Clinician Alert: Interim guidance updated March 11 for COVID-19 in Oregon

March 11, 2020

Oregon has identified fifteen COVID-19 cases out of 295 individuals tested; as of this writing sixty-seven tests are pending and there have been no deaths; full results are on the OHA Coronavirus website. Patients are from multiple counties, mostly in western Oregon; more than half are from Washington County. The majority of the cases in California, Oregon and Washington are community acquired and not related to travel. 

Infection Prevention Updates

Updated Clinical and Infection Control Guidance has been posted to OHA’s site. This OHA guidance addresses many topics about healthcare for individuals, both inpatient and outpatient, with respiratory symptoms.

Main Points

  • If a patient with acute respiratory illness needs face-to-face care:

    • Mask the patient upon entry, limit exposure to others, room promptly 

    • Wear PPE when entering the room: goggles or face shield, minimum surgical or procedure mask, gloves, gown (if available). This is a change from the previous N-95 or better or PAPR requirement.

  • Obtaining NP or OP swabs is not considered to be aerosol-generating procedure. The document lists what are considered aerosol-generating procedures.

  • N95 mask or PAPR is recommended for aerosol-generating procedures.

  • Detailed work exclusion guidance 

The CDC also updated healthcare guidance on 3/10/20

Testing

Testing at the Oregon State Public Health Lab (OSPHL) is currently limited to patients hospitalized with viral pneumonia and a negative flu test. These requests no longer require public health approval by phone but a completed online form  and the OSPHL virology form MUST accompany the specimen.

Other high risk symptomatic individuals can be tested with local public health approval at OSPHL via the same electronic links above.

Commercial lab testing is now available without restriction by at least three labs: LabCorp, Quest Diagnostics, and University of Washington Virology; results will go to the ordering provider and public health agencies. Contact these vendors directly for details.

Public Health does not recommend testing asymptomatic or mildly symptomatic individuals. 

As resources allow, outpatient providers may consider testing:

  • Patients with compatible illness who are pregnant, over age 60 or have underlying chronic conditions

  • Patients with compatible illness who are part of a respiratory illness cluster or work in congregate settings such as health care, long-term care, shelters or corrections 

Public health request

  • Please continue to see patients who have a fever or cough illness that need evaluation for treatable conditions. 

  • Continue to promote influenza vaccine since the season has not ended.

  • For any ill individuals who can safely stay at home, please recommend they stay home until they are well for at least 24 hours to prevent avoidable exposures to others. Make sure they know what to do if their symptoms get worse.

  • Make sure your patients over 60 or who have underlying medical conditions are aware of CDC guidance recommending avoiding crowds and staying home while COVID-19 circulates in the community.

  • Understand that the situation and guidance are changing quickly. Please remain on the lookout for updates.

Public Health 24-hour numbers 

Clackamas County Public Health: 503-655-8411

Clark County Public Health: 564-397-8182

Multnomah County Public Health: 503-988-3406

Washington County Public Health: 503-846-3594