When COVID-19 Patients Return
When appropriate, patients who have tested positive for the virus and need to return for follow-up care in the outpatient setting should have a telehealth visit instead of an in-person consultation. If an in-person visit is necessary, please refer to this guidance to determine what personal protective equipment to use.
Approach to follow-up outpatient visits for persons with confirmed COVID-19
Purpose: To provide guidance on the handling of necessary, in-person follow-up clinic visit for patients with confirmed COVID-19
Scope: All outpatient clinic areas which may see patients in follow-up have been diagnosed with COVID-19
Approved: ICC Operations, ICC Safety, ICC Med-Tech, ICC Commander
Date: May 11, 2020
Process:
All patients requiring outpatient follow-up with either confirmed or suspected COVID-19 should be evaluated using the following criteria to determine appropriate precautions for protection of staff and other patients during follow-up visits.
1. Evaluate patient/situation for telehealth visit if possible.
2. If an in-person visit is deemed necessary, determine the time since symptom onset and period for which the patient has been afebrile with other symptoms improving.
This determination should be performed (if possible) the day prior to the scheduled visit
If the patient cannot reliably provide the time since symptoms onset use the date of positive SARS-CoV-2 test
3. Use the following guidance to determine precautions/PPE use during visit:
Symptoms onset ≥10 days ago and afebrile for 72 hrs (without fever-reducing medication) with other symptoms improving
a. Standard precautions/PPE
b. Room can be safely cleaned immediately upon patient discharge from clinic
Less than 10 days since symptom onset or fever/worsening symptoms within the last 72 hours
a. Precautions/PPE for COVID-19+/PUI
b. After the patient leaves the room, the room should be left empty with the door closed for 2 hours, and then can be safely cleaned
Definitions:
Confirmed COVID-19: positive results for SARS-CoV-2 by PCR
Suspected COVID-19: compatible clinical symptoms with no test done for SARS-CoV-2 and no clear alternative etiology
Standard PPE- includes mask for all patients, surgical mask for all providers
COVID-19/PUI precautions/PPE- patient placed in exam room immediately with surgical mask. Provider N95 masks, gown, eye protection, and gloves.