Homeless service provider outbreak toolkit

1. COVID-19 case list

Create and maintain a positive COVID-19 case list. Include all residents, clients, patients, students, employees, volunteers, and contractors at your facility who test positive for COVID-19. Example of this is found here: Download a COVID-19 Case List template (MS Excel). You will need to keep a complete case list for internal use to assist with contact tracing and internal management of your outbreak. However, you will not need to submit this case list to Public Health. Instead, you will use this list as a reference to submit weekly and end of outbreak cumulative case counts.

2. Reporting cases and serious outcomes

Report to Public Health – Seattle & King County

• Public Health recommends all homeless service sites report if there is an outbreak occurring at the facility. Please internally keep track of cases at your facility and if you believe you are experiencing an outbreak at your facility (see outbreak definition above) make a report to public health using Public Health COVID-19 Intake Survey. You will receive a confirmatory email with additional information and guidance links.
• Investigation start: After your report has been processed, Public Health may open an investigation for your facility. You will receive an email with follow up instructions and a COVID-19 Investigator may contact you. An investigation is a non-punitive Public Health process for collecting information about how a disease is affecting our community and for providing guidance and resources.
• Submit weekly investigation updates: Every Monday while the investigation is open, you will receive an email prompting you to submit a weekly investigation update. Use the Investigation Update Form link provided to you to report a cumulative case count, most recent symptom onset date, and any hospitalizations or deaths associated with your facility.
• Investigation closure:
• If your facility meets outbreak criteria, your investigation will close when 15 days have passed since the last positive COVID-19 case was identified. Please submit an Investigation Update Form to indicate that your outbreak is over and report your cumulative case counts.
• If your facility does not meet outbreak criteria, your investigation will close when 8 days have passed since the last positive COVID case was identified.
• Report subsequent cases: After the investigation is closed, subsequent cases should be reported using thee Public Health COVID-19 Intake Survey.

3. Isolation and quarantine guidance and resources

• COVID-19 strategies tool for homeless service sites, Public Health – Seattle & King County
• Please see page 2 of this document for information on isolation and quarantine length for staff and clients
• Tips for sheltering in place for COVID-19, Public Health – Seattle & King County

4. Personal protective equipment (PPE)

• Universal indoor mask use is strongly recommended during outbreaks.
• Review DOH guidance for masking in non-healthcare settings. COVID-19 Mask Guidance, WA Dept. of Health
• Ensure staff wear source control (a well-fitting, high-quality mask) for a full 10 days after exposure to a confirmed case of COVID-19
• Respiratory virus guidance, CDC
• Masks and Respiratory Viruses Prevention, CDC
• Order PPE through your distributor or other resources

5. Testing

• COVID-19 Isolation Guide for Homeless Shelters and Corrections, DOH
• Testing and Respiratory Viruses, CDC

Ordering testing and testing supplies

• Mobile testing remains available on a limited basis. If you are in need of this service, please speak with your assigned investigator or call our CD/Epi main line at 206-296-4774.
• Information on where staff can get testing if they cannot get tested at your facility.

Become a point-of-care COVID-19 testing site

Sites can now implement their own rapid testing on site. Receive free BinaxNOW rapid antigen tests from PHSKC for screening and diagnostic testing. Prior to using rapid tests at your facility, your site will need to meet regulatory and reporting requirements.

This Checklist will help support your site in preparing for point-of-care testing: Point-of-Care COVID-19 Testing Checklist for Homeless Service Providers.

6. Vaccination

Please email CHS.HEART@kingcounty.gov if you would like to have a team hold a vaccination clinic at your site. The team can also provide information about COVID-19 and consult with staff about how to engage, support, and open dialogue with anyone who may still feel ambivalent about vaccination.

• Encourage residents and staff to stay up to date with COVID-19 vaccinations.
• For vaccine appointments, visit the DOH Vaccine Locator.
• Encourage staff and residents to get the annual influenza vaccination. Those who are 60 years and older are also eligible for the RSV vaccine.

7. Facility level mitigation

Local workplace safety and health requirements may differ slightly from federal guidance. Please review Washington State Dept of Labor & Industries resources to ensure regulatory compliance.

Public Health – Seattle & King County’s Environmental Health team can provide your facility with ventilation and air quality technical assistance. Information for requesting technical assistance can be found on the Improving indoor air quality webpage. If your facility acquired portable HEPA air cleaners in the past and you have questions about their proper use or when to replace filters, please reach out to the HEART team at CHS.HEART@kingcounty.gov so we may assist.

Ventilation and filtration guidance

• Improving indoor air quality, Public Health – Seattle & King County
• Ventilation and Air Quality for COVID-19, WA Dept. of Health
• Ventilation in Buildings, CDC

Cleaning and disinfection guidance

• Safer cleaning, sanitizing, and disinfecting: a homeless service provider’s guide during the COVID-19 pandemic, Public Health – Seattle & King County
• About List N: Disinfectants for Coronavirus (COVID-19), EPA