Because Coronavirus is a hot topic and could impact many of our clients and their patients, we pulled together some information to ensure that you stay up to date with how to protect yourself, your clinic, and your patients from this fast-moving virus. This information was relevant as of March, 2020.
What is the Coronavirus disease?
Coronavirus disease (COVID-19) is a respiratory disease caused by a new coronavirus outbreak that began in Wuhan, Hubei Province, China. Coronaviruses are a large family of viruses that are common in people and many different species of animals, including camels, cattle, cats, and bats. This virus has its origin in bats. Another known coronavirus is severe acute respiratory syndrome (SARS) which caused an outbreak in 2003 and was contained with no known cases since 2004.
Due to the person-to-person spread of COVID-19, the virus has now been detected in 60 locations internationally due to international travelers carrying the virus. The CDC reported community spread of the virus in California, Oregon, and Washington during the week of February 23rd. The last update released from the CDC on 3/3/2020 notes cases in the US to have reached a total of 60 cases, 6 deaths, and 12 states reporting cases. The states with reported cases are Washington, Oregon, California, Arizona, Wisconsin, Illinois, New York, New Hampshire, Massachusetts, Rhode Island, Georgia, and Florida. At this time, however, most people in the United States will have little immediate risk of exposure to this virus. Due to this being a novel virus, it is a rapidly evolving situation with new information being released as more details are learned.
How does it spread?
Based on what is currently known about COVID-19 and what is known about other coronaviruses, spread is thought to occur mostly from person-to-person via respiratory droplets among close contacts.
How to Protect Your Clinic and Patients
Here are the recommendations from the CDC for healthcare facilities and businesses to be taking at this time.
- Stay informed on the local situation and make sure you know about healthcare and public health emergency planning and response activities in your community.
- Communicate with your staff and patients.
- Consider posting visual alerts (e.g., signs, posters) at the entrance and in strategic places (e.g., waiting areas, elevators, cafeterias) to provide patients and health care professionals with instructions (in appropriate languages) about hand hygiene, respiratory hygiene, and cough etiquette.
- Screen patients and visitors for symptoms of acute respiratory illness (e.g. fever, cough, difficulty breathing), have recently traveled from an affected area, or have been in close contact with someone with COVID-19 or pneumonia of unknown cause, and ensure proper use of personal protection equipment (PPE). Seek guidance from your management team on how to handle the situation of someone displaying these symptoms while in your clinic.
- Employees who have symptoms of acute respiratory illness are recommended to stay home and not come to work until they are free of fever (100.4° F [37.8° C] or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines (e.g. cough suppressants). Employees who appear to have acute respiratory illness symptoms (i.e. cough, shortness of breath) upon arrival to work or become sick during the day should be separated from other employees and be sent home immediately.
- Conduct an inventory of PPE.
- Provide supplies for respiratory hygiene and cough etiquette, including 60%-95% alcohol-based hand sanitizer (ABHS), tissues, no touch receptacles for disposal, and facemasks at healthcare facility entrances, waiting rooms, patient check-ins, etc.
- Ensure that environmental cleaning and disinfection procedures are followed consistently and correctly.
- Routinely clean all frequently touched surfaces in the workplace, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label. No additional disinfection beyond routine cleaning is recommended at this time.
- Provide disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls, desks) can be wiped down by employees before each use.
How to Protect Yourself
You can protect yourself by following the below guidelines:
- Avoid close contact with people who are sick.
- Avoid touching your eyes, nose, and mouth.
- Stay 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 using a regular household cleaning spray or wipe.
- Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
COVID-19 and Children
On February 7th, an article was released titled “What pediatricians need to know about 2019-nCoV.” This was before the official name of the disease was updated to COVID-19. They made recommendations to parents of children stating the following:
“Parents and children should also take the usual precautions that they take to prevent influenza such as avoiding contact with sick people; limiting contact with other people if sick themselves; staying home when sick; covering the nose and mouth when coughing or sneezing; avoiding contact with the nose and mouth; disinfecting surfaces and objects; and washing hands often with soap and water or using an alcohol-based hand sanitizer that has at least 60% alcohol.”
The CDC has released specific information about the disease as it relates to children. They list the same preventative steps as noted by this article.
The clinical presentation of COVID-19 is the same in children so you can screen when extra precautionary measures need to be taken during your treatment sessions. The CDC references limited reports from China are siting cold-like symptoms, such as fever, runny nose, and cough. Gastrointestinal symptoms (vomiting and diarrhea) have been reported in at least one child with COVID-19. These limited reports suggest that children with confirmed COVID-19 have generally presented with mild symptoms, and though severe complications (acute respiratory distress syndrome, septic shock) have been reported, they appear to be uncommon.
For more information regarding the current status of the Coronavirus and recommendations for healthcare professionals, visit www.cdc.gov.