3/24/2020 - Health Guidance for Faculty and Supervisors Regarding Ill Supervisees

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To: The Caltech Community
From: John Tsai, Medical Director of Health Services; Jennifer Howes, Executive Director of Student Wellness Services

The spread of the novel coronavirus that causes COVID-19 is of significant concern to individuals within the Caltech community, and faculty members and supervisors are often approached with questions about how best to proceed if someone reports an illness, particularly one that shares symptoms with COVID-19.

The State of California, Los Angeles County, and City of Pasadena "Safer at Home" orders direct everyone to remain at home unless they are engaged in essential activities. Caltech's president and provost have issued several communications outlining expectations around telecommuting and the management of personnel and affiliates on campus. The only individuals who are authorized to be on campus are students living on campus and those who are involved in supporting critical functions (including online instruction) and/or the maintenance and management of laboratories and facilities with unique agents and equipment. When reporting to campus, it is the expectation that appropriate social distancing measures are in place at all times.

Guidance from Human Resources regarding timekeeping and administrative concerns may be found here, and HR staff remain available to consult about specific circumstances.

Of special note: If a member of the Caltech community directly shares personal health information (PHI) with you (specifically a doctor's note, disclosure of test results, direct communications between doctor and patient, etc.) DO NOT forward or disclose this information. Please immediately call the Disability and Leave unit at 626-395-3092 within Caltech Human Resources (for PHI involving non-student individuals) or Student Wellness Services at 626-395-6393 (for PHI involving students) for assistance in how to handle these records in a way that is consistent with privacy guidelines.

Many faculty members and supervisors have additional questions about the availability of COVID-19 testing and guidance around quarantine, isolation, deep cleaning of laboratory spaces, and notification of laboratory or building occupants if a coworker, laboratory group member, or supervisee has reported illness. While the information below can help clarify these questions, further inquiries about the management of a particular situation should be addressed via an email message to Jennifer Howes (Executive Director of Student Wellness Services) and John Tsai (Medical Director of Student Wellness Services and liaison to the Pasadena Public Health Department) that includes the following:

A description of the situation
Names, positions, and contact information for all involved parties
Any specific questions or concerns

Inquiries will receive a response within 24 hours. Drs. Tsai and Howes will work with the Pasadena Public Health Department and the individuals directly impacted by each situation.

In case of illness

If a Caltech student, faculty or staff member, postdoctoral fellow, or affiliate becomes ill with respiratory symptoms, they should immediately return home, or, if already there, stay home and practice self-care and monitoring of symptoms. The Los Angeles County Department of Public Health (LACDPH) has issued guidance for self-care measures, which should be used for individuals with mild illness.
Caltech students who are ill or become ill with a respiratory illness should immediately notify their supervisor, as well as Student Wellness Services at 626-395-6393. Student Wellness Services will monitor the student and communicate with relevant parties, including the student's faculty member or supervisor, with public health related concerns, as appropriate.
Caltech personnel who are ill or become ill with a respiratory illness should immediately notify their supervisor, who should in turn communicate with the Disability and Leave unit for further guidance. As a reminder please do not ask for any specific information about the individual's health or medical condition.
If symptoms worsen (difficulty breathing, dehydration, can't keep fluids down, confusion, or other serious symptoms), non-student individuals should contact their primary care provider or urgent care by phone to determine next steps.
If symptoms are severe or life-threatening, call 911 or go to a hospital emergency room. For on-campus emergencies, call Campus Security at 626-395-5000; they will direct emergency medical personnel to the specific location.
Individuals recovering from illness should consult with their supervisor and, if a non-student, Human Resources regarding a plan to return to work

Communications and coordination around reported illnesses

The division chairs, faculty, laboratory managers, and other supervisory staff are important partners in the management of health and safety issues within laboratories and the entire instructional and research enterprise.
Faculty members, laboratory managers, and other supervisory staff should notify division chairs and the Disability and Leave unit (for non-students) or Student Wellness Services, if they have a student, faculty or staff member, postdoctoral fellow, or affiliate who reports a respiratory illness.
Once notified, the Disability and Leave unit will contact Drs. Tsai and Howes to enable coordination of the campus response with the public health department.
Once the facts of each situation are understood and a plan has been formulated for next steps (e.g., cleaning/disinfecting, notification of relevant close contacts, and other public health measures), Dr. Tsai and/or Dr. Howes will communicate directly with the relevant division chair, faculty member, and/or laboratory manager to discuss the recommended actions. This will enable all parties to ask questions, understand the rationale, and explore any further action items needed to resolve each incident.
In particular, the division chair, faculty member, and/or laboratory manager may have specific recommendations, precautions, or considerations for the cleaning and disinfecting of sensitive laboratory spaces; these discussions will involve the relevant partners within the Facilities and Environmental Health and Safety units.
In general, individuals should remain home until a minimum of 7 days after the onset of symptoms and should be fever-free for 72 hours without medication, as well as see improvements in other symptoms prior to returning to work.

Testing for COVID-19

Testing for COVID-19 is becoming more widely available; however, access varies quite considerably within the greater Los Angeles and Pasadena areas.
Caltech Student Wellness Services contracts with LabCorp for COVID-19 testing. Specimen collection occurs at a testing site on campus; specimens are then sent to a LabCorp processing facility. No specimen processing or test protocols are conducted by Caltech.
Specimen collection is currently available for Caltech students who meet clinical criteria for testing.
In the event of a positive test for COVID-19 in a student, appropriate measures will be taken to notify close contacts as well as faculty or supervisors for further assistance with contact tracing and liaison work with the Pasadena Public Health Department.
Unless there is a suspected illness in a non-student community member (faculty and staff members, postdoctoral fellows, and affiliates) that would have significant public health implications for the campus, non-students are directed to their primary care provider for testing. Such community members might include a Caltech health care provider who is ill, or an ill staff member who had some potential contact with others on campus while supporting the critical services that remain operational.
Any positive test for COVID-19 in a non-student community member should be reported to the Disability and Leave unit, which will coordinate with Dr. Tsai for further assistance with contact tracing and liaison work with the Pasadena Public Health Department.
The LACDPH strongly advises against testing asymptomatic individuals, as well as those who report mild respiratory illnesses that can be managed at home. These measures are in place to preserve critical personal protective equipment (PPE) supplies as well as reduce potential exposure to healthcare workers during specimen collection. LACDPH recommends that providers test only persons with symptoms compatible with COVID-19 where a diagnostic result will change clinical management or inform public health response.

Instructions for those on campus/providing essential services who have been in close contact with an ill person within the last 14 days

If a Caltech student, faculty or staff member, postdoctoral fellow, or affiliate comes in close contact with a person ill with respiratory symptoms (within 6 feet for 10 or more minutes, or prolonged contact of common spaces even if staying 6 feet apart), they should self-quarantine at home for 14 days from the time of exposure to monitor for symptoms.
The individual in self-quarantine should immediately notify their supervisor, who in turn will communicate with Student Wellness Services or the Disability and Leave unit.

Notifications to laboratory groups, building occupants, etc.

While public health emergencies do allow for disclosure of some personally identifiable health information for the purposes of contact tracing and disease mitigation, the scope and process for doing so is the responsibility of the involved medical personnel and public health officials. Please do not share personal health information of Caltech students, personnel, or affiliates, beyond the processes and protocols outlined herein.
Depending on the circumstances, it may be necessary to notify other individuals who may have had close contact with an ill person or someone who has been exposed to respiratory illness; however, please do not send broadly distributed messages to the occupants of a laboratory or building every time there is a report of any illness. This approach could cause unnecessary alarm (particularly when the vast majority of individuals should be working remotely and not in contact with individuals on campus) or result in a large number of notifications that individuals may disregard over time.
Please consult with Drs. Tsai and Howes before sending any messages regarding respiratory illness or COVID-19.

Cleaning and disinfection of laboratory or common space

Any positive test for COVID-19 should be reported to Student Wellness Services or the Disability and Leave unit, which will coordinate with Dr. Tsai, Facilities, and Environmental Health and Safety to initiate a protocol for cleaning and disinfecting affected physical spaces in consultation with the cognizant division chair or supervisor.
Until cleaning and disinfection is complete, the space should be closed and secured, and access prohibited.
Caltech faculty and staff members, students, postdoctoral fellows, or affiliates who used or accessed the affected space(s) will be notified of any relevant facts regarding the public health implications and asked to quarantine at home for 14 days from the date of exposure, and self-monitor for symptoms.
Although Facilities is currently working with reduced staff in compliance with the "Safer at Home" orders, additional cleaning or disinfecting may still be available for physical spaces even in the absence of a positive COVID-19 test result. An assessment will be made by the relevant professionals in concert with the faculty, laboratory manager, and division chair to determine cleaning prioritization for impacted spaces.