KAPP Member COVID-19 Quick Reference Guide

KAPP Member COVID-19 Quick Reference Guide

Updated: 3/9/2020How COVID-19 Spreads
Person-to-person spread
• The virus is thought to spread mainly from person-to-person:
– Between people who are in close contact with one another (within about 6 feet).
– Through respiratory droplets produced when an infected person coughs or sneezes.
• These droplets can land in the mouths or noses of people who are nearby or possibly be
inhaled into the lungs.
Can someone spread the virus without being sick?
• People are thought to be most contagious when they are most symptomatic (the sickest)
• Some spread might be possible before people show symptoms; there have been reports
of this occurring with this new coronavirus, but this is not thought to be the main way the
virus spreads.
Spread from contact with contaminated surfaces or objects
• It may be possible that a person can get COVID-19 by touching a surface or object that
has the virus on it and then touching their own mouth, nose, or possibly their eyes, but
this is not thought to be the main way the virus spreads.
How easily the virus spreads
• How easily a virus spreads from person-to-person can vary. Some viruses are highly
contagious (spread easily), like measles, while other viruses do not spread as easily.
Another factor is whether the spread is sustained, spreading continually without stopping.
Symptoms
Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed
coronavirus disease 2019 (COVID-19) cases.
The following symptoms may appear 2-14 days after exposure:
NOTE: The virus that causes COVID-19 seems to be spreading easily and sustainably in the
community (“community spread”) in some affected geographic areas, including Kentucky
Community spread means people have been infected with the virus in an area, including
some who are not sure how or where they became infected.
Illness Severity
The complete clinical picture with regard to COVID-19 is not fully known. Reported illnesses
have ranged from very mild (including some with no reported symptoms) to severe,
including illness resulting in death.
While information so far suggests that most COVID-19 illness is mild, report out of China
suggests serious illness occurs in 16% of cases. Older people and people of all ages with
severe underlying health conditions — like heart disease, lung disease and diabetes, for
example — seem to be at higher risk of developing serious COVID-19 illness.
There are ongoing investigations to learn more. This is a rapidly evolving situation and
information will be updated as it becomes available.
Prevention
There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19). The best way to
prevent illness is to avoid being exposed to this virus. However, as a reminder, CDC always
recommends everyday preventive actions to help prevent the spread of respiratory diseases,
including:
• Avoid close contact with people who are sick.
• Avoid touching your eyes, nose, and mouth.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household
cleaning spray or wipe.
• Follow CDC’s recommendations for using a face mask.
◦ CDC does not recommend that people who are well wear a face mask to protect
themselves from respiratory diseases, including COVID-19.
◦ Face masks should be used by people who show symptoms of COVID-19 to help
prevent the spread of the disease to others. The use of face masks is also crucial
for health workers and people who are taking care of someone in close
settings (at home or in a health care facility).
• Wash your hands often with soap and water for at least 20 seconds, especially after
going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
◦ If soap and water are not readily available, use an alcohol-based hand sanitizer
with at least 60% alcohol. Always wash hands with soap and water if hands are
visibly dirty.
For information about hand washing, see CDC’s Handwashing website
For information specific to healthcare, see CDC’s Hand Hygiene in Healthcare Settings
General Strategies to Help Prevent the Spread of
COVID-19
Stay home except to get medical care.
• Stay home: People who are mildly ill with COVID-19 are able to isolate at home during
their illness. You should restrict activities outside your home, except for getting medical
care.
• Avoid public areas: Do not go to work, school, or public areas.
• Avoid public transportation: Avoid using public transportation, ride-sharing, or taxis.
Separate yourself from other people and animals in your home.
• Stay away from others: As much as possible, you should stay in a specific room and
away from other people in your home. Also, you should use a separate bathroom, if
available.
• Limit contact with pets & animals: You should restrict contact with pets and other
animals while you are sick with COVID-19, just like you would around other people.
Although there have not been reports of pets or other animals becoming sick with
COVID-19, it is still recommended that people sick with COVID-19 limit contact with
animals until more information is known about the virus.
• When possible, have another member of your household care for your animals while
you are sick: If you are sick with COVID-19, avoid contact with your pet, including
petting, snuggling, being kissed or licked, and sharing food. If you must care for your pet
or be around animals while you are sick, wash your hands before and after you interact
with pets and wear a facemask. See COVID-19 and Animals for more information.
Call ahead before visiting your doctor.
• Call ahead: If you have a medical appointment, call the healthcare provider and tell them
that you have or may have COVID-19. This will help the healthcare provider’s office take
steps to keep other people from getting infected or exposed.
Wear a face mask if you are sick.
• If you are sick: You should wear a face mask when you are around other people (e.g.,
sharing a room or vehicle) or pets and before you enter a healthcare provider’s office.
Follow the steps below: If you are sick with COVID-19 or suspect you are infected with the
virus that causes COVID-19, follow the steps below to help prevent the disease from
spreading to people in your home and community.
• If you are caring for others: If the person who is sick is not able to wear a face mask
(for example, because it causes trouble breathing), then people who live with the person
who is sick should not stay in the same room with them, or they should wear a
facemask if they enter a room with the person who is sick.
Cover your coughs and sneezes.
• Cover: Cover your mouth and nose with a tissue when you cough or sneeze.
• Dispose: Throw used tissues in a lined trash can.
• Wash hands: Immediately wash your hands with soap and water for at least 20 seconds
or, if soap and water are not available, clean your hands with an alcohol-based hand
sanitizer that contains at least 60% alcohol.
Clean your hands often.
• Wash hands: Wash your hands often with soap and water for at least 20 seconds,
especially after blowing your nose, coughing, or sneezing; going to the bathroom; and
before eating or preparing food.
• Hand sanitizer: If soap and water are not readily available, use an alcohol-based hand
sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them
together until they feel dry.
• Soap and water: Soap and water are the best option if hands are visibly dirty.
• Avoid touching: Avoid touching your eyes, nose, and mouth with unwashed hands.
Avoid sharing personal household items.
• Do not share: You should not share dishes, drinking glasses, cups, eating utensils,
towels, or bedding with other people or pets in your home.
• Wash thoroughly after use: After using these items, they should be washed thoroughly
with soap and water.
Clean all “high-touch” surfaces everyday.
• Clean and disinfect: Practice routine cleaning of high touch surfaces.
• High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets,
phones, keyboards, tablets, and bedside tables.
• Disinfect areas with bodily fluids: Also, clean any surfaces that may have blood, stool,
or body fluids on them.
• Household cleaners: Use a household cleaning spray or wipe, according to the label
instructions. Labels contain instructions for safe and effective use of the cleaning product
including precautions you should take when applying the product, such as wearing
gloves and making sure you have good ventilation during use of the product.
Monitor symptoms
• Seek medical attention: Seek prompt medical attention if illness is worsening (e.g.,
difficulty breathing).
• Call your doctor: Before seeking care, call your healthcare provider and tell them that
you have, or are being evaluated for, COVID-19.
• Wear a face mask when sick: Put on a face mask before you enter the facility. These
steps will help the healthcare provider’s office to keep other people in the office or waiting
room from getting infected or exposed.
• Alert health department: Ask your healthcare provider to call the local or state health
department. Persons who are placed under active monitoring or facilitated selfmonitoring should follow instructions provided by their local health department or
occupational health professionals, as appropriate.
Strategies to Prevent the Spread of COVID-19 in
Long-Term Care Facilities (LTCF)
The general strategies the U.S. Centers for Disease Control and Prevention (CDC) recommends
to prevent the spread of COVID-19 in LTCF are the same strategies these facilities use every
day to detect and prevent the spread of other respiratory viruses like influenza.
Prevent the introduction of respiratory germs INTO your facility:
• Post signs at the entrance instructing visitors NOT to visit if they have symptoms of
respiratory infection.
• Assess residents’ symptoms of respiratory infection upon admission to the facility and
implement appropriate infection prevention practices for incoming symptomatic residents.
Symptoms of respiratory infection, including COVID-19 include fever, coughing, and
shortness of breath.
Prevent the spread of respiratory germs WITHIN your facility:
• Keep residents and employees informed.
– Describe what actions the facility is taking to protect them, including answering their
questions and explaining what they can do to protect themselves and their fellow
residents.
• Monitor residents and employees for fever or respiratory symptoms.
Note: Kentucky’s Department for Public Health has not issued HCB service specific
guidance. The guidance below can be applicable to HCB settings.
Important: Any provider concerned that a resident, visitor, or employee may meet the criteria
to be designated a COVID-2019 patient under investigation (PUI) should contact their local or
state health department immediately for consultation and guidance.
Call 911 if you have a medical emergency: If you have a medical emergency and need to
call 911, notify the dispatch personnel that you have, or are being evaluated for COVID-19. If
possible, put on a face mask before emergency medical services arrive
– Attempt to restrict residents with fever or acute respiratory symptoms to their room.
– If they must leave the room, have them wear a facemask (if tolerated).
– In general, for care of residents with undiagnosed respiratory infection use Standard,
Contact, and Droplet Precautions with eye protection unless suspected diagnosis
requires Airborne Precautions (e.g., tuberculosis).
• If there is transmission of COVID-19 in the community, in addition to implementing the
precautions described above for residents with acute respiratory infection, facilities should
also consult with public health authorities for additional guidance.
• Support hand and respiratory hygiene, as well as cough etiquette by residents, visitors,
and employees.
• Ensure employees clean their hands according to CDC guidelines, including before and
after contact with residents, after contact with contaminated surfaces or equipment, and
after removing personal protective equipment (PPE).
• Put alcohol-based hand rub in every resident room (ideally both inside and outside of the
room).
• Make sure tissues are available and any sink is well-stocked with soap and paper towels
for hand washing.
• Identify dedicated employees to care for COVID-19 patients and provide infection control
training.
– Guidance on implementing recommended infection prevention practices is available
in CDC’s free online course — Nursing Home Infection Preventionist Training —
which includes checklists for facilities and employees to use.
• Provide the right supplies to ensure easy and correct use of personal protection
equipment (PPE)
– Post signs on the door or wall outside of the resident room that clearly describe the
type of precautions needed and required PPE.
– Make PPE, including face masks, eye protection, gowns, and gloves available
immediately outside of the resident room.
– Position a trash can near the exit inside any resident room to make it easy for
employees to discard PPE.
– Be mindful of PPE resources
Prevent the spread of respiratory germs BETWEEN facilities:
• Notify facilities prior to transferring a resident with an acute respiratory illness, including
suspected or confirmed COVID-19, to a higher level of care.
• Notify other service providers who may come in contact with a resident with an acute
respiratory illness.
• Report any possible COVID-19 illness in residents and employees.
• Call the Kentucky Department for Public Health (KDPH) at:
– Daytime (502) 564-3418
– After hours (888) 9-REPORT / (888) 973-7678
• For questions regarding infection control, transmission based precautions, and PPE use,
call the Healthcare-Associated Infection / Antibiotic Resistance Prevention Program:
– Andrea Flinchum (502) 564-3261 ext. 4248
– Michael Curran (502) 564-3261 ext. 4249
– Chad Eldridge 502( 564-3261 ext. 4251
• For the most up-to-date information, visit the following sites: CDC General COVID-19 site
www.cdc.gov/covid19 Information specific to long term care https://www.cdc.gov/
coronavirus/2019-ncov/healthcarefacilities/prevent-spread-in-long-term-carefacilities.html KDPH www.KYCOVID19.ky.gov
FAQs
Does the flu shot help? Can Zinc lozenges help prevent COVID-19? How can we boost
our immune system?
Following CDC guidance (https://www.cdc.gov/coronavirus/2019-nCoV/summary.html):
• There is no specific antiviral treatment recommended for COVID-19. (https://
www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html)

• It’s currently flu and respiratory disease season and CDC recommends getting a flu
vaccine, taking everyday preventive actions to help stop the spread of germs, and taking
flu antivirals if prescribed.
Are there recommended cleaning products?
Following CDC guidance (https://www.cdc.gov/coronavirus/2019-ncov/community/home/
cleaning-disinfection.html):
• For disinfection, diluted household bleach solutions, alcohol solutions with at least 70%
alcohol, and most common EPA-registered household disinfectants should be effective.
• Diluted household bleach solutions can be used if appropriate for the surface. Follow
manufacturer’s instructions for application and proper ventilation. Check to ensure the
product is not past its expiration date. Never mix household bleach with ammonia or any
other cleanser. Unexpired household bleach will be effective against coronaviruses when
properly diluted.
• Prepare a bleach solution by mixing:
◦ 5 tablespoons (1/3rd cup) bleach per gallon of water or
◦ 4 teaspoons bleach per quart of water
• A list of products with EPA-approved emerging viral pathogens claims, maintained by the
American Chemistry Council Center for Biocide Chemistries (CBC), is available at: https://
www.americanchemistry.com/Novel-Coronavirus-Fighting-Products-List.pdf. Products
with EPA-approved emerging viral pathogens claims are expected to be effective against
COVID-19 based on data for harder to kill viruses. Follow the manufacturer’s instructions
for all cleaning and disinfection products (e.g., concentration, application method and
contact time, etc.).
Should more frail people be kept home?
Following CDC Guidance for People at Higher Risk for COVID-19 Complications (https://
www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html)
• What to do if you are at higher risk:
◦ Stay at home as much as possible.
◦ Make sure you have access to several weeks of medications and supplies in case
you need to stay home for prolonged periods of time.
◦ When you go out in public, keep away from others who are sick, limit close
contact and wash your hands often.
◦ Avoid crowds.
◦ Stay up to date on CDC Travel Health Notices.
Additionally, please reference:
• CDC recommended Steps Healthcare Facilities Can Take Now to Prepare for Coronavirus
Disease 2019 (https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/steps-toprepare.html)
• CDC Strategies to Prevent the Spread of COVID-19 in Long-Term Care Facilities (https://
www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/prevent-spread-in-long-termcare-facilities.html)

What about masks? Who needs to wear them? How to get them? How do we get training
on proper use of masks?
• Follow CDC’s recommendations for using a face mask:
◦ CDC does not recommend that people who are well wear a face mask to protect
themselves from respiratory diseases, including COVID-19.
◦ Face masks should be used by people who show symptoms of COVID-19 to help
prevent the spread of the disease to others. The use of face masks is also crucial
for health workers and people who are taking care of someone in close settings (at
home or in a health care facility).
Additionally, please reference CDC page on COVID-19 FAQs on Personal Protective Equipment
(https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirator-use-faq.html):
• CDC does not recommend the routine use of respirators outside of workplace settings (in
the community).
• Most often, spread of respiratory viruses from person-to-person happens among close
contacts (within 6 feet).
• What is a Surgical N95 respirator and who needs to wear it?
◦ A surgical N95 (also referred as a medical respirator) is recommended only for use
by healthcare personnel (HCP) who need protection from both airborne and fluid
hazards (e.g., splashes, sprays).
◦ These respirators are not used or needed outside of healthcare settings.
◦ In times of shortage, only HCP who are working in a sterile field or who may be
exposed to high velocity splashes, sprays, or splatters of blood or body fluids
should wear these respirators, such as in operative or procedural settings.
◦ Most HCP caring for confirmed or suspected COVID-19 patients should not need
to use surgical N95 respirators and can use standard N95 respirators.

How to care for someone infected? What steps should we consider taking if we have a
concentration of higher-risk individuals?
• If you are a healthcare provider or a public health responder caring for a COVID-19
patient, please take care of yourself and follow recommended infection control
procedures.
• For people who are ill with COVID-19, but are not sick enough to be hospitalized, please
follow CDC guidance on how to reduce the risk of spreading your illness to others. People
who are mildly ill with COVID-19 are able to isolate at home during their illness.
Additionally, please reference CDC page on Strategies to Prevent the Spread of COVID-19 in
Long-Term Care Facilities (https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/
prevent-spread-in-long-term-care-facilities.html) which offers specifics to prevent the spread of
respiratory germs INTO your facility, WITHIN your facility, and BETWEEN your facilities.

• To prevent the spread of germs within your facility, CDC recommends:
◦ Identify dedicated employees to care for COVID-19 patients and provide infection
control training.
◦ Guidance on implementing recommended infection prevention practices is
available in CDC’s free online course — The Nursing Home Infection Preventionist
Training — which includes resources checklists for facilities and employees to use.
◦ Provide the right supplies to ensure easy and correct use of PPE.
◦ Post signs on the door or wall outside of the resident room that clearly describe
the type of precautions needed and required PPE.
◦ Make PPE, including facemasks, eye protection, gowns, and gloves, available
immediately outside of the resident room.
◦ Position a trash can near the exit inside any resident room to make it easy for
employees to discard PPE.
Do you have any strategies on how to work though staffing shortages that might occur is
staff start getting sick?
• KAPP is partnering with our national organization ANCOR on this issue.
• ANCOR is working with its members to identify and share creative ideas for supporting
people served if the pools of available DSPs are depleted as a result of wide-spread
infections. More to come on this topic.
Can people who recover from COVID-19 be infected again?

• The immune response to COVID-19 is not yet understood. Patients with MERS-CoV
infection are unlikely to be re-infected shortly after they recover, but it is not yet
known whether similar immune protection will be observed for patients with COVID-19.
Medicaid Disaster Response Toolkit – Medicaid, Children’s Health Insurance Program, and
Basic Health Program services provide critical health coverage to millions of vulnerable
Americans. Over the past several years, numerous states have been impacted by natural or
man-made disasters, and these programs serve an important role as states respond to these
disasters. Access the Toolkit here
What is the ANCOR toolkit and when will it be available? ANCOR is developing a toolkit to
help organizations teach people about precautions during public health events like the
COVID-19 outbreak. It will be posted to ACC/Emergency Preparedness and Response forum
when available.
Are there Pandemic plan templates available to share? ANCOR member Diversified
Enterprises from Georgia has shared their disaster preparedness plan. It is available on
the ACC/Emergency Preparedness and Response along with other resources.
Does warmer weather stop the outbreak of COVID-19?
• The CDC reports that it is not yet known if weather and temperature effect the sprea