Standard Precautions should be followed when caring for any patient, regardless of suspected or confirmed COVID-19. If the patient is afebrile (temperature is less than 100.0oF) and otherwise without even mild symptoms* that might be consistent with COVID-19 (e.g., cough, sore throat, shortness of breath), then precautions specific to COVID-19 are not required. However, until the patient is determined to be without such symptoms, HCP should wear all recommended PPE for the patient encounter. If the primary evaluation confirms the patient is without symptoms, management and need for any Transmission-Based Precautions should be based with the condition for which they are being evaluated (e.g., patient colonized with a drug-resistant organism), rather than potential exposure to COVID-19.
This public health response is an important opportunity to reinforce the importance of strict adherence to Standard Precautions during all patient encounters. Standard Precautions are based on the principles that all blood, body fluids, secretions, excretions except sweat, nonintact skin, and mucous membranes may contain transmissible infectious agents. The application of Standard Precautions is determined by the nature of the HCP-patient interaction and the extent of anticipated blood, body fluids, and pathogen exposure. For example, a facemask and eye protection should be worn during the care of any patient if splashes, sprays, or coughs could occur during the patient encounter. Similarly, gloves should be worn if contact with body fluids, mucous membranes, or nonintact skin are anticipated.
*Note: In addition to cough and shortness of breath, nonspecific symptoms such as sore throat, myalgia, fatigue, nausea, and diarrhea have been noted as initial symptoms in some cases of COVID-19. These symptoms can have several alternative explanations; however, failure to identify and implement proper precautions in a healthcare setting for persons infected with COVID-19 can contribute to widespread transmission in that facility due to the presence of susceptible patients and close interactions with healthcare personnel. For this reason, a lower temperature of 100.0oF and the inclusion of mild and non-specific symptoms should be used by healthcare settings evaluating these patients to increase the ability to detect even mild cases of COVID-19.