CDPH reminds all facilities of requirements to report outbreaks and unusual infectious disease occurrences to the local LHD & L&C District Office. It provides investigation and reporting thresholds for COVID-19 and incorporates updated joint CORHA and CSTE outbreak investigation and reporting thresholds. These are intended to expedite facilities’ investigation of cases and reporting to public health authorities, to help ensure early detection of possible outbreaks and timely intervention to prevent the virus’ spread. When the recommended reporting threshold is reached and reported, the LDH will determine if the cases constitute and outbreak.

Long-Term Care Facilities: Threshold for Additional Investigation by Facility

· ≥1 suspect, probable or confirmed COVID-19 case in a resident or HCP;

· ≥3 cases of acute illness compatible with COVID-19 in residents with onset within a 72-hour period

· ≥1 suspect, probable or confirmed COVID-19 case in HCP

Threshold for Reporting to Local Public Health

· ≥1 probable or confirmed COVID-19 case in a resident or HCP;

· ≥3 cases of acute illness compatible with COVID-19 in residents with onset within a 72-hour period

· ≥1 probable or confirmed COVID-19 case in HCP

Outbreak Definition

· ≥1 facility-acquired COVID-19 case in a resident

· ≥3 suspect, probable or confirmed COVID-19 cases in HCP with epi-linkage and no other more likely sources of exposure for at least 2 of the cases

Probable Case

· A person meeting presumptive laboratory evidence

Suspect case

· A person meeting supportive laboratory evidence OR meeting vital records criteria with no confirmatory or presumptive laboratory evidence for SARS-CoV-2. Supportive laboratory evidence includes the detection of SARS-CoV-2 specific antigen by immunocytochemistry OR detection of SARS-CoV-2 RNA or specific antigen using a test performed without CLIA oversight.

Facility-acquired COVID-19 infection in a long-term care resident refers to SARS-CoV-2 infections that originated in the facility. It does not refer to the following:

· Residents who were known to have SARS-CoV-2 infection on admission to the facility

· Residents who tested positive on day 1, 3 or 5 after new admission.

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