COVID-19 Response UpdatePresented by: Dawn Emerick, Ed.D, Director

April 14, 2020

Screening & Testing

Case InvestigationsContact Tracing, Surveillance &

Analysis

Prevention & Enforcement

Health Alerts, Education &

Policy

Wraparound RecoveryResponse

COVID-19 Hotline

Primary/Urgent Care

Self-Screening

MH Hotline

STRAC Hotline

911/Hospital

MIH

Test

Sit

es

Lab

s

EPI

MedCom

Testing

MIH Intervention (if needed)

Hospitalization (if needed)

Positive IndexQuarantine Monitoring

Case Management

RecoveredHospitalized

DeathAss

ign

Ca

se

EPI A

ssig

n

Inve

stig

ato

r

Investigate

Determine Close Contact

Close Contact(s) 14 Day Monitoring

If symptoms develop, call hotline

Contact Management

Analysis and Reporting

SymptomaticNo Symptoms

Common Platform

Dashboards and Reports

Monitor Analytics

Reg

iste

r

Pati

ent

(po

s a

nd

neg

res

ult

s)

Outbound Calls

40

10

10

400

Nursing Home Testing

Nu

rse

Ca

ll

+7 14-Day

Epidemiological Process

Contact Tracing Process

Positive COVID-19 Labs or Faxes

Received

Phone call received

Review National Electronic Disease Surveillance System (NEDSS) Base System (NBS) and Electronic Laboratory Reporting (ELR) for new positive cases

Review faxes for all positive test results

Back up to NBS searches and updates as time permits

Data Entry and Follow Up

Follow up with provider to ensure all information is submitted (patient lab results, contact information, demographics, clinical notes, etc.)

Enter initially available data into Confirmed Cases Database

Assign Investigator

Assign investigator to begin disease intervention

After interview is complete, enter data in Confirmed Cases and Contact Database

Perform Investigation

Initiate investigation utilizing DSHS COVID-19 Investigation Form and Metro Health Contact Tracing Forms

(Attempt to make at least 3 phone calls. Send a letter out if not able to reach by phone. Interview a proxy if individual is not capable of being interviewed.)

Finalize investigation and provide forms to Haley/Maria for data entry into the Confirmed Cases Database

Once data entry has been completed, send file to Immunization Supervisor on Duty, who will ensure “contact” file is created and assign a nurse to notify medium-risk contacts of their exposures

Contact and Notification

Call all “medium risk” contacts with phone numbers (2 phone call attempts) and leave a voicemail if necessary (follow script for limited information left in voicemail)

Ensure all progress notes are complete

Submit final files to supervisor on duty who will update the Close Contact Tracker

Close Contact Supervisor will provide daily list of contacts completed to Epi team to update Confirmed Cases & Contact List

14-Day Follow Up

Close Contact/14 Day Immunization Supervisor tracks patients by symptom onset to conduct follow up once 14 days has passed since symptom onset

Supervisor assigns a nurse to complete the 14 day follow up

Nurses calls all COVID-19 positive individuals after 14 days to follow up on symptoms and recovery status

Nurses updates patient’s file in progress notes

If patient is recovered, confirmed list is updated. If not, follow up call is conducted in 7 days

Sally the Nail Tech

Started to feel ill on March 15

but went to work anyway

and had 5 clients

Went to work on March 16

and had 4 client

appointments

Sally worked on March 11, 12, 13, and 14 and had a total of

15 clients

Went to work on March 17

and had 2 client

appointments

Called COVID-19 Hotline on

March 18

Tested for COVID-19 at

Freeman Coliseum on

March 19

Test results were positive on March 22

Epidemiology Contact

Investigation begins March

23

Epidemiology Contact

Tracing begins March 24 with 26 clients and

mom

Isolation and monitoring for

Sally by MH and MIH for

14 days + (April 7 or

longer)

Sally is: 26 years old; Single; Healthy; No Children; Uninsured; African American; Lives at Home with Mom

Offered Isolation Care

Facility and other services

27 people quarantined

and monitored by MH for 14

days (April 7th)

Recovery

April 2, he & kids went to

CVS pharmacy, visited his

mom at senior living aprtmt

April 2, went to HEB for a grocery pick

up

Harry didn’t feel well on

April 1 but just explained it

away. It was just his allergies

April 3, called 911. Couldn’t

breath

EMS responded

and transported to local hospital

Kids were picked up by Harry’s sister

Test results were positive

on April 4Metro Health

notified

Epidemiology Contact

Investigation begins April 5

but Harry is on ventilator

Epidemiology Contact

Tracing begins with kids,

sister & mom on April 6

Mom’s test was positive,

at home, monitored by

MH / MIH team

Family offered Isolation

Facility and other services

Harry’s mom is quarantined at her aprtmt and

being monitored by

MH for 14 days (April 20th)

Mom (77 y/o) develops

symptoms and calls Metro

Health

Harry is: 55 years old; Single Parent; Diabetes and Heart Disease; Two Children; Insured; Hispanic; Small Business Owner; Works from home

Harry the Insurance Salesman

Harry’s sister & kids are

quarantined at his sister’s house and

being monitored

MIH visits mom to test her. Prevent

an outbreak at the senior

living aprtmt

Self-Screening by Zip Code

Hotline Calls by Zip Code

Positive Cases by Zip Code

Overlay by Zip Code

Testing Site Coverage

Overlay by Zip Code