Monday, November 23, 2020

CDC Expands Definition of Who is a ‘Close Contact’ of an Individual with Covid-19


In the continuing and ongoing struggle of the global pandemic that is Covid-19, one of the most difficult aspects for healthcare providers is attempting to keep up (even now) with the continuing evolution of knowledge and guidance being provided by those doing research into the infectious aspects of the virus.  Things can change daily, and when they do we are expected tone able to put those advised changes into practice immediately.  It's a challenge, but that's why we do what we do.  As my grandfather used to say, "Son if it was easy... everyone would be doing it."  That's just one of the reasons I spend so much time trying to bring the profession up to speed.  

I'm no virologist or epidemiologist, so I'm trying as hard as I can to keep up and when I find something out, I figure I should tell my fellow practitioners as well.

With that in mind, here is the latest from the CDC on their definition of "Close Contact" of an Individual with Covid-19.  

Close Contact

Someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period* starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated.

* Individual exposures added together over a 24-hour period (e.g., three 5-minute exposures for a total of 15 minutes). Data are limited, making it difficult to precisely define “close contact;” however, 15 cumulative minutes of exposure at a distance of 6 feet or less can be used as an operational definition for contact investigation. Factors to consider when defining close contact include proximity (closer distance likely increases exposure risk), the duration of exposure (longer exposure time likely increases exposure risk), whether the infected individual has symptoms (the period around onset of symptoms is associated with the highest levels of viral shedding), if the infected person was likely to generate respiratory aerosols (e.g., was coughing, singing, shouting), and other environmental factors (crowding, adequacy of ventilation, whether exposure was indoors or outdoors). Because the general public has not received training on proper selection and use of respiratory PPE, such as an N95, the determination of close contact should generally be made irrespective of whether the contact was wearing respiratory PPE.  At this time, differential determination of close contact for those using fabric face coverings is not recommended.

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