A guide to CMC’s Community of Care

Testing

What is the Novel CoronaVirus (COVID-19)?

A novel coronavirus is a new coronavirus that has not been previously identified. The virus causing coronavirus disease in 2019 ( COVID-19 ), is not the same as the coronaviruses that commonly circulate among humans and cause mild illness, like the common cold.

How does the virus spread?

The virus that causes COVID-19 is thought to spread mainly from person to person, mainly through respiratory droplets produced when an infected person coughs, sneezes, or talks. These droplets can land in the eyes, mouths or noses of people who are nearby, or possibly be inhaled into the lungs. Spread is more likely when people are in close contact with one another (within about 6 feet), particularly when not wearing face coverings.

What signs & symptoms are associated with COVID-19 infection?

People with COVID-19 have reported a wide range of symptoms – from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus.

COVID-19 Symptoms May Include:

Fever or Chills – body temperature above 99.6 degrees fahrenheit or sensation of chills or shivers

Sore Throat or Cough – scratchy, sore sensation in throat, dry or wet cough

Shortness of Breath – unexpectedly feeling out of breath, or winded, or breathing fast and hard

Fatigue – extreme tiredness or feeling of weakness

Muscle or Body Aches – soreness throughout the body

Headache – continuous pain or throbbing sensation in or around the head

New Loss of Taste or Smell – suddenly unable to taste or smell commonly consumed foods or drinks

Congestion – an excessive accumulation of mucus or fluids in mucous cavities (nose, sinuses, chest, eyes)

Runny Nose – excess drainage, ranging from a clear fluid to thick mucus, from the nose and nasal passages.

Nausea – a feeling of sickness with an inclination to vomit.

Vomiting – forcefully expelling the stomach’s contents out of the mouth.

Diarrhea – loose, watery stools that occur more frequently than usual.

When should I seek Emergency Care if I have COVID-19?

If you show any of these signs, seek emergency medical care immediately * :

  • Chest pain or trouble breathing
  • New confusion or excessive drowsiness
  • Temperature reaches 103°F or higher at any time
  • A fever of any temperature >99.6°F that lasts more than three days

*This list does not include all possible life-threatening conditions. Please call your medical provider for any other symptoms that are severe or concerning to you.

 

Call 911 or call ahead to your local emergency facility: notify the operator that you are seeking care for someone who has or may have COVID-19.

What is Close Contact?

For COVID-19, a close contact is defined as anyone who was within six feet of an infected person for at least 15 minutes starting from 48 hours before the person began feeling sick until the time the patient was isolated – with or without a mask.

Am I considered to have been in close contact if I was wearing a face mask?

Yes, according to the CDC, you are still considered to have been in close contact even if you were wearing a cloth face covering while you were within 6 feet of an infected person for at least 15 minutes.

What is Quarantine?

Quarantine is a word used to define the separation or restriction of movement of a person who may have been exposed to a communicable disease to see if they become ill.

You will be asked to Quarantine if you experience signs & symptoms of COVID-19, have come into close contact with anyone who has or is suspected of having COVID-19, or while you wait for your test results confirmation.

What is Isolation?

Isolation separates sick people with a contagious disease from people who are not sick.

If you have been diagnosed POSITIVE for COVID-19, you will be asked to Isolate for a period of time to be determined by a medical professional.

How do I protect myself and others from contracting COVID-19?

WASH YOUR HANDS OFTEN

  • Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
  • It’s especially important to wash:

○ Before eating or preparing food

○ Before touching your face

○ After using the restroom

○ After leaving a public place

○ After blowing your nose, coughing, or sneezing

○ After handling your cloth face covering

○ After changing a diaper

○ After caring for someone sick

○ After touching animals or pets

  • If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.

○ Avoid touching your eyes, nose and mouth with unwashed hands.

AVOID CLOSE CONTACT WITH OTHERS

  • Inside your home: avoid close contact with people who are sick.

○ If possible, maintain 6 feet between the person who is sick and other household members.

  • Outside your home: keep 6 feet of distance (about 2 arms’ length) between yourself and people who don’t live in your household.

○ Remember that some people without symptoms may be able to spread the virus.

COVER YOUR MOUTH AND NOSE WITH A MASK OR FACE COVER

  • You could spread COVID-19 to others even if you do not feel sick.
  • The mask or cloth face cover is meant to protect other people in case you are infected.
  • Everyone should wear a mask or cloth face cover in public settings and when people who don’t live in their household, especially when other social distancing measures are difficult to maintain.

○ Masks or cloth face coverings should not be placed on children under age two, or anyone who has trouble breathing,is unconscious, incapacitated or otherwise unable to remove the mask without assistance.

  • Continue to keep about 6 feet between yourself and others. The mask or cloth face cover is not a substitute for social distancing.

COVER YOUR COUGHS AND SNEEZES

  • Always cover your mouth and nose with a tissue when you cough or sneeze, or use the inside of your elbow, and do not spit.
  • Throw used tissues in the trash.
  • Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.

CLEAN & DISINFECT

  • Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
  • Avoid sharing difficult to clean items, including electronic devices, personal grooming items, etc.
  • Keep working, learning and living environments and personal items as clean as possible
  • If surfaces are dirty, clean them. Use detergent or soap and water prior to disinfection.
  • Then, use a household disinfectant. Know the most common EPA-registered household disinfectants .

MONITOR YOUR HEALTH DAILY

  • Be alert for symptoms. Watch for fever, cough, shortness of breath, or other symptoms of COVID-19.

○ Especially important if you are running essential errands, going into the office or workplace, and in settings where it may be difficult to keep a physical distance of 6 feet .

  • Take your temperature if symptoms develop.

○ Don’t take your temperature within 30 minutes of exercising or after taking medications that could lower your temperature, like acetaminophen.

○ Please note that lack of fever does not necessarily mean that you do not have COVID-19.

How does washing your hands with soap and water help prevent COVID-19 infection?

On a molecular level, soap molecules disrupt the fatty layer or coat that surrounds the virus, once the external viral coat is broken down, the virus is no longer able to function. The soap molecules need some time to react with the viral coat and break it up. That is why it is recommended to lather soap and water by rubbing your hands thoroughly for a minimum of 20 seconds each time you wash our hands.

According to the CDC, handwashing is one of the best ways to protect yourself and your family from getting sick. Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol.

WARNING: The FDA has recently announced that Methanol is not an acceptable ingredient for hand sanitizers and must not be used due to its toxic effects.

Why are face masks required in public?

According to the CDC, COVID-19 is thought to spread from person to person, mainly through respiratory droplets produced when an infected person coughs, sneezes, or talks. These droplets can land in the mouths or noses * of people who are nearby or possibly be inhaled into the lungs. Spread is more likely when people are in close contact with one another (within about 6 feet). For this reason, face masks and social distancing are the most effective ways to protect yourself and protect others from becoming infected with COVID-19.

*COVID-19 can also be transmitted through respiratory droplets that may infect the mucous membranes of the eyes, glasses can serve as a protective barrier for the eyes.

What is the difference between cloth face masks, surgical face masks, and N95 Face Masks?

Cloth Face Masks

The Centers for Disease Control and Prevention (CDC) has recommended that people wear cloth face coverings in public to help prevent the spread of COVID-19, regardless of whether they have a fever or other COVID-19 symptoms. There is evidence that COVID-19 can be transmitted by people who don’t have symptoms. Wearing cloth masks helps slow the spread of the virus, which is primarily transmitted from person to person through respiratory droplets produced when we talk, cough or sneeze. The CDC recommends wearing cloth face coverings in stores and other places where social distancing is hard to maintain, especially in areas where there is significant community-based transmission.

Surgical Masks

Surgical masks (also called medical masks) are loose-fitting, disposable coverings for the nose and mouth. They are intended to be worn by healthcare workers. They are fluid resistant and protect the wearer against large droplets, splashes and sprays, according to the CDC. They also capture the wearer’s respiratory droplets, helping to protect patients against contamination.

N95 Face Masks:

Per the CDC, N95 Face Masks are not to be worn by the general public as protection from COVID-19. N95 face masks are intended to be tight-fitting. Normally, wearers must pass a “Fit Test” to confirm a proper seal before using one. Due to concerns about a shortage of fit-testing kits and test solutions, OSHA is encouraging employers to prioritize fit-testing for those who must use N95 face masks in high-hazard procedures such when performing COVID-19 Testing on patients, intubating or extubating patients, and treating patients in negative pressure isolation rooms.

Face Mask Questions and Care

How to properly put on your face mask:

  • Wash your hands before putting on your face mask.
  • Secure the mask over your nose and mouth and secure it under your chin.
  • Ensure that your mask fits securely against the sides of your face.
  • Make sure you can breathe easily.
  • Don’t touch the front surface of your face mask, and, if you do, wash your hands or use hand sanitizer to disinfect .
  • Don’t wear a face mask under your nose, above the chin, around your neck, up on your forehead, hanging off one ear, or on your arm/elbow.

 

How NOT To Wear Your Mask

  • Do not wear your mask under your nose.
  • Do not pull your mask under your chin, even to drink.
  • Don’t put the face covering around your neck or up on your

forehead

  • Do not wear your mask on your arm/elbow.
  • Do not hang your mask from one ear.

 

How to properly take off your face mask:

  • Handle only by the ear loops or ties.
  • Carefully remove the face mask by using your fingers to stretch the ear loops away from the face.
  • Fold outside corners together & discard in trash.
  • For cloth face masks, immediately place in washing machine.
  • Be careful not to touch your eyes, nose, and mouth when removing and wash hands immediately after removing.

 

How to Wash a Cloth Face Mask:

According to the CDC, masks should be washed after each use. It is important to always remove masks correctly and wash your hands after handling or touching a used mask.

 

Washing machine

  • You can include your mask with your regular laundry.
  • Use regular laundry detergent and the warmest appropriate water setting for the cloth used to make the mask.

Dryer

  • Use the highest heat setting and leave in the dryer until completely dry.

Washing by hand

  • Wear gloves and prepare a bleach solution by mixing:

○ 5 tablespoons (1/3rd cup) household bleach per gallon of room temperature water; or

○ 4 teaspoons household bleach per quart of room temperature water.

  • Check the label to see if your bleach is intended for disinfection. Some bleach products, such as those designed for safe use on colored clothing, may not be suitable for disinfection. Ensure the bleach product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser.
  • Soak the mask in the bleach solution for 5 minutes.
  • Rinse thoroughly with cool or room temperature water.

Air dry

  • Lay flat and allow to completely dry. If possible, place the

mask in direct sunlight.

 

Who is at higher risk for serious illness from COVID-19?

Based on currently available information and clinical expertise, older adults and people with underlying medical conditions are at higher risk for severe illness from COVID-19.

People of any age with the following conditions are at increased risk of severe illness from COVID-19:

  • Cancer
  • Chronic kidney disease
  • COPD (chronic obstructive pulmonary disease)
  • Immunocompromised state (weakened immune system) from solid organ transplant
  • Obesity (body mass index [BMI] of 30 or higher)
  • Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
  • Sickle cell disease
  • Type 2 diabetes mellitus

 COVID-19 is a new disease. Currently there are limited data and information about the impact of underlying medical conditions and whether they increase the risk for severe illness from COVID-19. Based on what we know at this time, people with the following conditions might be at an increased risk for severe illness from COVID-19:

  • Asthma (moderate-to-severe)
  • Cerebrovascular disease (affects blood vessels and blood supply to the brain)
  • Cystic fibrosis
  • Hypertension or high blood pressure
  • Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
  • Neurologic conditions, such as dementia
  • Liver disease
  • Pregnancy
  • Pulmonary fibrosis (having damaged or scarred lung tissues)
  • Smoking
  • Thalassemia (a type of blood disorder)
  • Type 1 diabetes mellitus
What should people at higher risk of serious illness with COVID-19 do?

In addition to social distancing, practicing hand hygiene, and wearing a mask, those that are at risk for severe illness from COVID-19 should:

  • Continue your medicines and do not change your treatment plan without talking to your healthcare provider.
  • Have at least a 30-day supply of prescription and non-prescription medicines.
  • Do not delay getting emergency care for your underlying medical condition because of COVID-19. Emergency departments have contingency infection prevention plans to protect you from getting COVID-19 if you need care.
What are the different types of COVID tests?

TYPES OF COVID-19 TESTS:

Diagnostic tests for current infection: If you want to know if you are currently infected with the COVID-19 virus, there are two types of tests: molecular tests and antigen testing.

MOLECULAR TEST (also called PCR tests, viral RNA tests, nucleic acid tests)

How is it done? Nasal swabs or throat swabs

Where can you get this test? At a hospital, in a medical office, drive-by testing stations (will be available at the CMC campus)

What does the test look for? Molecular tests look for genetic material that comes only from the virus.

How long does it take to get results? It depends on lab capacity. Results may be ready the same day, but usually take at least a day or two. Throughout the pandemic, especially lately, delayed turnaround times of up to a week or two have been reported in many places.

What about accuracy? False negatives — that is, a test that says you don’t have the virus when you actually do have the virus — may occur. The reported rate of false negatives is as low as 2% and as high as 37% .

A molecular test using a deep nasal swab is usually the best option, because it will have fewer false negative results than other diagnostic tests or samples from throat swabs or saliva.

ANTIGEN TEST

How is it done? A nasal or throat swab.

Where can you get these tests? At a hospital or doctor’s office.

What does the test look for? This test identifies protein fragments (antigens) from the virus.

How long does it take to get results? The technology involved is similar to a pregnancy test or a rapid strep test, with results available in minutes.

What about accuracy? The reported rate of false negative results is as high as 50% , which is why antigen tests are not favored by the FDA as a single test for active infection.

Tests for past infection

ANTIBODY TEST (also called serologic testing)

How is it done? A sample of blood is taken.

Where can you get these tests? At a doctor’s office, blood testing lab, or hospital.

What does the test look for? These blood tests identify antibodies that the body’s immune system has produced in response to the infection. While a serologic test cannot tell you if you have an infection now, it can accurately identify past infection.

How long does it take to get results? Results are usually available within a few days.

What about accuracy? Having an antibody test too early can lead to false negative results. That’s because it takes a week or two after infection for your immune system to produce antibodies. The reported rate of false negatives is 20%. However, the range of false negatives is from 0% to 30% depending on the study and when in the course of infection the test is performed.

Research suggests antibody levels may wane over just a few months. And while a positive antibody test proves you’ve been exposed to the virus, it’s not yet known whether such results indicate a lack of contagiousness or long-lasting, protective immunity.

If it is clinically indicated that I need to be tested for COVID-19, which type of test will Hamilton Health Box be providing to the CMC community?

Hamilton Health Box will be providing diagnostic testing for the CMC community through the means of a Molecular PCR Test. This test will be collected using the naso-phyrengeal swab method. A molecular test using a deep nasal swab is usually the best option, because it will have fewer false negative results than other diagnostic tests or samples from throat swabs or saliva.

Are there any limitations to COVID-19 diagnostic tests?

With any diagnostic test, there is the potential for false negatives or false positives. For existing COVID-19 tests in the U.S., there have been reports of false negative tests. False negative tests can occur if a specimen was not properly obtained or if a patient was tested too early or too late in their infection. Laboratory error is also a possible cause of false negative test results. Conversely, false positive reports are less common.

Can someone test negative and later test positive for COVID-19?

Yes, it is possible. You may test negative if the sample was collected too early in your infection. You could also be exposed to COVID-19 after the test and get infected then. Even if you test negative, you still should take steps to protect yourself and others . See Testing for Current Infection for more information.

 

What is Contact Tracing?

Contact tracing will be conducted by Hamilton Health Box to help prevent the spread of the virus amongst the CMC community. In general, contact tracing involves identifying people who have an infectious disease (cases) and their contacts (people who may have been exposed due to close contact) and working with the contacts to interrupt disease transmission. For COVID-19, this includes asking people to either isolate or quarantine.

Contact tracing for COVID-19 typically involves:

  • Interviewing people with COVID-19 to identify everyone with whom they had close contact during the time they may have been infectious,
  • Notifying contacts of their potential exposure,
  • Referring contacts for testing,
  • Monitoring contacts for signs and symptoms of COVID-19, and
  • Connecting contacts with services they might need during the self-quarantine period.

To prevent the further spread of disease, COVID-19 contacts are encouraged to stay home and maintain social distance (at least 6 feet) from others until 14 days after their last exposure to a person with COVID-19. Contacts should monitor themselves by checking their temperature twice daily and watching for symptoms of COVID-19 .

What happens during contact tracing?

Generally, contact tracing includes the following steps:

  • Case investigation: A medical professional works with the patient to help them recall everyone with whom they have had close contact during the time when they may have been infectious.
  • Contact tracing: The medical professional will begin contact tracing by notifying exposed individuals (contacts) of their potential exposure as rapidly and sensitively as possible, not revealing the infected patient’s identity.
  • Contact support: Contacts are provided with education, information, and support to help them understand their risk, what they should do to separate themselves from others who are not exposed, and how to monitor themselves for illness. In addition, they are informed of the possibility that they could spread the infection to others even if they do not feel ill.
  • Self-quarantine: Contacts are encouraged to stay home, monitor their health, and maintain social distance (at least 6 feet) from others until 14 days after their last exposure to the infected patient, in case they also become ill.
What can a person diagnosed with COVID-19 expect to happen during a contact tracing investigation?

If you are diagnosed with COVID-19, a case investigator from Hamilton Health Box and/or the LA County Health Department may call you to check-in on your health, discuss who you’ve been in contact with, and ask where you spent time while you may have been infectious and able to spread COVID-19 to others. You will also be required to self-isolate , if you are not doing so already.

  • Your name will not be revealed to those you may have exposed, even if they ask.
  • Self-isolation means staying at home in a specific room away from other people and pets, and using a separate bathroom, if possible.
  • Self-isolation helps slow the spread of COVID-19 and can help keep your family, friends, neighbors, and others you may come in contact with healthy.
What will happen with my personal information during contact tracing?

Discussions with health department staff are confidential. This means that your personal and medical information will be kept private and only shared with those who may need to know. Your name will not be revealed to those you came in contact with. The health department will only notify your close contacts that they might have been exposed to COVID-19.

What can close contacts expect to happen during COVID-19 contact tracing?

If you have been in close contact with someone who has COVID-19, a contact tracer from the health department might contact you to inform you that you’ve been exposed to COVID-19. You should stay at home and self-quarantine for 14 days, starting from the last day you were possibly exposed to COVID-19. The contact tracer will help identify the dates of your self-quarantine.

  • Self-quarantine means staying home, monitoring your health, and maintaining social distancing (at least 6 feet) from others at all times.
  • If you need to be around other people or animals in or outside of the home, wear a cloth face covering. This will help protect the people around you.
  • If you need support or assistance with self-quarantine, the College may be able to provide assistance.

You should take your temperature twice a day, watch for symptoms of COVID-19, and notify your health department if you develop symptoms. You should also notify people you had close contact with recently if you become ill, so they can monitor their health. If your symptoms worsen or become severe, you should

seek medical care. Severe symptoms include trouble breathing, persistent pain or pressure in the chest, confusion, inability to wake or stay awake, or bluish lips or face.

Should I get a flu vaccine this fall? Why is it important for influenza (flu) vaccines to be given during the COVID-19 pandemic?

Per the CDC, annual flu vaccination for 2020-2021 is highly recommended for everyone 6 months of age and older, with rare exceptions, because it is an effective way to decrease flu illnesses, hospitalizations, and deaths.

Efforts to reduce the spread of COVID-19, such as stay-at-home and shelter-in-place orders, have led to decreased use of routine preventive medical services, including immunization services.

Ensuring that people continue or start getting routine vaccinations during the COVID-19 pandemic is essential for protecting people and communities from vaccine-preventable diseases and outbreaks, including flu. Routine vaccination prevents illnesses that lead to unnecessary medical visits and hospitalizations, which further strain the healthcare system.

For the upcoming flu season, flu vaccination will be very important to reduce flu because it can help reduce the overall impact of respiratory illnesses on the population and thus lessen the resulting burden on the healthcare system during the COVID-19 pandemic.

A flu vaccine may also provide several individual health benefits, including keeping you from getting sick with flu, reducing the severity of your illness if you do get flu and reducing your risk of a flu-associated hospitalization.

How does domestic or international travel influence your chances of contracting COVID-19?

According to the CDC, Department of State, and the State of California there is ongoing transmission of novel coronavirus within the United States and in destinations throughout the world.

After You Travel:

You may have been exposed to COVID-19 on your travels. You may feel well and not have any symptoms, but you can be contagious without symptoms and spread the virus to others. You and your travel companions (including children ) pose a risk to your family, friends, and community for 14 days after you were exposed to the virus. Regardless of where you traveled or what you did during your trip, take these actions to protect others from getting sick after you return:

  • When around others, stay at least 6 feet (about 2 arms’ length) from other people who are not from your household. It is important to do this everywhere, both indoors and outdoors.
  • Wear a mask to keep your nose and mouth covered when you are outside of your home.
  • Wash your hands often or use hand sanitizer (with at least 60% alcohol).
  • Watch your health: Look for symptoms of COVID-19, and take your temperature if you feel sick.

If at any time you develop signs or symptoms of COVID-19 during or after your trip, please quarantine yourself and seek medical attention as soon as possible.

U.S. Citizens Returning from China

Any U.S. citizen returning to the United States who has been in China in the previous 14 days may be subject to up to 14 days of quarantine.

 

 

Hamilton Health Box

Qualtrics

Health Screening

Household Testing

Downloadable Forms

Additional Resources

Please see the following for COVID-19 updates for  Los Angeles and the state of California, in addition to federal resources listed below.

COVID 19: Keeping Los Angeles Safe