1. Background Information

Covid-19 is respiratory disease caused by novel (new) coronavirus that was first detected in China and which has now been detected in more than 100 locations internationally, including the United States. The virus has been named “SARS-CoV-2” and the disease it causes has been named “coronavirus disease 2019” (abbreviated “COVID-19”)

On January 30, 2020 , the International Health Regulations Emergency Committee

of the World Health Organization declared the outbreak a “public health emergency of international concernexternal icon” (PHEIC). On January 31, 2020, Health and Human Services Secretary Alex M. Azar II declared a public health emergency (PHE) for the United States to aid the nation’s healthcare community in responding to COVID-19.

Source and Spread of the Virus

Coronaviruses are a large family of viruses that are common in people, many different species of animals , including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS-CoV, SARS-CoV, and now with this new virus (named SARS-CoV-2).

The SARS-CoV2 virus is a beta coronavirus, like MERS-CoV and SARS-CoV. All three of these viruses have their origins in bats. The sequence from U.S. patients are similar to the one that China initially posted, suggesting a likely single, recent emergence of this virus from an animal reservoir.

Early on, many of the patients at the epicenter of the outbreak in Wuhan, Hubei Province, China had some link to a large seafood and live animal market, suggesting animal-to-person spread. Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread. Person-to-person spread was subsequently reported outside Hubei and in countries outside China, including in the United States. Some international destinations now have apparent community spread with the virus that caused COVID-19, as do some parts of the United States. Community spread means some people have been infected and it is not known how or where they have became exposed.

2. Policy purpose

This policy outlines Holvik Family Health Center intent to minimize the exposure of the Employees and Patients to pandemic disease and to effectively respond to this threat should an incident occur.

3. 1. Holvik Family Health Center is committed to providing staff, students , patients, volunteers and contractors with a safe working and learning environment that is free of health hazards, inclusive of pandemic diseases such as COVID-19.

   2. Holvik Family Health Center assigns the highest priority to assessing, minimizing and managing the risk to the clinic, employees, patients, and community of being exposed to pandemic diseases such as COVID-19.

4. Roles and Responsibilities

4.1 Holvik Family Health Center will:

• continually review CDC information for updates and changes, monitor Commonwealth and state health directives and advice, and assess and manage the risks that are identified in these communications;

• comply with current guidelines from minimizing its exposure to COVID-19.

• Notify Tulare County Health Department if there is significant risk that any of its staff members, students or volunteers have been affected with COVID-19, and Holvik Family Health Center will comply with any Government requests to supply the person the personal information that is associated with these exposures;

• Comply with quarantine requirements in response to advice from the government or State Health Agencies when there is a significant possibility staff, clinicians, students or patients pose an infection risk.

5. Clinical Operation, Clinician/Staff/Student/Responsibilities.

5. 1. Clinicians/Staff will:

• consult recent guidelines, issued by CDC

5. 2. During daily operations in dealing with possible COVID-19:

• Staff will screen patients who call and encourage them not to enter the clinic lobby if it its determined that they could have COVID-19 or could have been exposed to COVID-19

• If patients have entered the clinic and it is determined that they likely have been exposed or have COVID-19, they will be asked to wait in their vehicle to minimize exposure to others. They will also be provided a mask.

• Patients who are found to be at risk for exposure or at risk for having COVID-19 will be tested for Influenza and RSV initially. If influenza and RSV have been ruled out via nasal swab, the patient will be tested for COVID-19 in accordance with Tulare County Health Dept. instruction.

• Once patient has been tested for COVID-19. Tulare County Health Department will be notified and ID number will be obtained. Case Report information will be completed and relayed to Tulare County Health Department.

• Treatment will be based on the most recent CDC guidelines and the Tulare County Health Department recommendations.

• If it is felt that patient’s symptoms require higher level of care, Kaweah Delta Hospital House Supervisor will be contacted . Report will be given to the House Supervisor by the Clinician (including case number and case report) and further care of the patient will be turned over to the local hospital.

5. Application of Policy

The policy applies to all staff, students, volunteers and contractors, within the clinic.

6. Policy Review

The Policy will be reviewed by Human Resources, as necessary.