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Coronavirus Disease 2019 (COVID-19)

COVID-19 Updates

EDUCATE yourself.
IDENTIFY and ISOLATE patients with COVID-19.

USE precautions.

COVID-19 is here. NORCAL Group Insureds should be prepared.

Information about the extent of confirmed and active COVID-19 cases globally and nationally can quickly be viewed at Johns Hopkins: COVID-19 Global Cases tracking.

NORCAL Group insureds have a critical role in containing the spread of COVID-19 infection. An important first step is accessing reputable, regularly updated, accurate, and evidence-based information. This webpage provides links to information that can support the protection of both patients and healthcare personnel.

Patient Interactions: Advice for Physicians and Staff

According to the CDC, patients should receive treatment consistent with the standard of care regardless of suspected infection with COVID-19. However, it is important to provide treatment in a manner that minimizes the risk of exposure to yourself and your patients. As the number of infections in your area increases, containment strategies may change. Regularly check with your local public health authorities in case locations are designated to triage patients in an effort to limit exposure in general medical treatment locations. 

Before the Appointment

Appointment Scheduling

Instruct patients who are scheduling appointments to call ahead or inform front office staff upon arrival if they have symptoms of any respiratory infection (e.g., cough, runny nose, fever) and to take appropriate preventive action when arriving for treatment (e.g., respiratory hygiene, hand hygiene and cough etiquette, entrance through a separate door, isolation from other patients). Consider establishing triage stations outside the facility to screen patients before they enter. 

During the Appointment

Identifying an Infected Patient

The clinical spectrum of COVID-19 ranges from mild disease with non-specific signs and symptoms of acute respiratory illness, to severe pneumonia with respiratory failure and septic shock. There have also been reports of asymptomatic infection with COVID-19.i Frequently reported signs and symptoms include fever, cough, myalgia or fatigue, and shortness of breath at illness onset. Sore throat has also been reported in some patients early in the clinical course. Less commonly reported symptoms include sputum production, headache, hemoptysis, and diarrhea. Some patients have experienced gastrointestinal symptoms such as diarrhea and nausea prior to developing fever and lower respiratory tract signs and symptoms.ii No vaccine or specific treatment for COVID-19 is available; care is supportive.iii

Interacting with a Potentially Infected Patient

The CDC provides detailed strategies healthcare providers can use while in contact with potentially infected patients that includes:

  • Encouraging patients to don a surgical mask as soon as they are identified.
  • Advising patients to adhere to respiratory hygiene and cough etiquette, hand hygiene, and triage procedures throughout the duration of the visit.
  • Separating waiting patients with respiratory symptoms from other patients by at least 6 feet in a space with infection prevention supplies. Or, as an alternative for stable patients, having them wait in their car and await cell phone notification.
  • Evaluating patients in a private room with the door closed, ideally an airborne infection isolation room (AIIR), if available.
  • Using standard precautions, contact precautions, airborne precautions, and using eye protection (e.g., goggles or a face shield) at all times.
  • Determining whether a patient is a persons under investigation (PUI) for COVID-19

Suspected Infection Reporting and Diagnostic Testing

Known and suspected PUI should be reported to your local health department. Currently, diagnostic testing for COVID-19 is being performed at state public health laboratories and the CDC. 

Patient Education

Provide up-to-date, factual information on the virus to the patient and their close contacts, including how to follow infection-control practices at home, such as in-home isolation, hand hygiene, cough etiquette, waste disposal, and the use of face masks. Patients and their families should be encouraged to access information about COVID-19 through reputable sources, not social media.

Centers for Disease Control: About Coronavirus Disease 2019 (COVID-19)

World Health Organization: Coronavirus Disease (COVID-19) Advice for the Public

National Institute of Health: Coronavirus Disease 2019 (COVID-19)

Physician and Staff Resources

Become educated about prevention and reporting before encountering an infected patient.

CDC: What Healthcare Personnel Should Know about Caring for Patients with Confirmed or Possible COVID-19 Infection

CDC: Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease 2019 (COVID-19)

CDC: Interim Infection Prevention and Control Recommendations for Patients with Confirmed Coronavirus Disease 2019 (COVID-19) or Persons Under Investigation for COVID-19 in Healthcare Settings

CDC: Evaluating and Reporting Persons Under Investigation (PUI)


WHO: Interim Guidance on Clinical Management of Severe Acute Respiratory Infection when Novel Coronavirus (nCoV) Infection is Suspected

COVID-19 Update With Anthony Fauci, MD, Director, NIAID - March 6, 2020

CDC: Clinician Outreach and Communication Activity (COCA) COVID-19 Conference Calls/Webinars

Healthcare Operations: Advice for Leadership and Administrators

Healthcare entities and facilities should have policies and procedures in place to protect both their patients and staff. Leadership, managers and administrators should be accessing reliable, up-to-date information; for example, on the CDC and local health department websites. Emergency plans should be up-to-date and potential healthcare community partnerships should be established. Encourage physicians and staff to increase their knowledge of COVID-19 in general and specific issues such as COVID-19 infection control strategies, and how your entity will manage a potential surge of patients. Consider how you will communicate with patients about issues such as changes to your policies about appointments and non-urgent patient care—if that becomes necessary.

New policies and protocols may be necessary to provide direction on topics such as: patient telephone triage, proper use of personal protection equipment, and employee sick leave. Some thought also must be given to finding waiting room space to separate potentially infected individuals from other patients and managing potential shortages of medical supplies.

Healthcare entities should also assess potential workplace exposure to COVID-19, evaluate the risk of exposure, and select, implement, and ensure that workers use controls to prevent exposure. Control measures may include a combination of engineering and administrative controls, safe work practices, and PPE. Additionally, the CDC is urging employers to take a conservative approach to monitoring and restricting from work healthcare personnel who show signs and symptoms of contagion. Keep track of staff/physician contact with patients who are suspected of infection.

Healthcare Operations Resources

Preparation and Response

CDC: Steps Healthcare Facilities Can Take Now to Prepare for Coronavirus Disease 2019 (COVID-19)

CDC: Healthcare Professional Preparedness Checklist For Transport and Arrival of Patients With Confirmed or Possible COVID-19

CDC: Coronavirus Disease 2019 (COVID-19) Hospital Preparedness Assessment Tool

American Hospital Association: Updates and Resources on Novel Coronavirus (COVID-19)

Disease Updates

CDC: Situation Summary

WHO: Situation Reports

Johns Hopkins: COVID-19 Global Cases Tracking


WHO: Coronavirus disease (COVID-19) Training

ACCME: Novel Coronavirus Education Resources

Healthcare Workforce Infection Control Resources

OSHA: COVID-19 Control and Prevention for Healthcare Workers and Employers

CDC: Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease 2019 (COVID-19)

CDC: Guidelines for Environmental Infection Control in Health-Care Facilities

CDC: Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings [section IV.F. Care of the environment]

Supply Chain

CDC: Healthcare Supply of Personal Protective Equipment

Strategies for Optimizing the Supply of N95 Respirators

FDA: Coronavirus Disease 2019 (COVID-19)




Page Updated: March 13, 2020

The information provided on this website is intended as risk management advice. It does not constitute a legal opinion, nor is it a substitute for legal advice. Legal inquiries about topics covered on this website should be directed to an attorney.

Reference herein to any specific product, process, service, or entity does not necessarily constitute or imply the endorsement, recommendation, or favoring by the NORCAL Group of companies.