Page updated March 14, 2020
Federal, state and local health officials are working with communities across the region to slow the spread of the novel coronavirus COVID-19. Local health clinics play a pivotal role in supporting their patients in good health and minimizing the risk of spreading the virus to staff and other patients.
The Oregon Health Authority released updated guidance for testing March 16, following provisional guidance on clinical care and healthcare infection prevention and control issued March 9.
Health care providers also have a responsibility to treat those who need care, and that begins by understanding actual risks and avoiding reacting out of fear. A person’s ethnicity, language, association with a country, neighborhood or school affiliation are not inherent risk factors.
Be cautious about turning away patients who feel they need to be evaluated. A plan to return for care should be developed so the patient knows what to do if symptoms become worse.
There are simple steps a clinic can take to help prevent the spread of viral infections, including having a plan to ensure that a person ill with any respiratory illness follows good cough etiquette and hand hygiene.
For patients who might be ill with a respiratory viral infection, clinics should also have a plan in place that addresses how to care for a patient before they arrive, during intake, and while the patient is being seen.
Plans might include:
- Instruct patients to call ahead — or inform the health care provider upon arrival — if they have symptoms including a cough, shortness of breath and fever. Ask the patient to wear a facemask to contain their cough, and place the patient in an exam room as quickly as possible.
- Consider screening patients for other germs that cause respiratory illness.
- If a person with possible COVID-19 arrives unexpectedly, ask the patient to wear a mask and take them immediately to an exam room. Keep the exam room door closed.
- If possible, schedule a person who may have COVID-19 as the last patient of the day.
- If possible, suspected COVID-19 patients should be escorted into the building through an entrance that allows them to access an exam room without exposing others.
- Minimize the number of healthcare workers interacting with the patient. Caregivers should follow Oregon Health Authority's guidance, which includes eye protection and a surgical or procedure mask.
- Collect all specimens and perform clinical interventions in the exam room if possible.
- The exam room should be left empty for as long as possible after the patient has left; the room should be thoroughly cleaned and disinfected.
- Patients who are under evaluation for COVID-19 may stay at home if they are not sick enough to be admitted, but will need a plan for who to contact if clinical symptoms worsen. See CDC guidance for home care.
Clinics play a vital role to keep their communities healthy. To do that, they need to take care of their providers. There are basic steps every employer should take to plan for the unexpected.
Those steps should include:
- Ensure that your leave policies support employees who need to stay home when they are ill.
- Instruct anyone who becomes sick with a fever and cough illness at work to go home immediately, and return only after they are free of symptoms for at least 24 hours (without the use of fever-reducing medicines or cough suppressants).
- If your organization works with companies that provide contract or temporary employees, talk to those agencies about the importance of sick employees staying home, and encourage partners to develop flexible sick leave policies.
- For employees who are sick with acute respiratory illness, do not require they provide a healthcare provider’s note to validate their illness or to return to work.
- Create or update policies to allow employees to stay home to care for a sick family member or child who cannot go to school.
- Plan for absenteeism by identifying essential functions and creating plans for continuity of operations.
- Cross-train personnel to perform essential functions so the workplace can operate even if key staff are absent.
- Consider what your business would require to maintain critical operations (identify alternative suppliers, prioritize customers, temporarily suspend some operations if needed).