{"id":10401,"date":"2025-03-01T14:07:56","date_gmt":"2025-03-01T19:07:56","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan427\/"},"modified":"2025-03-02T00:55:05","modified_gmt":"2025-03-02T05:55:05","slug":"dhan427","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan427\/","title":{"rendered":"php\/alerts\/dhan427 ~  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\/dhan427.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\"]-->427 <!--[END]--> <\/h1>\n\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->March 20, 2020 7:24 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\" 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Facebook<\/a><\/li>\n        <li class=\"twitter\"><a href=\"https:\/\/twitter.com\/Delaware_DHSS\" target=\"_blank\" title=\"Delaware Health and Social Services Twitter Account\"><i class=\"fa fa-twitter-square fa-lg\"><\/i> Twitter<\/a><\/li>\n        <!-- <li class=\"googleplus\"><a href=\"#\"><i class=\"fa fa-google-plus-square fa-lg\"><\/i> Google +<\/a><\/li>\n        <li class=\"flickr\"><a href=\"#\"><i class=\"fa fa-flickr fa-lg\"><\/i> Flickr<\/a><\/li>\n        <li class=\"youtube\"><a href=\"#\"><i class=\"fa fa-youtube-square fa-lg\"><\/i> Youtube<\/a><\/li>\n        <li class=\"instagram\"><a href=\"#\"><i class=\"fa fa-instagram fa-lg\"><\/i> Instagram<\/a><\/li>\n        <li class=\"linkedin\"><a href=\"#\"><i class=\"fa fa-linkedin-square fa-lg\"><\/i> Linkedin<\/a><\/li>\n        <li class=\"pinterest\"><a href=\"#\"><i class=\"fa fa-pinterest-square fa-lg\"><\/i> Pinterest<\/a><\/li> -->\n      <\/ul>\n    <\/li>\n  <\/ul>\n\n\n              <\/div>\n\n\n            <\/div>\n\n\n          <\/div>\n\n\n        <\/div><br>\n\n\n      <\/div>\n\n\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n\n  \n\n\n<h2 class=\"center\">Health\n\n\n<!--[type=EDIT name=\"DHANType\"]-->\n\n\n\n\n\n\n\n\n\nAlert<!--[END]-->\n\n\n<br>\n\n\n<!--[type=EDIT name=\"DHAN Heading\"]-->\n\n\n\n\n\n\n\n\n\nSTRATEGIES FOR OPTIMIZING THE SUPPLY OF PPE-N95 RESPIRATORS<!--[END]-->\n\n\n<\/h2>\n\n\n\n\n\n<!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<h2 class=\"text-center\">CENTERS FOR DISEASE CONTROL AND PREVENTION<br>\n\n\n\n\n\nSTRATEGIES FOR OPTIMIZING THE SUPPLY OF PPE<\/h2>\n\n\n\n\n\n<h3 class=\"text-center\">Strategies for Optimizing the Supply of N95 RESPIRATORS<\/h3>\n\n\n\n\n\n\n\n\n\n\n\n<h3>Conventional Capacity Strategies<\/h3>\n\n\n\n\n\n\n\n\n\n\n\n<h4>Engineering Controls reduce exposures for healthcare personnel (HCP) by placing a barrier between the hazard and the HCP.<\/h4>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Isolate patients in an airborne infection isolation room (AIIR)<\/li>\n\n\n\n\n\n<li>Use physical barriers such as glass or plastic windows at reception areas, curtains between patients, etc.<\/li>\n\n\n\n\n\n<li>Properly maintain ventilation systems to provide air movement from a clean to contaminated flow direction<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<h3>Administrative Controls refer to employer-dictated work practices and policies that reduce or prevent hazardous exposures<\/h3>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Limit the number of patients going to hospitals or outpatient settings by screening patients for acute respiratory illness prior to non-urgent care or elective visits<\/li>\n\n\n\n\n\n<li>Exclude all HCP not directly involved in patient care (e.g., dietary, housekeeping employees)<\/li>\n\n\n\n\n\n<li>Reduce face-to-face HCP encounters with patients (e.g., bundling activities, use of video monitoring)<\/li>\n\n\n\n\n\n<li>Exclude visitors to patients with known or suspected COVID-19<\/li>\n\n\n\n\n\n<li>Implement source control: Identify and assess patients who may be ill with or who may have been exposed to a patient with known COVID-19 and recommend they use facemasks until they can be placed in an AIIR or private room.<\/li>\n\n\n\n\n\n<li>Cohort patients: Group together patients who are infected with the same organism to confine their care to one area<\/li>\n\n\n\n\n\n<li>Cohort HCP: Assign designated teams of HCP to provide care for all patients with suspected or confirmed COVID-19<\/li>\n\n\n\n\n\n<li>Use telemedicine to screen and manage patients using technologies and referral networks to reduce the influx of patients to healthcare facilities<\/li>\n\n\n\n\n\n<li>Train HCP on indications for use of N95 respirators<\/li>\n\n\n\n\n\n<li>Train HCP on use of N95 respirators (i.e., proper use, fit, donning and doffing, etc.)<\/li>\n\n\n\n\n\n<li>Implement just-in-time fit testing: Plan for larger scale evaluation, training, and fit testing of employees when necessary during a pandemic<\/li>\n\n\n\n\n\n<li>Limit respirators during training: Determine which HCP do and do not need to be in a respiratory protection program and, when possible, allow< limited re-use of respirators by individual HCP for training and then fit testing\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Implement qualitative fit testing to assess adequacy of a respirator fit to minimize destruction of N95 respirator used in fit testing and allow for limited re-use by HCP\n\n\n\n\n\n<\/li><\/ul>\n\n\n\n\n\n<\/li><\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<h3>Personal Protective Equipment and Respiratory Protection should be used as part of a suite of strategies to protect personnel, complementing the use of engineering and administrative controls as needed.<\/h3>\n\n\n\n\n\n\n\n\n\n\n\n<p>Use surgical N95 respirators only for HCP who need protection from both airborne and fluid hazards (e.g., splashes, sprays). If needed but unavailable, use faceshield over standard N95 respirator.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>Use alternatives to N95 respirators where feasible (e.g., <a href=\"https:\/\/www.cdc.gov\/niosh\/npptl\/topics\/respirators\/disp_part\/default.html\">other disposable filtering facepiece respirators<\/a>, elastomeric respirators with appropriate filters or cartridges, powered air purifying respirators)<\/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>Contingency Capacity Strategies may change practices but may not have a significant impact on patient care or HCP safety.<\/h4>\n\n\n\n\n\n\n\n\n\n\n\n<h4>Administrative Controls<\/h4>\n\n\n\n\n\n\n\n\n\n\n\n<p>Decrease length of hospital stay for medically stable patients with COVID-19 who cannot be discharged to home for social reasons by identifying alternative non-hospital housing.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h4>Personal Protective Equipment and Respiratory Protections<\/h4>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Use N95 respirators beyond the manufacturer-designated shelf life for training and fit testing<\/li>\n\n\n\n\n\n<li>Extend the use of N95 respirators by wearing the same N95 for repeated close contact encounters with several different patients, without removing the respirator (i.e., <a href=\"https:\/\/www.cdc.gov\/niosh\/topics\/hcwcontrols\/recommendedguidanceextuse.html\">recommended guidance<\/a> on implementation of extended use)<\/li>\n\n\n\n\n\n<li>Implement <a href=\"https:\/\/www.cdc.gov\/niosh\/topics\/hcwcontrols\/recommendedguidanceextuse.html\">re-use<\/a> of N95 respirators by one HCP for multiple encounters with different tuberculosis patients, but remove it after each encounter<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<h3>Crisis\/Alternate Strategies<\/h3>\n\n\n\n\n\n \n\n\n\n\n\n<h4>Crisis\/Alternate Strategies are not commensurate with current U.S. standards of care but may need to be considered during periods of expected or known N95 respirator shortages.<\/h4>\n\n\n\n\n\n\n\n\n\n\n\n<h3>When N95 Supplies are Running Low<\/h3>\n\n\n\n\n\n\n\n\n\n\n\n<h4>Personal Protective Equipment and Respiratory Protection<\/h4>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Use respirators as identified by CDC as performing adequately for healthcare delivery <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/healthcare-supply-ppe-index.html\">beyond the manufacturer-designated shelf life<\/a><\/li>\n\n\n\n\n\n<li>Use respirators approved under standards used in other countries that are similar to NIOSH-approved N95 respirators but that may not necessarily be NIOSH-approved<\/li>\n\n\n\n\n\n<li>Implement limited <a href=\"https:\/\/www.cdc.gov\/niosh\/topics\/hcwcontrols\/recommendedguidanceextuse.html\">re-use<\/a> of N95 respirators for patients with COVID-19, measles, and varicella<\/li>\n\n\n\n\n\n<li>Use additional respirators identified by CDC as NOT performing adequately for healthcare delivery beyond the manufacturer-designated shelf life<\/li>\n\n\n\n\n\n<li><a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/respirators-strategy\/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Frespirator-supply-strategies.html\">Prioritize the use of N95 respirators and facemasks by activity type<\/a> with and without masking symptomatic patients<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<h3>When No Respirators Are Left<\/h3>\n\n\n\n\n\n\n\n\n\n\n\n<h4>Administrative Controls<\/h4>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Exclude HCP at higher risk for severe illness from COVID-19 from contact with known or suspected COVID-19 patients (i.e., those of older age, those with chronic medical conditions, or those who may be pregnant)<\/li>\n\n\n\n\n\n<li>Designate convalescent HCP for provision of care to known or suspected COVID-19 patients (those who have clinically recovered from COVID-19 and may have some protective immunity) to preferentially provide care)<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<h4>Engineering Controls<\/h4>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Use an expedient patient isolation room for risk-reduction<\/li>\n\n\n\n\n\n<li>Use a ventilated headboard to decrease risk of HCP exposure to a patient-generated aerosol<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<h4>Personal Protective Equipment and Respiratory Protection<\/h4>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Use masks not evaluated or approved by NIOSH or homemade masks as a last resort<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<p>************************************<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<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>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<!--[END]-->\n\n\n  \n\n\n        <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><br>  \n\n\n\n\n\n      <\/div>\n\n\n    <\/div>\n\n\n  <\/div><!-- \/container -->\n\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #427 March 20, 2020 7:24 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-10401","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10401","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=10401"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10401\/revisions"}],"predecessor-version":[{"id":11577,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10401\/revisions\/11577"}],"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=10401"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}