{"id":10405,"date":"2025-03-01T14:07:56","date_gmt":"2025-03-01T19:07:56","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan432\/"},"modified":"2025-03-02T00:55:06","modified_gmt":"2025-03-02T05:55:06","slug":"dhan432","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan432\/","title":{"rendered":"php\/alerts\/dhan432 ~  Division of Public Health &#8211; Health Alert  &#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\/dhan432.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\"]-->432 <!--[END]--> <\/h1>\n\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->July 31, 2020 1:09 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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The CDC has also updated its criteria for health care personnel to return to work after suspected or confirmed cases of COVID-19. These are interim guidances and are subject to change.<\/p>\n\n\n\n\n\n\n\n<h2>Background<\/h2>\n\n\n\n\n\n\n\n<p><strong>Recent changes for the discontinuation of transmission-based precautions and disposition of patients with COVID-19 in healthcare settings:<\/strong><\/p>\n\n\n\n\n\n\n\n<ul>\n\n\n\n <li>\u00a0Except for rare situations, a test-based strategy is no longer recommended to determine when to discontinue Transmission-Based Precautions.<\/li>\n\n\n\n <li>\u00a0For patients with <a href=\"https:\/\/gcc02.safelinks.protection.outlook.com\/?url=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Fdisposition-hospitalized-patients.html%23definitions&#038;data=02%7C01%7Csean.dooley%40delaware.gov%7Ce7701bdb46954d02849d08d834a09cea%7C8c09e56951c54deeabb28b99c32a4396%7C0%7C0%7C637317211715932000&#038;sdata=zzF2kAESPBvt8%2FBl1BTYq4ua3aoRvO7cCGKDEamVcnc%3D&#038;reserved=0\">severe to critical illness<\/a> or who are severely immunocompromised<sup>1<\/sup>, the recommended duration for Transmission-Based Precautions was extended to 20 days after symptom onset (or, for asymptomatic severely immunocompromised<sup>1<\/sup> patients, 20 days after their initial positive SARS-CoV-2 diagnostic test).<\/li>\n\n\n\n <li>\u00a0Other symptom-based criteria were modified as follows:\n\n\n\n <ul>\n\n\n\n  <li>\u00a0Changed from \u201cat least 72 hours\u201d to \u201cat least 24 hours\u201d have passed <em>since last<\/em>\u00a0fever without the use of fever-reducing medications.<\/li>\n\n\n\n  <li>\u00a0Changed from \u201cimprovement in respiratory symptoms\u201d to \u201cimprovement in symptoms\u201d to address expanding list of symptoms associated with COVID-19.<\/li>\n\n\n\n  <li>\u00a0A summary of current evidence and rationale for these changes is described in a <a href=\"https:\/\/gcc02.safelinks.protection.outlook.com\/?url=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Fduration-isolation.html&#038;data=02%7C01%7Csean.dooley%40delaware.gov%7Ce7701bdb46954d02849d08d834a09cea%7C8c09e56951c54deeabb28b99c32a4396%7C0%7C0%7C637317211715951992&#038;sdata=v7v6jVCKfl1W0P7ED%2FLAqD5DfkuVz23gkVUrapsG7%2BY%3D&#038;reserved=0\">decision memo<\/a>.<\/li>\n\n\n\n <\/ul>\n\n\n\n <\/li>\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n<p>The decision to discontinue <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/infection-control\/control-recommendations.html\">Transmission-Based Precautions<\/a> for patients with confirmed SARS-CoV-2 infection should be made using a symptom-based strategy as described below. The time period used depends on the patient\u2019s <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/disposition-hospitalized-patients.html#definitions\">severity of illness<\/a> and if they are severely immunocompromised<sup>1<\/sup>. <strong>Meeting criteria for discontinuation of Transmission-Based Precautions is not a prerequisite for discharge from a healthcare facility.<\/strong><\/p>\n\n\n\n\n\n\n\n<p>A test-based strategy is no longer recommended (except as noted below) because, in the majority of cases, it results in prolonged isolation of patients who continue to shed detectable SARS-CoV-2 RNA but are no longer infectious.<\/p>\n\n\n\n\n\n\n\n<p><em>Patients with <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/disposition-hospitalized-patients.html#definitions\">mild to moderate illness<\/a> who are not severely immunocompromised<\/em>:<\/p>\n\n\n\n\n\n\n\n<ul>\n\n\n\n <li>\u00a0At least 10 days have passed <em>since symptoms first appeared<\/em> <strong>and<\/strong><\/li>\n\n\n\n <li>\u00a0At least 24 hours have passed <em>since last<\/em> fever without the use of fever-reducing medications <strong>and<\/strong><\/li>\n\n\n\n <li>\u00a0Symptoms (e.g., cough, shortness of breath) have improved<\/li>\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n<p>Note:\u00a0For patients who are <strong>not severely immunocompromised<\/strong> and who were <strong>asymptomatic<\/strong> throughout their infection, Transmission-Based Precautions may be discontinued when at least 10 days have passed since the date of their first positive viral diagnostic test.<\/p>\n\n\n\n\n\n\n\n<p><em>Patients with <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/disposition-hospitalized-patients.html#definitions\">severe to critical illness<\/a> or who are severely <em>immunocompromised<\/em><sup>1<\/sup><\/em>.<\/p>\n\n\n\n\n\n\n\n<ul>\n\n\n\n <li>\u00a0At least 20 days have passed <em>since symptoms first appeared<\/em> <strong>and<\/strong><\/li>\n\n\n\n <li>\u00a0At least 24 hours have passed <em>since last fever<\/em> without the use of fever-reducing medications <strong>and<\/strong><\/li>\n\n\n\n <li>\u00a0Symptoms (e.g., cough, shortness of breath) have improved<\/li>\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n<p>Note:\u00a0 For <strong>severely immunocompromised<\/strong> patients who were <strong>asymptomatic<\/strong> throughout their infection, Transmission-Based Precautions may be discontinued when at least 20 days have passed since the date of their first positive viral diagnostic test.\n\n\n\n\n\n\n\n<\/p><p>As described in the <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/duration-isolation.html\">Decision Memo<\/a>, an estimated 95% of severely or critically ill patients, including some with severe immunocompromise, no longer had replication-competent virus 15 days after onset of symptoms; no patients had replication-competent virus more than 20 days after onset of symptoms.\u00a0 Because of the risks for transmission and the number of patients in health care settings at risk for severe illness if infected with SARS-CoV-2, a conservative approach was taken when assigning duration of Transmission-Based Precautions. However, because the majority of severely or critically ill patients no longer appear to be infectious 10 to 15 days after onset of symptoms, facilities operating under crisis standards of care might choose to discontinue Transmission-Based Precautions at 10 to 15 days, instead of 20 days, in order to maximize resources for those earlier in their clinical course who are at highest risk for being a source of transmission.<\/p><p>\u00a0<\/p><h2>Test-Based Strategy for Discontinuing Transmission-Based Precautions<\/h2><p>In some instances, a test-based strategy could be considered for discontinuing Transmission-based Precautions earlier\u00a0 than if the symptom-based strategy were used. However, as described in the <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/duration-isolation.html\">Decision Memo<\/a>, many individuals will have prolonged viral shedding, limiting the utility of this approach. A test-based strategy could also be considered for some patients (e.g., those who are severely immunocompromised<sup>1<\/sup>) in consultation with local infectious diseases experts\u00a0 if concerns exist for the patient being infectious for more than 20 days.<\/p><p>The criteria for the test-based strategy are:<\/p><p><em>Patients who are symptomatic<\/em>:<\/p><ul>\n\n\n\n <li>\u00a0Resolution of fever without the use of fever-reducing medications <strong>and<\/strong><\/li>\n\n\n\n <li>\u00a0Symptoms (e.g., cough, shortness of breath) have improved, <strong>and<\/strong><\/li>\n\n\n\n <li>\u00a0Results are negative from at least two consecutive respiratory specimens collected \u226524 hours apart (total of two negative specimens) tested using an FDA-authorized molecular viral assay to detect SARS-CoV-2 RNA. See <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/lab\/guidelines-clinical-specimens.html\">Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens for 2019 Novel Coronavirus (2019-nCoV)<\/a>.<\/li>\n\n\n\n<\/ul><p><em>Patients who are not symptomatic<\/em>:<\/p><ul>\n\n\n\n <li>\u00a0Results are negative from at least two consecutive respiratory specimens collected \u226524 hours apart (total of two negative specimens) tested using an FDA-authorized molecular viral assay to detect SARS-CoV-2 RNA. See <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/lab\/guidelines-clinical-specimens.html\">Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens for 2019 Novel Coronavirus (2019-nCoV)<\/a>.<\/li>\n\n\n\n<\/ul><p>\u00a0<\/p><p><\/p><h2>Criteria for Return to Work for Health Care Personnel (HCP) with Suspected or Confirmed COVID-19:<\/h2><ul>\n\n\n\n <li>\u00a0Except for rare situations, a test-based strategy is no longer recommended to determine when to allow HCP to return to work.<\/li>\n\n\n\n <li>\u00a0For HCP with <a href=\"https:\/\/gcc02.safelinks.protection.outlook.com\/?url=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Freturn-to-work.html%23severe-illness&#038;data=02%7C01%7Csean.dooley%40delaware.gov%7Ce7701bdb46954d02849d08d834a09cea%7C8c09e56951c54deeabb28b99c32a4396%7C0%7C0%7C637317211715951992&#038;sdata=Ocbj6gseIeNcO07ZXsP%2Bv7jjY%2BFhaU9VKyfjXBpv6hk%3D&#038;reserved=0\">severe to critical illness<\/a> or who are severely immunocompromised1, the recommended duration for work exclusion was extended to 20 days after symptom onset (or, for asymptomatic severely immunocompromised<sup>1<\/sup> HCP, 20 days after their initial positive SARS-CoV-2 diagnostic test).<\/li>\n\n\n\n <li>\u00a0Other symptom-based criteria were modified as follows:\n\n\n\n <ul>\n\n\n\n  <li>\u00a0Changed from \u201cat least 72 hours\u201d to \u201cat least 24 hours\u201d have passed <em>since last<\/em> fever without the use of fever-reducing medications<\/li>\n\n\n\n  <li>\u00a0Changed from \u201cimprovement in respiratory symptoms\u201d to \u201cimprovement in symptoms\u201d to address expanding list of symptoms associated with COVID-19<\/li>\n\n\n\n <\/ul>\n\n\n\n <\/li>\n\n\n\n <li>\u00a0A summary of current evidence and rationale for these changes is described in a <a href=\"https:\/\/gcc02.safelinks.protection.outlook.com\/?url=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Fduration-isolation.html&#038;data=02%7C01%7Csean.dooley%40delaware.gov%7Ce7701bdb46954d02849d08d834a09cea%7C8c09e56951c54deeabb28b99c32a4396%7C0%7C0%7C637317211715961985&#038;sdata=WDlQpc459bg3OneTz9EgOPNmVaIvDUCBij%2B0RnZwDuo%3D&#038;reserved=0\">Decision Memo<\/a>.\u200b<\/li>\n\n\n\n<\/ul><p>\u00a0<\/p><p>Occupational health programs and public health officials making decisions about return to work for health care personnel (HCP) with confirmed SARS-CoV-2 infection, or who have suspected SARS-CoV-2 infection (e.g., developed <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/%5Ccoronavirus%5C2019-ncov%5Csymptoms-testing%5Csymptoms.html\">symptoms of COVID-19<\/a>) <strong>but were never tested for SARS-CoV-2<\/strong>.<\/p><p><br>\n\n\n\nHCP with symptoms of COVID-19 should be prioritized for viral testing with approved nucleic acid or antigen detection assays.\u00a0 When a clinician decides that testing a person for SARS CoV-2 is indicated, <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/faq.html#Testing\">negative results<\/a> from at least one FDA Emergency Use Authorized COVID-19 molecular viral assay for detection of SARS-CoV-2 RNA indicates that the person most likely does not have an active SARS-CoV-2 infection at the time the sample was collected. A second test for SARS-CoV-2 RNA may be performed at the discretion of the evaluating health care provider, particularly when a higher level of clinical suspicion for SARS-CoV-2 infection exists.\u00a0 For HCP who were suspected of having COVID-19 and had it ruled out, either with at least one negative test or a clinical decision that COVID-19 is not suspected and testing is not indicated, then return to work decisions should be based on their other suspected or confirmed diagnoses.<\/p><p><br>\n\n\n\nDecisions about return to work for HCP with SARS-CoV-2 infection should be made in the context of local circumstances. In general, a symptom-based strategy should be used as described below. The time period used depends on the HCP\u2019s severity of illness and if they are severely immunocompromised.<sup>1\u00a0<\/sup><\/p><h2>Additional Information<\/h2><p>\u2022\u00a0Delaware EmployeeTesting Guidance For Businesses: <a href=\"https:\/\/coronavirus.delaware.gov\/wp-content\/uploads\/sites\/177\/2020\/07\/Business-Testing-Guidance-7.13.20.pdf\">https:\/\/coronavirus.delaware.gov\/wp-content\/uploads\/sites\/177\/2020\/07\/Business-Testing-Guidance-7.13.20.pdf<\/a><br>\n\n\n\n\u2022\u00a0Delaware Essential Services Screening Recommendations for COVID-19 Pandemic: <a href=\"https:\/\/coronavirus.delaware.gov\/wp-content\/uploads\/sites\/177\/2020\/07\/7.21-Essential-Services-Screening-Policy_final.pdf\">https:\/\/coronavirus.delaware.gov\/wp-content\/uploads\/sites\/177\/2020\/07\/7.21-Essential-Services-Screening-Policy_final.pdf<\/a><br>\n\n\n\n\u2022\u00a0Delaware Phase 2 General and Industry-Specific Reopening Guidance: <a href=\"https:\/\/business.delaware.gov\/coronavirus\/delawares-recovery-phase-2-guidance\/\">https:\/\/business.delaware.gov\/coronavirus\/delawares-recovery-phase-2-guidance\/<\/a><\/p><p>\u00a0<\/p><h2>References<\/h2><ul>\n\n\n\n <li><sup>\u00a01<\/sup>The studies used to inform this guidance did not clearly define \u201cseverely immunocompromised.\u201d For the purposes of this guidance, CDC used the following definition:\n\n\n\n\n\n\n\n <ul>\n\n\n\n  <li>\u00a0Some conditions, such as being on chemotherapy for cancer, untreated HIV infection with CD4 T lymphocyte count < 200, combined primary immunodeficiency disorder, and receipt of prednisone >20mg\/day for more than 14 days, may cause a higher degree of immunocompromise and inform decisions regarding the duration of Transmission-Based Precautions.<\/li>\n\n\n\n  <li>\u00a0Other factors, such as advanced age, diabetes mellitus, or end-stage renal disease, may pose a much lower degree of immunocompromise and not clearly affect decisions about duration of Transmission-Based Precautions.<\/li>\n\n\n\n  <li>\u00a0Ultimately, the degree of immunocompromise for the patient is determined by the treating provider, and preventive actions are tailored to each individual and situation.<\/li>\n\n\n\n <\/ul>\n\n\n\n <\/li>\n\n\n\n<\/ul><h2>Resources<\/h2><p>\u2022\u00a0Discontinuation of Transmission-Based Precautions and Disposition of Patients with COVID-19 in Healthcare Settings (Interim Guidance): <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/disposition-hospitalized-patients.html\">https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/disposition-hospitalized-patients.html<\/a><br>\n\n\n\n\u2022\u00a0Criteria for Return to Work for Healthcare Personnel with SARS-CoV-2 Infection (Interim Guidance): <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/return-to-work.html\">https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/return-to-work.ht<\/a><\/p><p>************************************<\/p><p>You are receiving this email because you are a registered member of the Delaware Health Alert Network. If 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<br>\n\n\n\n<br>\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.  A free copy of Adobe Acrobat Reader can be downloaded directly from <a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\">Adobe <\/a>. 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 #432 July 31, 2020 1:09 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-10405","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10405","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=10405"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10405\/revisions"}],"predecessor-version":[{"id":11581,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10405\/revisions\/11581"}],"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=10405"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}