Coronavirus
disease 2019 (COVID-19) – “A threat that everyone should be aware of.”
Coronavirus
disease 2019 (COVID-19) - is an infectious disease caused by SARS-CoV-2, a virus closely related
to the SARS virus. The disease is the cause of the 2019-2020 coronavirus
outbreak. It is primarily spread between people via respiratory droplets from
infected individuals when they cough or sneeze. Time from exposure to onset of
symptoms is generally between 2 and 14 days. Spread can be limited by
handwashing and other hygiene measures.
People may have few symptoms or develop fever, cough, and shortness of breath. Cases can progress to pneumonia and multi-organ failure. The mortality rate is around 2%. There is no vaccine or specific antiviral treatment, with management involving treatment of symptoms, supportive care, and experimental measures.
Cases were initially identified in Wuhan,
capital of Hubei province in china in December 2019. Cases reported outside
China have predominantly been in people who have recently travelled to Mainland
China, however a few cases of local transmission have also occurred. More than
2,300 deaths have been reported in Mainland China, and 15 deaths in other parts
of the world.
Cases of Covid-19 first emerged in December 2019,
when a mysterious illness was reported in Wuhan, China. The cause of the disease
was soon confirmed as a new kind of coronavirus, and the infection has spread
to a number of countries around the world.
On 11 February the World Health Organization
announced that the official name would be covid-19, a shortened version of
coronavirus disease 2019. The WHO refers to the specific virus that causes this
disease as the covid-19 virus.
A member
of the coronavirus family, COVID-19 is a zoonotic disease – meaning it jumped
from animals to humans. These viruses often originate in bats, but may travel
through another species on its way to infecting humans.
Bats are very rarely found in wildlife markets like the one where the
outbreak likely began.
Researchers in China suspect the endangered pangolin may serve as an
intermediate host between bats and humans, pangolins are also rarely found in
wildlife markets. Though it’s the world most trafficked animal, pangolins are
typically killed and their scales removed for medicinal use.
People wearing protective masks shopping at a super market in
Shenyang in China’s northeastern Liaoning province.
On the
animal front, it’s still an ongoing battle to balance awareness (considering
potential zoonotic sources and what to do with exposed animals) and
over-reaction (resulting in paranoia about contact with any animals). We still
have no evidence that this virus affects domestic animals, but since we also
still have no real evidence that it doesn’t, it’s best to continue to take
reasonable precautions to reduce the risk of exposure of animals to infected
people, and to properly manage pets of people who are infected. It’s not
necessarily complicated, and it hopefully won’t be necessary, but it’s always
better to practice prevention than damage control.
China’s
National Health Commission reported an additional 114 deaths, and 394 new
confirmed cases as of Feb. 19. That brings that total deaths in the mainland to
2, 118 and the confirmed cases to 74,576 cases.
A disinfection worker in protective gear sterilizes a restaurant against
the novel coronavirus, in Tong-in Market placed in the center of Seoul, on
February 07, 2020.
What Nurses Need to Know
1. Preparedness, Early
Identification, and Notification
Develop and educate
all staff on a preparedness plan that provides infection control procedures and
protocols used within your healthcare facility for the early identification,
containment, and care of patients with symptoms associated with Coronavirus Disease
(COVID-19) to prevent spread within your healthcare facility.
o
Develop inpatient, ambulatory, and home care policies and procedures
that are in line with current CDC guidelines for COVID-19
o
Provide training to all personnel on screening and isolation procedures
o
Provide updated training and guidelines on the use of Personal
Protective Equipment (PPE), such as the use of gloves, gowns, masks, eye
protection, and a face shield
o
Display clear signage with instructions for the use of PPE
o
Ensure consistent use of proper hand hygiene, standard precautions,
contact precautions, and airborne precautions, along with the proper use of a
National Institute for Occupational Safety and Health (NIOSH)-Approved N-95
respirator or higher
o
Clearly display signage for patients that lists symptoms and
instructions to wear a face mask before entering the healthcare facility if
symptoms are present.
o
Incorporate assessment questions to document a detailed travel history
when patients present with fever, cough, or respiratory illness. Consider COVID-19 if the patient traveled to China
within the last 14 days.
o
Identify, in advance, airborne infection isolation rooms (AIIR) or
negative pressure rooms, for quarantine and screening
o
Outline staffing protocols to facilitate care of patients with COVID-19 and to minimize
patient-to-patient transmission
o
Have available for immediate notification of Patient’s Under
Investigation (PUI) the infection control personnel at your facility and the
local and state health department. Click here for additional Recommendations for Reporting,
Testing, and Specimen Collection and the fillable COVID-19 PUI case investigation form
For Patients Under
Investigation (PUI), follow the Criteria to Guide Evaluation of PUI
for COVID-19
2. Isolation,
Quarantine, Monitoring, and Hospitalization
The CDC recommends
several steps for identification and maintenance of
COVID-19 along with detailed guidelines for isolation
precautions to prevent transmission. Have clearly displayed a flowchart for early identification
and assessment of COVID-19 At this time, the exact mode(s) of
transmission remain undetermined, but person-to-person transmission has been
identified.
1.
Have masks available for PUI to don before entering the healthcare
facility
2.
Once identified, isolate the patient to airborne infection isolation
rooms (AIIR) or negative pressure room and keep the door closed. Conduct the
assessment in this room.
3.
Healthcare personnel entering the room should use standard precautions,
contact precautions, airborne precautions, and eye protection (goggles or a
face shield)
4.
Don Personal Protective Equipment (PPE) before entering the room
5.
Have guidelines for the proper use of PPE displayed throughout the
healthcare facility
Notify your infection
control personnel and the local and state health department of suspected cases
3. How to Educate Your
Patients and Minimize Spread within the Community
Per the CDC, it is
known that coronavirus is part of a large family of viruses that can cause
illness in people and animals.1 While the mode(s)
of transmission of COVID-19 remain under investigation, the CDC provides the following
interim guidance to help prevent COVID-19 from spreading among people in homes
and communities4:
o
Stay home except to get medical care, do not use public transportation
or taxis
o
Call first before visiting your healthcare provider to notify of the
need for evaluation for COVID-19. Follow the instructions provided by your
healthcare team.
o
Separate yourself from other people in your home, utilize a separate
bathroom
o
Wear a facemask
o
Cover your coughs and sneezes
o
Wash your hands frequently with soap and water for at least 20 seconds
o
Avoid sharing household items
o
Monitor your symptoms
Standard recommendations to prevent the spread
of COVID-19 include frequent
cleaning of hands using alcohol-based hand rub or soap and water; covering the
nose and mouth with a flexed elbow or disposable tissue when coughing and
sneezing; and avoiding close contact with anyone that has a fever and cough.
