2020-03-30: Guidelines for the Asymptomatic Healthcare Worker with Exposure to an Individual with COVID-19 with Prolonged Contact in the Healthcare or Community Setting
Individuals with prolonged, close contact with an individual with COVID-19 may be at increased risk for infection with SARS-CoV-2, the virus that causes COVID-19. For the purpose of this evaluation, exposed prolonged contact is defined as being within 6 feet of the infected individual for > 15 minutes.
Several factors, including the type of exposure as well as the use of any personal protective equipment dictate the overall risk to the exposed healthcare worker.
The following categories meet the criteria of a High-Risk Exposure
- A Healthcare Worker not wearing a facemask or respirator is exposed to a patient with COVID-19 who is not wearing a facemask.
- A Healthcare Worker not wearing a mask or respirator is exposed to a patient with COVID-19 and one of the following has occurred:
- The Healthcare Worker had extensive body contact with the patient or
- The Healthcare Worker was present during an aerosol generating procedure such as intubation/extubation, bronchoscopy or sputum induction without wearing a respirator
- Living in the same household as or providing direct care for a person with symptomatic, laboratory-confirmed COVID-19 infection without using the recommended precautions.
Individuals with High-Risk Exposure should contact the COVID-19 Call Center and report their exposure to Employee Health. If the criteria are met a 14-day quarantine will be recommended.
Low-Medium Risk Exposure
All other scenarios not classified as High-Risk Exposure generally meet the criteria for Low-Medium Risk Exposure.
These may include but are not limited to:
- A Healthcare Worker who was in prolonged close contact with a patient with COVID-19 while wearing a facemask at all times even though the patient was not wearing a mask.
- A Healthcare Worker who was in prolonged close contact with a patient with COVID-19 while the patient was wearing a mask at all times.
- A Healthcare Worker who has recently traveled to a country with widespread community COVID-19 transmission.
- Close contact with an individual with symptomatic COVID-19 infection outside a healthcare setting that does not meet criteria for High-Risk Exposure.
A healthcare worker who has had Low Risk exposure may continue to work, provided he/she remains asymptomatic, following the guidance below. A healthcare worker who has had Medium Risk exposure may continue to work, if he/she remains asymptomatic, if staffing needs reach critical levels, under the guidance of Employee Health and/or an Employee Health designee. In doing so, he/she must adhere to the following requirements:
- A procedure or surgical mask must be worn at all times in all settings for 14 days from the date of exposure.
- The healthcare worker must take his/her temperature twice daily and record this value on a temperature log and check in with their supervisor daily. If the healthcare worker has a temperature > 100 F he/she must notify Employee Health through the COVID-19 Call Center immediately.
- If the healthcare worker develops any new onset of cough, shortness of breath, subjective fever, chills, body aches he/she must notify Employee Health through the COVID-19 Call Center immediately.
Please call the COVID-19 Call Center if there are any questions about a potential COVID-19 exposure.
2020-03-16: UConn Health Guidelines for COVID Pandemic Rescheduling of Surgical Cases
With the priorities of patient care, staff health, resource utilization and public health considerations, the OR Executive Committee endorses a policy for rescheduling of elective cases for the immediate future. The following are guidelines for this process with decisions to be made by the individual surgeon, respective surgical Chair and OR Executive Committee if required.
- Elective cases are those scheduled in advance that do not involve medical emergency.
- Effective immediately, all elective cases will be postponed
- Emergent cases will proceed as usual without delay.
- In general, emergent cases are defined as:
- Acute life or limb threatening condition (i.e., unstable angina or vascular disease with tissue loss, open fracture, perforated viscus)
- Acute loss of function (i.e., myelopathy)
- Cannot wait until the patient is medically stable
- In general, emergent cases are defined as:
- Semi-urgent cases will require evaluation on a case by case basis to determine timeliness of the procedure.
- Case does not need to be done immediately for medical reasons, but should be performed within a few weeks, i.e., cancer or suspicious lesion requiring diagnosis or treatment, or cesarean section.
All procedures will require evaluation of the following factors:
- High risk procedures for clinicians
- ENT, upper and lower endoscopy, pulmonary, dental procedures where aerosolization of virus is present.
- Any procedure requiring non closed airway manipulation, i.e., monitored anesthesia care, conscious sedation.
- High risk patients
- Patients exhibiting signs of respiratory illness
- Age > 65
- Multiple comorbidities, especially pulmonary or cardiac
- Cancer patients due to immunosuppression
This situation is fluid and will require ongoing review and revision by the OR Executive Committee. Once we have defined the scope, duration and magnitude of the postponements, rescheduling of these cases will proceed.
2020-03-12: Schools, Telecommuting, Large Group Meetings, and Visitors
Message from Dr. Andrew Agwunobi, Chief Executive Officer, UConn Health; Dr. Bruce Liang, Dean, UConn School of Medicine; and Dr. Steven Lepowsky, Interim Dean, UConn School of Dental Medicine
The health and well-being of our community is always our highest priority. During extraordinary times, such as the current global pandemic, we need to support that primary obligation while doing our best to carry out our academic, research and clinical missions. Consistent with these values, along with directives from our governor and our desire to collectively support the CDC’s public health activities, UConn Health is taking the following steps:
UConn School of Medicine
- Beginning on Monday, March 16, UConn School of Medicine preclerkship classes will move to online course delivery. This will be evaluated for its continuation on a regular basis.
- All clinical clerkships will continue, but students will not participate in the direct care of suspected or known COVID-19 patients.
- All community-based weekly clinics will be cancelled until the week of April 6.
- All research and its operations will continue as usual.
- Specific guidance on medical education activities will be communicated individually to students.
UConn School of Dental Medicine
- The didactic components of the predoctoral (DMD) curriculum are transitioning to a virtual, online delivery beginning March 16. The School of Dental Medicine will evaluate its continuation on an ongoing basis.
- Preclinical simulation courses will be rescheduled or modified to permit social distancing.
- Clinical operations will continue and will be evaluated on an ongoing basis. Modifications to processes and procedures for patient care activities will be implemented as appropriate.
- Research activities will continue.
- Specific guidance for each year of the predoctoral (DMD) curriculum is being communicated to each cohort of students and specific guidance for each postdoctoral residency program is being communicated directly to the residents.
Telecommuting for UConn Health Employees
All UConn Health employees who are able to perform some or all of the essential functions of their jobs from home will be reviewed by managers for approval to telecommute. Managers and supervisors are currently assessing the telecommuting appropriateness and applicable resource needs, such as technology, for all employees in their units. Please work directly with your manager or supervisor regarding your particular situation. UConn Health’s goal is to have as many employees work from home a possible while still allowing UConn Health to perform functions critical to its mission. While the formal telecommuting form and process will be temporarily relaxed during this time, employees will still need approval from directors or higher-level leaders and Human Resources to telecommute. Human Resources questions can be emailed to HR-EmployeeResource@uchc.edu.
Large Group Meetings
Effective immediately, no events larger than 100 people will be permitted at any UConn Health site. This includes all events and meetings. If possible, alternatives such as teleconference or virtual conferencing methods should be used to hold large events; otherwise they should be cancelled or postponed. In addition, UConn Health strongly recommends the postponement or cancellation of any non-essential live gatherings and meetings of large groups, even those smaller than 100 people.
Visitors to UConn Health Clinical Sites
Effective immediately, UConn Health has implemented new restrictions on visitors to our clinical sites (inpatient and outpatient) to ensure a healthy and safe environment for patients, staff, and visitors amid the outbreak of novel coronavirus (COVID-19). All visitors to our clinical locations will be screened. Additionally, the number of visitors that patients are allowed will be limited per the new Visitor Policy.
The current situation continues to be very fluid. Ongoing evaluation of policies and procedures will continue, and we will strive to communicate any new developments or changes as they occur.
To that end, we will be holding another audioconference call, Monday, March 16, at noon, to address your questions. Please forward questions ahead of the call to firstname.lastname@example.org. Questions will also be accepted during the call.
I want to thank you for your patience and flexibility, as well as your prompt effort to adopt these steps to help reduce risk to our own community and to contribute to curtailing the global spread of the virus.
2020-03-12: Upcoming Patient Appointments
In response to the COVID-19 outbreak (also known as coronavirus) and in following with guidelines from the CDC, we ask that if you have been in contact with someone that has tested positive for the virus, or if you have travelled outside of the country within the last 14 days or are experiencing a fever, a new cough, or a new or worsened shortness of breath, that you give us a call before you come in for your appointment.
2020-03-12: COVID-19 Visitor Guidelines and Restrictions
Dear Patients and Families,
Effective immediately, UConn Health has implemented new restrictions on visitation to ensure a healthy and safe environment for patients, staff, and visitors amid the outbreak of novel coronavirus (COVID-19). Out of an abundance of caution, we are limiting visitation to the following:
|All Departments||Under 14 not permitted|
|Inpatient, Emergency Department, New England Sickle Cell Institute, and Neag Comprehensive Cancer Center||ONLY ONE (1) visitor per patient at a time|
|Labor and Delivery, OB/GYN||ONLY ONE (1) visitor per patient (must be the same visitor) for the duration of the patient’s stay|
|Outpatient||ONLY TWO (2) support people will be allowed with each patient|
This temporary change does not apply if extenuating circumstances exist, such as visiting patients who are receiving end-of-life care.
If you have traveled or been exposed to someone with a confirmed or possible case of COVID-19, or if you have a cough, fever, or shortness of breath, please DO NOT visit our patients.
All patients, visitors, and vendors will receive a brief health screening before entry. If screeners determine that a visitor is a potential health risk, that person will not be allowed to visit and will be asked to consult their doctor for further guidance.
We apologize for any inconvenience that this may cause you and your family, but we feel strongly about the importance of limiting the risk of possible exposure to COVID-19. Please visit https://uconn.edu/public-notification/coronavirus for updates on this evolving situation.
Rest assured that we are prepared to manage infectious diseases effectively. We have existing clinical and operational plans in place across UConn Health. We are also implementing new protocols as we monitor updates from the Centers for Disease Control and Prevention (CDC) and local and state health departments.
2020-03-04: Information for Clinicians and Clinical Staff on COVID-19
Dear UConn Health clinicians and clinical staff,
As the COVID-19 epidemic evolves, clinical leadership is working closely with Infectious Disease and Infection Control, as well as state agencies and the Connecticut Hospital Association, to help provide guidance regarding patient care activities at UConn Health. We have to anticipate the future probability of patients with COVID-19 in our state, and potentially at our facility.
There are several overarching principles to consider when providing care for patients with possible COVID-19 infection. Based on data from other countries, most patients with COVID-19 will receive care in ambulatory settings. Only a small proportion require Emergency Department-level care and a very small percentage will warrant admission to the hospital.
Testing for COVID-19 remains regulated by the CT Department of Public Health, and at this time is focused on hospitalized patients. Based on the current testing procedures, most ambulatory patients would not meet testing criteria. As testing becomes more readily available, we anticipate that this testing criteria will expand.
When patients with possible COVID-19 call or present to outpatient clinics with symptoms that warrant non-emergency outpatient medical management, they should not be referred to the Emergency Department. Referral to the ED will not facilitate laboratory testing. Rather it will force the ED to reallocate resources to patients who do not require emergency care and will potentially unnecessarily expose patients and ED staff to COVID-19 and other respiratory infections.
Staff in the ambulatory setting should follow the following steps when encountering a patient with symptoms of possible COVID-19 infection (fever and/or acute respiratory symptoms such as cough, shortness of breath).
- Ensure the patient is provided a mask and wears it when he/she is in the healthcare facility.
- Segregate the patient from other patients by placing him/her in a private room. If a private room is not available, segregate the patient from other patients in the waiting room.
- Inform the clinic nurse or physician/PA/APRN, who should then call Infection Control for guidance (can be reached through the page operator).
- Inform the clinic manager or director.
- Perform hand hygiene and then don the appropriate personal protective equipment (PPE). PPE guidance will be provided by Infection Control on a case-by-case basis.
- Minimize direct patient contact as much as possible – try to maintain a distance of at least six feet away from the patient, if feasible.
- Exercise caution when doffing and disposing PPE as usual precaution in the red bin, as this is a time when contamination risk is highest.
- Perform hand hygiene following doffing and disposing of PPE.
- After the provider and patient exit the room, ensure the room in which the patient was evaluated is cleaned using routine cleaning and disinfecting processes.
Patients with mild symptoms should be advised to self-care at home for the duration of symptoms with guidance to seek care or reevaluation if their symptoms worsen. Consider close follow-up through telecommunication.
We will be posting additional signage throughout the institution to provide instructions to patients on infection prevention strategies. Additionally, processes to direct patients who call for appointments with symptoms are being finalized and will be distributed to outpatient staff.
We appreciate your flexibility as guidance from public health agencies and UConn Health changes. We will keep you updated on these changes. Please see the following websites for additional information on COVID-19.
2020-02-29: Iran and Italy
The situation regarding coronavirus continues to change quickly. The CDC issued new guidance Friday night (February 28). In addition to China and South Korea, Iran and Italy were deemed “Warning Level 3” nations, which the CDC advises people against traveling to at this time.
Given that, effective today, UConn and UConn Health have barred all university-related travel to these nations in addition to China and South Korea.
We will keep you updated as new information becomes available.
2020-02-28: Travel to China and South Korea
As we continue to monitor updates regarding COVID-19, the novel coronavirus, UConn (including UConn Health) has decided as a precautionary measure to suspend or cancel all official travel to China and South Korea, which have been designed Warning Level 3 nations by the Centers for Disease Control and Prevention (CDC).
All non-essential institutionally sponsored travel to those nations is suspended.
The CDC has designed Iran, Italy and Japan at Alert Level 2. While official travel to these nations is permissible, the CDC advises that older adults and those with chronic medical conditions should consider postponing nonessential travel.
The health and safety of our patients, students, faculty and staff is our highest priority as we assess this ever-evolving situation and UConn’s preparedness and response plans. The situation regarding COVID-19 is fluid and can change quickly. We will send regular updates to the community as we receive new information and guidance from the CDC.
Please rest assured that working in collaboration with our state and local health departments, we feel prepared to respond to any cases of COVID-19 that might present themselves at UConn Health. Our front line staff and healthcare providers are screening all of our patients in all portals of entry according to the CDC Guidelines. Other measures we have taken include establishing cough etiquette stations in patient waiting areas to protect all patients and staff from potential respiratory illness.
We have and continue to assess our supplies, pharmaceuticals, Emergency Department readiness, and staffing, and as we communicated in a State Agency briefing this week, we feel prepared to respond to an outbreak. We are working internally to ensure that, should such an outbreak be of prolonged duration, we can mount an appropriately sustained response. We recognize that the situation is rapidly evolving and are monitoring for new CDC recommendations and guidelines daily along with our state and local departments of public health.
Fortunately, at present, there has been no person diagnosed with COVID-19 in the state of Connecticut. Nevertheless if you are experiencing fever and/or respiratory symptoms such as cough or shortness of breath and wish to seek in-person care, please visit our emergency room or one of our urgent care locations today. If possible, please contact your healthcare provider to alert them prior to your arrival to one of our facilities so that the appropriate infection control precautions can be initiated when you arrive.
Note that many patients with respiratory infections do not necessarily need care in an Emergency Department or Urgent Care setting. If you are uncertain whether in-person evaluation is warranted please contact your healthcare provider to discuss your symptoms. In doing so, again please provide your healthcare provider with any recent travel history or any known contact with an individual with COVID-19.
We urge you to remember that many of our students, faculty and staff have loved ones in China and other affected countries and may understandably feel heightened stress and anxiety. UConn is an inclusive and global community, and we encourage everyone to be mindful and compassionate of the impact on others on our campuses.
We will continue to provide updates, and encourage you to visit the list of resources available below as we work collaboratively in this unusual and evolving situation.
2020-01-29: From Department of Epidemiology, Infection Prevention and Control
We are closely monitoring the public health situation related to the novel strain of coronavirus (2019-nCoV) that originated in Wuhan, China. Our healthcare providers are screening all of our patients in urgent care and the Emergency Department according to the CDC Guidelines.
Working in collaboration with our local and state public health departments, we are prepared to respond to any suspect cases of 2019-nCoV. At present there has been no person diagnosed with novel coronavirus in the state of Connecticut.
If you are experiencing flu-like symptoms and wish to seek in-person care, please visit our emergency room or one of our urgent care locations today. If you are uncertain whether in-person evaluation is warranted please contact your healthcare provider to discuss your symptoms. Please provide your healthcare provider with any recent travel history.
This is an evolving situation and we will continue to monitor and update you if there are further changes.
We recognize that the situation is rapidly evolving and are monitoring for new CDC recommendations and guidelines daily along with our state and local departments of public health.