Many of you may remember past public health incidents that we wrote about, namely the SARS outbreak and potential EBOLA concerns. Today, we will take a look at the emerging concerns and preparations surrounding the Coronavirus (COVID-19). Many of the guidelines and precautions that we discussed in earlier publications apply to this virus, however we caution our readers that this is a quickly changing situation and first responder agencies would be well served in assigning a position within their agency to coordinate with other relevant agencies in their jurisdiction such as Public Health, Fire and EMS. Simply put, if someone in your jurisdiction has not coordinated a meeting between relevant agencies to discuss response procedures and protocols, we suggest that happen sooner rather than later.
Appropriate response protocols are still in a state of change and our purpose here today is not to give you a definitive protocol to follow; certainly, specific details for your response plan will be based on local and state laws and advice you receive from local counsel. We are, however, asking our departments to take the time to develop an Infectious Disease Response Plan for their respective jurisdictions. As you develop your plan it is important that you involve your public services colleagues in this endeavor. Involve your Fire, EMS, Public Health and Hospital personnel in plan development and have the final plan reviewed by counsel. Failure to do so will result in a fractured response, inefficient use of public resources, exposure of your personnel and possible legal claims.
Long before this latest virus made its way to our shores, police agencies should have issued a general “Infectious Disease Response” policy and procedure to address exposures our personnel face on a daily basis. As you know, exposure to Hepatitis, TB or HIV are risks that our employees face every day. An agency’s “Infectious Disease Response” document should identify a Designated Infection Control Officer (DICO) within the department to coordinate suspected exposures and provide a communications conduit to health care agencies. No matter the type of infectious disease, response planning is a necessary action, so don’t wait until it’s too late.
So, moving forward, what areas should be included in your response protocol? Most importantly, the protocol should follow the guidelines published by the experts. These guidelines can be found at the Center for Disease Control (CDC), and specific law enforcement guidance can be found at the CDC site. Your state or regional Emergency Management Agency, and your state or regional Department of Public Health may also identify response proticals. By including your partner agencies (Health, Fire, and EMS) in the planning, you will assure the safety of your personnel and the most efficient use of public safety resources. Your response plan should include:
1. Response Protocols By Agency: The response guidelines should begin with procedures to be followed by Communications personnel. Three or four important questions asked by Communications personnel can provide important information to the responders so there is no reason to require a large, multi-disciplinary response to the initial call for service. Typically, patients present with flu-like symptoms that do not require a large number of first responders to be exposed to the patient. The patient can usually be met outside of the premises by two properly-equipped EMS personnel and an assessment conducted at that point. By planning out the response protocols in advance, agencies will reduce the exposure of their personnel and conserve equipment.
We often forget Communications personnel in our response planning but they are key to a successful response. Good communication between public health officials and first responders will keep personnel aware of changes in your area and whether there are “Persons Under Investigation” (PUI) in your area. CDC guidelines concerning this particular subject can be found here.
2. Protection from Exposure for Responding Personnel: The CDC and state health agencies have published guidance on proper response procedures and PPE levels for first responders. CDC guidelines state that officers should maintain a distance of six feet from the individual and stress that proper hand-washing techniques (i.e. washing for at least twenty seconds). If soap and water is not available, personnel should use an alcohol-based hand sanitizer that is comprised of at least 60% alcohol.
According to the CDC, for those personnel who need to have direct contact with individuals confirmed or suspected to have COVID-19, the following PPE is recommended:
- Disposable examination gloves
- Disposable isolation gown or coveralls
- Any NIOSH- approved particulate respirator (N-95); and
- Eye protection
CDC guidelines also recommend that if officers are unable to wear a gown or coveralls all duty gear should be disinfected after contact with the individual.
3. Quarantine protocols: While law enforcement agencies may not decide if a quarantine is warranted, we may very well be tasked with enforcing the order. Therefore, it is important that all agencies tasked with issuing the order and enforcing the order work together to set the guidelines in advance. Certainly, this is an area that has received a great deal of attention in the media and could form the basis for a constitutional claim.
4. PIO responsibilities: Agencies need to establish ICS protocols to assure that a clear and consistent message is provided to the media and, ultimately, the public. This is a subject that easily stirs an emotional response of fear and panic so the message needs to be carefully constructed and issued with a collective voice.
5. Communication between agencies: Some agencies are quick to play the HIPPA card and claim that patient information cannot be shared with other first responders. Last week the U.S Department of Health and Human Services issued a bulletin entitled “HIPPA Privacy and Novel Coronavirus“. This bulletin recognizes the need for agencies to share information in order to properly protect responders and the general public. We suggest that first responder agencies maintain a copy of the bulletin and have it available when speaking with their responder partners to alleviate any concerns regarding information sharing.
Understandably, this is a quickly evolving situation. It appears clear that if your jurisdiction has not experienced an incident involving a confirmed or suspected COVID-19 patient already, you may be dealing with this issue at some point in the near future. It makes sense to sit down with your partners in Fire, EMS and Health to establish a comprehensive plan now.
Prepared by Chief Michael Whalen (Ret.)
This publication is produced to provide general information on the topic presented. It is distributed with the understanding that the publisher (Daigle Law Group, LLC.) is not engaged in rendering legal or professional services. Although this publication is prepared by professionals, it should not be used as a substitute for professional services. If legal or other professional advice is required, the services of a professional should be sought.