Global & Disaster Medicine

Archive for February, 2020

The Center for Health Security & COVID-19

February 17, 2020

 

EPI UPDATES China’s National Health Commission reports 2,048 new confirmed cases, 1,563 suspected cases, and 105 deaths (including 100 in Hubei province). There have been 70,548 confirmed cases, and 1,770 deaths across 31 provincial regions in mainland China. A total of 150, 539 individuals are now under medical observation.

 

WHO reports a total of 683 confirmed cases outside of China across 25 countries and 3 deaths.

France has reported its first death in an 80-year Chinese tourist, becoming the first fatality in Europe from COVID-19.

Japan reports that 454 individuals have tested positive on the Diamond Princess cruise ship, including 189 asymptomatic cases. Japan also reported an additional 38 cases in the country.

Singapore has also confirmed a total of 77 cases, with 103 cases pending test results. Among the new cases reported in the country today, one came from Wuhan and one was linked to a previous case.

 

 

 

US STATEMENT ON REPATRIATION OF DIAMOND PRINCESS PASSENGERS The US State Department undertook voluntary repatriation of over 300 US citizens and immediate family members from the Diamond Princess cruise ship. During the evacuation, US officials were notified that 14 passengers had tested positive for the virus. These individuals, who were asymptomatic, were isolated on the aircraft. The flight will land at Travis Air Force Base or Joint Base San Antonio and individuals will remain under quarantine for 14 days.

 

 

COMPLEX SUPPLY CHAINS Supply chain disruptions and access to critical commodities such as personal protective equipment continues to be a primary concern during the ongoing COVID-19 outbreak. The challenge rests not only in the manufacturing of final product goods, but in the access to raw materials needed for manufacturing. For the United States, even if a commodity is manufactured domestically, it is likely that at least some component comes from a foreign supplier. So while economic projections may be estimating the impact epidemic in one way, understanding of supply chain complexities suggests that the indirect impacts may be far greater. Currently Chinese manufacturers of masks are operating at 76% capacity, producing approximately 15.2 million masks daily. However, projections of mask demand are estimated to be 50-60 million resulting in global runs on face masks and the implementation of rationing procedures by the Chinese government.

 

 

WHO RESPONSE TEAM ON THE GROUND IN CHINA The multidisciplinary international team of experts responding on behalf of the World Health Organization arrived in China and is beginning meetings with Chinese officials to discuss response strategies. The team is currently in Beijing and scheduled to visit Guangdong and Sichuan. The question remains on whether the team will visit Hubei province, the epicenter of the epidemic. Without visiting the epicenter of the outbreak it is unclear how well the team will be able to fully understand the current situation on the ground.

 

 

EMERGING CRITICISM OF RESPONSE IN CHINA Some news media have been critical of China’s home quarantine policy in Wuhan, citing the deaths of four family members while self-quarantining in their home.


Storm Dennis and the UK


In past four days alone, more than 150,000 Syrians flee villages as government forces close in on rebel-held Idlib.

 

AJ


Is there a risk for transportation of COVID-19 from Wuhan to other cities in China?

Du Z, Wang L, Chauchemez S, Xu X, Wang X, Cowling BJ, et al. Risk for transportation of 2019 novel coronavirus disease from Wuhan to other cities in China. Emerg Infect Dis. 2020 May [date cited]. https://doi.org/10.3201/eid2605.200146

DOI: 10.3201/eid2605.200146

Abstract:  “On January 23, 2020, China quarantined Wuhan to contain 2019 novel coronavirus disease (COVID-19). We estimated the probability of transportation of COVID-19 from Wuhan to 369 other cities in China before the quarantine. Expected COVID-19 risk is >50% in 130 (95% CI 89–190) cities and >99% in the 4 largest metropolitan areas.

Risks for transportation of 2019 novel coronavirus disease (COVID-19) from Wuhan, China, before a quarantine was imposed on January 23, 2020. A) Daily travel volume to and from Wuhan, given as a percentage of the Wuhan population. Gray shading indicates the start of Spring Festival season on January 10, 2020, a peak travel period in China. B) Estimated and reported daily prevalence of COVID-19 in Wuhan. The green line and shading indicate model estimates of cumulative cases since December 1, 201

Risks for transportation of 2019 novel coronavirus disease (COVID-19) from Wuhan, China, before a quarantine was imposed on January 23, 2020. A) Daily travel volume to and from Wuhan, given as a percentage of the Wuhan population. Gray shading indicates the start of Spring Festival season on January 10, 2020, a peak travel period in China. B) Estimated and reported daily prevalence of COVID-19 in Wuhan. The green line and shading indicate model estimates of cumulative cases since December 1, 2019, with 95% credible interval bounds, assuming an epidemic doubling time of 7.31 days (95% credible interval 6.26–9.66 days). Black dots indicate cumulative confirmed case counts during January 1–22, 2020 (10). Gray shading at right indicates the start of Spring Festival season. C) Probability that >1 COVID-19 case infected in Wuhan traveled to cities in China by January 22, 2020. The 131 cities with a risk threshold >50% are indicated in shades of orange; 239 cities below that threshold are indicated in shades of blue. Map generated by using Mapbox (https://www.mapbox.com).

 


China: Feb 13’s briefing on novel coronavirus cases in China

 

Feb 13: Daily briefing on novel coronavirus cases in China

Updated: 2020-02-13

|

en.nhc.gov.cn

On Feb 12, 31 provincial-level regions on the Chinese mainland as well as the Xinjiang Production and Construction Corps reported 15,152 new cases of confirmed infections (including 13,332 clinical cases in Hubei province), 2,807 new cases of suspected infections and 254 deaths (242 in Hubei province, 2 in Henan province, 1 in Tianjin, 1 in Hebei province, 1 in Liaoning province, 1 in Heilongjiang province, 1 in Anhui province, 1 in Shandong province, 1 in Guangdong province, 1 in Guangxi Zhuang autonomous region, 1 in Hainan province and 1 in the Xinjiang Production and Construction Corps). Serious cases decreased by 174. 1,171 patients were released from hospitals after being cured. 29,429 people who had had close contact with infected patients were freed from medical observation.

As of 24:00 on Feb 12, the National Health Commission had received 59,804 reports of confirmed cases and 1,367 deaths in 31 provincial-level regions on the Chinese mainland and the Xinjiang Production and Construction Corps, and in all 5,911 patients had been cured and discharged from hospital. There still remained 52,526 confirmed cases (including 8,030 in serious condition) and 13,435 suspected cases. So far, 471,531 people have been identified as having had close contact with infected patients. 181,386 are now under medical observation.

On Feb 12, Hubei province reported 14,840 new cases of confirmed infections (including 13,436 in Wuhan), 1,377 new cases of suspected infections (including 620 in Wuhan), and 242 deaths (including 216 in Wuhan). 802 patients were released from hospitals after being cured, including 538 in Wuhan.

As of 24:00 on Feb 12, Hubei province had reported 48,206 cases of confirmed infections (including 32,994 in Wuhan) and 1,310 deaths (including 1,036 in Wuhan). In all, 3,441 patients had been cured and discharged from hospital, including 1,915 in Wuhan. There still remained 43,455 confirmed cases (including 30,043 in Wuhan), with 7,084 in serious condition (including 5,426 in Wuhan), and 9,028 suspected cases (including 4,904 in Wuhan).

In order to promote the early diagnosis and treatment of patients infected with novel coronavirus and ensure all the patients in Hubei can be received and treated, the diagnosis criteria have been differentiated between Hubei and other provincial regions. Clinically diagnosed criteria have been established in Hubei. Suspected cases with pneumonia images are diagnosed as clinical cases, so that they can receive standard treatment as soon as possible in accordance with the relevant requirements of confirmed cases, further improving the success rate of treatment. At present, 13,332 clinical cases reported in Hubei have been included in the confirmed case statistics, and all-out efforts have been made to enhance treatment, reduce serious cases and decrease the fatality rate.

As of 24:00 on Feb 12, 78 confirmed infections had been reported in the Hong Kong and Macao special administrative regions and Taiwan province: 50 in Hong Kong (1 had been dead  and 1 had been cured and discharged from hospital), 10 in Macao (2 had been cured and discharged from hospital) and 18 in Taiwan (1 had been cured and discharged from hospital).


World experts and funders set priorities for COVID-19 research

https://www.who.int/news-room/detail/12-02-2020-world-experts-and-funders-set-priorities-for-covid-19-research

12 February 2020

News release
Geneva, Switzerland

Leading health experts from around the world have been meeting at the World Health Organization’s Geneva headquarters to assess the current level of knowledge about the new COVID-19 disease, identify gaps and work together to accelerate and fund priority research needed to help stop this outbreak and prepare for any future outbreaks.

The 2-day forum was convened in line with the WHO R&D Blueprint – a strategy for developing drugs and vaccines before epidemics, and accelerating research and development while they are occurring.

“This outbreak is a test of solidarity — political, financial and scientific. We need to come together to fight a common enemy that does not respect borders, ensure that we have the resources necessary to bring this outbreak to an end and bring our best science to the forefront to find shared answers to shared problems. Research is an integral part of the outbreak response,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “I appreciate the positive response of the research community to join us at short notice and come up with concrete plans and commitment to work together.”

The meeting, hosted in collaboration with GloPID-R (the Global Research Collaboration for Infectious Disease Preparedness) brought together major research funders and over 300 scientists and researchers from a large variety of disciplines. They discussed all aspects of the outbreak and ways to control it including:

  • the natural history of the virus, its transmission and diagnosis;
  • animal and environmental research on the origin of the virus, including management measures at the human-animal interface;
  • epidemiological studies;
  • clinical characterization and management of disease caused by the virus;
  • infection prevention and control, including best ways to protect health care workers;
  • research and development for candidate therapeutics and vaccines;
  • ethical considerations for research;
  • and integration of social sciences into the outbreak response.

“This meeting allowed us to identify the urgent priorities for research. As a group of funders we will continue to mobilize, coordinate and align our funding to enable the research needed to tackle this crisis and stop the outbreak, in partnership with WHO,” said Professor Yazdan Yazdanpanah, chair of GloPID-R. “Equitable access – making sure we share data and reach those most in need,  in particular those in lower and middle-income countries, is fundamental to this work which must be guided by ethical considerations at all times.”

During the meeting, the more than 300 scientists and researchers participating both in person and virtually agreed on a set of global research priorities. They also outlined mechanisms for continuing scientific interactions and collaborations beyond the meeting which will be coordinated and facilitated by WHO. They worked with research funders to determine how necessary resources can be mobilized so that critical research can start immediately.

The deliberations will form the basis of a research and innovation roadmap charting all the research needed and this will be used by researchers and funders to accelerate the research response.

Note to editors

GloPID-R is a global alliance of international research funding organizations investing in preparedness and response to epidemics.


Singapore: As of 13 February 2020, 12pm, the Ministry of Health (MOH) has confirmed and verified eight additional cases of COVID-19 infection in Singapore, all of which are linked to previous cases.

https://www.moh.gov.sg/news-highlights/details/eight-more-confirmed-cases-of-covid-19-infection

As of 13 February 2020, 12pm, the Ministry of Health (MOH) has confirmed and verified eight additional cases of COVID-19 infection in Singapore, all of which are linked to previous cases.

Links between previous cases found

1.     Further epidemiological investigations and contact tracing have uncovered links between previously announced and new cases. This was made possible with the assistance of the Singapore Police Force.

a.    Cases 8 and 9, as well as Cases 31, 33 and 38, are linked to The Life Church and Missions Singapore (146B Paya Lebar Road). This is a possible cluster involving five cases (Cases 8, 9, 31, 33 and 38).

b.     Nine of the confirmed cases (Cases 19, 20, 21, 24, 25, 27, 28, 34 and 40) are linked to the cluster associated with Yong Thai Hang (24 Cavan Road).

c.     Three of the confirmed cases (Cases 30, 36 and 39) are linked to the private business meeting held at Grand Hyatt Singapore from 20 to 22 January.

d.     Four of the confirmed cases (Cases 42, 47, 52 and 56) are linked to the Seletar Aerospace Heights construction site.

e.     Seven of the confirmed cases (Cases 48, 49, 51, 53, 54, 57 and 58) are linked to the Grace Assembly of God.

Investigations on these clusters are ongoing.

3.     Contact tracing is underway for the other seven locally transmitted cases to establish any links to previous cases or travel history to mainland China. Case 44 was a contact of Cases 13 and 26. Case 55 is linked to Case 50.

About the confirmed cases

Case 51

4.     Case 51 is a 48 year-old male Singapore Citizen with no recent travel history to China. He is currently warded in an isolation room at the National Centre for Infectious Diseases (NCID). He is linked to the cluster at Grace Assembly of God.

 

5.    He reported onset of symptoms on 4 February and sought treatment at a general practitioner (GP) clinic on 5 February and 10 February. He went to NCID on 11 February, and subsequent test results confirmed COVID-19 infection on 12 February afternoon.

 

6.     Prior to hospital admission, he went to work at Grace Assembly of God (Tanglin) (355 Tanglin Road) and Grace Assembly of God (Bukit Batok) (1 Bukit Batok West Avenue 4). He stays at Bishan Street 13.

Case 52

7.     Case 52 is a 37 year-old male Bangladesh national who is a Singapore Work Pass holder, and has no recent travel history to China. He is currently warded in an isolation room at NCID. He is linked to the cluster at Seletar Aerospace Heights construction site.

8.     He reported onset of symptoms on 7 February. As he was identified as a close contact of Cases 42 and 47, he was transported by an ambulance to Tan Tock Seng Hospital on 11 February. Subsequent test results confirmed COVID-19 infection on 12 February afternoon.

9.     Prior to hospital admission, he had gone to work at the Seletar Aerospace Heights construction site, the same location where Cases 42 and 47 had worked. He reported that he had mostly stayed at his rental apartment at Campbell Lane since the onset of symptoms.

Case 53

10.     Case 53 is a 54 year-old male Singapore Citizen with no recent travel history to China. He is currently warded in an isolation room at NCID. He is linked to the cluster at Grace Assembly of God.

11.     He reported onset of symptoms on 10 February, and went to NCID on 12 February where he was immediately isolated. Subsequent test results confirmed COVID-19 infection on 12 February afternoon.

12.     Prior to hospital admission, he reported that he had mostly stayed at home at Hillview Avenue. He works at the National University of Singapore, but had not interacted with colleagues and students after onset of symptoms.

Cases 54 to 58

13.     Cases 54 (54 year-old female Singapore Citizen), 57 (26 year-old male Singapore Citizen) and 58 (55 year-old male Singapore Citizen) are linked to the cluster at Grace Assembly of God. All three cases did not have recent travel history to China. They were confirmed to have COVID-19 infection on 13 February morning, and are currently warded in separate isolation rooms at NCID.

14.     Case 55 is a 30 year-old male Singapore Citizen with no recent travel history to China. He was confirmed to have COVID-19 infection on 13 February morning, and is currently warded in an isolation room at NCID. He is a family member of Case 50.

15.     Case 56 is a 30 year-old male Bangladesh national with no recent travel history to China. He was confirmed to have COVID-19 infection on 13 February morning, and is currently warded in an isolation room at NCID. He is linked to the cluster at the Seletar Aerospace Heights construction site.

16.     MOH has initiated epidemiological investigations and contact tracing to identify individuals who had close contact with the cases.

Case 50 (Announced on 12 February)

17.     Case 50 is a 62 year-old male Singapore Citizen with no recent travel history to China. He is currently warded in an isolation room at NCID.

18.     He reported onset of symptoms on 7 February and had sought treatment at two GP clinics on 7 February, 10 February and 11 February. He was admitted to NCID on 11 February and was immediately isolated. Subsequent test results confirmed COVID-19 infection on 12 February morning.

19.     Prior to hospital admission, other than going to work at DBS Asia Central at Marina Bay Financial Centre (12 Marina Boulevard), he had stayed at his home at Mei Hwan Drive, except to seek medical treatment.

Update on condition of confirmed cases

20.     To date, a total of 15 cases have fully recovered from the infection and have been discharged from hospital. Of the 43 confirmed cases who are still in hospital, most are stable or improving. Seven are in critical condition in the intensive care unit.

Update on suspect cases

21.     As of 13 February 2020, 12pm, 711 of the suspect cases have tested negative for COVID-19, and 58 have tested positive. Test results for the remaining 82 cases are pending.

Update on contact tracing for confirmed cases

22.     Contact tracing for the confirmed cases is ongoing. Once identified, MOH will closely monitor all close contacts. As a precautionary measure, they will be quarantined for 14 days from their last exposure to the patient. In addition, all other identified contacts who have a low risk of being infected will be under active surveillance, and will be contacted daily to monitor their health status.

23.     As of 13 February 2020, 12pm, MOH has identified 1,278 close contacts. Of the 1,161 who are still in Singapore, 1,144 have been contacted and are being quarantined or isolated. Efforts are ongoing to contact the remaining 17 close contacts.

Health advisory

24.     Singaporeans are advised to defer all travel to Hubei Province and all non-essential travel to Mainland China.

 

25.     All travellers should monitor their health closely for two weeks upon return to Singapore and seek medical attention promptly if they feel unwell. Travellers should inform their doctor of their travel history. If they have a fever or respiratory symptoms (e.g. cough, shortness of breath), they should wear a mask and call the clinic ahead of the visit.

26.     Travellers and members of the public should adopt the following precautions at all times:

  • Avoid close contact with people who are unwell or showing symptoms of illness;
  • Observe good personal hygiene;
  • Practise frequent hand washing with soap (e.g. before handling food or eating, after going to toilet, or when hands are dirtied by respiratory secretions after coughing or sneezing);
  • Wear a mask if you have respiratory symptoms such as a cough or shortness of breath;
  • Cover your mouth with a tissue paper when coughing or sneezing, and dispose the soiled tissue paper in the rubbish bin immediately; and
  • Seek medical attention promptly if you are feeling unwell.
  • MOH will continue to monitor the situation closely. As medical practitioners are on the lookout for suspect cases, Singapore is likely to see more cases that will need to be investigated.

MINISTRY OF HEALTH

13 FEBRUARY 2020


CDC Confirms 14th Case of 2019 Novel Coronavirus

Media Statement

For Immediate Release: Wednesday, February 12, 2020
Contact: Media Relations
(404) 639-3286

CDC today confirmed another infection with 2019 novel coronavirus (COVID-19) in the United States in California. The patient is among a group of people under a federal quarantine order because of their recent return to the U.S. on a State Department-chartered flight that arrived on February 7, 2020.

All people who have been in Hubei Province in the past 14 days are considered at high risk of having been exposed to COVID-19 and subject to a temporary 14-day quarantine. This is the second person at this base who has tested positive for COVID-19. The first and second patients arrived on different planes and were housed in separate facilities; there are no epidemiologic links between them.

According to CDC on-site team lead Dr. Chris Braden, “At this time there is no indication of person-to-person spread of this virus at the quarantine facility, but CDC will carry out a thorough contact investigation as part of its current response strategy to detect and contain any cases of infection with this virus.”
This brings the total of number of COVID-19 cases in the United States to 14. There are likely to be additional cases in the coming days and weeks, including among other people recently returned from Wuhan. While 195 people were discharged from quarantine yesterday, more than 600 people who returned on chartered flights from Wuhan remain under federal quarantine.

For the latest information on the outbreak, visit CDC’s Novel Coronavirus 2019 website.

###
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESexternal icon

CDC works 24/7 protecting America’s health, safety and security. Whether disease start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.

Page last reviewed: February 12, 2020


CDC: Frequently Asked Questions about Respirators and their Use

This document is intended to address frequently asked questions about respirators and their use.

Respiratory Protection

  1. Should I wear a respirator in public?
    1. CDC does not recommend the routine use of respirators outside of workplace settings (in the community). Most often, spread of respiratory viruses from person-to-person happens among close contacts (within 6 feet). CDC recommends everyday preventive actions to prevent the spread of respiratory viruses, such as avoiding people who are sick, avoiding touching your eyes or nose, and covering your cough or sneeze with a tissue. People who are sick should stay home and not go into crowded public places or visit people in hospitals. Workers who are sick should follow CDC guidelines and stay home when they are sick.
  2. What is a respirator?
    1. A respirator is a personal protective device that is worn on the face or head and covers at least the nose and mouth. A respirator is used to reduce the wearer’s risk of inhaling hazardous airborne particles (including infectious agents), gases or vapors. Respirators, including those intended for use in healthcare settings, are certified by the CDC/NIOSH.
  3. What is an N95 filtering facepiece respirator (FFR)?
    1. An N95 FFR is a type of respirator which removes particles from the air that are breathed through it. These respirators filter out at least 95% of very small (0.3 micron) particles. N95 FFRs are capable of filtering out all types of particles, including bacteria and viruses.
  4. What makes N95 respirators different from facemasks (sometimes called a surgical mask)?
    1. Infographic: Understanding the difference between surgical masks and N95 respiratorspdf icon
    2. N95 respirators reduce the wearer’s exposure to airborne particles, from small particle aerosols to large droplets. N95 respirators are tight-fitting respirators that filter out at least 95% of particles in the air, including large and small particles.
    3. Not everyone is able to wear a respirator due to medical conditions that may be made worse when breathing through a respirator. Before using a respirator or getting fit-tested, workers must have a medical evaluation to make sure that they are able to wear a respirator safely.
    4. Achieving an adequate seal to the face is essential. United States regulations require that workers undergo an annual fit test and conduct a user seal check each time the respirator is used. Workers must pass a fit test to confirm a proper seal before using a respirator in the workplace.
    5. When properly fitted and worn, minimal leakage occurs around edges of the respirator when the user inhales. This means almost all of the air is directed through the filter media.
    6. Unlike NIOSH-approved N95s, facemasks are loose-fitting and provide only barrier protection against droplets, including large respiratory particles. No fit testing or seal check is necessary with facemasks. Most facemasks do not effectively filter small particles from the air and do not prevent leakage around the edge of the mask when the user inhales.
    7. The role of facemasks is for patient source control, to prevent contamination of the surrounding area when a person coughs or sneezes.  Patients with confirmed or suspected 2019-nCoV should wear a facemask until they are isolated in a hospital or at home. The patient does not need to wear a facemask while isolated.
  5. What is a Surgical N95 respirator and who needs to wear it?
    1. A surgical N95 (also referred as a medical respirator) is recommended only for use by healthcare personnel (HCP) who need protection from both airborne and fluid hazards (e.g., splashes, sprays). These respirators are not used or needed outside of healthcare settings. In times of shortage, only HCP who are working in a sterile field or who may be exposed to high velocity splashes, sprays, or splatters of blood or body fluids should wear these respirators, such as in operative or procedural settings. Most HCP caring for confirmed or suspected 2019-nCoV patients should not need to use surgical N95 respirators and can use standard N95 respirators.
    2. If a surgical N95 is not available for use in operative or procedural settings, then an unvalved N95 respirator may be used with a faceshield to help block high velocity streams of blood and body fluids.
  6. My employees complain that Surgical N95 respirators are hot and uncomfortable – what can I do?
    1. The requirements for surgical N95 respirators that make them resistant to high velocity streams of body fluids and help protect the sterile field can result in a design that has a higher breathing resistance (makes it more difficult to breath) than a typical N95 respirator. Also, surgical N95 respirators are designed without exhalation valves which are sometimes perceived as warmer inside the mask than typical N95 respirators. If you are receiving complaints, you may consider having employees who are not doing surgery, not working in a sterile field, or not potentially exposed to high velocity streams of body fluids wear a standard N95 with an exhalation valve.
  7. My N95 respirator has an exhalation valve, is that okay?
    1. An N95 respirator with an exhalation valve does provide the same level of protection to the wearer as one that does not have a valve. The presence of an exhalation valve reduces exhalation resistance, which makes it easier to breathe (exhale). Some users feel that a respirator with an exhalation valve keeps the face cooler and reduces moisture build up inside the facepiece. However, respirators with exhalation valves should not be used in situations where a sterile field must be maintained (e.g., during an invasive procedure in an operating or procedure room) because the exhalation valve allows unfiltered exhaled air to escape into the sterile field.

CDC: Flowchart to Identify and Assess 2019 Novel Coronavirus

 

Flowchart to Identify and Assess 2019 Novel Coronavirus for the evaluation of patients who may be ill with or who may have been exposed to 2019 Novel Coronavirus (2019-nCoV)

Text Equivalent

For the evaluation of patients who may be ill with or who may have been exposed to 2019 Novel Coronavirus (2019-nCoV)

  1. Identify if in the past 14 days since first onset of symptoms a history of either travel to china or close contact with a person known to have 2019-nCoV illness*
  2. AND the person has fever or symptoms of lower respiratory illness (e.g., cough or shortness of breath)

if both exposure and illness are present

  1. Isolate
  • Place facemask on patient
  • Isolate the patient in a private room or a separate area
  • Wear appropriate personal protective equipment (PPE)
  1. Assess clinical status.

EXAM

Is fever present?

Subjective?

Measured? _____°C/F

Is respiratory illness present?

Cough?

Shortness of breath?

  1. Inform
  • Contact health department to report at-risk patients and their clinical status
  • Assess need to collect specimens to test for 2019-nCoV
  • Decide disposition

If discharged to home

Instruct patient as needed depending on severity of illness and health department consultation

  • Home care guidance
  • Home isolation guidance

Advise patient if the patient develops new or worsening fever or respiratory illness

  • Call clinic to determine if reevaluation is needed
  • If reevaluation is needed call ahead and wear facemask

* Documentation of laboratory-confirmation of 2019-nCoV may not be possible for travelers or persons caring for patients in other countries. For more clarification on the definition for close contact see CDC’s Interim Guidance for Healthcare Professionals.


Categories

Recent Posts

Archives

Admin