COVID-19 Reporting Requirements & Instructions

Must report the following within one (1) working day to the Alameda County Public Health Department per  CDPH AFL 23-08, Title 17 California Code of Regulations (CCR) sections 2500  

Please use the following reporting thresholds from CDPH: 

• ≥2 cases of probable¹ or confirmed COVID-19 among residents identified within 7 days  

OR  

• ≥3 cases of acute illness compatible with COVID-19 among residents with onset within a 72h period 

Epi-linkage among patients or residents is defined as overlap on the same unit or ward, or other patient care location (e.g., radiology suite), or having the potential to have been cared for by common HCP within a 7-day time period of each other. Determining epi-linkages requires judgment and may include weighing evidence whether or not patients had a common source of exposure. 

• ≥2 cases of probable¹ or confirmed COVID-19 among patients 4 or more days after admission for a non-COVID condition, with epi-linkage²
  
  OR 
  
  
• ≥2 cases of suspect³, probable¹ or confirmed COVID-19 among HCP⁴ AND ≥1 case of probable¹ or confirmed COVID-19 among patients 4 or more days after admission for a non-COVID condition, with epi-linkage^2,5

¹ Probable case is defined as a person meeting presumptive laboratory evidence. Presumptive laboratory evidence includes the detection of SARSCoV-2 specific antigen in a clinical or post-mortem specimen using a diagnostic test performed by a CLIA-certified provider (includes those tests performed under a CLIA certificate of waiver). 

² Epi-linkage among patients or residents is defined as overlap on the same unit or ward, or other patient care location (e.g., radiology suite), or having the potential to have been cared for by common HCP within a 7-day time period of each other. Determining epi-linkages requires judgment and may include weighing evidence whether or not patients had a common source of exposure.  

³ Suspect case is defined as a person meeting supportive laboratory evidence OR meeting vital records criteria with no confirmatory or presumptive laboratory evidence for SARS-CoV-2. Supportive laboratory evidence includes the detection of SARS-CoV-2 specific antigen by immunocytochemistry OR detection of SARS-CoV-2 RNA or specific antigen using a test performed without CLIA oversight. 

⁴ Healthcare Personnel (HCP), defined by CDC, include, but are not limited to, emergency medical service personnel, nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, students and trainees, contractual staff not employed by the healthcare facility, and persons not directly involved in patient care, but who could be exposed to infectious agents that can be transmitted in the healthcare setting (e.g., clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, and volunteer personnel)(6). Facilities should prioritize investigations of cases in HCPs whose duties require them to have close contact with patients or visitors. Healthcare facility infection prevention or occupational health personnel should, wherever feasible, interview HCP with COVID-19 to identify likely sources of exposure and assess whether there are epi-linkages with other HCP or patient cases. 

⁵ Epi-linkage among HCP is defined as having the potential to have been within 6 ft for 15 minutes or longer while working in the facility during the 7 days prior to the onset of symptoms; for example, worked on the same unit during the same shift, and no more likely sources of exposure identified outside the facility. Determining epi-linkages requires judgment and may include weighing evidence whether or not transmission took place in the facility, accounting for likely sources of exposure outside the facility.  

• 5 or more COVID-19 cases within a 7-day period in residents and/or staff.