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State of California—Health and Human Services Agency
California Department of Public Health

AFL 20-11
January 31, 2020

All Facilities

Updated 2019 Novel Coronavirus Information (2019-nCoV), Including Patient Under Investigation (PUI) Guidance from the Centers for Disease Control and Prevention (CDC)


​All Fac​ilties Letter (AFL) Summary 

This AFL provides updated information on 2019-nCoV including updated CDC guidance for PUI. 

NOTE: This AFL is no longer in effect and is for historical purposes only​​

​​The World Health Organization (WHO) has declared 2019-nCoV a Public Health Emergency of International Concern. China has reported a 26 percent increase of 2019-nCOV cases since January 30, 2020. Over 7,000 new cases worldwide have been reported within the past week. The CDC is taking progressive action to protect the public and decrease impact on the United States (US). The risk to the American public is still considered to be low.​

Updated 2019-nCoV Information

  • 2019-nCoV can be spread through person-to-person transmission
  • Recent report from Germany confirms that the disease can be transmitted from an asymptomatic individual
  • Screening with current laboratory tests is not effective in recognizing those who are incubating 2019-nCoV asymptomatically
  • A negative result does not mean someone will not start to show symptoms or contract 2019-nCoV
  • CDC does not recommend the use of face masks for the general public

For additional information, see the CDC 2019 Novel Coronavirus webpage.  ​

Updated CDC PUI Guidance

The CDC Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation for 2019 Novel Coronavirus (2019-nCoV) in a Healthcare Setting webpage

US Temporary Measures

A White House Briefing on January 31, 2020, announced that beginning at 5:00 p.m. Eastern Time on Sunday February 2, 2020, the US will implement the following temporary measures:

  • Any US citizen returning to US from Hubei province in the previous 14 days will be subject to up to 14 days mandatory quarantine to ensure they receive proper health screening and medical care
  • Any US citizen returning to the US from the rest of mainland China within the previous 14 days will undergo proactive entry health screening at a select number of ports of entry and up to 14 days of monitored self-quarantine to ensure they have not contracted the virus and do not pose a public health risk
  • President Trump has signed a Presidential Proclamation temporarily suspending entry into the US of foreign nationals that pose a risk of transmitting 2019-nCoV
  • Foreign nationals other than immediate family of US citizens and permanent residents who have traveled in China within the last 14 days will be denied entry into the US at this time​


If a PUI for 2019-nCoV is identified, or if a patient's status as a PUI is uncertain, health facilities must report this event, as required in Title 22 California Code of Regulations, to the local public health officer immediately and to your local CDPH Licensing & Certification District Office (DO), so the DO can communicate with the CDPH Medical and Health Coordination Center. See AFL 19-18 for additional information on the requirements of reporting outbreaks and unusual infectious disease occurrences.

If you have any questions regarding the infection prevention and control of 2019-nCoV, please contact the CDPH Healthcare-Associated Infections (HAI) Program at


Original signed by Heidi W. Steinecker

Heidi W. Steinecker

Deputy Director



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