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

AFL 20-13
February 10, 2020

All Facilities

2019 Novel Coronavirus Interim Guidance for Risk Assessment and Health Management of Healthcare Personnel with Potential Exposure

​All Facilities Letter (AFL) Summary 

This AFL notifies health facilities that the Centers for Disease Control and Prevention (CDC) has released interim guidance on risk assessment and management of potential exposure of healthcare personnel (HCP) to the 2019-nCoV. ​

NOTE: This AFL is no longer in effect and is for historical purposes only​

​On February 8, 2020, the CDC released interim guidance to assist health facilities with assessment of risk, monitoring, and work restriction decisions for HCP with potential exposure to 2019-nCoV. Healthcare facilities should review the CDC's Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with 2019 Novel Coronavirus (2019-nCoV).

Risk Assessment

The CDC Interim Guidance includes risk assessment categories for health facilities to use when assessing the level of risk after a HCP has experienced potential exposure. Additionally, the interim guidance provides monitoring recommendations based on each risk assessment category. The HCP exposure risk factors described in the CDC interim guidance include, but are not limited to, the following:

  • The duration of exposure (e.g., longer exposure time likely increases exposure risk)
  • Clinical symptoms of the patient (e.g., coughing likely increases exposure risk)
  • Whether the patient was wearing a facemask (which can efficiently block respiratory secretions from contaminating others and the environment)
  • Whether an aerosol generating procedure was performed
  • The types of personal protective equipment (PPE) used by HCP

Information on the 2019-nCoV remains limited; therefore, the CDC recommends that heath facilities use clinical judgment as well as the principles outlined in the CDC Interim Guidance when evaluating risk of exposure and management of potential exposure of HCP. Health facilities should use this guidance in coordination with their local public health department to assess risk, determine the need for work restrictions, and guide monitoring decisions.

Travel or Community Exposure

HCP with potential travel or community exposures to 2019-nCoV should have their exposure risk assessed according to the CDC Interim Guidance for travel or community-associated exposures. HCP who fall into the high- or medium- risk category described there should undergo monitoring as defined by their local public health authority and be excluded from work in a healthcare setting until 14 days after their exposure. Healthcare facilities should additionally consider work exclusion for HCP that returned from China before the CDC guidance became effective on February 3, 2020 and are still within the 14-day incubation period.


Since response and prevention planning for the 2019-nCoV is constantly changing as we learn more about this emerging disease, CDPH will host weekly All Facility Calls every Tuesday morning at 7:45 a.m. Depending on what new information develops, we will adjust these calls each week to be for all facilities, or only for specific facility types. Tomorrow's call will be geared toward hospitals only, but future calls will include all facilities. You will receive information for the call-in number via the California Health Alert Network (CAHAN) and meeting invitations from our Medical and Health Coordination Center (MHCC).

Again, 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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