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KHN Algorithm for Removing Suspect or Confirmed COVID-19 Patients from Isolation Precautions

For Confirmed COVID-19 Positive Patients: 

Option 1:  Continue Droplet Precautions or Airborne (for patients undergoing aerosol-generating procedures) and contact precautions until discharge. If the Designated Unit is full, then follow option 2. 

Option 2: Patients can have Droplet and contact precautions discontinued and can be transferred off a Designated Unit if they meet the following CDC Criteria: 

  • Resolution of fever without the use of fever-reducing medications and 
  • Improvement in respiratory symptoms (e.g., cough, shortness of breath), and 
  • Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 RNA from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of two negative specimens) 

For Suspected COVID-19 Patients 

Patients with one negative SARS-CoV-2 PCR and a definitive alternate diagnosis can be transferred off the Designated Unit and removed from Droplet and contact precautions. 

Patients with one negative SARS-CoV-2 PCR and a compatible clinical course for COVID-19 per the physician should be re-tested. If two SARS-CoV-2 PCRs are negative at least 24 hours apart and the patient is afebrile for 24 hours, then they can be transferred off the Designated Unit and removed from Droplet and contact precautions. 

April 2, 2020