Case: In the sections below, “cases” refer to individuals with a positive viral test (i.e., a PCR or antigen test, including self-administered and self-read tests) for COVID-19. For outbreak investigations individuals who tested positive for COVID-19 with an over-the-counter rapid antigen test, without CLIA oversight, are included in the outbreak case counts.
Epidemiological links: Epidemiological links among cases exist when the cases are present in the same setting during the same time period while at least one case was infectious. Epidemiological links indicate a higher likelihood of transmission of disease between cases in that setting rather than sporadic transmission from the broader community.
Education settings: Include TK-12 schools, early care and childhood centers, institutes of higher education, and programs serving school-aged children (including day care, camps, and youth sports programs).
Workplace settings: Include, but not limited to: manufacturing, storage, transport, distribution, offices, retail, construction, media, fitness/gyms, restaurants, ticketed and non-ticketed transit, civic organizations, law enforcement, places of worship, government, auto, hotels, banks, and veterinary offices.
Non-residential settings: Worksites, food service facilities, places of worship, law enforcement and courts, and educational settings such as early care and education, TK-12 schools, programs serving school-aged children, and institutes of higher education (IHE). (Programs serving school-aged children include day care, camps, and youth sports programs.) Educational settings where no students are present (such as District Offices) will be reported as Education Outbreaks and should follow Reporting Procedures for Education Settings, but the Outbreak Investigation team may choose to follow General Investigation Guidelines for Workplace Settings.
Residential settings: Residential congregate facilities associated with the sectors listed above where employees and/or students reside.Outbreak-associated cases are:
For additional information regarding the incubation, transmission, infectiousness, and diagnostic procedures, see the COVID-19 Core Information/Background chapter.
Under Title 17, Section 2500, California Code of Regulations, all suspected outbreaks are reportable.
GENERAL COMMUNITY: NON-RESIDENTIAL SETTINGS
Outbreak definition: At least 3 cases with symptomatic or asymptomatic COVID-19 infection within a 7-day period who are epidemiologically linked,* do not share a household, and are not close contacts of each other outside of the outbreak site (except when transportation is provided by the employer or site).
For workplace settings with more than 100 employees on-site, an outbreak is also defined as 5% of the facility census are cases (symptomatic or asymptomatic) within a 7-day period even in the absence of identifiable epidemiological links. This second definition does NOT apply to educational settings.
NOTE: Cases sharing housing or transportation provided by the employer are evaluated as individual cases as employer-provided facilities are considered an extension of the worksite.
GENERAL COMMUNITY: RESIDENTIAL SETTINGS
Outbreak definition: At least 3 cases with symptomatic or asymptomatic COVID-19 infection within a 7-day period who are epidemiologically linked* and are residents and/or staff who live within the same dwelling or multiple dwellings that share a common area.
Dwelling includes residential settings where groups of staff or students reside, e.g., shared housing provided by employer or residence halls on an IHE campus.
*Epidemiological links require cases to be present in the same setting during the same time period while at least one case was infectious. (See COVID-19 Core/Background Information for communicability/period of infectiousness.) Epidemiologically-linked cases include persons with identifiable connections to each other, such as sharing a physical space (e.g., same physical work area, same shift/department, same office, same classroom, or same team/club) within likely timing of exposure and without other more likely sources of exposure. Epidemiological links indicate a higher likelihood of transmission of disease between cases in that setting rather than sporadic transmission from the broader community.
EDUCATION SETTING OUTBREAK INVESTIGATIONS can be conducted over the phone. The frequency of follow-up with the facility for outbreak
updates will be at least weekly, but more frequently as needed and determined by Outbreak Investigation team.
WORKSITE OUTBREAK INVESTIGATIONS will be classified by ACDC for Enhanced Investigation or Employer Guidance. If an outbreak that ACDC opened as Employer Guidance later meets Enhanced Investigation criteria, Outbreak Investigation team can re-classify without the need for ACDC notification or approval.
In addition to the measures outlined above, the following actions should be implemented for residential congregate settings associated with these sectors where employees and students may reside.
CalCONNECT New User Access
Line List Templates (for internal use only, not to be shared with outbreak site liaison)
SPOT Quick Guides for outbreak site liaisons