First Published: January 27, 2020
Last Update: March 25, 2020

Earlier this month a new coronavirus was identified in Wuhan City, Hubei Province of China. The novel coronavirus, or COVID-19, belongs to a group of virus known to cause symptoms ranging from the common cold to severe acute respiratory infections (SARI). Two prior coronaviruses, Severe Acute Respiratory Syndrome (SARS-CoV) and Middle East Respiratory Syndrome (MERS-CoV) together have affected over 10,000 people and have resulted in over 1,600 deaths. COVID-19 has been spreading between people in close contact (within 6 feet) via respiratory droplets typically when an infected person coughs or sneezes. 

If you suspect a patient may be infected with COVID-19, immediately implement appropriate infection prevention and control (IPC) measures (World Health Organization, 2020).

• Institute standard precautions for all patients
  • Practice strict hand washing and respiratory hygiene
  • Apply masks to suspect patients and place them on isolation if possible
  • Instruct patients to cover nose and mouth when coughing or sneezing
  • Perform hand hygiene after contact with respiratory secretions
  • Use personal protective equipment (PPE) [mask, gown, gloves] to avoid contact with patient blood and other body fluids
  • Prevent needle-stick or sharps injury
  • Ensure safe waste management, environmental cleaning and sterilization of patient equipment
• Implement contact and droplet precautions for suspected COVID-19 infection
  • Patients should be placed in properly ventilated single rooms
  • Don PPE: medical mask, goggles or face shield, a clean, non-sterile, long-sleeve fluid resistant gown, and always wear gloves; remove PPE when leaving the room.
  • Use single use, disposable equipment or dedicated equipment; if equipment must be shared, clean and disinfect with 70% ethyl alcohol between each patient use
  • Clean and disinfect patient-contact surfaces regularly
• Institute airborne precautions for aerosol-generating procedures such as open suction of the respiratory tract, administration of nebulized treatments, tracheal intubation, tracheotomy, cardiopulmonary resuscitation, manual ventilation before intubation, disconnecting the patient from the ventilator, non-invasive positive pressure ventilation (NIPPV), physical proning of the patient, and bronchoscopy
  • Use particulate respirator (i.e. N95, FFP2 or equivalent)
  • Don PPE: eye protection, gown, gloves
  • Perform procedures in a negative pressure room
  • Limit the number of people in the room to the minimum required to care for and support the patient.

Patient education

The only way to avoid COVID-19 virus is to prevent exposure to it. The Centers for Disease Control and Prevention (CDC, 2020) recommends the following everyday actions to help deter the spread of all respiratory viruses:

• Wash your hands often with soap and water for 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay at home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces.

Anyone who may have been exposed to COVID-19 should contact their healthcare provider immediately.

References:
Centers for Disease Control and Prevention (2020). About 2019-nCov: Prevention & Treatment. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html

World Health Organization (2020a). Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected. Retrieved from https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected