COVID-19 Response Update

Presented by: Dawn Emerick, Ed.D, Director

April 14, 2020

 Case Investigations
COVID-19 Screening & Contact Tracing,
Hotline Testing Surveillance &
Analysis

Health Alerts, Wraparound

Prevention &
Education & Recovery
Enforcement
Policy Response
 Testing Epidemiological Process

Register

Test Sites

Labs
Self-Screening
400
MH Hotline

(pos and neg results)

MedCom
Patient

STRAC Hotline
10
911/Hospital
10
Primary/Urgent Care
MIH 40 Case Management

Assign Case
Investigator
EPI Assign

Nurse Call
Contact Management Positive Index Recovered
Symptomatic EPI Quarantine Monitoring Hospitalized
No Symptoms Death
Monitor Analytics Investigate Common 14-Day +7
Determine Platform Outbound Calls
Close Contact MIH Intervention (if needed)
Close Contact(s)
14 Day Monitoring Hospitalization (if needed)
Dashboards
If symptoms develop, call hotline Nursing Home Testing
and Reports

Analysis and Reporting

 Contact Tracing Process
Positive COVID-19
Data Entry and
Labs or Faxes
Follow Up
Received
Phone call received
Review National Electronic
Disease Surveillance System
(NEDSS) Base System (NBS)
and Electronic Laboratory
Reporting (ELR) for new
positive cases
Review faxes for all positive test
results
Back up to NBS searches and
updates as time permits
Investigator
Follow up with provider to
ensure all information is
submitted (patient lab
results, contact information,
demographics, clinical notes,
etc.)
Enter initially available data
into Confirmed Cases
Database
Assign
Investigation
Assign investigator to begin
disease intervention
After interview is complete,
enter data in Confirmed
Cases and Contact Database
Perform
Initiate investigation utilizing
DSHS COVID-19 Investigation
Form and Metro Health Contact
Tracing Forms
(Attempt to make at least 3
phone calls. Send a letter out if
not able to reach by phone.
Interview a proxy if individual is
not capable of being
interviewed.)
Finalize investigation and provide
forms to Haley/Maria for data
entry into the Confirmed Cases
Database
Once data entry has been
completed, send file to
Immunization Supervisor on
Duty, who will ensure “contact”
file is created and assign a nurse
to notify medium-risk contacts of
their exposures
Contact and
14-Day Follow Up
Notification
Call all “medium risk” contacts
with phone numbers (2 phone
call attempts) and leave a
voicemail if necessary (follow
script for limited information
left in voicemail)
Ensure all progress notes are
complete
Submit final files to supervisor
on duty who will update the
Close Contact Tracker
Close Contact Supervisor will
provide daily list of contacts
completed to Epi team to update
Confirmed Cases & Contact List
Close Contact/14 Day
Immunization Supervisor
tracks patients by symptom
onset to conduct follow up
once 14 days has passed
since symptom onset
Supervisor assigns a nurse to
complete the 14 day follow up
Nurses calls all COVID-19
positive individuals after 14
days to follow up on
symptoms and recovery
status
Nurses updates patient’s file
in progress notes
If patient is recovered,
confirmed list is updated. If
not, follow up call is
conducted in 7 days
 Sally worked on Started to feel Went to work Went to work Called COVID-
March 11, 12, ill on March 15 on March 16 on March 17 19 Hotline on
13, and 14 and but went to and had 4 and had 2 March 18
had a total of work anyway client client
15 clients and had 5 appointments appointments
clients
Sally the
Nail Tech Tested for Test results Epidemiology Epidemiology Offered
COVID-19 at were positive Contact Contact Isolation Care
Freeman on March 22 Investigation Tracing begins Facility and
Coliseum on begins March March 24 with other services
March 19 23 26 clients and
mom

27 people Isolation and Recovery

Sally is: quarantined monitoring for
26 years old; Single; and monitored Sally by MH
Healthy; No Children; by MH for 14 and MIH for
Uninsured; African days (April 7th) 14 days +
American; Lives at Home (April 7 or
with Mom longer)
 Harry didn’t April 2, he & April 2, went April 3, called EMS
feel well on kids went to to HEB for a 911. Couldn’t responded
April 1 but just CVS pharmacy, grocery pick breath and
explained it visited his up transported to
Harry the away. It was just mom at senior local hospital
Insurance his allergies living aprtmt
Salesman
Kids were Test results Epidemiology Epidemiology Family offered
picked up by were positive Contact Contact Isolation
Harry’s sister on April 4 Investigation Tracing begins Facility and
Metro Health begins April 5 with kids, other services
notified but Harry is on sister & mom
ventilator on April 6

Harry’s mom is Harry’s sister Mom (77 y/o) MIH visits Mom’s test
Harry is: quarantined at & kids are develops mom to test was positive,
55 years old; Single Parent; her aprtmt and quarantined at symptoms and her. Prevent at home,
Diabetes and Heart Disease; being his sister’s calls Metro an outbreak at monitored by
Two Children; Insured; monitored by house and Health the senior MH / MIH
Hispanic; Small Business MH for 14 days being living aprtmt team
Owner; Works from home (April 20th) monitored
Self-Screening
by Zip Code
Hotline Calls
by Zip Code
Positive Cases
by Zip Code
Overlay
by Zip Code
Testing Site Coverage
Overlay
by Zip Code