes:
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Request of Healthcare Facility Resources and Conservation of PPE
PPE and other Healthcare Facility Resources Requests
Healthcare providers* who need PPE, antigen tests, or other resources to continue delivering healthcare services during this time can make a request through the County Emergency Operations Center (EOC).
Please fill out the 213 Resource Request (213RR) form, save and send as an
attachment to: email@example.com.
Requests for PPE/Medical Supplies (Goods & Services)
Requests for non-medical personnel/staff
Requests for medical personnel/staff
Please read "How to use the EOC Form 213RR" on page 1 of the request form:
- Page 1 contains required information for all requests and must include signatures for "Approved
By" (box 7).
- Last page is completed by the OA EOC.
Providers from approved skilled nursing facilities requesting antigen tests please see this sample 213 RR form for guidance.
Please do not call the Public Health Department for PPE, as you will be routed to the above
*The Santa Clara County Dental Society (SCCDS) will manage all PPE requests from dental providers in Santa Clara
County. Please email the SCCDS at firstname.lastname@example.org.
PPE Use and Conservation Strategies
Supply chains for respirators are not fully restored, however, the supply of respirators for hospitals and other employers involved with healthcare has improved. During PPE shortages with limited supply chain, refer to SCC PHD Resource Request Process. Submit a 213RR to email@example.com.
Conservation strategy for extended use of N95s refers to wearing N95s for an entire shift or during the care of more than one resident within the same respiratory pathogen cohort. Refer to Cal/OSHA August 6, 2020 interim guidance on COVID-19 for Healthcare Facilities. PPE conservation measures also include cleaning and re-use of face-shields. The re-use of gowns is not recommended except in contingency or crisis mode. See CDC’s Optimizing Supply of PPE and Other Equipment during Shortages and addendum for additional strategies to conserve specific PPE.
These recommendations are not intended to replace your organization's policies regarding personal protective equipment. They are intended to supplement those policies to help reduce demand of existing limited supplies.
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