Responses to COVID
COVID CONTACT TRACING: The San Francisco Department of Public Health needs your help to stop COVID-19.
Ellen Weber, MD
The DPH is currently calling all people who test + for COVID-19 in San Francisco. At that time, we determine their ability to isolate and elicit any close contacts. Our contact tracing then calls the contacts to give them quarantine instructions and recommend testing. However, with the current surge, this process is taking too long. COVID-19 is transmitted from person to person. The most infectious period is 2 days before and the first several days of symptoms. Close contacts of these cases must be identified as soon as possible to stop the onward spread of disease. Providers are usually reaching patients with COVID-19 several days before the DPH can. This is an opportunity to slow transmission of the disease down.
What we ask: When you call a patient to disclose results, take a few extra minutes to obtain the names and phone numbers of their household (or other) contacts. Complete the Confidential Morbidity Report (fillable PDF) for COVID-19, then fax or email to DPH. Contacts can also be sent to DPH at https://bit.ly/sfcovidcontacts. If the patient needs help to isolate (food, cleaning supplies or a separate place to stay while in isolation or quarantine), the CMR also contains information on how to provide referrals. For more information, contact ellen.weber@ucsf.edu
San Francisco Department of Public Health
STOP TRANSMISSION OF COVID-19 with D.A.R.T.S.
COVID-19 can rapidly spread •
On average, a patient with COVID-19 will infect 1.5 to 3.5 other people
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Case isolation with contact tracing reduces transmission by up to 64% 1
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There is a very narrow window of opportunity to notify contacts of their exposure and recommend quarantine to prevent further transmission. We need providers to help gather this information from patients so public health officials can act sooner.
What providers can do to break the transmission cycle Prior to test, conduct a brief social history Ask the patient how many people live in their household, do they work or go to school, and do they have symptoms.
After a positive result, utilize previously obtained social history to guide case investigation & contact elicitation
Disclose, Advise, Refer, Trace, Support (DARTS) • Disclose test results to the patient. A positive PCR test is highly likely to be a true positive. • Advise isolation. Patients who test positive should isolate for at least 10 full days from the onset of symptoms (or the positive test if they are asymptomatic). They must be fever-free without use of feverreducing medications for 3 days before ending isolation. Isolation is to protect others in the household from getting Isolation means: the virus as well as others in the community. • Do not leave the house Refer: Ask the patient if they are able to isolate. If they cannot isolate from • Separate yourself from others in the household by staying in a room alone others, provider should place a referral for a city-sponsored hotel room at • If possible, use a separate bathroom, or https://covid19isorequest.getcare.com/referral clean the bathroom after every use Trace who else may have been exposed and recommend urgent testing. • Do not share food, utensils, linens or Encourage them to immediately notify their work supervisor or school. Who other items with those in the household • When you have to be around others in lives in their household? Is anyone over 60 or immunocompromised? Obtain the household, wear a face mask and the names and contact information for household contacts & share with SFDPH stay at least 6 feet apart with the COVID-19 CMR. Recommend that all household contacts immediately • Arrange for someone to shop for you, test and quarantine. Remind patients to answer any calls from SFDPH to get and obtain necessary medications free testing, resources and support.
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Support: Provide ongoing support to safely self-isolate. If the patient needs assistance (food, medications, pet care), refer to a
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social worker or direct them to call 311. Follow up with the patient for wellness checks as needed.
Don’t forget to complete the COVID-19 CMR form at https://www.sfcdcp.org/covid19cmr 1
MacIntyre CR. Case isolation, contact tracing, and physical distancing are pillars of COVID-19 pandemic control, not optional choices. The Lancet Infectious Diseases. 2020.
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SAN FRANCISCO MARIN MEDICINE
SEPTEMBER/OCTOBER 2020
WWW.SFMMS.ORG
