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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The California Department of Health has issued a new All Facilities Letter (AFL) reminding licensed health facilities of their reporting requirements for outbreaks and unusual infectious disease occurrences. The AFL provides updated investigation and reporting thresholds for COVID-19, incorporating recommendations from the Council for Outbreak Response – Healthcare-Associated Infections and Antimicrobial Resistance (CORHA) and Council of Territorial Epidemiologists (CSTE). The letter emphasizes that local health departments (LHDs) may adjust reporting thresholds and outbreak definitions based on current conditions and local epidemiology. Healthcare facilities must report suspected or confirmed outbreaks, even if reporting thresholds for healthcare personnel cases are adjusted. The updated CORHA/CSTE recommendations include adding suspect and probable case definitions and shortening the interval between admission and a potentially hospital-acquired case in patients from 7 to 4 days. Acute care hospitals and long-term care facilities have specific thresholds for additional investigation, reporting to local public health, and outbreak definitions.

Clearpol Inc. does not make any guarantees regarding the accuracy of the opinions or summaries provided on our platform. Please use your own judgement.