Thursday, February 21, 2013

Exactly How Contagious is the Coronavirus?

[Below is an excerpt from the document, published on February 20th, from the HPA: "Infection Control Advice Novel Coronavirus Cases". The editing below is mine. The whole document can be found as a pdf file link provided at the bottom of page.   I have got to wonder exactly how contagious this is. I also wonder if the family members that visited the Index case (Case #10) and the case that just died (Case #11) wore an FFPE Respirator while in the room?]  

This document outlines infection control and other general advice for personnel who may be involved in receiving and caring for patients, primarily within healthcare settings, who may be infected with a novel coronavirus.
Added/updated: 20 February 2013

Excerpt of document below:

The remainder of this document concerns infection control advice solely for probable or confirmed cases.

Patients requiring admission should be admitted directly to negative-pressure single rooms, if available. If this is not possible then a single room with en-suite facilities should be used. Room doors should be kept closed. Positive pressure, single rooms should not be used.
• If on a critical care unit, the patient should be nursed in a negative pressure room where available, or if not available, a neutral pressure side room with (closed ventilator circuit) should be used.
Staff should wear protective clothing as detailed below. Rooms should be appropriately decontaminated before being used again (see below: Cleaning). Suitable written information must be placed on the isolation room door indicating the need for respiratory and enteric isolation, though there will be a need to respect patient confidentiality.
Only essential staff should enter the room.
• A record of all staff that have had contact with a confirmed/probable patient should be kept.

• Staff must comply with all infection control procedures as detailed above.
A record of all staff caring for the patient must be maintained. The record sheet should be placed at the door and all staff entering must complete this.
• The use of bank or agency staff should be avoided wherever possible.
• All HCW should be vigilant for any respiratory symptoms in the ten days following last exposure to a case and should not come to work if they have a fever or cough. They should seek advice from their infection control team/occupational health department as per the local policy. Their hospital infection control team and/or local HPU will advise on where they should be medically assessed. During this period, symptomatic healthcare workers should avoid close contact with people both in the hospital and in the general community.

The number of visitors should be restricted.
Visitors entering the isolation room must wear PPE as previously detailed.
• Visitors must be trained in the appropriate use of protective clothing and hand hygiene.
A log of all visitors must be kept.

Contact tracing
• Follow up of staff contacts of patients will be co-ordinated by the Trust Occupational Health Department.
• Follow up of community contacts of patients will be co-ordinated by the local Health Protection Unit.

Protective clothing
To be worn by ALL staff and visitors entering the room (see appendix 1: putting on and removing personal protective equipment)
• Long sleeved, fluid-repellent disposable gown – the possibility of staff wearing scrubs underneath would obviate problems with laundering of uniforms and other clothing.
• Non-sterile surgical gloves.
An FFP3 respirator conforming to EN149:2001 to be worn by all personnel carrying out clinical care, visitors or staff in the room during aerosol generating procedures. Fit testing must be undertaken before using this equipment. Refer to DH poster: How to fit test an FFP3 respirator.  [added by me:  Definition Aerosol-generating procedures (AGP) are procedures that stimulate coughing and promote the generation of aerosols.  I was very curious about the FFP3 mask, so I did some research.  Below is a screen shot & link:]


Every time a respirator is used it should be fit-checked. Refer to DH poster: How to fit and fit check an FFP3 respirator.
• Eye protection (prescription glasses do not provide adequate protection against droplets, sprays and splashes).
It is vital that the protective clothing described above is worn for all airway management, including intubation

Hand hygiene
• This is essential before and after all patient contact, removal of protective clothing and cleaning of the environment.
• Use soap and water or use alcohol hand rub if hands are socially clean
Rings (other than a plain smooth band), wrist watches and wrist jewellery must not be worn by staff.

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