COVID-19: Health Care Providers

CDC Guidance for Fully Vaccinated Individuals in Health Care Settings

Up to date select health care infection prevention and control recommendations in response to COVID-19 vaccination are summarized in CDC guidance.

 

Health care professionals are those responsible for treating and working with patients and families affected by COVID-19. This page houses information and resources for health care professionals responding to COVID-19.

For patient education materials and other COVID-19 resources, visit the COVID-19: Communication Resources

Are you a provider with questions?

Contact DHSWIHAIPreventionProgram@dhs.wisconsin.gov for questions related to infection prevention and control, PPE, outbreak consultation, healthcare setting-specific guidance, National Healthcare Safety Network (NHSN) use, etc.

 


 

 
 
 

PPE

 

The Office of Civil Rights at the Department of Health and Human Services released a Bulletin: Civil Rights, HIPAA, and the Coronavirus Disease 2019 (COVID-19) (PDF) to ensure compliance with the Americans with Disabilities Act.

Physical health and safety guidance

 Considerations for allocation of scarce resources

The Wisconsin Department of Health Services, in collaboration with the State Disaster Medical Advisory Committee, and with input from Wisconsin clinicians, bioethicists, advocacy groups and residents through a public comment process, proposes a number of considerations for hospitals developing or revising allocation guidelines for mechanical ventilators and other scarce resources during a public health emergency.

Hospitals developing or revising allocation guidelines may benefit from reviewing documents developed on this topic by national organizations and other state health departments, which are referenced below.

  1. Institute of Medicine Committee on Guidance for Establishing Standards of Care for Use in Disaster Situations. Guidance for establishing crisis standards of care for use in disaster situations: a letter report. Washington DC: National Academies Press (US); 2009.
  2. Centers for Disease Control and Prevention; Ventilator Document Workgroup, Ethics Subcommittee of the Advisory Committee to the Director. Ethical considerations for decision making regarding allocation of mechanical ventilators during a severe influenza pandemic or other public health emergency (PDF), 2011. Atlanta, GA; 2011.
  3. White DB, Lo B. A Framework for Rationing Ventilators and Critical Care Beds During the COVID-19 Pandemic. JAMA. 2020;323(18):1773–1774. doi:10.1001/jama.2020.5046
  4. University of Pittsburgh Model Hospital Policy for Allocation of Scarce Critical Care Resources During a Public Health Emergency (PDF)
  5. New York State Health Department Ventilator Allocation Guidelines (PDF), 2015
  6. Minnesota Pandemic Ethics Project

 Reporting and surveillance guidance

The state epidemiologist declared COVID-19 a Category I reportable disease per a memo issued on Feb. 4, 2020 (PDF). Health care providers and laboratories must report confirmed or suspected cases to the Department of Health Services (DHS) within 24 hours of detection.

  • Per a memo issued on April 4, 2022, the following SARS-CoV-2 Laboratory Reporting Guidance are as follows:  
    • All positive, negative and inconclusive test results from NAAT (RT-PCR) testing conducted in a facility certified under CLIA to perform moderate or high complexity tests should be reported electronically within 24 hours of results being known through the Wisconsin Electronic Disease Surveillance System (WEDSS) or by fax to the patient's local health department. 
    • Facilities conducting all other SARS-COV-2 testing g (e.g., testing conducted in a setting operating under a CLIA certificate of waiver, non-NAAT testing conducted in a facility certified under CLIA to perform moderate- or high-complexity tests), excluding antibody and self-administered tests, should report positive test results to the appropriate STLT health department. Reporting negatives for these tests is optional.
    • Reporting test results from antibody and self-administered tests is not required
    • COVID-19 related hospitalizations and deaths are reportable (PDF) in Wisconsin.

In Wisconsin, all results should be reported electronically through WEDSS or by fax to the patient’s local health department. Facilities who wish to have DHS report to HHS on their behalf must report test results electronically to the WEDSS. Reporting can occur through already-established electronic laboratory reporting (ELR) connections, or by establishing a web-based laboratory reporting (WLR) connection


COVID-19 surveillance case definition

Note: The COVID-19 Surveillance Case Definition is a set of uniform criteria used to define COVID-19 disease or infection for public health surveillance, which enables public health officials to classify and count cases consistently across reporting jurisdictions. This surveillance case definition is not intended to be used by healthcare providers for making a clinical diagnosis, determining who should be tested for COVID-19, or determining how to meet an individual patient’s health needs.

Clinical Description

People with confirmed COVID-19 infections (also known as SARS-CoV-2) can have a wide range of symptoms, from asymptomatic infection to severe illness. Mild to moderate illness may include fever, sore throat, headache, myalgia, fatigue, and upper respiratory symptoms. Some people also have gastrointestinal symptoms including nausea, vomiting, or diarrhea. Symptoms of more severe illness may include, difficulty breathing, shortness of breath, confusion or change in mental status, persistent pain or pressure in the chest, pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone, or inability to wake or stay awake. In rare cases, people with COVID-19 may experience complications, such as pneumonia and acute respiratory distress syndrome (ARDS).  

Those at highest risk for severe disease and death include people aged over 60 years (especially those 85 years and older) and those with underlying conditions, including but not limited to obesity, hypertension, diabetes, cardiovascular disease, chronic respiratory or kidney disease, immunosuppression from solid organ transplant, and sickle cell disease. A complete list can be found on CDC’s COVID-19 People with Certain Medical Conditions webpage. Disease in children mostly appears to be relatively mild, and there is evidence that a significant proportion of infections across all age groups are asymptomatic, or presymptomatic at the time of testing. The incubation period of COVID-19 disease ranges from 1-14 days after infection, with an average time from infection to clinical illness of 5-6 days.


Clinical Criteria for Surveillance

Acute onset or worsening of at least two of the following signs or symptoms:

  • Fever (measured or subjective), or chills, or rigors (shaking chills)
  • Myalgia (muscle aches)
  • Headache
  • Sore throat
  • Nausea or vomiting
  • Diarrhea
  • Fatigue
  • Congestion or runny nose

OR

Acute onset or worsening of at least one of the following signs or symptoms:

  • Cough
  • Shortness of breath
  • Difficulty breathing
  • New olfactory disorder (loss of smell)
  • New taste disorder (loss of taste)
  • New confusion or change in mental status
  • Persistent pain or pressure in the chest
  • Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone
  • Inability to wake or stay awake

OR

Severe respiratory illness with at least one of the following:

  • Clinical or radiographic evidence of pneumonia
  • Acute respiratory distress syndrome (ARDS)

AND

No alternative more likely diagnosis.


Laboratory evidence for surveillance

Confirmatory laboratory evidence:

  • Detection of SARS-CoV-2 RNA in a clinical specimen or post-mortem respiratory swab using a diagnostic molecular amplification detection test (for example, PCR, LAMP, NAAT) performed by a CLIA-certified provider, or
  • Detection of SARS-CoV-2 RNA by genomic sequencing

Probable laboratory evidence: Detection of SARS-CoV-2 by antigen in a clinical specimen or post-mortem respiratory swab using a diagnostic test performed by a CLIA-certified provider.

Supportive laboratory evidence:

  • Detection of antibody in serum, plasma, or whole blood specific to natural infection with SARS-CoV-2 (antibody to nucleocapsid protein), or 
  • Detection of specific antigen by immunocytochemistry in an autopsy specimen, or 
  • Detection of SARS-CoV-2 RNA or specific antigen using a test performed without CLIA oversight (for example, at-home test)

Epidemiologic evidence for surveillance

Any one of the following exposures in the 14 days before onset of symptoms or positive lab test:

  • Close contact* with a confirmed OR probable case of COVID-19 disease.
  • Member of an exposed risk cohort as defined by public health authorities during an outbreak or during high community transmission

*For non-healthcare workers in a community setting, a person is considered to be in close contact of a COVID-19 case if any of following interactions occurred while the case was infectious: (1) was within 6 feet for more than 15 minutes total in a 24-hour period, (2) had physical contact, (3) had direct contact with the respiratory secretions of the infected individual (from coughing, sneezing, contact with dirty tissue, shared drinking glass, food, towels or other personal items), (4) lives with or stayed overnight for at least one night in a household without complete separation from the infected individual.

For healthcare workers, refer to CDC’s Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19 to determine whether an interaction should be considered close contact.


Vital records criteria for surveillance

A death certificate that lists COVID-19 disease or SARS-CoV-2 as an underlying cause of death or a significant condition contributing to death.


Surveillance case definitions for COVID-19

Confirmed case:

Meets confirmatory laboratory evidence

Probable case:

Meets clinical criteria and epidemiologic evidence with no confirmatory or probable lab evidence for SARS-CoV-2 (i.e., no confirmatory or probable lab evidence = molecular or antigen testing was not performed or was performed without CLIA oversight or was performed but results are uninterpretable, such as indeterminate or invalid)

OR

Meets probable laboratory evidence

OR

Meets vital records criteria

Suspect case:

Meets supportive laboratory evidence with no prior history of being a confirmed or probable case.


Criteria to distinguish a new case of COVID-19 from an existing case

The following should be enumerated as a new case: 

  • SARS-CoV-2 sequencing results from the new positive specimen and a positive specimen from the most recent previous case demonstrate a different lineage, or 
  • Person was most recently enumerated as a confirmed or probable case with onset date (if available) or first positive specimen collection date for that classification >90 days prior* (i.e., an existing confirmed or probable case is, again after 90 days, meeting criteria for either a confirmed or probable case), or  
  • Person was previously reported but not enumerated as a confirmed or probable case (i.e., suspect)**, but now meets the criteria for a confirmed or probable case. 

*Some individuals, (for example, severely immunocompromised persons) can shed SARS-CoV-2 detected by molecular amplification tests >90 days after infection. For severely immunocompromised individuals, clinical judgment should be used to determine if a repeat positive test is likely to result from long-term shedding and, therefore, not be enumerated as a new case. CDC defines severe immunocompromise as certain conditions, such as being on chemotherapy for cancer, untreated human immunodeficiency virus (HIV) infection with CD4 T lymphocyte count 20mg/day for more than 14 days. 

**Repeat suspect cases should not be enumerated. 

Note: The time period of 90 days may be extended further if more data become available to show risk of reinfection remains low beyond 90 days of the initial report.

 Testing

Updated Resources

Health care providers are encouraged to obtain COVID-19 testing for all symptomatic patients, even patients with mild symptoms. It is also encouraged to test everyone, regardless of vaccination status, that had a known exposure at least 5 days after their last close contact. 

Providers should educate patients who are being tested for an acute COVID-19 infection about how to properly isolate themselves and are encouraged to share DHS’s What should I do if I was tested for COVID-19 and am awaiting results? 

All patients who are suspected of having COVID-19 should be reminded to notify their close contacts of a potential exposure and are encouraged to share DHS's COVID-19: Isolation and Quarantine.


Access to testing

DHS has emergency supplies available at no charge to qualifying Wisconsin clinicians, local and tribal health centers, clinical laboratories, and others collecting specimens in response to COVID-19. The supplies and laboratory services are available for testing symptomatic and asymptomatic individuals. Decisions to test asymptomatic persons should be informed by public health or clinical priorities for a facility or region. For more information about what is available and to make a request, visit the DHS COVID-19 Testing Supplies Request webpage.


Testing at a public health laboratory

Wisconsin’s two public health labs testing for COVID-19, the Wisconsin State Laboratory of Hygiene (WSLH) and Milwaukee Health Department Laboratory (MHDL) (PDF), have worked with DHS to develop a priority list for public health lab testing for COVID-19. This list is NOT intended for use by clinicians or clinical or commercial labs for determining testing priority in the community or in their facility.

To conserve resources for testing in public health labs, WSLH and MHDL are only testing samples for the following patients:

  • Public Health Investigations as directed by state or local public health
  • Hospitalized patient with COVID-19 symptoms
  • Patient with COVID-19 symptoms for whom rapid diagnosis is needed to inform infection control practices (for example, labor and delivery, dialysis, aerosol-generating procedures)
  • Resident of a long-term care facility with COVID-19 symptoms
  • Resident in a jail, prison, or other congregate setting with COVID-19 symptoms
  • Health care worker or first Responder (for example, fire, EMS, police) with COVID-19 symptoms
  • Essential staff in high consequence congregate settings (for example, prisons or jails) with COVID-19 symptoms
  • Utility workers (water, sewer, gas, electric, power, distribution of raw materials, oil and biofuel refining) with COVID-19 symptoms
  • Underserved populations with poor access to testing (for example, underinsured, patients at Federally Qualified Health Centers, homeless patients, migrant workers) with COVID-19 symptoms
  • Post-mortem testing for a person with COVID-19 symptoms prior to death who died of unknown causes AND where results would influence infection control interventions at a facility or inform a public health response

Providers may send specimens to WSLH or MHDL only if they meet Wisconsin public health laboratory testing priorities listed above. If equivalent or more rapid turnaround is available through an in-house or commercial lab, providers are encouraged to use these other laboratory options.

Testing for patients who do not meet one of the Wisconsin public health laboratory priorities listed above, but for whom testing is requested by a provider, should have their specimen submitted to in-house, commercial, or reference labs for testing.


Responses to common questions about testing

Are serology (antibody test) results for SARS-CoV-2 also reportable?

DHS does not require any serology (antibody test) results to be reported.

Where should I send specimens?

Many commercial and clinical labs are now performing COVID-19 testing. If your health system is performing large numbers of tests (such as drive-through testing sites, testing of ill health care workers), these specimens should be sent to commercial or in-house labs. See the WSLH website for a list of Wisconsin reference labs accepting outside specimens.

How will we get patient results?

As with other testing, clinicians can expect results to be communicated directly from the lab. Please do not contact DHS or your local health department for test results.

How will my patient get their results?

As with other testing, clinicians should share test results with patients directly. Please do NOT tell patients to contact their local health department, lab, or DHS for test results, or updates on the status of their testing.

What are other testing considerations?

  • The number of health care providers present during the procedure should be limited to those essential for patient care and procedure support. Visitors should not be present for specimen collection. Specimen collection should be performed in a normal examination room with the door closed.
  • Specimen collection should be done by trained individuals.
  • The ordering provider is responsible for receiving COVID-19 test results from the laboratory and communicating the result to the patient.

 Caring for health care workers exposed or diagnosed with COVID-19

The following information reflects the most current recommendations for monitoring, excluding and return to work criteria for health care workers and was adapted from:

Who is considered a health care worker or health care personnel?

The following definition of health care workers (HCWs) was adapted from the CDC definition of a HCW and is broader than the common use of the phrase. The following should not be used as an exhaustive list but instead is intended to provide examples of the broad range of activities and job responsibilities that should be included in the definition of health care worker for the purposes of responding to COVID-19. The definition should also not be restricted to employees of a facility or agency, but should also be applied to volunteers.

HCWs include, but are not limited to: emergency medical service personnel, nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, dentists, laboratorians, students and trainees, aides, caregiver, others who provide care or services, contractual staff not employed by the healthcare facility, and persons not directly involved in patient care, but who could be exposed to infectious agents that can be transmitted in the healthcare setting (for example, clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, and volunteer personnel). This definition would also include workers who provide these services or serve these roles in a home or group health setting.


Routine monitoring of health care workers

For guidance on routine monitoring of health care personnel, refer to CDC Infection Control: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)


Testing, isolation and quarantine for healthcare workers

For guidance on testing, isolation and quarantine for healthcare workers, refer to CDC Potential Exposure at Work.


References

 Immunization services

Visit our page for COVID-19 vaccinators or view partner resources.

 

Ensuring that immunization services, including influenza vaccine services, are maintained or reinitiated is essential for protecting people and communities from vaccine-preventable diseases and outbreaks, and for reducing the burden of illness during influenza season.

The CDC has issued Interim Guidance for Immunization Services During the COVID-19 Pandemic to help immunization providers in a variety of clinical settings plan for safe vaccine administration during the COVID-19 pandemic. This guidance will be updated as the COVID-19 pandemic evolves.

Highlights include:

  • Considerations for routine administration of all recommended vaccinations for children, adolescents, and adults, including pregnant people.
  • General practices for the safe delivery of vaccination services, including considerations for alternative vaccination sites.
  • Strategies for catch-up vaccinations.

 Supporting adherence to isolation and quarantine

For the most up to date isolation and quarantine guidance, refer to: COVID-19 Quarantine and Isolation | CDC.

 

Isolation and quarantine play a critical role in containing the spread of COVID-19. Health care providers can promote patient adherence to isolation and quarantine requirements by providing educational materials and referring to the local or tribal health department to provide support.

Patient education materials

Additional resources are available on the COVID-19: Communication Resources.

COVID-19 Monitoring Resources

COVID-19 Testing Resources

Support from local and tribal health departments

Isolation and quarantine are required per state statute. If there is reason to believe that an individual may not voluntarily abide by isolation or quarantine recommendations, local and tribal health departments can assist by evaluating the individual's circumstances that make nonadherence likely. Local and tribal health departments may be able to provide linkages to available resources that can support quarantine at home such as social support, telehealth information, and mental health resources.

If individuals demonstrate they are unwilling to voluntarily isolate, health officers may issue an isolation or quarantine or isolation order. If the person fails to comply, the health officer may petition a court to order compliance. Anyone who willfully violates laws relating to public health may be subject to 30 days in jail or fined not more than $500, or both.

 Memos issued by DHS

Below is a listing of all memos issued by DHS containing guidance for COVID-19.

Official Number Description Issue Date Attachments Obsolete Date
BCD 2022-09
COVID-19 Vaccination for Wisconsin’s Youngest Children - To Pediatricians June 17, 2022
BCD 2022-10
COVID-19 Vaccination for Wisconsin’s Youngest Children - To Pharmacists June 17, 2022
BCD 2022-08
Recommendations for COVID-19 Prevention and Mitigation Among Migrant and Seasonal Agricultural Workers June 3, 2022
BCD 2022-07
COVID-19 Oral Antivirals Medications for Long-Term Care Residents May 6, 2022
BCD 2022-04
Updated SARS-CoV-2 Laboratory Data Reporting Guidance Effective April 4, 2022 April 25, 2022
BCD 2022-02
Standing Order for Distribution of COVID-19 At-Home Antigen Test Kits January 26, 2022
BCD 2022-01
Prioritization of Highest Impact Public Health Response Activities January 21, 2022
BCD 2021-13
Prevention and Control of Acute Respiratory Illness Outbreaks in Long-Term Care Facilities December 22, 2021
BCD 2021-12
Public Health Advisory: Anticipated Surge in COVID-19 Disease Activity due to Omicron Variant December 20, 2021
BCD 2021-09
Increased Incidence of Multi-System Inflammatory Syndrome in Children November 8, 2021
BCD 2021-08
Standing Prescription Order for COVID-19 Vaccines September 22, 2021
BCD 2021-07
Revised COVID-19 Monoclonal Antibody Ordering Process September 21, 2021
BCD-2021-03
Public Health Reporting Requirements for At-Home COVID-19 Tests June 16, 2021
21-01
CMS 1135 Waiver Provisions – Acute Hospital Care at Home Program January 12, 2021
BCD 2020-29
DHS recommends testing migrant and seasonal workers for COVID-19 prior to departure at the end of the work season November 12, 2020
June 3, 2022
20-25
Child Care Provider Temporary Closures Due to COVID-19 October 30, 2020
BCD 2020-28
Guidance Related to Viral Whole Genome Sequencing of SARS-CoV-2 for the Public Health Response October 1, 2020
BCD 2020-27: Memo replaced by
Prevention and Control of Acute Respiratory Illness Outbreaks in Long-Term Care Facilities September 23, 2020
December 13, 2021
BCD-2020-26: Memo replaced by
Prevention and Control of Acute Respiratory Illness Outbreaks in Long-Term Care Facilities September 17, 2020
September 23, 2020
BCD 2020-25
Crisis Standards of Practice for COVID-19 Contact Tracing and Symptom Monitoring September 15, 2020
2020-11 Action
Request for Applications: Behavioral Health Treatment for Long-Term Care Facility Staff Impacted by COVID-19 June 22, 2020
August 1, 2020
BCD 2020-19
Guidance on the role of COVID-19 testing in decisions around transfers from acute care hospitals to post-acute and long-term care facilities June 9, 2020
BCD 2020-20
Guidance on the transfer of hospitalized patients infected with COVID-19 to post-acute and long-term care facilities June 9, 2020
BCD 2020-21
Guidance on the disposition of medically stable post-acute and long-term care residents with confirmed or clinically suspected COVID-19 infection June 9, 2020
20-003
Wisconsin Hospices CMS 1135 Waiver Provisions and Governor Evers Emergency Order # 21 June 8, 2020
20-004
Wisconsin Nursing Homes – CMS 1135 Waiver Provisions and Governor Evers Executive Order # 21 June 8, 2020
20-007
Wisconsin Home Health Agencies – CMS 1135 Waiver Provisions and Governor Evers Emergency Order # 21 June 8, 2020
20-009
Licensure/Certification Application for Temporary Assisted Living Facility Expansion Units and Transfer Options during the COVID-19 Public Health Emergency State May 29, 2020
BCD 2020-18
Guidance to Coroners and Medical Examiners on Postmortem COVID-19 Testing at the Wisconsin State Laboratory of Hygiene and the Milwaukee Health Department Laboratory May 29, 2020
2020-09 Action
Applications for Awards to Address Behavioral Health Needs Arising from the COVID-19 Pandemic May 19, 2020
June 2, 2020
20-008
State Licensure Application for Temporary Nursing Facility Expansion Units and Transfer Options during the COVID-19 Public Health Emergency May 1, 2020
20-006
Use of Remote Support Providers in Regulated Adult Family Homes April 24, 2020
April 5, 2022
20-005
Guidance for Ambulatory Surgical Centers Temporarily Enrolling as a Hospital During the COVID-19 Public Health Emergency April 16, 2020
20-002
CMS 1135 Waiver Provisions – Wisconsin Hospitals April 6, 2020
BCD 2020-17
Changes to COVID-19 Reporting Requirements for Wisconsin Hospitals and Health Departments April 6, 2020
20-001
State Licensure Application for Temporary Expansion Locations during Public Health Emergency related to COVID-19 April 3, 2020
2020-04
Minimum Contact Standards for Support and Service Coordination: New Requirements Necessitated by the Novel Coronavirus (COVID-19) Pandemic April 2, 2020
September 1, 2021
BCD 2020-14
Information for Dental Health Care Professionals (DHCP): What You Need to Know about Coronavirus Disease (COVID-19) March 20, 2020
BCD 2020-15
Important Information for Recipients of Personal Protective Equipment (PPE) from the Strategic National Stockpile (SNS) March 20, 2020
BCD 2020-16
Important Guidance for Infection Prevention and Control of Coronavirus Disease 2019 (COVID-19) (REVISED) in Long-Term Care Facilities and Assisted Living Facilities March 20, 2020
BCD 2020-12
Updated guidance for local health departments and government partners about home isolation and quarantine for COVID-19 March 19, 2020
BCD 2020-13
What to do if someone breaks quarantine: Guidance for Local Health Departments (LHDs) March 19, 2020
BCD 2020-10
Ryan White Part B and Life Care Services Emergency Financial Assistance Policy in Response to COVID-19 March 18, 2020
BCD 2020-11
Adult/Juvenile Correctional Facilities, Local Jails, and Secure Treatment Centers in Wisconsin Guidance for Coronavirus Disease 2019 (COVID-19) March 18, 2020
BCD 2020-09
Urgent Update – Prioritization of COVID-19 Testing for Hospitalized Patients March 17, 2020
BCD 2020-07
Important Recommendations for Prevention of COVID-19 in Long-Term Care Facilities and Assisted Living Facilities March 13, 2020
March 20, 2020
BCD 2020-08
Public Health Guidance for Discontinuation of Home Isolation and Voluntary Home Quarantine for Individuals Infected with or Exposed to COVID-19 March 13, 2020
BCD 2020-04
Coronavirus Disease 2019 (COVID-19) Update: Recommendations on Domestic and International Travel March 12, 2020
BCD 2020-05
New Mass Gathering Guidance for Novel Coronavirus (COVID-19) March 12, 2020
March 19, 2020
BCD 2020-06
Updated Guidance on Infection Control during Specimen Collection for COVID-19 in Outpatient Settings March 12, 2020

Pages

 Dental health care professionals guidance

 Wisconsin Dental Professionals Infection Control Guidance 

The Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) recognize that the practice of dentistry presents unique challenges when working in our current COVID-19 environment and beyond. Public health guidance shifts as the COVID-19 pandemic evolves. All dental professionals should regularly check for updates to guidance for dental settings as well as the general infection prevention and control recommendations.

The updated Infection Control Guidance for Healthcare Professionals about Coronavirus (COVID-19) is applicable to all settings where healthcare is delivered, including Wisconsin dental settings. Dental healthcare personnel (DHCP) should refer to this and OSHA's standards and guidance on workplace hazards related to the current coronavirus pandemic.

To assist dental practices implementing the guidance, the Organization for Safety, Asepsis and Prevention (OSAP) and DentaQuest Partnership for Oral Health Advancement (DQP) have released Best Practices for Infection Control in Dental Practices During the COVID-19 Pandemic, a checklist to assist DHCP with implementing interim guidance. Designed as a fillable PDF, the checklist is printable and mobile-friendly.

Each dental practice should have a COVID-19 policy, written respiratory protection program, and documentation of staff training. Document DHCP training on updates and changes prior to seeing patients. Personal Protective Equipment (PPE) recommendations are determined by your local COVID-19 disease activity.

DHS COVID-19 Summar Data: This webpage provides up to date data regarding Wisconsin shows COVID-19 Community Levels and summary statistics. 

 Caring for pregnant people

Provider resources

 Home visiting programs

Have a Plan

Develop plans and policies to provide a balance of in-person and virtual home visiting in response to COVID-19. Agency-specific circumstances, program requirements, funding limitations, and local conditions will inform the plan. The plan also needs to acknowledge and focus on family choice since these services are voluntary. The following activities will support the planning process:

  • Assure home visiting services are addressed in the local continuity of operations plan or emergency preparedness plan. The purpose of the plan is to:
    • Respond to disasters and public health emergencies.
    • Continue priority activities in emergencies.
    • Restore programs and services after emergencies.
    • Provide for leadership succession and organization in any situation.
    • Redirect services and programs.
    • Assign staff to response activities and priority services.
  • Stay up to date with CDC guidelines, state and local recommendations, and media messaging.
  • Reach out to local/tribal health departments and other agencies and partner programs that send staff into homes to identify and align with their practices.
  • Monitor ForwardHealth updates for Medicaid-covered services.
  • Continue to talk with funders, models, and agencies about their requirements and recommendations and how they impact the provision of services.
  • Get input from parent leaders related to family choice. Work with partners to think about how to share that input with funders, agencies, and models.
  • Work with local programs and home visitors on the ground to get their input about concerns or questions. Work with partners to share that input with funders, agencies, and models.
  • Assure the home visiting workforce and families have access to well-fitting masks.
  • Assure families have access to technology for telehealth visits.

Telehealth
  • Per Health and Human Services Office for Civil Rights guidance, providers can use audio or video communication technology to provide telehealth to patients during the COVID-19 public health emergency. Health care providers will not be subject to penalties for violations of the HIPAA Privacy, Security, and Breach Notification Rules that occur in the good faith provision of telehealth during the COVID-19 nationwide public health emergency.
  • The current model recommendation for Maternal, Infant and Early Childhood Home Visiting programs in Wisconsin is to support the continuation of services via telecommunication/telehealth, such as telephone or video communication.
  • Medicaid allows real-time technology, including phone communication, for currently covered services that can be delivered with functional equivalency to face-to-face services. This applies to all components of prenatal care coordination (PNCC) including assessment, care planning, case management, health education and nutrition counseling, and postpartum services. Telehealth resources are available on the ForwardHealth website.

Home Visits

Best practice policies and procedures include the following:

  • Home visiting programs assess staff and clients for symptoms of COVID-19 infection prior to entering a home.
  • Home visiting staff and clients follow safety precautions related to physical distancing, hand washing and the use of cloth face coverings.
  • If any person within the home is found to be ill, they are referred for testing and medical care and the visit is conducted via telehealth options.
  • Staff at high risk of severe COVID-19 complications (those who are older or have underlying health conditions) avoid conducting in-person home visits with sick clients.
  • If a home visitor develops signs and symptoms of illness while on the job or after providing a home visit, they notify their supervisor and follow current CDC and local and state health department guidance.
  • All non-dedicated, non-disposable medical equipment used for patient care (such as scales, stethoscope, developmental screening tools) should be cleaned and disinfected according to manufacturer’s instructions and facility policies.

Preparing for a Home Visit

Home visitors need to inform families about safety measures for in-person visits. For more information, see the handout COVID-19: Protecting Yourself During a Home Visit, P-02664. The home visitor should make the final decision as to their ability to maintain safety and wellbeing of all participants; for themselves and families during a home visit. 


Training and Resources

 Infection preventionists

Visit our Infection Prevention Education webpage for helpful infection prevention resources, or contact your Regional Infection Preventionist for more information. 

 

Ensuring that infection prevention and control (IPC) practices are followed and maintained during the COVID-19 pandemic is critical in preventing the spread of disease.

The Centers for Disease Control and Prevention (CDC) has issued interim guidance for health care personnel in all settings during the COVID-19 pandemic: 

The CDC has also issued additional Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes, which also apply to assisted living facilities that provide any type of health care on-site, including medication passes, vital signs monitoring, and daily living activities assistance. Find additional COVID-19 guidance for nursing homes and assisted living facilities from DHS.

Additional COVID-19 infection prevention and personal protective equipment factsheets can be found on the COVID-19: Communication Resources webpage.  

 Pharmacist guidance

It is the responsibility of pharmacies conducting COVID-19 testing to report patient information to public health when a patient comes to be tested. This is because health care providers, including pharmacists, are required to report communicable diseases to public health. See Wis. Stat. ch. 252.05 and Wis. Admin Code. ch. DHS 145

In Wisconsin, all results should be reported electronically through WEDSS or by fax to the patient’s local health department. Facilities who wish to have DHS report to HHS on their behalf must report test results electronically to the WEDSS. Reporting can occur through already-established electronic laboratory reporting (ELR) connections, or by establishing a web-based laboratory reporting (WLR) connection.


Required laboratory reporting

In addition to reporting communicable disease information to public health, if a pharmacy is a laboratory, they must report the results of the COVID-19 tests for each patient to the Wisconsin State Lab of Hygiene. The Wisconsin State Lab of Hygiene has two ways to report test results to them: Electronic Laboratory Reporting (ELR) and Web-based Laboratory Reporting (WLR). Unless the laboratory has the ability to upload HL7 2.5.1 reportable laboratory results, they should use WLR to enter laboratory results; WLR is available for all laboratories. Pharmacies must register for a WLR account, and register through the Account request for web-based laboratory reporting webpage.

The laboratory must either manually enter data into WLR or upload a tab delimited text file within 24 hours of processing the test results. When information is entered into WLR, the Wisconsin State Lab of Hygiene ensures required information is reported to required state (WEDSS) and federal reporting systems.

To learn more about reporting into WLR, watch the Wisconsin State Lab of Hygiene training video.


Accessing WEDSS

To access WEDSS, you must complete the following steps:

  1. Secure a Wisconsin Logon Management System (WILMS) account.
    1. Enter your work email address in the prompt. If you do NOT have a WILMS ID, you will receive an error message.
    2. If you don't have a WILMS account, you can create one. Use your work email address and choose "WEDSS" as the system you will access.
  2. Get access to WEDSS.
    1. Email DHS WEDSS with your WILMS login ID and email address. The subject line of the email should be "WEDSS Access."
    2. DHS will forward the WEDSS User Security policy and, if applicable, the Security and Confidentiality policy. Return the signature page by email or fax.
  3. DHS will email you your WEDSS access, your account information, a temporary password, training information, and how to change your temporary password.
  4. You must notify your local health department that you are using WEDSS. WEDSS data is sent to the Department of Health and Human Services and the CDC.
  5. The Department of Health Services website has an instructional video on how to sign up for WILMS and WEDSS.

To locate additional information about WEDSS, see the State of Wisconsin WEDSS and Disease reporting webpages.


Informing the patient of test results

A pharmacy will typically be responsible for contacting patients with their test results regardless of whether they are only collecting the specimens or are also a CLIA-waived laboratory. However, if a pharmacy contracts with an external laboratory to process tests, they can choose to negotiate this point; in which case, the external laboratory would reach out to patients with their test results. In discussions with local and tribal public health, pharmacists should ask about their process for notifying patients of both positive and negative results to ensure that the pharmacy's internal practice for notifying patients is complementary.

Mental health guidance

Coping tips for those serving on the frontlines

Throughout Wisconsin, frontline workers provide essential health and safety services that keep our communities functioning during the COVID-19 pandemic. Braving increased risks to help others is part of their jobs, but it can come with a cost. Routine stress, added to the rational concern many frontline workers have for their own health and the well-being of their loved ones, can leave these professionals—and their families—vulnerable to the negative effects of secondary trauma and other mental and behavioral health challenges, like suicidal thoughts and harmful substance use.

Logo for Resilient Wisconsin: Connected. Stronger. Thriving.

Finding healthy ways to cope with challenges is more important than ever. Resilient Wisconsin offers strategies for practicing self-care, maintaining social connections, and reducing stress and anxiety.

Try these five strategies
  • Build a solid foundation: Invest in your health with adequate sleep, good nutrition, regular physical activity, and active relaxation.
  • Connect with colleagues: Celebrate successes and mourn sorrows with your co-workers as a group.
  • Take breaks: Time away from work, whenever possible, can help you see beyond the immediate crisis.
  • Stay connected: Communicate with friends and family as often as you can, even if you are practicing self-isolation.
  • Talk it out: Consider talking about your experiences and emotions with a trusted peer or mental or behavioral health professional. It’s okay to reach out for support, and talking can help.
Resources to help you manage stress and adapt to change

For frontline workers

Balancing your duty to the clients and patients in your care with your own mental, physical, and emotional health needs isn’t easy. Learn how to manage and reduce stress of providing care during the COVID-19 pandemic and prevent secondary trauma from negatively impacting your personal and professional life by exploring the resources below:

For families of frontline workers

Frontline workers aren’t the only ones who experience stress while providing essential health and safety services during large-scale emergencies like the COVID-19 pandemic. That stress is shared by the loved ones around them. Learn how to recognize toxic stress and build a support system that helps everyone in your circle offer and ask for support by exploring the resources below:

 

 

UW-Madison Research Participation Opportunity for Protecting Healthcare Workers from COVID-19. The research is titled, "Role of naso-oropharyngeal antiseptic decolonization to reduce covid-19 viral shedding and disease transmission." For more information on how to enroll, visit the Shield Research Study.

Last Revised: June 14, 2022

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