The
current version of Supplement C emphasizes that SARS preparedness
and response planning in healthcare facilities should not occur
in a vacuum but rather should build on existing preparedness
activities and relationships with the public health community.
Although healthcare facilities will likely play a key role in
the follow-up of exposed patients and healthcare workers, it
will be important to coordinate these activities with the local
health department, especially for patients being discharged and
for healthcare workers who live in the community. Supplement
C now recommends that healthcare facilities work with health
departments to coordinate this follow-up. Because activity restrictions
for healthcare workers who have been exposed to SARS-CoV might
depend on the level of SARS-CoV transmission in the community,
Supplement C now recommends coordinating decisions on these restrictions
with the health department, in accordance with the guidance in Supplement
D.
The
recommendations for surveillance in healthcare settings have
been revised for consistency with the recommendations in Supplement B. The guidance clarifies that, in patients who have epidemiologic
links to SARS-CoV, the presence of either fever or lower respiratory
symptoms should prompt further evaluation. In addition, in accordance
with the new SARS case definition, when persons have a high risk
of exposure to SARS-CoV (e.g., persons previously identified
through contact tracing or self-identified as close contacts
of a laboratory-confirmed case of SARS-CoV disease; persons who
are epidemiologically linked to a laboratory-confirmed case of
SARS-CoV disease), the clinical criteria should be expanded to
include, in addition to fever or lower respiratory symptoms,
the presence of two or more other early symptoms of SARS-CoV
disease.
The
term "universal respiratory etiquette" has been changed to "respiratory
hygiene/cough etiquette." Because patients with respiratory infections
may not present with fever, the document clarifies that the recommended
practices apply to all patients with symptoms of a respiratory
infection.
The
section on staffing emphasizes that healthcare workers will need
logistical and emotional support to help them cope with the challenges
of responding to a SARS outbreak. |
