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Overview and key takeaway

Case investigation and get in touch with tracing are an important a part of the COVID-19 response pdf icon. Immediate isolation of individuals recognized with COVID-19, and identification and quarantine of shut contacts, can successfully interrupt illness transmission and cut back unfold of SARS CoV-2. When carried out shortly, contact tracing, together with different neighborhood mitigation efforts work collectively to scale back transmission. The place will increase in COVID-19 instances pressure sources, well being departments might have to prioritize case investigation and get in touch with tracing.

Well being departments experiencing surge or disaster conditions round COVID-19 ought to prioritize case investigation interviews of people that examined optimistic for or have been recognized with COVID-19 prior to now 6 days (primarily based on specimen assortment date or symptom onset, if recognized). They need to additionally focus contact tracing efforts on:

  • family contacts uncovered prior to now 6 days, and
  • individuals dwelling, working, or visiting congregate dwelling amenities, excessive density workplaces or different settings (or occasions) with potential intensive transmission.

In some situations, additional prioritization could also be mandatory.

Individuals recognized with COVID-19 must be strongly inspired to inform all their family contacts:

  • to right away self-quarantine; and
  • to hunt further steerage from their well being division or CDC’s COVID-19 web site.

As sources permit, well being departments ought to increase case investigation and get in touch with tracing for individuals exterior the family who:

As sources permit or COVID-19 case charges decline, well being departments ought to:

  • increase case investigation interviews to individuals with optimistic COVID-19 take a look at specimens collected prior to now 14 days; and
  • increase contact tracing to all contacts uncovered inside the previous 14 days.

If greater than 14 days have elapsed since specimen assortment, case investigation and get in touch with tracing shouldn’t be pursued except there are distinctive circumstances related to the particular person examined (e.g., a part of massive outbreak related to congregate dwelling or excessive density office or work in a healthcare setting).

Viewers

These prioritization suggestions are supposed to help state, tribal, native, and territorial well being departments, significantly these with escalating COVID-19 case counts, delays in receipt of laboratory take a look at outcomes or healthcare supplier reviews, or with inadequate capability to conduct case investigation and get in touch with tracing for all newly reported COVID-19 instances in a well timed method.

Abstract of prioritization suggestions

When well being departments are dealing with a excessive burden of COVID-19 instances, they might not have the sources to finish well timed case investigation and get in touch with tracing actions for all reported instances of COVID-19. In these conditions, prioritization of public well being actions might grow to be mandatory. CDC’s Case Investigation & Contact Tracing Steerage means that when sources are restricted, well being departments ought to prioritize essentially the most impactful public well being actions. CDC’s COVID -19 Case Investigation and Contact Tracing Hierarchies define precedence populations for case investigation and get in touch with tracing. These new suggestions are supposed to supply further data and an summary of prioritization methods for consideration. Implementation of those suggestions must be guided by what is possible, sensible, and acceptable for every neighborhood.

Because the burden of COVID-19 worsens in an space, and the capability to research new instances in a well timed method turns into tougher or is just not possible, well being departments ought to prioritize which instances to research and which contacts to hint. As well as, well being departments ought to emphasize broader neighborhood mitigation measures. Figuring out when burden is excessive will range by space. Feasibility of case investigation and get in touch with tracing is decided by the amount and trajectory of latest instances, in addition to employees sources and capability.  Under are examples of learn how to assess an space’s capability to conduct case investigation and get in touch with tracing.

  • Excessive burden could possibly be outlined as a backlog of instances for every interviewer that’s no less than twice the quantity (100% extra) they can interview every day;
  • Medium burden could possibly be outlined as a backlog of instances for every interviewer that’s 50% greater than the variety of instances they can interview every day;
  • Low burden could possibly be outlined as an affordable variety of instances for every interviewer to name every day.

When experiencing a excessive burden of instances, Determine 1 is a abstract of suggestions that well being departments might use to prioritize case investigation and get in touch with tracing actions.

Determine 1

Highest Precedence  Actions

For instances, prioritize case investigations for individuals  recognized with COVID-19 prior to now 6 days

(primarily based on specimen assortment date or signs onset, if recognized)

For contacts, prioritize:

  • Family contacts uncovered prior to now 6 days
  • Individuals dwelling, working, or visiting congregate dwelling amenities, excessive density workplaces or different settings (or occasions) with potential intensive transmission

Subsequent Stage Precedence Actions

As sources permit, increase case investigations and get in touch with tracing to individuals exterior the family who’re:

  • At elevated threat for extreme sickness
  • A part of a cluster
  • Uncovered inside the previous 6 days

Low Precedence Actions

  • As sources permit or COVID-19 case charges decline, increase case investigation interviews to individuals with optimistic COVID-19 take a look at specimens collected prior to now 14 days, and increase contact tracing to all contacts uncovered inside the previous 14 days
  • If greater than 14 days have elapsed since specimen assortment, case investigation and get in touch with tracing ought to usually not be pursued



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