Infection Prevention Reminders: Outbreak Definitions, HCW Isolation/RTW, and Testing ReportingA friendly reminder of current guidance regarding COVID-19 infection prevention and control practices for LTC providers:
Maine CDC now defines a SARS-CoV-2 outbreak as “5 or more people who have been in-person at a facility with confirmed or probable COVID-19 within a 14-day period.”
- Confirmed: At least 5 total positive cases (resident [healthcare onset] + staff) in 14 days, with at least one PCR positive in mix, PER UNIT/DEPARTMENT.
- Probable: At least 5 total positive cases (resident [healthcare onset] + staff) in 14 days, all cases are results based on antigen testing, no PCR results available, PER UNIT/DEPARTMENT.
Reporting requirements for Maine
Any facility conducting point-of-care SARS-CoV-2 testing shall report data for all testing completed, for each individual tested, within 24 hours of results being known or determined, on a daily basis to the state, per HHS CARES Act.
- For CMS-certified long-term care facilities (skilled nursing and/or nursing facilities), the CDC-and CMS-preferred pathway is to submit data via CDC's NHSN.
- Test data submitted to NHSN will be reported to the state health department. If a facility is reporting aggregate data ONLY into NHSN they must also report data into REDCap.
- Other types of LTC facilities should fulfill the HHS CARES Act reporting requirement using REDCap.
Facilities should report to Maine CDC by calling 1-800-821-5821 at the identification of 5 total positive cases (resident [healthcare onset] + staff). As resources allow, an outbreak investigator will be assigned for review.
At the identification of a positive case facilities should continue with their internal response of an exposure investigation with close contact identification, testing, instituting quarantine of patients or work restrictions of HCWs when indicated.
HCW Isolation following positive case with symptoms:
Following the first day of positive test:
If HCW tests positive on day 5, 6, or 7, and is symptomatic continue isolation until a full 10 days have elapsed since symptoms first appeared.
If no testing is performed
If HCW tests negative, remain in isolation until 7 full days since symptoms first appeared On Day 10: Can be released from isolation today if HCW meets all of the following criteria on day 7 Tested negative within 48 hrs. of planned return to work. At least 24 hours have passed since their last fever without the use of fever reducing medication. Their symptoms have improved.
HCW Isolation following positive case without symptoms:
If HCW tests positive on day 5, 6, or 7, continue isolation until a full 10 days have elapsed since symptoms first appeared.
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