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Reporting LAHAN Alerts

Non-Residential Settings

B73 COVID-19 - Procedural Guidance for DPH Staff



Non-Residential Settings (including Worksites, Food Service Facilities, Places of Worship, and Law Enforcement and Courts).
For Adult Day Care facilities, please visit the Adult Day Care B73 page.

Forms / Quick Links

  • COVID-19 Outbreak Non-Residential Settings PDF
  • COVID-19 Outbreak Form Guidance PDF
  • COVID-19 Line List for Non-Residential Congregate Settings Excel
  • Respiratory Virus Death Report Form PDF
  • Resources (intranet access required)

REPORTING PROCEDURES

Outbreak Definitions

Under Title 17, Section 2500, California Code of Regulations - all suspected outbreaks are reportable.

At least 3 laboratory-confirmed cases with symptomatic or asymptomatic COVID-19 within a 14-day period who are epidemiologically linked, who do not share a household, and are not close contacts of each other outside of the outbreak site (except when housing or transportation is provided by the employer); OR at least 5% of the facility census are laboratory-confirmed cases (symptomatic or asymptomatic), with a minimum of 5 laboratory-confirmed, within a 14-day period, and in the absence of identifiable epidemiological links.

NOTE: Epidemiologically linked cases include persons with identifiable connections to each other, such as being present the same setting during the same time period (e.g., same shift/department, same physical work area) within likely timing of exposure and without other more likely sources of exposure. Epidemiologic links indicate a higher likelihood of transmission of disease between cases compared to sporadic incidence. Cases sharing housing or transportation provided by the employer are evaluated as individual cases as employer-provided facilities are considered an extension of the worksite.

Symptomatic illness compatible with COVID-19:
  • At least two of the following symptoms: fever (measured or subjective), chills, rigors, myalgia, headache, sore throat, nausea or vomiting, diarrhea, fatigue, congestion or runny nose; OR
  • At least one of the following symptoms: cough, shortness of breath, difficulty breathing, or new olfactory and taste disorder(s); OR
  • Severe respiratory illness with at least one of the following: clinical or radiographic evidence of pneumonia or acute respiratory distress syndrome (ARDS).

Epidemiologic Data for Outbreaks

  1. Complete COVID-19 Line List for Non-Residential Congregate Settings (see Forms) that includes:
    1. Name
    2. Date of birth or age
    3. Address and phone number
    4. Job duties
    5. Work location
    6. Dates worked at facility
    7. Specimen collection date (COVID-19 test date)
    8. Symptom status and onset date
    9. Hospitalization and fatality
    10. Results of laboratory tests
    11. Vaccination status and date of last dose
  2. Document confirmed cases and ill employees (suspected cases) on the Case Line List and contacts to confirmed cases on the Contact Outbreak Line List in the COVID-19 Line List for Non-Residential Congregate Settings (see Forms). The Other Employees line list can be completed to document cases excluded from the outbreak, employees participating in response testing or mass testing, or matching full employee lists to IRIS case surveillance data or other purpose as needed.
  3. Obtain site floor plan, if appropriate.
  4. Maintain surveillance until there are no new outbreak-associated cases for at least 2 weeks from last exposure in a facility (see Closing Outbreaks). Last exposure refers to the latest (most-recent) day any outbreak-associated case was present at the facility while infectious.
  5. Create an epi-curve using the symptom onset date, if available, or the first positive specimen collection date (whichever date is earlier). (Optional)
  6. Complete COVID-19 Outbreak Non-Residential Settings form at the conclusion of investigation (see Report Forms).

GENERAL INVESTIGATION GUIDELINES

  1. Communications to ACDC regarding outbreaks in non-residential settings can be directed to:
    1. FoodSafety@ph.lacounty.gov for restaurants, grocery stores, food processing/manufacturing, or food warehouses; and
    2. ACDCVector@ph.lacounty.gov for most other worksites.
    3. CovidCorrections@ph.lacounty.gov for law enforcement/court facilities
    4. Additional ACDC outbreak teams for special settings (e.g. Hospital Outbreak Bioterrorism Response team for places of worship, gyms, mass transit and ticketed and non-ticketed events).
  2. Employer-reported laboratory-confirmed cases generally do not need to be verified with laboratory test results or linkages in IRIS.
  3. As deemed necessary by outbreak team leaders, conduct immediate interview of cases to obtain information regarding job duties, shifts and areas worked, contacts, dates of attendance, and other critical information.
  4. The frequency of follow-up with the facility or site coordinator for outbreak updates, including requesting updated line lists, should be at least weekly (but may be more frequent initially), as needed by the Outbreak Management Branch (OMB) MD..
  5. ACDC will immediately notify EH upon opening an outbreak. Site visits will be conducted jointly by OMB and EH.
    1. Upon notification of an outbreak, OMB will contact EH immediately to coordinate a joint site visit.
    2. Communications to EH can be directed (EHSurvey@ph.lacounty.gov) and must include the following information at minimum:
      • IRIS Outbreak #
      • Facility's name and address
      • Name of facility's point of contact
      • Phone number of point of contact
      • Email of of point of contact
      • Description of each OB zone
      • Number of cases in each OB zone
      • Number of employees in each OB zone
      • Total number of cases (entire facility)
      • Total number of onsite employees (entire facility)
      • Summary of known information
      • OMB PHI & MD
      • Specific request(s) of EH
  6. Inform the facility, or site, that they will be included on a public outbreak notification list posted on the LAC Public Health website until the facility meets criteria for closing outbreaks (see Closing Outbreaks).
  7. Outbreaks identified as high priority must be immediately reported to ACDC and the Division of Environmental Health. See High Priority Outbreaks section for definition and additional response.
  8. Immediately notify ACDC and EH if OMB has determined a need for a DPH-ordered closure due to circumstances that prevent the facility to safely operate as noted in Criteria for Closing Facilities.
  9. Notify ACDC within 24 hours of identification of any of following:
    1. Concerning issues of non-compliance
    2. Significant increase in case counts
    3. Voluntary facility closures that are planned to last longer than 48 hours
  10. If during the course of investigation, OMB determines that the outbreak does not meet outbreak criteria, please consult with ACDC, so that ACDC may review findings and make a final determination on whether outbreak should be closed as false.

Additional guidance and resources:

 

COVID-19 Core Information:

For up-to-date information on symptoms, transmission, period of infectiousness, contacts, and fully vaccinated persons please refer to the B73 COVID-19 Home Page.

GENERAL CONTROL RECOMMENDATIONS FOR OUTBREAKS

  1. DPH testing recommendations should be communicated to the facility administrator/manager or site coordinator.
  2. Testing is recommended for all individuals, regardless of vaccination status, in the defined outbreak area (see Determining OB-Associated Cases and OB Zones) in all non-residential congregate settings. Asymptomatic employees who have previously tested positive for SARS-CoV-2 within the past 90 days do not need to test in most circumstances. Home testing is not recommended. See Testing Considerations.
  3. Enforce masking while indoors among all individuals on site (including clients, customers, and vendors), regardless of vaccination status. All persons must wear masks outdoors if social distancing cannot be maintained.
  4. Evaluate if and where physical distancing measures need to be implemented by the employer to enable employees and other individuals to the extent possible, maintain 6 feet physical distance from others including when eating or drinking.
  5. Emphasize respiratory etiquette and good hand hygiene (cover cough and sneezes, dispose of tissues properly).
  6. Signage should be posted at the site to reinforce wearing face masks, frequent hand washing, covering your cough, and maintaining social distancing.
  7. Sick persons (including clients, customers and vendors) with any illness, even with mild symptoms, should be restricted from entering the facility/site. They should be instructed to stay home and self-isolate and get tested for COVID-19..
  8. Screen all employees for symptoms, either at home or in-person, and if feasible also clients, customers and vendors. Consider checking for fever by measuring body temperature.
  9. Emphasize importance of early detection of cases and removing them from contact with others.
  10. Ensure adequate and easily accessible supplies for good hygiene, including:
    1. Tissues and trash receptacles
    2. No touch hand sanitizer dispenser near customer entrances, if feasible
    3. Handwashing stations
    4. Soap
    5. Paper towels
    6. Alcohol‐based hand sanitizer
  11. Provide employees, and, if possible, clients, customers and vendors, with accurate and updated Public Health information and materials about novel coronavirus.
  12. Minimize, where possible, close contact and the sharing of objects such as cups, food, and drink (see Sector Specific Best Practices for specific guidance in each setting).
  13. Increase routine cleaning and disinfection and when staff and customers are not present, conduct a thorough cleaning and disinfection of equipment and the work environment of the employee case(s) along with frequently touched surfaces and objects such as doorknobs/push bars, elevator buttons, restroom doors, etc. Use cleaning chemicals with EPA-registered disinfectant labels with claims against emerging viral pathogens (see www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2). Temporary closure is not essential as long as environmental cleaning can be appropriately conducted.
  14. Clean touchable, shared equipment between shifts or between users, whichever is more frequent, including, but not limited to, working surfaces, tools, handles and latches, and controls on stationary and mobile equipment.
  15. Notify all employees of COVID-19 outbreak at site while maintaining patient privacy and reinforce prevention measures across the facility/site. A template letter for employers to draft notification on company letterhead is available if needed. If necessary, investigators can request employers to submit a draft template in legible font (size 14 or larger) to DPH for approval prior to distributing or posting. See Template for Notification to Visitors and Employees in Additional Guidance and Resources.
  16. Post a notification letter of outbreak at the entrance of the facility/site and community area (see COVID-19 Template for Notification to Visitors and Employees in Additional Guidance and Resources).
  17. Issue a public notification regarding on-site exposures if unidentifiable employees, attendees, clients, or customers may have been close contacts. Examples of a public notification include, but are not limited to, issuing a press release, using social media, and/or including information in communications released to the public and/or customer list.
  18. Assess if there are shared spaces that are used by persons at nearby sites, including but not limited to employees of other businesses or residents living in a multiuse building. Shared spaces include, but are not limited to bathrooms, breakrooms, conference rooms and kitchens. Instruct management at the outbreak location that notices should be posted alerting persons to COVID-19 exposure in these shared spaces. See Exposure Notification Poster.
  19. Implement strategies to protect employees who are at higher risk for adverse health complications. This may include strategies such as telecommuting, staggering shifts, and cross training staff.
  20. Instruct site to maintain daily visitor log, if feasible, with date and time of visit.
  21. Assess need for referrals to vaccination sites or the mobile vaccine unit.

HIGH PRIORITY OUTBREAKS

  1. A worksite outbreak is classified as high-priority if, during the outbreak investigation, a facility is associated with:
    1. 10 or more confirmed COVID-19 cases occurring in the defined outbreak area of a facility within a 14-day period
    2. Worksite closures, either voluntary or ordered by LAC DPH, for any reason
    3. Identification of a noteworthy COVID-19 variant from one or more outbreak-associated cases
    4. Special circumstances (i.e. a sensitive environment or population, significant political or media attention, notable fatalities or other complications, etc.)
  2. Other considerations that may qualify a worksite outbreak as high-priority include:
    1. The majority of employees at the facility are not represented by a union, are low-wage workers, or are working in a high-risk setting (e.g. employees are in close contact with others indoors, require frequent contact with others in daily work tasks). These settings often include those in the manufacturing and warehousing sectors.
    2. Labor partners, or other external groups, have elevated their concerns to elected officials or to DPH.
    3. Significant media interest.
    4. OMB or ACDC determines that the outbreak should be included on the list.
  3. OMB to complete a high priority log report to submit to the Policy Group by the evening prior to the next log report update. Written reports will include the latest information about the latest data from the facility (e.g., case count, number of deaths, number of workers tested), a plan for ensuring the worksite comes into compliance, and a description of any enforcement actions that should be taken.

 

CONTROL OF CASE, CONTACTS & CARRIERS

Cases

  1. Instruct employees with confirmed COVID-19 to self-isolate at home, regardless of vaccination status.
    1. Cases should not return to the worksite for at least 10 days after symptom onset and 24 hours after fever has resolved (without use of fever reducing medicines) and symptoms have improved. For asymptomatic laboratory-confirmed cases, the specimen collection date may be used instead of the symptom onset date. See Home Isolation Instructions.
    2. Asymptomatic laboratory-confirmed cases who have a prior positive SARS-CoV-2 test within the past 90 days do not need to isolate again.
    3. A negative COVID-19 test is not required for a case to return to work once they’ve met isolation criteria outlined above. Return to work guidance for symptomatic close contacts can require additional testing (see Responding to COVID-19 in the Workplace).
  2. Identify any ill employees and immediately exclude them from working in-person at the worksite. Instruct them to not return to work until they have met return-to-work criteria described in Responding to COVID-19 in the Workplace.
  3. Employer, or site coordinator, should recommend all symptomatic employees get tested as soon as possible, even if they have been fully vaccinated (at least 2 weeks have passed since the final dose of their vaccine series). They can be referred to their primary care provider or 2-1-1 to access county or city testing resources.
    1. Symptomatic cases and close contacts that test negative or indeterminate/inconclusive for SARS-CoV-2, regardless of vaccination status, should not return to work until they have met return-to-work criteria described in Responding to COVID-19 in the Workplace.
    2. It is strongly recommended that those with indeterminate or inconclusive SARS-CoV-2 results have repeat testing.
  4. If the employee came to the site while ill, they should be separated from others with door closed, masked, and directed to go home right away.
  5. Determine when the employee was first symptomatic and when they were tested.
  6. Determine which days or shifts the case was on site.
  7. If ill person has severe symptoms, call 9-1-1. Notify EMS and the receiving healthcare facility of possible exposures.
  8. Consider alternative work options like teleworking if employee is well enough to do so.
  9. Instruct employee case to notify all other employers of their illness in order to initiate contact investigations or other necessary infection control measures.
  10. Document suspected and confirmed cases on the Case Line List or Other Employees tab in the COVID-19 Line List for Non-Residential Congregate Settings (see Forms). See Determining Outbreak-Associated Cases and Outbreak Zone section for instructions.
  11. Instruct the employer to notify the public health outbreak manager assigned to the facility immediately if any additional employees or contacts, if known, test positive for COVID-19.

Contacts of Cases

  1. Employers or site coordinators should initiate contact investigation around each confirmed case to identify all close contacts associated with the site (employee or client/customer/vendor) during the infectious period of the case(s).
    1. In instances where there is a known confirmed COVID-19 case in a client, customer or vendor, the employer or site coordinator should initiate investigation to identify exposed employees at site.
  2. Employers should instruct asymptomatic contacts to not return to work until they have met return-to-work criteria described in Responding to COVID-19 in the Workplace.
    1. Asymptomatic close contacts who are fully vaccinated or have tested positive for SARS-CoV-2 within the last 90 days can immediately return to work and do not need to quarantine after exposure to a case.
    2. If direct communication with exposed contacts is possible, a template letter for notification and instructions for reporting symptoms or positive test results back to facility or site coordinator can be provided as a guide for messaging.
    3. If exposed contacts cannot be individually contacted or none could be identified, a template letter for general notification and instructions for self-monitoring can be provided as a guide for messaging to employees.
  3. If contacts have or develop symptoms, then they should not return to work until they have met return-to-work criteria described in Responding to COVID-19 in the Workplace.
  4. Exposed employees in all industries, including those employed in critical infrastructure such as food services, transportation, government services, law enforcement, and other sectors, must adhere to the same return-to-work criteria.
    1. Requests for asymptomatic contacts who work in critical infrastructure to continue work must be reviewed and approved by the OMB MD and ACDC.
  5. Clients, customers and vendors (i.e., non-staff): Contact any clients, customers and vendors that may have been exposed to a confirmed employee case, if feasible.
    1. Advise contacts to self-quarantine (see Home Quarantine Guidance). Clients, customers and vendors should call their primary care provider or 2-1-1 to discuss testing options.
    2. If direct communication with exposed contacts is possible, a template letter for notification and instructions for reporting symptoms or positive test results to the facility can be provided to contact as a guide for messaging.
    3. If exposed contacts cannot be identified or contacted, a template letter for general notification and instructions for self-monitoring can be provided as a guide for messaging. A notification poster can also be posted (see Exposure Notification Poster.)
  6. Document the contacts on the Contact Outbreak Line List in the COVID-19 Line List for Non-Residential Congregate Settings (see Forms), regardless of prior testing or vaccination status, and submit it to DPH Nursing Informatics Line List DPH-NIU-LineList@ph.lacounty.gov as soon as possible in order for contacts to be followed up by Case/Contact Interview Branch (CCIB) in a timely manner.
  7. Employer, or site coordinator, should recommend PCR testing for employee contacts who had exposure to a site-associated COVID-19 case. Home tests are not recommended. They can be referred to their primary care provider or 2-1-1 to access county or city resources for testing. See Responding to COVID-19 in the Workplace and Testing Considerations below.
    1. Testing is recommended for close contacts who are symptomatic, regardless of vaccination status or history of prior infections. Testing is also recommended for asymptomatic close contacts, regardless of vaccination status. Close contacts that are fully vaccinated should get tested 3-5 days after their exposure to the COVID-19 case.
    2. Asymptomatic close contacts who have had a prior positive test within the last 90 days should not test.
    3. If testing identifies additional cases, a new contact investigation is initiated around the new case to identify, isolate, and test their close contacts. This protocol is repeated for each identified case at the workplace.
    4. Asymptomatic close contacts who test negative cannot return to site until they meet return-to-work criteria in Responding to COVID-19 in the Workplace.
  8. Do not require a healthcare provider's note for employees to return to work.

Note: CDC does not recommend testing, symptom monitoring, or special management for people exposed to asymptomatic people with potential exposures to SARS-CoV-2 (i.e., "contacts of contacts"), these people are not considered exposed to SARS-CoV-2.

TESTING CONSIDERATIONS

  1. DPH recommendations for testing should be communicated to the facility administrator/manager or site coordinator (see Responding to COVID-19 in the Workplace).
  2. Worksites should note that Return-to-Work guidance requires employees to remain off-site for a longer period than specified by the California Department of Public Health Guidance on Isolation and Quarantine for COVID-19 Contact Tracing
  3. Employer or site coordinator should recommend PCR testing for all employees in the defined outbreak area, regardless of vaccination status. Employer can refer employees to any of the following for testing:
    1. Primary care provider
    2. Employer occupational health
    3. 2-1-1 for county or city testing sites
  4. Employers may request that employees report their test results (see California Department of Fair Employment and Housing and www.eeoc.gov/wysk/what-you-should-know-about-covid-19-and-ada-rehabilitation-act-and-other-eeo-laws). Employers must maintain confidentiality in compliance with privacy laws.
  5. Asymptomatic employees who have previously tested positive for SARS-CoV-2 within the past 90 days, do not need to test in most circumstances. However, these employees can be considered for testing if they are identified as a close contact in certain high-risk settings or outbreak situations, including, but not limited to, high-priority outbreaks, facilities with low adherence to protocols, facilities with a large number of unvaccinated employees, manufacturing facilities, or outbreaks involving variants of concern.
  6. Retesting of contacts is not recommended if they remain asymptomatic from date of exposure to end of time away from the worksite due to exposure to COVID-19. Retesting is recommended if any of the contacts become symptomatic.
  7. Site-wide testing may be considered in if outbreak is extensive or close contacts are not identifiable).
  8. Only FDA approved viral COVID-19 tests that are collected and performed in a healthcare setting or by a certified testing site are acceptable documentation of infection status in an outbreak. Home testing is not recommended given variability in sample collection and test performance.
  9. Document test results of employees who are not cases or contacts, including employees participating in site-wide testing, in the Other Employees list in the COVID-19 Line List for Non-Residential Congregate Settings (see Forms).
  10. Document pertinent COVID-19 testing practices and testing history that the facility has performed in IRIS including:
    1. Whether targeted testing was conducted
    2. Whether wider testing (e.g. mass testing) was conducted
    3. Dates of targeted or mass testing
    4. Number of employees tested
    5. Test results

DETERMINING OUTBREAK-ASSOCIATED CASES AND OUTBEAK ZONES (OB ZONES)

  1. If the boundaries of an outbreak can be characterized in smaller, more specific area(s) of a facility rather than the entire worksite, an outbreak zone (OB zone) can be used to monitor the outbreak. Cases associated with the OB zone are followed as outbreak-associated cases and outbreaks can be closed when there are no new cases associated with the OB zone by the end of the surveillance period.
    1. ACDC will define the OB zone, if applicable to the setting, when the outbreak is opened.
    2. OMB can redefine the OB zone as needed upon further investigation.
    3. Additionally, OMB can expand the outbreak during the course of the investigation to include new OB zone(s) if a new epi-linked cluster of 3 or more cases within a 14-day period occurs outside of the previously identified OB zone.
  2. The start of an active outbreak is defined as the earliest date any case among the first epi-linked cluster was present at the facility while infectious. Sporadic case/cases occurring prior to the identified epi-linked cluster can be considered part of the outbreak if there is an identifiable epi-link between the sporadic case to a case in the cluster or a subsequent outbreak-associated case and the epi-linked cases are within 14 days of each other.
  3. All cases associated with the defined outbreak area (the facility or OB zone) occurring with a symptom onset or positive test after the first case, regardless of whether they are epi-linked, should be counted as part of the outbreak until the end of the surveillance period. The surveillance period ends 14 days from the latest day any case associated with the defined outbreak area was on-site while infectious (i.e. last exposure in a facility).
  4. The cases that determine the start of an outbreak and the end of the surveillance period may not necessarily be the first and last case of the outbreak, respectively, as they may have left the facility and developed illness many days later.

Cases to Exclude from Further Investigation:

  1. Some cases can be excluded from the outbreak and do not need further investigation. Document these cases in the Other Employees line list in the COVID-19 Line List for Non-Residential Congregate Settings (see Forms). These are cases that cannot be associated with the facility during their exposure period in which they could acquire SARS-CoV-2 infection nor the infectious period in which they could transmit it to another employee. The following cases can be excluded:
    1. Cases whose primary work location is within the defined outbreak area but have episode onset before OB start date (i.e., a previous case in the outbreak location one month earlier)
    2. Cases who previously tested positive in the past 90 days and are asymptomatic.
    3. Cases that were not on-site at any time during their exposure period. The exposure period begins 14 days prior to the episode onset date. Episode onset is the date of symptom onset or positive specimen collection date – whichever is earlier.
    4. Cases with household or carpool exposure to a COVID-positive individual, if the employer can provide detailed information, including exact dates, that meets all below criteria:
      1. Episode onset occurred after the episode onset of the household member or carpool passenger, but within the case’s exposure period, AND
      2. Contact occurred while the household member or carpool passenger was infectious, AND
      3. The case was not present on-site during their infectious period. The infectious period begins two days prior to episode onset. For example, case was already in quarantine due to exposure to household contact.

Cases to Include in the Outbreak

  1. Outbreak-associated (OB-associated) cases are those that can be counted as part of the outbreak. Document these cases on the Case Line List in the COVID-19 Line List for Non-Residential Congregate Settings (see Forms) by noting “Yes” in the column titled “Outbreak-Associated”. These cases can be associated with the defined outbreak area (the OB zone or the entire facility, whichever is applicable) either during their exposure period or the infectious period. Cases that are not OB-associated are noted with a “No” in the same column. OB-associated cases are defined as:
    1. Cases whose primary work location is within the defined outbreak area (the facility or the OB zone) with an episode onset date after the OB start date, OR
    2. Cases whose primary work location is outside of the defined OB area, but are epi-linked to the outbreak at any time within their exposure period or infectious period.
    3. Special Considerations:
      • Cases who carpool together in private vehicles or are from same household and have an episode onset within a 14-day period:
        1. If cases have the same episode onset date, designate those that work primarily within the defined outbreak area as OB-associated (e.g., employees testing positive during mass testing) and those that primarily worked outside of the defined outbreak area as not OB-associated.
        2. If cases have different episode onset dates, the case with the earliest episode onset should be designated as OB-associated if they work primarily within the defined outbreak area. Subsequent cases who primarily work within the defined outbreak area can also be designated as OB-associated if they were present on-site during infectious period given the risk of subsequent worksite transmission to others. All other cases can be designated as not OB-associated including subsequent cases that were not present on-site during their infectious period.
      • Cases that result from secondary transmission from an OB-associated case and use shared housing facilities (e.g., migrant labor camps, man camps) or shared transportation services, provided by the employer, should be designated OB-associated.

Cases that are Not Outbreak Associated

  1. Cases not OB-associated should not be counted as part of the outbreak. They may still have acquired or transmitted SARS-CoV-2 infection at the facility and should remain on the Case Line List for continued evaluation. Document these cases on the Case Line List in the COVID-19 Line List for Non-Residential Congregate Settings (see Forms) by noting “No” in the column titled “Outbreak-Associated”. Cases that are not outbreak-associated cases are:
    1. Cases whose primary work location is outside of the defined outbreak area and are not epi-linked to the outbreak.
    2. Cases with household or carpool exposure as described above in Special Considerations.

CRITERIA FOR CLOSING FACILITIES

  1. If OMB determines an ordered closure is needed because certain circumstances prevent the facility from operating safely, immediately notify EH and ACDC and initiate the closure protocol. Facilities may be ordered to close temporarily under the following circumstances:
    1. Magnitude of outbreak and/or lack of disease-control measures that significantly increase the risk of continued disease transmission.
    2. New case(s) identified above baseline, despite implementation of outbreak-control measures.
    3. Inability of facility to implement outbreak-control measures recommended by DPH.
    4. Absence of clear, timely updates or communication from the facility to DPH
  2. If EH or ACDC have reason to believe that a facility that is experiencing an outbreak should be closed, OMB will immediately be notified and OMB will initiate closure protocol.
  3. In most cases, a temporary closure is not essential if environmental cleaning and other standard infection control measures, including deep-cleaning of COVID-19 case’s work and shared spaces, can be appropriately conducted without closure. Notify ACDC immediately if the facility plans to close longer than 48 hours— either voluntarily or by recommendation, such as for extensive environmental cleaning.

DEATH REPORTING

The Public Health outbreak manager must be notified of a death associated with the facility.

 

OUTBREAK RESOLUTION

  1. The last day of surveillance is the 14th day after the last date that any outbreak-associated case was on site.
  2. New cases occurring during the 14-day surveillance period should be evaluated as described in Determining Outbreak-Associated Cases and Outbreak Zones.
  3. The outbreak is considered resolved if all conditions below are met:
    1. No cases  have occurred in the defined outbreak area within the 14-day surveillance period; and
    2. No cases  outside of the defined outbreak area are epi-linked to the defined outbreak area or to an outbreak-associated case within the 14-day surveillance period; and
    3. No additional clusters of 3 or more cases that meet outbreak criteria are identified in other areas of the facility; and
    4. The location appears to have effectively implemented all necessary COVID-19 control and preventive measures and observed violations have been abated.

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  • Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.

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