Coronavirus (COVID-19): We Want to Hear from You

[NormaSaline]

Good that you're doing this!

[scribblz, BSN, CNA, LPN]

Our Infectious Disease Dept. has the ED screening all people with respiratory illness for recent travel to China. People who meet that criteria are placed on airborne precautions until we can verify that they don't have the virus.

[mmc51264, BSN, MSN, RN]

One of the lucky ones!!! We have one case where I am-not confirmed yet. We had a protocol I place before the 1st one identified in US.

[OliveOyl91, BSN, RN]

I work in Washington state. We are also screening individuals for respiratory illnesses and recent travel activity. I happened to be taking a class with our infection control nurse earlier in the week and she went onto a coronavirus tangent saying that until we learn more about the virus and how it’s spread, we will be to placing any potential coronavirus patient into airborne isolation much like how we did during our measles outbreak. I haven’t worked the floor since (I’m back tomorrow night), but I’m sure more education has been sent to our emails.

Addendum:

Our hospital has also discontinued using N95 masks and anyone working with airborne patients is required to use a PAPR.

[tnbutterfly - Mary, BSN]

On 1/25/2020 at 1:11 PM, OliveOyl91 said:

I work in Washington state. We are also screening individuals for respiratory illnesses and recent travel activity. I happened to be taking a class with our infection control nurse earlier in the week and she went onto a coronavirus tangent saying that until we learn more about the virus and how it’s spread, we will be to placing any potential coronavirus patient into airborne isolation much like how we did during our measles outbreak. I haven’t worked the floor since (I’m back tomorrow night), but I’m sure more education has been sent to our emails.

Addendum:

Our hospital has also discontinued using N95 masks and anyone working with airborne patients is required to use a PAPR.

Thanks for the info. Please post your updates here as you receive additional guidelines.

[LovingLife123]

Just found out there may be a local case here. This will be interesting as they have told pregnant workers to stay home. It’s not my particular hospital, but the one actually in my neighborhood. It’s all hush hush at the moment. I’m waiting to see if it gets confirmed.

[Sbhayes09, ADN, RN]

There was a suspected case in Raleigh NC but they just confirmed it wasn't the coronavirus.

[Walti, LPN, LVN, RN, EMT-I]

This is a very concerning outbreak. China is placing entire cities on lock-down. I don't think it is possible to contain it. At best the rate of contagion might be slowed but it is likely to go worldwide fairly quickly.

I doubt that we re getting a very complete picture of the problem. What pictures we I've seen show this is beyond gowns, gloves and masks. workers are shown in full on hazmat suits. This will stretch resource available resources to the breaking point and I fear it will break. I would be very interested in incubation period, duration and mortality rate.

Quarantining suspected cases should not be done by cohorting as we will be exposing non infected but suspicious to infected but not confirmed pts.

[SummitRN, BSN, RN]

Epic rolled out traveler screening to all Epic clients 5 days ago. I'm nor sure for Cerner or Meditech.

Please make sure you have read the latest CDC HAN on nCoV2019: https://emergency.cdc.gov/han/han00426.asp

CDC Update page on nCoV 2019 for HCPs: https://www.cdc.gov/coronavirus/2019-nCoV/guidance-hcp.html

Clinical Presentation of 2019-nCoV: https://www.thelancet.com/action/showPdf?pii=S0140-6736(20)30183-5

nCoV 2019 recommended isolation is AIRBORNE + CONTACT. Out of an abundance of precaution and preparedness, I think now is a good time to suggest your facility:

1. Tabletop exercise a suspected nCoV patient arrive. Procedures down pat? Problems to overcome?

2. Practice converting normal rooms to AIIR with constructed barrier anterooms and HEPA filters. How long did it take from request to completion? How many rooms can you convert in your ED or MICU?

3. Have staff practice donning and doffing contact+airborne both with PAPRs and N95s (because I guarantee your PAPR only facility has a N95 stock backup). https://www.cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf

4. PAPR-only facilities should examine the N95 fit-testing plan if N95s are needed. This should be part of your EP plan.

5. Increase reserve PPE inventory levels by one month.

[NurseSpeedy, ADN, LPN, RN]

On 1/25/2020 at 12:12 AM, scribblz said:

Our Infectious Disease Dept. has the ED screening all people with respiratory illness for recent travel to China. People who meet that criteria are placed on airborne precautions until we can verify that they don't have the virus.

I have to wonder if any airplane travel would pose an increased risk. We all know the planes go all around the world and are probably less clean than a day care center. Trays never wiped down, etc.

[EngineerPaul]

In answer to your question, airplane travel is an increased risk. I say that based on the fact that it is said to be airborne transmission, and an airplane is a confined space where many are in close proximity to each other much more so than what is found in most offices or homes.

As such travel by trains, buses, taxi are all much greater risk than your own vehicle with a new cabin filter. However there are reports of taxi drivers cleaning the inside of vehicles in China between passengers. This may not be enough, as none have said for certain. Also there are many locations inside vehicles that are nearly impossible to access and clean based on personal experience.

As my first thoughts reading how China is handling this, they appear to be not completely sure of all the transmission paths based on the fact that some bodies have been incinerated, as we know this is the only guaranteed way of killing all agents. In addition the mandatory quarantines, and cleaning protocols that have been mentioned.

Perhaps cleaning trays with bleach, but that is not effective against everything. It is better than doing nothing.

All that I have found is:

Abstract

As reported by the World Health Organization, a novel coronavirus (2019-nCoV) was identified as the causative virus of Wuhan pneumonia of unknown etiology by Chinese authorities on 7 January, 2020. In this study, we developed a Bats-Hosts-Reservoir-People transmission network model for simulating the potential transmission from the infection source (probable be bats) to the human infection. Since the Bats-Hosts-Reservoir network was hard to explore clearly and public concerns were focusing on the transmission from a seafood market (reservoir) to people, we simplified the model as Reservoir-People transmission network model. The basic reproduction number (R0) was calculated from the RP model to assess the transmissibility of the 2019-nCoV.

Not one article listing anything that is completely clear when it comes to transmission paths, other than we are not sure.