CDC’s recommendations for implementation of mitigation strategies for Florida, based on current situation with COVID-19 transmission and consideration of the state’s large older adult population

Note: Florida has recently implemented many interventions included in the CDC guidance (https://www.cdc.gov/coronavirus/2019-ncov/community/index.html).

The most recent recommendations from Florida can be found at: http://www.floridahealth.gov/diseases-and-conditions/COVID-19/index.html

The following describes CDC recommendations for community interventions in Florida.

Bottom Line Up Front:
Florida has had several COVID-19 confirmed cases and exposures related to ports of entry, including shipping ports and airports. Additionally, Florida is a large tourism hub and has an older age population. However, at this time there is not widespread transmission. Due to the current level of COVID-19 transmission in the United States, and Florida’s large older adult population, CDC recommends certain community mitigation activities to help slow the spread of COVID-19 into the community and to protect vulnerable members of the community. CDC recommends the following interventions be implemented at this time (see below). These recommendations may be updated, if necessary, based on any changes in the current local situation.

Goals
The goals for using mitigation strategies for Florida are to protect:

  • Individuals at increased risk for severe illness, including older adults and persons of any age with underlying health conditions (See Appendix A).
  • The healthcare workforce and critical infrastructure workforces

These approaches are used to minimize morbidity and mortality caused by COVID-19 and minimize social and economic impacts of COVID-19. Individuals, communities, businesses, and healthcare organizations are all part of a community mitigation strategy.

Implementation emphasizes:

  • Emphasizing individual responsibility for implementation of recommended personal-level actions,
  • Empowering businesses, schools, and community organizations to implement recommended actions, particularly in ways that protect persons at risk of severe illness such as older adults and persons with serious underlying health conditions (e.g., Dialysis patients, congestive heart failure, emphysema)
  • Focusing on settings that provide critical services to implement recommended actions to protect critical infrastructure and individuals at risk of severe disease
  • Minimizing disruptions to daily life to the extent possible

Community mitigation strategies for Florida

For Every Individual and Families at Home:

  • Monitor local information about COVID-19 in your community.
  • Know the signs and symptoms of COVID-19 and what to do if you become symptomatic.
  • Practice personal protective measures (e.g., hand washing).
  • Create a household plan of action (https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf)
  • Ensure 30-day supply of all medicines.
  • Know about emergency operations plans for schools/workplaces of household members.
  • Individuals at risk of severe illness (including older adults and persons of any age with underlying health conditions) should stay at home as much as possible.
    o Avoid cruise travel and non-essential air travel
    o Avoid gatherings or other situations of potential exposures, including church attendance and social events with 10 or more people as much as possible.

For Every School/Childcare Facility:

  • Consider extending Spring Breaks for schools.
  • Monitor local information about COVID-19 in your community.
  • Know the signs and symptoms of COVID-19 and what to do if students or staff become symptomatic at school/childcare site.
  • Review and update emergency operations plan (including implementation of social distancing measures) or develop plan if one is not available.
  • Students at increased risk of severe illness should consider implementing individual plans for distance learning (e-learning).
  • Short-term dismissals for school and extracurricular activities as needed (e.g., if cases in staff/students) for cleaning and contact tracing

For Every Assisted Living Facility, Senior Living Facility, and Adult Day Programs:

  • Conduct daily temperature and symptom screening of attendees, staff, and visitors.
  • Support training of staff about strong infection control practices.
  • Restrict visitors to long-term care facilities.
  • Monitor local information about COVID-19 in your community.
  • Know the signs and symptoms of COVID-19 and what to do if clients/residents or staff become symptomatic.
  • Review and update emergency operations plan (including implementation of social distancing measures) or develop a plan if one is not available.
  • Encourage personal protective measures among staff, residents and clients who live elsewhere (e.g., stay home or in residences when sick, handwashing, respiratory etiquette).
  • Clean frequently touched surfaces daily.
  • Ensure hand hygiene supplies are readily available in all buildings.

Every Workplace:

  • Monitor local information about COVID-19 in your community.
  • Know the signs and symptoms of COVID-19 and what to do if staff become symptomatic at the worksite.
  • Review, update, or develop workplace plans to include liberal leave and telework policies.
    o Consider 7-day leave policies for people with COVID-19 symptoms
    o Consider alternate team approaches for work schedules.
    o Encourage staff to telework (when feasible), particularly individuals at increased risk of severe disease.
  • Work with all local employers to ensure all workers have the financial support to stay home with any respiratory symptoms
  • Encourage personal protective measures among staff (e.g., stay home when sick, handwashing, respiratory etiquette).
  • Clean and disinfect frequently touched surfaces daily.
  • Ensure hand hygiene supplies are readily available in building.
  • Limit large work-related gatherings (e.g., staff meetings, after-work functions).
  •  Cancel non-essential work travel.
  • Cancel work-sponsored conferences, tradeshows, etc.

Every Community and Faith-Based Organization:

  • Ensure polling sites are not in assisted-living or other facilities. Follow election guidance: https://www.cdc.gov/coronavirus/2019 ncov/community/electionpolling- locations.html
  • Cancel large gatherings (e.g., >250 people), and smaller gatherings that may bring persons together from multiple parts of the country.
  • Consider screening persons at smaller gatherings.
  • Conduct fever and respiratory screening of staff working at theme parks
  • Limiting the number of visitors to theme parks
  • Monitor local information about COVID-19 in your community.
  • Know the signs and symptoms of COVID-19 and what to do if organization members/staff become symptomatic.
  • Determine ways to continue providing support services to individuals at increased risk of severe disease (services, meals, checking in) while limiting group settings and exposures.
  • For organizations that serve high-risk populations, consider cancelling gatherings of more than 10 people.
  • Encourage staff and members to stay home and notify organization administrators of illness when sick.
  • Encourage personal protective measures among organization/members and staff (e.g.,
  • stay home when sick, handwashing, respiratory etiquette).
  • Clean frequently touched surfaces at organization gathering points daily.
  • Ensure hand hygiene supplies are readily available in building.
  • Close areas with known exposures in highly trafficked tourist areas, such as cruise ship wharfs.

Healthcare Settings and Healthcare Providers (Including Outpatient, Nursing Homes/Long-Term Care Facilities, Inpatient, Telehealth):

  • Implement telehealth for rural communities
  • Consider reducing elective procedures
  • Implement triage before entering facilities (e.g. parking lot triage, front door); phone triage and telemedicine; limit unnecessary healthcare visits
  • Encourage HCP to stay home and notify healthcare facility administrators when sick.
  • Actively monitor HCP absenteeism and respiratory illness among HCP and patients.
  • Consider implementing temperature/symptom checks for staff, visitors, limit visitor movement in the facility.
  • Actively monitor PPE supplies
  • Establish processes to evaluate and test large numbers of patients and HCP with respiratory symptoms (e.g. designated clinics for people with fever, surge tent for overflow triage, offsite testing locations)
  • Cross train HCP for working in other units to support staffing shortages

Appendix A: Underlying medical conditions that may increase the risk of serious COVID-19 for
individuals of any age.

  • Blood disorders (e.g., sickle cell disease or on blood thinners)
  • Chronic kidney disease as defined by your doctor. Patient has been told to avoid or reduce the dose of medications because kidney disease, or is under treatment for kidney disease, including receiving dialysis
  • Chronic liver disease as defined by your doctor. (e.g., cirrhosis, chronic hepatitis) Patient has been told to avoid or reduce the dose of medications because liver disease or is under treatment for liver disease.
  • Compromised immune system (immunosuppression) (e.g., seeing a doctor for cancer and treatment such as chemotherapy or radiation, received an organ or bone marrow transplant, taking high doses of corticosteroids or other immunosuppressant medications, HIV or AIDS)
  • Current or recent pregnancy in the last two weeks
  • Endocrine disorders (e.g., diabetes mellitus)
  • Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
  • Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
  • Lung disease including asthma or chronic obstructive pulmonary disease (chronic bronchitis or emphysema) or other chronic conditions associated with impaired lung function or that require home oxygen
  • Neurological and neurologic and neurodevelopment conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury].