Updated COVID-19 Screen Tool
By Nufactor - December 28, 2022

Nufactor^® revised its COVID-19 screen tool based on the most recent CDC recommendations. If you do not have a COVID-19 screen tool, please feel free to use ours. Please share this information with nurses within your organization. If you have any questions, please contact us.

Highlights of changes:

• If exposed to someone with COVID-19, the person should isolate at home for 5 days, follow masking recommendations for 10 days, test (even if no symptoms) at least 5 full days after exposure, and, if positive, immediately isolate. If the person had COVID-19, there are different testing recommendations (see COVID-19 Testing: What You Need to Know | CDC). Consideration of vaccination status and brand have been removed.
• If a person tests positive for COVID-19, actions are based on COVID-19 symptom severity and whether or not the person is moderately-to-severely immunocompromised.
• COVID-19 symptom severity classification:
• Mild: Includes fever, cough, sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhea, loss of taste and smell but who do not have shortness of breath, dyspnea, or abnormal chest imaging.
• Moderate: Shows evidence of lower respiratory disease during clinical assessment or imaging and who have an oxygen saturation (SpO2) ≥94% on room air at sea level.
• Severe: Would not likely be encountered in the home setting. Shows SpO2 <94% on room air at sea level, a ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2) <300 mm Hg, a respiratory rate >30 breaths/min, or lung infiltrates >50%.
• Moderate and severe immunocompromising conditions and treatments include many seen in patients who receive immune globulin and monoclonal antibody therapies provided by Nufactor^®. The degree of immunocompromise for the patient is determined by the treating provider, and preventive actions should be tailored to each patient and situation. Conditions and treatments include, but are not limited to the following.
• Active treatment for solid tumor and hematologic malignancies
• Receipt of solid-organ transplant and taking immunosuppressive therapy
• Receipt of chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic cell transplant (HCT) (within 2 years of transplantation or taking immunosuppressive therapy)
• Moderate or severe primary immunodeficiency (e.g., CVID, Selective Antibody Deficiency, Subclass Deficiency, SCID)
• Advanced HIV infection (people with HIV and CD4 cell counts less than 200/mm3, history of an AIDS-defining illness without immune reconstitution, or clinical manifestations of symptomatic HIV) or untreated HIV infection
• Active treatment with high-dose corticosteroids (i.e., 20 mg or more of prednisone or equivalent per day when administered for 2 or more weeks), alkylating agents, antimetabolites (e.g., methotrexate, immunosuppressive drugs used for transplants/other reason (e.g., azathioprine/Imuran^®, cyclosporine, mycophenolate/CellCept^®, tacrolimus), cancer chemotherapeutic agents classified as severely immunosuppressive, tumor necrosis factor (TNF) blockers (e.g., infliximab/Inflectra^®/Remicade^®/Renflexis^®, Enbrel^®, Humira^®, Cimzia^®, and Simponi^®), and other biologic agents that are immunosuppressive or immunomodulatory
• If COVID-19 positive and not moderately-to-severely immunocompromised, recommendations are based on symptom severity. There are various isolation/masking period recommendations. Ending isolation/masking is based on symptoms and additional serial testing.
• If COVID-19 positive and moderately-to-severely immunocompromised isolation and masking are recommended for 20 days. Ending isolation/masking is based on symptoms and additional serial testing.

Nufactor^® also wanted to remind you of guidelines, important for patients, household members and nurses to follow to protect everyone.

Reminders to help prevent infection during nursing visits

The day before a visit, screen the patient for COVID-19.

The day before a visit, screen household members for COVID-19.

The day of visit, self-screen for COVID-19.

The day of a visit, before entering the home, asks if there have been changes since screening the day before.

When possible, only the patient and nurse should be in the area/room.

When possible, during a visit, maintain a distance of 6 feet (e.g., after starting an infusion, monitoring vital signs, etc.) but always stay in visual contact with the patient.

Regardless of vaccination status, the nurse and patient should wear a mask while the nurse is in the home. If household members are present, they also should wear a mask. The nurse is provided with an N-95 mask. The patient is provided with a surgical mask. If present, household members should wear CDC-recommended masks, which do NOT include bandanas, gaiters or buffs.

For patients with known or possible COVID-19 infection, contact Nufactor^® for guidance.

References

1. Symptoms of COVID-19 | CDC dated 10/26/22
2. What to Do If You Were Exposed to COVID-19 | CDC dated 08/24/22
3. Isolation and Precautions for People with COVID-19 | CDC dated 08/11/22
4. Ending Isolation and Precautions for People with COVID-19: Interim Guidance (cdc.gov) 08/31/22
5. COVID-19 Testing: What You Need to Know | CDC dated 09/28/22
6. Clinical Guidance for COVID-19 Vaccination | CDC dated 10/19/22