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HIGH RISK INDIVIDUALS
Fever and symptom screening alone does not identify infected individuals. Asymptomatic individuals can transmit COVID 19 to others. Therefore, it should be assumed that every person is potentially infected or colonized with a pathogen that could be transmitted to others.
The best way to prevent COVID from spreading on a school campus requires a combination of layers of interventions to build a strong, fool proof system. Engineering and administrative controls should be instituted to facilitate social distancing, active monitoring of people on campus for symptoms of the disease, and prompt detection and isolation of ill individuals.
After reviewing all the evidence that is currently available to us about the spread of COVID-19, Clinical Staffing Solutions has developed the following protocol which prioritizes safety of all individuals in a practical manner and also conserves crucial PPE resources.
All individuals on campus will be differentiated into two groups: vulnerable (“high risk”) and non-vulnerable (“low risk”). The type of personal protective equipment recommended will defer for each of these two groups.
The vulnerable group comprises of individuals who are high-risk; i.e. they are more likely to have serious complications due to COVID-19, including death. It is recommended that these individuals take extra-precautions to prevent the disease. The non-vulnerable group includes everyone else.
The following list further describes the high-risk category as it applies to staff and students on school campuses. It is not an exhaustive list of all patients who are high-risk for severe illness. For instance, people who are living in a nursing home or long-term care facility are not included in the group below as they are not expected to be relevant on a school campus.
INDIVIDUALS WITH THE FOLLOWING CONDITIONS ARE CLASSIFIED AS HIGH RISK INDIVIDUALS (HRI):
Based on your medical evaluation, you have been identified as a high risk individual based on the higher likelihood of complications should you contract COVID-19.
| Age 65 years and older (the risk is highest among those 85 years or older) | Chronic lung disease or moderate to severe asthma |
| Serious heart disease (including heart failure, coronary artery disease, congenital heart disease, cardiomyopathies, and pulmonary hypertension) | Immuno-compromised state (including but not limited to patients receiving cancer treatment, long-term smokers, bone marrow or organ transplant recipients, poorly controlled HIV or AIDS, prolonged use of corticosteroids or other immunosuppressive medications): |
| Severe obesity (BMI of 40 or above) | Diabetes Type 1 or Type 2, especially when poorly controlled |
| Chronic kidney disease requiring dialysis | Liver disease |
| Pregnancy and breastfeeding |
The best way to prevent illness from COVID-19 is to avoid being exposed to the virus, as there is currently no vaccine to prevent the disease.
The virus spreads mainly through person-to-person contact, when individuals are within about 6 feet of each other. When an infected person cough, sneezes or talks, it produces respiratory droplets. These droplets can be inhaled by nearby individuals, leading to an infection. The infected person may be asymptomatic at the time they are spreading the infection to others.
It is also possible for a person to get COVID-19 when they touch a surface or object which has recently been contaminated by respiratory droplets from infected individuals, and then touch their eyes, mouth or nose. The virus can live for many hours or days on such surfaces.
For this reason, it is safest to assume that every individual is potentially infected with COVID-19, and can spread it to others. All individuals on campus must be instructed to follow these general hygiene guidelines to prevent the spread of COVID-19.
Wash hands with soap and water for at least 40 seconds, especially after being in a public place, after contact with respiratory droplets, such as by blowing ones nose, coughing, or sneezing or after touching eyes, nose and mouth.
If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry. Avoid touching eyes, nose, and mouth with unwashed hands.
Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow when you do not have your face covering on. Throw used tissues in the trash and immediately perform hand hygiene.
Avoid close contact and maintain at least 6 feet of distance from people who are sick, even inside your home.
If a household member is sick, inform school administration immediately so they can decide on the most appropriate quarantine recommendations for you.
Stay at least 6 feet (about 2 arms’ length) from other people, both indoors and outdoors. Stay out of crowded places and do not gather in groups.
Recommendations For Personal Protection For The Non-Vulnerable Group
Vulnerable individuals should make every effort to practice social distancing. They should only come within 6 feet of contact with other persons when absolutely necessary. In these circumstances, vulnerable individuals should adhere to standard precautions as described above and use a respirator (or facemask if a respirator is not available), and wear eye protection.
N95 respirators are approved for 8 hours of continuous use by healthcare providers. These respirators may be in limited supply. Safe single-person reuse of N95 masks has been recommended by the CDC to help conserve resources in healthcare settings. The following recommendations are developed using national guidelines and models used by other hospitals in the country for healthcare workers.
Vulnerable individuals should wear N95 respirators, if available, when in crowded areas or when coming within 6 feet of other individuals. The respirator can be removed when the individual is out of such high risk situations.
Vulnerable individuals should consider wearing a washable cloth covering on top of the N95 respirator. This will prolong the life of the respirator as the cloth covering can be washed in between uses and prevent the N95 respirator from getting soiled.
N95 respirators are approved for 8 hours of continuous use by healthcare providers. These respirators may be in limited supply. Safe single-person reuse of N95 masks has been recommended by the CDC to help conserve resources in healthcare settings. The following recommendations are developed using national guidelines and models used by other hospitals in the country for healthcare workers.
Vulnerable individuals should wear N95 respirators, if available, when in crowded areas or when coming within 6 feet of other individuals. The respirator can be removed when the individual is out of such high risk situations.
Vulnerable individuals should consider wearing a washable cloth covering on top of the N95 respirator. This will prolong the life of the respirator as the cloth covering can be washed in between uses and prevent the N95 respirator from getting soiled.
Extended use
Wearing the same N95 respirator for repeated close contact encounters with several individuals, without removing it between encounters.
Extended use or reuse of the N95 respirators can be done for 8 hours continuously. In either case, the N95 respirator must be discarded:
| When potentially soiled with dirt or fluids |
| If it becomes visibly damaged or loses its seal |
| If it becomes in contact with any known infected surface/hands |
Reuse
Use of the same N95 respirator by a single-user for multiple encounters, but removing it between encounters.
For reuse of N95 respirators:
| Use a pair of clean gloves while donning and removing a used N-95 respirator |
| Ensure the respirator is sitting comfortably on the your face and sealed over your nose. |
| Avoid touching the mask after initial seal check |
| Clean hands with soap and water or alcohol-based sanitizer before and after touching the respirator |
Between uses, store the mask in a clean, breathable, labeled, disposable container, such as a paper bag. Dispose of the storage container when the mask is discarded. Clean hands with soap and water or an alcohol-based hand sanitizer before and after touching or adjusting the respirator.
Recommended eye protection includes goggles or a disposable face shield that covers the front and sides of the face. Personal eyeglasses and contact lenses are NOT considered adequate eye protection.
This reusable eye protection (e.g., goggles) must be cleaned and disinfected according to manufacturer’s reprocessing instructions prior to re-use.
Clean and disinfect frequently touched surfaces twice daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
If surfaces are visibly soiled, use detergent or soap and water prior to disinfection.
Then, use a household disinfectant. See the list below for disinfectants that are recommended for use against the SARS-CoV-2 virus.
https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2
RETURN TO CAMPUS GUIDELINES FOR INDIVIDUALS WITH SUSPECTED OR CONFIRMED COVID-19
COVID-19 PCR Testing (Nasal Swab): Interpretation of Results
COVID-19 Viral Test Testing for COVID-19 looks to see whether an active virus is present in your body, specifically the coronavirus also known as SARS-CoV-2. These tests require samples obtained from your nasal or throat cavities, which are evaluated to see whether genetic material from the virus is present.
See the link below for more guidance on how to interpret results of COVID-19 tests:
https://www.whitehouse.gov/wp-content/uploads/2020/05/Testing-Guidance.pdf
Reference
Criteria for Return to Work for Healthcare Personnel with Confirmed or Suspected COVID-19 (Interim Guidance). 5/2/20 https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/hcp-return-work.html Last accessed: 3/18/20
COVID-19 Antibody Testing: Frequently Asked Questions
COVID-19 antibody testing looks for evidence of the body’s immune response to the virus. These antibodies appear in the blood after a patient has had a previous infection with the virus. Studies of patients infected with other coronaviruses in the past suggest that the presence of neutralizing antibodies confers some degree of immunity against re-infection with the same coronavirus.
For this reason, Clinical Staffing Solutions is currently recommending all school students, faculty and staff get tested for COVID-19 antibodies prior to the joining the school.
After you get infected with the coronavirus, your white blood cells make antibodies to destroy the virus. So, when an antibody test comes back positive for the coronavirus, it means 1) you were exposed to SARS-CoV2 at some point in the past and 2) your immune system launched an antibody-forming immune response.
It is likely that most healthy people start making antibodies 11 to 14 days after symptoms first appear. IgM antibodies are the first to appear and are present in nearly 95% of individuals two weeks after an infection. This is followed by the IgG antibody which is thought to confer sustained immunity. It is possible for others to make antibodies much later or to make no antibodies at all despite recovering from a COVID-19 infection.
Patients who are malnourished, have cancer or another chronic health condition, or take immune suppressing drugs may not be able to make enough of these antibodies even after a COVID-19 infection.
It is also possible for a patient to test positive for antibodies without ever having symptoms of COVID-19. This is known as having an asymptomatic infection, or an infection without symptoms.
We don’t know what having a positive antibody result means for your immunity. It may mean you have full immunity or partial immunity or no immunity at all.
Therefore, having a positive antibody test for COVID-19 means you will either be: protected against getting another COVID-19 infection in the future OR if you do get infected by COVID-19, your symptoms will be very mild OR you will still be able to get COVID-19 as if you were never infected previously.
It is possible that if you get COVID-19 once, you will be immune for the rest of your life. It is also possible that you might be immune for six months to a year, and the immunity will wear off after that time.
Since we do not know what kind of immunity having a positive antibody test means for you this time, a positive antibody test should not change your behavior. You should continue to wear a facemask in public places and personal protective equipment at work, and practice frequent hand washing and social distancing.
If you have no symptoms of a viral respiratory infection (such as a fever, cough, congestion or sore throat), you likely do not have an active infection today and no additional follow-up is needed.
If you develop any of the above symptoms, you may have COVID-19. Speak to your doctor about whether or not you should get a diagnostic test for COVID-19 and follow the usual quarantine guidelines to prevent giving the virus to other people.
If your antibody test is negative, you will need to get PCR testing for COVID-19 two weeks prior to the beginning of school.
See the link below for more guidance on how to interpret results of COVID-19 tests:
https://www.whitehouse.gov/wp-content/uploads/2020/05/Testing-Guidance.pdf
Reference
Antibody responses to SARS-CoV-2 in patients with COVID-19. Long QX, Huang AI, et al. Nat Med. 2020 Apr 29. [Epub ahead of print]
TREATMENTS & SERVICES
Diligent Urgent Care offers professional medical services for patients who need urgent care and who do not require admission to the ER. We treat a wide range of illnesses, injuries and a variety of other medical services.
When you are sick, injured or in need of a doctor for any medical care, we have physicians and medical professionals available 7-days that are dedicated to providing you and your family with convenient, affordable and quality healthcare.
Our state of the art facilities allow for the treatment to address any illness or injury, and provide for any medical services you may need.
| Illness | |
| Colds + Flu | Sore Throat |
| High Fever | Severe Cough |
| Sinus Congestion | Eye & Ear Infections |
| Urinary Tract Infections | Abdominal Pain |
| Allergies & Rashes | Migraines |
| Illness | |
| Back Pain | Sports Injuries |
| Strains & Sprains | Broken Bones |
| Illness | |
| Vaccines | Wound Care |
| Stitches & Suturing | STD Treatments |
| Digital X-Ray | Physicals |
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Union City, NJ 07087
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Sat-Sun: 9am-5pm
