COVID-19 Guidelines

General Precautions

Individuals with COVID-19 should not go to work if they are feeling sick, have a fever, or have respiratory symptoms, and should isolate for at least 5 days from symptom onset or positive test if asymptomatic 1
Verbal screening and temperature checks should be conducted at the start of each shift, including screening questions for fever, chills, cough, or difficulty breathing, and contact with known COVID-19 cases in the past 14 days 1
Maintain physical distancing of at least 2 meters from others, wear a face mask, practice frequent hand hygiene with soap and water for at least 20 seconds, and use alcohol-based hand sanitizer (>60% ethanol or >70% isopropanol) when handwashing isn't available 1
Avoid large gatherings or meetings of 10 or more people, drive to worksites alone, and disinfect shared equipment and surfaces regularly 1

Healthcare workers should change out of work clothing/uniforms at the worksite to prevent home contamination, and implement full airborne isolation precautions, including gown, gloves, and N95 mask, when managing a patient with symptoms 1, 2
Use N95 respirators during aerosol-generating procedures, and consider dedicated or disposable equipment when possible 2, 3, 4
Patients should be placed in a negative pressure isolation room if available, and dedicate specific areas/rooms for COVID-19 patients to minimize transmission risk 2, 5, 6

Consider short-term use of codeine linctus, codeine phosphate tablets, or morphine sulfate oral solution for distressing cough, and use dexamethasone 6 mg daily for up to 10 days for patients requiring oxygen 7, 8
Consider tocilizumab for patients with elevated inflammatory markers who are rapidly deteriorating despite corticosteroids, but corticosteroids are not recommended for viral pneumonia unless indicated for another condition 9, 8, 3
Put treatment escalation plans in place early, and consider hospitalization for patients with oxygen saturation <90%, respiratory rate >30/min, or signs of severe disease, with prophylactic-dose low-molecular-weight heparin (LMWH) recommended for non-ICU hospitalized patients without contraindications 7, 10, 11

Consider intensified VTE prophylaxis (intermediate or half-therapeutic LMWH dosage) for ICU patients with additional risk factors, and therapeutic-dose LMWH is the standard of care for confirmed VTE 12, 11
Consider post-discharge prophylaxis for 14-30 days in high-risk patients, and LMWH or DOACs (rivaroxaban, betrixaban) can be used for extended prophylaxis 11

Recommend COVID-19 vaccination for all eligible individuals, including those with previous SARS-CoV-2 infection, with immunocompromised patients requiring additional vaccine doses and assessment for antibody response 3-5 weeks after the last dose 10, 13, 2
Use RT-PCR testing as the gold standard for diagnosis of COVID-19, and screen all patients for fever and respiratory symptoms before entry 14

Maintain physical distancing of at least 2 meters when possible, and practice rigorous hand hygiene with soap and water for at least 20 seconds, or use alcohol-based hand sanitizer (>60% ethanol or >70% isopropanol) when handwashing isn't available 1
Regularly disinfect equipment and surfaces with 2-3% hydrogen peroxide, 2-5g/l chlorine disinfectant, or 75% alcohol 15
Healthcare workers with COVID-19 should isolate for a minimum of 5 days from symptom onset or positive test if asymptomatic 15