{"id":10399,"date":"2025-03-01T14:07:55","date_gmt":"2025-03-01T19:07:55","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan425\/"},"modified":"2025-03-02T00:55:04","modified_gmt":"2025-03-02T05:55:04","slug":"dhan425","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan425\/","title":{"rendered":"php\/alerts\/dhan425 ~  Division of Public Health  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n\n\n  <br>\n\n\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n\n    <!-- BEGIN readspeaker div -->\n\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan425.html\" title=\"Listen to this page using ReadSpeaker\">\n\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n\n      <\/a>\n\n\n    <\/div>\n\n\n    <!-- END readspeaker div -->\n\n\n\n\n\n    \n\n\n    <header class=\"pull-left\">\n\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->425 <!--[END]--> <\/h1>\n\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->March 20, 2020 6:53 pm <!--[END]--> <\/h2>\n\n\n    <\/header>\n\n\n  <\/div><br>\n\n\n \n\n\n  <div class=\"container\">\n\n\n    <div class=\"row\">\n\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n\n          <div class=\"panel sectionmenu_panel\">\n\n\n            <div class=\"panel-heading\">\n\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n\n            <\/div>\n\n\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; 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Wellness<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\n      <\/li><\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &#038; Reports<\/a><\/li>\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &#038; 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When selecting the most appropriate protective clothing, employers \n\n\n\n\n\nshould consider all of the available information on recommended protective clothing, including the potential limitations. \n\n\n\n\n\nNonsterile, disposable patient isolation gowns, which are used for routine patient care in healthcare settings, are \n\n\n\n\n\nappropriate for use by HCP when caring for patients with suspected or confirmed COVID-19. In times of gown shortages, \n\n\n\n\n\nsurgical gowns should be prioritized for surgical and other sterile procedures. Current U.S. guidelines do not require \n\n\n\n\n\nuse of gowns that <a href=\"https:\/\/www.cdc.gov\/niosh\/npptl\/topics\/protectiveclothing\/\">conform to any standards<\/a>.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h3>Contingency Capacity Strategies<\/h3>\n\n\n\n\n\n\n\n\n\n\n\n<h4>Selectively cancel elective and non-urgent procedures and appointments for which a gown is typically used by HCP.<\/h4>\n\n\n\n\n\n\n\n\n\n\n\n<p>Shift gown use towards cloth isolation gowns.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>Reusable (i.e., washable) gowns are typically made of polyester or polyester- cotton fabrics. Gowns made of these fabrics \n\n\n\n\n\ncan be safely laundered according to <a href=\"https:\/\/www.cdc.gov\/infectioncontrol\/guidelines\/environmental\/background\/laundry.html#g6\">routine procedures<\/a> and reused. Care should be taken to ensure that HCP do not touch outer surfaces of the gown during care.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Laundry operations and personnel may need to be augmented to facilitate additional washing loads and cycles<\/li>\n\n\n\n\n\n<li>Systems are established to routinely inspect, maintain (e.g., mend a small hole in a gown, replace missing fastening ties), and replace reusable gowns when needed (e.g., when they are thin or ripped)<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<h4>Consider the use of coveralls.<\/h4>\n\n\n\n\n\n\n\n\n\n\n\n<p><a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/respirator-use-faq.html\">Coveralls<\/a> typically provide 360-degree protection because they are designed to cover the whole body, including the back and lower legs, and sometimes the head and feet as well. While the material and seam barrier properties are essential for defining the protective level, the coverage provided by the material used in the garment design, as well as certain features including closures, will greatly affect the protective level. HCP unfamiliar with the use of coveralls must be trained and practiced in their use, prior to using during patient care.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>In the United States, the <a href=\"Nhttps:\/\/www.nfpa.org\/codes-and-standards\/all-codes-and-standards\/list-of-codes-and-standards\/detail?code=1999\">FPA 1999 standard<\/a> specifies the minimum design, performance, testing, documentation, and certification requirements for new single-use and new multiple-use emergency medical operations protective clothing, including coveralls for HCP.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h4>Use of expired gowns beyond the manufacturer-designated shelf life for training.<\/h4>\n\n\n\n\n\n \n\n\n\n\n\n<p>The majority of isolation gowns do not have a manufacturer-designated shelf life. However, consideration can be made to using gowns that do and are past their manufacturer-designated shelf life. If there is no date available on the gown label or packaging, facilities should contact the manufacturer.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h4>Use gowns or coveralls conforming to international standards.<\/h4>\n\n\n\n\n\n\n\n\n\n\n\n<p>Current guidelines do not require use of gowns that conform to any standards. In times of shortages, healthcare facilities can consider using <a href=\"https:\/\/www.cdc.gov\/niosh\/npptl\/topics\/protectiveclothing\/\">international gowns and coveralls<\/a>. Gowns and coveralls that conform to international standards, including with EN 13795 and EN14126, could be reserved for activities that may involve moderate to high amounts of body fluids.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h3>Crisis Capacity Strategies<\/h3>\n\n\n\n\n\n\n\n\n\n\n\n<h4>Cancel all elective and non-urgent procedures and appointments for which a gown is typically used by HCP.<\/h4>\n\n\n\n\n\n\n\n\n\n\n\n<p>Extended use of isolation gowns.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>Consideration can be made to extend the use of isolation gowns (disposable or cloth) such that the same gown is worn by the same HCP when interacting with more than one patient known to be infected with the same infectious disease when these patients housed in the same location (i.e., COVID-19 patients residing in an isolation cohort). This can be considered only if there are no additional co-infectious diagnoses transmitted by contact (such as Clostridioides difficile) among patients. If the gown becomes visibly soiled, it must be removed and discarded as per <a href=\"https:\/\/www.cdc.gov\/niosh\/npptl\/pdfs\/PPE-Sequence-508.pdf\">usual practices<\/a>.\n\n\n\n\n\n\n\n\n\n\n\n<\/p><h4>Re-use of cloth isolation gowns.<\/h4><p>Disposable gowns are not typically amenable to being doffed and re-used because the ties and fasteners typically break during doffing. Cloth isolation gowns could potentially be untied and retied and could be considered for re- use without laundering in between.<\/p><p>In a situation where the gown is being used as part of standard precautions to protect HCP from a splash, the risk of re-using a non-visibly soiled cloth isolation gown may be lower. However, for care of patients with suspected or confirmed COVID-19, HCP risk from re-use of cloth isolation gowns without laundering among (1) single HCP caring for multiple patients using one gown or (2) among multiple HCP sharing one gown is unclear. The goal of this strategy is to minimize exposures to HCP and not necessarily prevent transmission between patients. Any gown that becomes visibly soiled during patient care should be disposed of and cleaned.<\/p><h4>Prioritize gowns.<\/h4><p>Gowns should be prioritized for the following activities:<\/p><ul>\n\n\n\n\n\n<li>During care activities where splashes and sprays are anticipated, which typically includes aerosol generating procedures<\/li>\n\n\n\n\n\n<li>During the following high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of healthcare providers, such as:\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Dressing, bathing\/showering, transferring, providing hygiene, changing linens, changing briefs or assisting with toileting, device care or use, wound care<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n<\/li>\n\n\n\n\n\n<\/ul><p>Surgical gowns should be prioritized for surgical and other sterile procedures. Facilities may consider suspending use of gowns for endemic multidrug resistant organisms (e.g., MRSA, VRE, ESBL-producing organisms).<\/p><h3>When No Gowns Are Available<\/h3><h4>Consider using gown alternatives that have not been evaluated as effective.<\/h4><p>In situation of severely limited or no available isolation gowns, the following pieces of clothing can be considered as a last resort for care of COVID-19 patients as single use. However, none of these options can be considered PPE, since their capability to protect HCP is unknown. Preferable features include long sleeves and closures (snaps, buttons) that can be fastened and secured.<\/p><ul>\n\n\n\n\n\n<li>Disposable laboratory coats<\/li>\n\n\n\n\n\n<li>Reusable (washable) patient gowns<\/li>\n\n\n\n\n\n<li>Reusable (washable) laboratory coats<\/li>\n\n\n\n\n\n<li>Disposable aprons<\/li>\n\n\n\n\n\n<li>Combinations of clothing: Combinations of pieces of clothing can be considered for activities that may involve body fluids and when there are no gowns available:\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Long sleeve aprons in combination with long sleeve patient gowns or laboratory coats<\/li>\n\n\n\n\n\n<li>Open back gowns with long sleeve patient gowns or laboratory coats<\/li>\n\n\n\n\n\n<li>Sleeve covers in combination with aprons and long sleeve patient gowns or laboratory coats<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n<\/li>\n\n\n\n\n\n<\/ul><p>Reusable patient gowns and lab coats can be safely laundered according to <a href=\"https:\/\/www.cdc.gov\/infectioncontrol\/guidelines\/environmental\/background\/laundry.html#g6\">routine procedures<\/a>.<\/p><ul>\n\n\n\n\n\n<li>Laundry operations and personnel may need to be augmented to facilitate additional washing loads and cycles<\/li>\n\n\n\n\n\n<li>Systems are established to routinely inspect, maintain (e.g., mend a small hole in a gown, replace missing fastening ties) and replace reusable gowns when needed (e.g., when they are thin or ripped)<\/li>\n\n\n\n\n\n<\/ul><p>************************************<\/p><p>You are receiving this email because you are a registered member of the Delaware Health Alert Network.\n\n\n\n\n\nIf you are not a member and would like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a><\/p><p>\n\n\n\n\n\n\n\n\n\n\n\n<br>\n\n\n\n\n\n<br>\n\n\n\n\n\n<\/p><p class=\"smalltext\"><a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\"><img loading=\"lazy\" decoding=\"async\" alt=\"Download Adobe Acrobat Reader\" height=\"21\" src=\"\/wp-content\/uploads\/dhss\/img\/getacro60.gif\" width=\"60\"><\/a> Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader.  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If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe&#8217;s <a href=\"http:\/\/access.adobe.com\">Accessibility Tools page<\/a>.<\/p><p>\n<!--[END]-->\n\n\n  \n\n\n        <\/p><div class=\"panel panel-danger\">\n\n\n          <div class=\"panel-heading\">    \n\n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n\n       <\/div>\n\n\n       <div class=\"panel-body\">\n\n\n      <ul>\n\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n\n            <\/ul>\n\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n\n          <\/div> \n\n\n        <\/div><p><br>  \n\n\n\n\n\n      <\/p><\/div>\n\n\n    <\/div>\n\n\n  <\/div><!-- \/container -->\n\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #425 March 20, 2020 6:53 pm Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10399","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10399","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10399"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10399\/revisions"}],"predecessor-version":[{"id":11575,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10399\/revisions\/11575"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10399"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}