To: CAHAN San Diego Participants
Date: March 14, 2020
From: Epidemiology and Immunizations Services Branch, Public Health Services
Health Advisory Update #5: Infection Control and Prevention Guidance for Coronavirus Disease 2019
(COVID-19)
This health advisory updates CAHAN participants about updated infection control and prevention
guidance from the Centers for Disease Control (CDC) and County of San Diego Public Health Services. For
current testing guidance, please see the March 10th CAHAN and please refrain from referring patients to
Public Health for the sole purpose of specimen collection.
Key Points
• Providers should use standard, contact, and droplet precautions.
•

Facemasks are an acceptable alternative when respirators (i.e., N95) are not available and
respirators should be conserved for procedures with high risk of aerosol-generation (i.e.,
sputum induction or bronchoscopy) when in short supply.

•

Eye protection, gown, and gloves continue to be recommended. If there are shortages of
gowns, they should be prioritized for procedures with high risk of aerosol-generation.

•

Patients with suspected or known COVID-19 can be cared for in a single-person room.
Airborne Infection Isolation Rooms (AIIRs) should be reserved for patients undergoing for
procedures with high risk of aerosol-generation.

Updated Infection Control and Prevention Guidelines
The County of San Diego Public Health Services recommends that health care workers use standard,
contact, and droplet precautions when caring for suspected or known cases of COVID-19.
For low risk procedures or procedures with low risk of aerosol-generation such as collecting Oro- and
Nasopharyngeal specimens, gloves, eye protection, gowns, and either a surgical mask or N95 respirator.
A gown and respirator, if in short supply, can instead be prioritized for higher risk procedures that
generate respiratory aerosols and a facemask can be an acceptable alternative. Low risk aerosol
generating procedures can be done in a single-person room with a closed door.
For high risk procedures or procedures with high risk of aerosol-generation such as sputum induction or
bronchoscopy, utilize respirators, gowns, gloves, N95 respirator and eye protection in an Airborne
Infection Isolation Room (AIIRs).

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CAHAN San Diego Alerts are intended for the use of public health, medical and laboratory professionals in San Diego County. This alert has been approved for reproduction
and distribution to interested professionals. An online CAHAN San Diego application is available at http://www.cahansandiego.com for appropriate and interested individuals.

 Of note, CDC has released updated infection control and prevention guidance. As per the CDC,
facemasks are now considered an acceptable alternative when respirators are not available for
healthcare workers caring for patients with suspected or confirmed COVID-19. N95 respirators are
recommended for use when performing procedures likely to generate aerosol and use should be
generalized to all known or suspect cases if/when supply increases. Eye protection, gloves, and gowns
are still recommended for use during patient care and, if supply issues exist, gowns can be conserved for
aerosol-generating procedures. Known or suspected patients for COVID-19 can be cared in a singleperson room with the door closed. Use of Airborne isolation rooms (AIIRs) should be reserved for
patients undergoing aerosol-generating procedures.
Please click here for the full CDC updated infection control and prevention guidance.
For current testing guidance, please see the March 10th CAHAN and please refrain from referring
patients to Public Health for the sole purpose of specimen collection.
Thank you for your participation.
CAHAN San Diego
County of San Diego Health & Human Services Agency
Epidemiology and Immunization Services Branch
Phone: (619) 692-8499; Fax: (858) 715-6458
E-mail: cahan@sdcounty.ca.gov
Secure Website: http://cahan.ca.gov
Public-Access Website: http://www.cahansandiego.com

Page 2 of 2
CAHAN San Diego Alerts are intended for the use of public health, medical and laboratory professionals in San Diego County. This alert has been approved for reproduction
and distribution to interested professionals. An online CAHAN San Diego application is available at http://www.cahansandiego.com for appropriate and interested individuals.