FROM: Wayne Perry, REMS Council Executive Director
DATE: Monday, January 27, 2020
SUBJECT: infectious disease update on Novel Coronavirus (n2019CoV)
As I’m sure you have heard, there is a novel coronavirus impacting individuals in China and those that travel to the Wuhan region. In consultation with the Regional OMD, providers are encouraged to gather complete travel history on every patient. Take respiratory precautions dealing with patients who have recently traveled to China, Japan, Thailand, and/or Korea; especially when performing airway procedures.
Here is a link to information from the European Respiratory Society which provides guidance for patient interactions. Additional and potentially rapidly changing/updating information can be found on the CDC website and through situation reports from the World Health Organization. Attached is a letter distributed throughout the medical community in the RAHD via the health department. The Northern Virginia Hospital Alliance has posted an event log in VHASS as a platform for agencies to update and communicate on the emerging landscape for n2019CoV. As an example of the rapidly changing status, as of this morning the VDH is currently monitoring three potential cases near the PD16 region; here is an excerpt from the VDH press release:
VDH is encouraging health care providers to ask patients about recent international travel and consider 2019-nCoV infection in patients who traveled to Wuhan, China within 14 days of onset of symptoms, including fever and respiratory symptoms. When potential cases are reported, laboratory samples are submitted to the CDC for testing. These cases are called Patients Under Investigation.
Currently Virginia is investigating three residents in the central (2) and northern (1) regions of Virginia who meet both clinical and epidemiologic criteria for 2019-nCoV. Beginning January 27, VDH will post the number of Patients Under Investigation (PUIs) who meet both clinical and epidemiologic criteria for 2019-nCoV testing at the Centers for Disease Control and Prevention (CDC) on the VDH novel coronavirus webpage. To protect patient confidentiality, specific details about these patients will not be provided. Public health is working closely with these patients and anyone who was in close contact to prevent the spread of illness. – read the full press release here.
SPECIFIC EMS MANAGEMENT AND TRANSPORT CONSIDERATIONS
- If the patient exhibits symptoms of an acute febrile** lower respiratory infection (fever, shortness of breath/difficulty breathing, cough):
a. Place a surgical mask on the patient AND
b. Obtain a detailed travel history to affected countries within the past 14 days*** or close contact with someone under investigation for 2019-nCoV
- If there is a history consistent with concern for potential 2019-coronavirus (2019-nCoV), initiate standard contact and airborne precautions (gloves, gown, N95 respirator) and eye protection (goggles) for EMS clinicians.
- Notify the receiving hospital (according to local protocols) of potential infection as soon as possible to allow for emergency department preparation.
- Use caution with aerosol generating procedures.
- Properly doff and dispose of PPE according to protocol.
- Cleaning and disinfection using EPA registered disinfectants with known effectiveness against human coronaviruses.
- Waste management per policy for medical waste (red bag).
*Close contact is defined as being within about 6 feet, or within the same room or care area, of a patient with confirmed 2019-nCoV without wearing PPE for a prolonged period of time OR having direct contact with 2019-nCoV patient secretions.
We encourage you to post this in all patient care areas and help disseminate this information as widely as possible to all of your providers.
If you should have any questions or feedback, please contact the REMS Council at 540.373.0249.