Patient Screening Procedures

Recent fever, cough or difficulty breathing and international travel in the last 30 days should be ascertained and documented as early in the patient encounter as possible; if possible, before arrival for patients making appointments by phone. During phone screening, patients with any of those symptoms should be asked about ALL international travel. If they have travelled internationally or have been exposed to someone who has, and the patients are symptomatic, refer them to their personal physicians. For patients whose primary providers are LSU Healthcare Network physicians, ask the patients about an ED preference, consult that ED and then direct the patients to that ED.
Upon arrival at the clinic, patients should be asked if they have traveled to any country with sustained local transmission, which currently include China, South Korea, Italy, Iran and Japan, or had close contact with a person under investigation (PUI) for 2019 Novel Coronavirus within the last 14 days.
All patients with symptoms of lower respiratory infection and/or fever as well as a relevant travel or exposure history:

• Should immediately be asked to wear a surgical mask.
• Be roomed as soon as possible in a private room with the door closed, ideally an airborne infection isolation room if available.
• Health care personnel caring for a PUI should use Standard Precautions, Contact Precautions, Airborne Precautions, and use eye protection (e.g., goggles or a face shield).
• If a PUI provides advance notice of their visit, health care personnel should make every effort to provide them with a surgical mask before they enter the facility.

Health care personnel should follow internal procedures to immediately notify the Infection Control contact for your clinic. Clinics should then immediately notify the Infectious Disease Epidemiology Section (IDEpi) of the Louisiana Department of Health by calling 1-800-256-2748.
The Louisiana Department of Health Office of Public Health will issue instructions that will include gathering information including:
Travel history – date traveled to China, South Korea, Iran, Italy or Japan; how long and where in these countries; date traveled from one of these countries, date returned to the US
Information about close contact with PUI or confirmed case.
Close contact is defined as:
Being within approximately 6 feet, or within the room or care area, of a novel coronavirus case for a prolonged period of time while not wearing recommended personal protective equipment or PPE (e.g., gowns, gloves, NIOSH-certified disposable N95 respirator, eye protection); close contact can include caring for, living with, visiting, or sharing a health care waiting area or room with a novel coronavirus case.
Or
Having direct contact with infectious secretions of a novel coronavirus case (e.g., being coughed on) while not wearing recommended personal protective equipment.
Patient's signs and symptoms including fever, cough, sore throat, shortness of breath, as well as any additional symptoms like chills, headache, muscle aches, vomiting, abdominal pain, diarrhea or other symptoms.
Patient's co-morbid conditions, if any, such as pregnancy, diabetes, cardiac disease, hypertension, chronic pulmonary disease, chronic kidney disease, chronic liver disease, immunocompromised, or other.
Patient's current living situation (house vs apartment vs group home/residential facility, and how many roommates or family members sharing the space.)

Fever may not be present in some patients, such as those who are very young, elderly, immunosuppressed, or taking certain fever-lowering medications.
EPA-registered disinfectants or 1:100 dilution of household bleach and water should be used for low-level disinfection of surfaces and noncritical patient-care equipment.
Clinics should routinely:
Display respiratory etiquette signs at entry and waiting points.
Provide easy access to hand hygiene supplies in patient waiting areas.
Room patients as soon as possible for evaluation.