During this time of rapidly changing and readily available information surrounding the Coronavirus (COVID-19) pandemic, it is important to remember a basic tenet of healthcare: infection prevention is critical. Understanding risk levels for Coronavirus (COVID-19) contributes valuable information we can use to help guide our practice and protect the public. For elderly and frail patients with increased risk of dying mortality, this means providing quality home-based care in a safe environment so they can avoid community-based exposure. As healthcare professionals, we must also understand how to limit exposure risk to ourselves and our families as we provide care to our patients.
Who Is at Increased Risk for Serious Illness?
The U.S. Centers for Disease Control and Prevention (CDC) has recognized some groups that are at an increased risk for serious illness. These include the elderly, and those with underlying medical conditions. According to the CDC, eight out of ten deaths in the U.S. were in patients over 65 years old. In cases of illness coupled with underlying medical conditions, such as asthma, diabetes, and heart disease, the severity of the disease can increase, and these patients have poorer prognoses. The CDC offers instructions on how to care for patients with increased risk.
Who Is at Increased Risk to Contract and Transmit the Disease to Others
The CDC has also recognized risk levels for individuals in the community who have potentially been exposed to the virus and are more likely to contract the disease or transmit the disease to others. It is important to note that these risk levels are a basic guide, and assume you are in an area that is not affected by sustained community transmission (or you have not recently returned from travel to an area of sustained community transmission.) You should always default to more recent information and recommendations provided by your local community health officials.
High risk: Living in the same household as, being an intimate partner of, or providing care in a nonhealthcare setting (such as a home) for a person with symptomatic laboratory-confirmed COVID-19 infection without using recommended precautions for home care and home isolation.
Currently, the CDC recommends quarantine, no public activities, and active daily monitoring, if possible, for these individuals while asymptomatic.
If a member of this group becomes symptomatic, the recommendations include self-isolation and medical evaluation, with diagnostic testing if warranted. Any transport to a healthcare facility, if necessary, should be coordinated with that facility.
Medium risk: Close contact with a person with symptomatic laboratory-confirmed COVID-19 while consistently using recommended precaution for home care and home isolation. Close contact is defined as being within approximately six feet of a COVID-19 case for a prolonged time period. Close contact can occur while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case or having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on).
Currently, the CDC recommends that asymptomatic people at medium risk remain at home or in a comparable setting, practice social distancing and participate in active monitoring as determined by local authorities. These people should postpone long-distance travel
If a member of this risk group becomes symptomatic, they should also follow the same recommendations above for a high-risk symptomatic individual, including self-isolation and medical evaluation with pre-notification and controlled travel.
Low risk: Being in the same indoor environment (e.g., a classroom, a hospital waiting room) as a person with symptomatic laboratory-confirmed COVID-19 for a prolonged time period but not meeting the definition of close contact.
While asymptomatic, a person in this category should perform self-observation to evaluate for symptoms of the illness, including fever, cough, and shortness of breath.
If an individual in this risk category becomes symptomatic, the CDC recommends self-isolation. The person should seek health advice to determine if a medical evaluation is needed, and diagnostic testing for COVID-19 is indicated per CDC guidelines. Travel should be postponed until the individual is no longer symptomatic.
The CDC has many other recommendations and precautions for household members, intimate partners, and caregivers of COVID-19 cases in settings like the home. Understanding the risk levels will help to slow the spread of the virus and deliver better patient care. Axxess is your partner in care in the home education and technology solutions. Find additional COVID-19 information on our resources page and our Help Center.
