Please note these updates are meant to provide general information on Novel Coronavirus (COVID-19) for the Lurie Children’s Community. Below you'll find provider resources, communications to Lurie Children's employees, frequently asked questions and recent news articles. Because the situation is rapidly evolving, for the most up-to-date information, please continue to refer back to this page or the resources listed below.
Updated: March 18, 3:48 p.m.
The High Consequence Infectious Diseases (HCID) team is aware and closely monitoring national activity of novel coronavirus (COVID-19) with close coordination with the Chicago Department of Public Health (CDPH). We would like to reiterate that the risk of COVID-19 to the general population remains low at this time. Nonetheless, it is imperative that healthcare workers continue to strictly follow existing protocols for keeping themselves and other patients safe during the current RSV and influenza season. Because our top priority is the safety of our patients, families, healthcare workers, and staff, Lurie Children’s High Consequence Infectious Diseases (HCID) team will continue to focus considerable effort on preparing for a potential outbreak in coordination with public health officials and peer institutions. Our number one priority is to keep patients, healthcare workers, and staff safe. We will continue our preparedness efforts and update this page as necessary as this public health issue evolves.
Coronaviruses are a large family of viruses that typical cause a mild illness like the common cold. From time to time new coronaviruses emerge and have the potential to cause severe disease and global epidemics. Coronavirus Disease 2019, or COVID-19, is caused by a new respiratory virus, which is also sometimes referred to as SARS-CoV-2. This virus is different than SARS and MERS that caused previous outbreaks of respiratory illness. This virus was first identified as the cause of an outbreak in Wuhan, Hubei Province, China and has subsequently spread to more than 100 countries on several continents. Early cases were believed to be animal-to-human spread linked to a large seafood and animal market, but it is now known that person-to-person spread is occurring.
Symptoms of those confirmed to have COVID-19 include fever, cough and shortness of breath. While most cases are relatively mild, some patients have had a severe respiratory illness. Severe respiratory disease is more common in the elderly and patients with medical co-morbidities. It is believed that symptoms may appear in as few as 2 days or as long as 14 days after exposure.
Coronaviruses are mostly spread from person-to-person through:
A person may also get infected by touching a surface with the virus on it, and then touching their mouth, nose or eyes before cleaning their hands.
The general risk to those living in the US and Chicago remains low. The severity of illness of COVID-19 and risk of dying is less than other epidemics of new coronaviruses (SARS and MERS) over the past 20 years. Children and young adults are particularly likely to only have mild disease. However, reported cases of COVID-19 have already surpassed the prior SARS and MERS epidemics. At higher risk are those older than 60 years old and those with chronic medical conditions.
We advise to take general measures that are effective for preventing all causes of respiratory viral illness, including:
At this time, laboratory diagnostic testing for COVID-19 is being conducted at the IDPH laboratory. CDC currently recommends collecting and testing clinical specimens from lower respiratory (sputum, tracheal aspirate, BAL) and upper respiratory (NP/OP swab) specimens only. Testing should not be ordered until IP&C has been contacted who will provide further recommendations. The COVID-19 strain can only be detected at a public health laboratory. The respiratory viral panel PCR test at Lurie Children's detects some coronavirus strains that cause the common cold but does not detect COVID-19. There is no cross reactivity between COVID-19 and the coronavirus strains on the respiratory viral panel PCR test.
There is no current antiviral treatment recommended for COVID-19 infection. However, scientists and public health officials are assessing whether certain antivirals and monoclonal antibodies can be effective treatments. Individuals who have been infected with COVID-19 will receive supportive care to help manage symptoms.
For all patients with a febrile and/or respiratory illness, staff need to ask whether they or their close contacts have travelled internationally within the past 2 weeks, with a particular concern for the countries with travel advisories as listed in the section below. Infection Prevention and Control will provide guidance for healthcare workers seeing ill patients with this travel history and who are suspected of having 2019-nCoV. If you suspect a patient may have COVID-19 based on their symptoms and travel history (i.e., a febrile respiratory illness and travel to China, South Korea, Italy, Iran, Japan, or Hong Kong in the past 14 days), please place on airborne/contact isolation (with additional use of eye protection). Additionally at this time, irrespective of travel history, we are advising that any child with a severe (i.e., requiring admission to the critical care unit) acute febrile respiratory illness of unknown etiology also be placed on airborne/contact isolation (with additional use of eye protection). This level of isolation would require gowns, gloves, eye protection, and either an appropriately sized N95 mask (based on fit testing results) or powered air purifying respirator (PAPR). If these scenarios arise, please contact Infection Prevention and Control at 7-4290 immediately.
If you are called by a patient with a history of travel to China, South Korea, Italy, Iran or other area with COVID-19 activity in the past 2 weeks, please ask about signs/symptoms of respiratory illness and/or exposure to someone known to have COVID-19. If a patient with a significant travel or exposure history has symptoms of a respiratory illness, the patient will require medical evaluation.
If a patient was exposed, but not yet symptomatic, additional education may be needed. Healthcare providers should report suspected symptomatic COVID-19 cases or known COVID-19 exposures immediately to Infection Prevention & Control via the 24 hours pager 7-4290 to guide plans for evaluation. Known COVID-19 exposures in an asymptomatic patient can be reported to Infection Prevention & Control within 1 business day. Please do not refer the patient to a medical facility without contacting them ahead of time so that steps can be taken to minimize exposure.
In addition to being a pandemic that none of us have experienced in our lifetimes, the recommendations for workplace safety are changing rapidly, leading to confusion. Initial recommendations were made out of a substantial abundance of caution until risk assessments could be completed and better understood. Now with a better understanding of risk to healthcare workers, we can now provide more streamlined recommendations for PPE that are fortunately more operational in ambulatory settings.
These recommendations are made with the expectation that eventually COVID-19 could be widespread in the community. Thus, these recommendations will keep you safe if or when children with COVID-19 present to your clinic. Currently, the prevalence of COVID-19 in the general community is very low but increasing. The prevalence of COVID-19 in the general pediatric community is even lower. We know in Seattle, where there is community transmission, the prevalence of COVID-19 among children tested for COVID-19 has been less than 1%. However, out of a desire to keep you as protected as possible, while also limiting unnecessary use of PPE, a real-time risk assessment is needed by providers. That risk assessment is based on likelihood of COVID-19 and the types of procedures that are performed. This is why there are some differences in PPE suggestions based on risk. Current PPE guidance can be found here:
The bottom line for the ambulatory setting:
Please consider the following:
The susceptibility of pregnant women to COVID-19 is largely unknown but initial reports suggest risk is relatively low. While pregnancy is not necessarily an exclusion for providing care to a patient with suspected or confirmed COVID-19, it is prudent for pregnant healthcare workers to limit exposure, especially during aerosol generating procedures.
We anticipate travel restrictions will continue to change rapidly over the next several weeks to months. Thus, it is possible that travel and return-to-work restrictions may be expanded to other countries in the future. If you anticipate any future international travel, please stay abreast on travel advisories here: https://wwwnc.cdc.gov/travel/notices.
When considering spring travel, make sure you can check off all the following items:
Level 3 travel advisories are currently in place for mainland China, and now additionally South Korea, Iran and most of Europe. This means that you should avoid ANY non-essential travel to these countries. Thus, the following policies are effective immediately:
To optimize safety in the setting of a rapidly evolving public health issue, if you have travelled internationally anywhere outside of North America, South America, or the Caribbean in the past 14 days and develop fever or respiratory illness, please DO NOT report to work. Additionally, if a household contact has travelled internationally (outside of North America, South America, or the Caribbean) AND becomes ill with fever or respiratory symptoms, also please DO NOT report to work. If these situations occur, please then call the Return from Travel Abroad telephone line at 312.227.2300 for a telephone triage health screening. Employee and Corporate Health will work with Infectious Prevention and Control to define return-to-work status.
Our number one priority is to keep patient/families, healthcare workers, and staff safe. At Lurie Children’s, since 2014, we have had a High Consequence Infectious Diseases (HCID) team that focuses exclusively on preparedness efforts for rare pathogens of high clinical and/or public health significance. We prepare healthcare workers throughout the organization by providing information about how to rapidly identify patients at risk for coronavirus and prepare protocols for safely evaluating and treating those patients. We monitor epidemiology of coronavirus daily and get debriefings from the Chicago Department of Public Health weekly. This information is crucial for rapidly modifying policy and clinical practice recommendations in real time. We communicate important updates to our patients/families, healthcare workers, and staff promptly as needed. By doing the above, we are confident that we can continue provide safe, effective, and compassionate care, even during an infectious diseases outbreak.
As of March 10, 2020, all events to be held at Lurie Children's Facilities including the main hospital involving non-employed staff should be cancelled. The duration of this policy will be based on COVID-19 epidemiology but current CDC estimates are that this could go for three months.
These meetings and events can be moved to a non-Lurie Children's facility outside of the main hospital and/or have a dial-in option to avoid large numbers of outside personnel at the hospital.
When moving meetings to a non- Lurie Children's facility with non-hospital personnel, please request that attendees have no respiratory symptoms and have not travelled internationally to high risk areas in the last 14 days. As always, remember to use proper hand hygiene and sensible social distance.
As we see an increase of confirmed COVID-19 patients in Illinois and across our health system, we have, and will continue to implement policy changes to ensure we effectively care for patients and maintain the safety of our workforce.
Effective March 12, we are implementing a temporary foreign and domestic business-related travel ban for all faculty and staff, and suspension of external events or conferences in all Lurie Children's facilities through April 15th or sooner, if conditions warrant.
Please contact the Accounts Payable Department regarding changes to your business travel plans. We are aware that many organizations have cancelled or are contemplating cancelling upcoming meetings and conferences due to the ongoing travel concerns. The Medical Center has elected to reimburse fees incurred due to these unforeseen business travel changes and/or cancellations.
For business travel arrangements made through our travel partner, Uniglobe Travel Designers, please contact them directly to process any changes and/or cancellations needed. Uniglobe works with the major airlines including United, Delta, and American Airlines to waive change fees on our behalf. They will also work with the hotels to have fees waived when possible. They can be reached Monday thru Friday from 9:30am – 4:00pm at firstname.lastname@example.org or 614.237.4488 and after hours at email@example.com or 800.966.6512.