Wednesday, February 12, 2020

Coronavirus – Protecting Staff, Residents, and the Community - What you need to know!

Pam Truscott

2019 Novel Coronavirus (2019-nCoV) is a virus (more specifically, a coronavirus) identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China.   Additional cases have been identified in a growing number of other international locations, including the United States. Since family members of residents may have traveled internationally as well as staff or their family members, we recommend that members stay on alert for individuals who have traveled to China, AND have symptoms (fever, cough, and difficulty breathing or shortness of breath). Facilities should report such individuals to their local or state health department.  Individuals who have recently traveled to China, need to know how to self-monitor and what to communicate with their physician or a clinic if they start to develop symptoms. The Centers for Disease Control and Prevention (CDC) provides information for returning travelers: http://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html. If you have additional questions you should stay in touch with your state and/or local health departments.

Right now, this virus is not spreading in the community in the United States, and the vast majority of Americans have a low risk of exposure. At some point, 2019-nCoV may start spreading in the United States among people without international travel. Long-term and post-acute care centers should act now to help reduce the potential for spread, which will also help with influenza and other circulating viruses that can impact our residents.  The 2019-nCoV spreads from person-to-person through droplets suspended in the air very similar to how influenza spreads. Centers should review their infection prevention and control policies and procedures for droplet precautions among residents and staff.

Currently there is no vaccine to prevent Coronavirus infection.  CDC is currently recommending Standard, Contact, and Airborne Precautions, including the use of eye protection when providing care for patients with confirmed or suspected 2019-nCoV.  Review CDC’s interim infection prevention and control guidelines for 2019-nCoV: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/infection-control.html. Everyday actions can prevent the spread of respiratory viruses, including proper hand hygiene practices and/or the use of alcohol-based hand sanitizers with at least 60% alcohol, avoid touching the face, avoid close contact with people who are sick and stay home when you are sick, cover your mouth and nose when you cough or sneeze, and clean and disinfect frequently touched objects and surfaces. In addition, centers should consider educating families and visitors on signs and symptoms of respiratory illness and encourage them to visit with loved ones through alternative means when they are ill, such as telephone, Skype, or wearing a mask during visits.

2019-nCoV is a virus identified as the cause of an outbreak of respiratory illness first detected in China and has now spread internationally.  More specifically, the 2019-nCoV is a coronavirus which are a large family of viruses that are common in many different species of animals, including camels, cattle, cats, and bats.  Rarely, animal coronaviruses can infect people and then spread between people such as with MERS, SARS, and now with 2019-nCoV.  According to CDC, there is limited information known about 2019-nCoV at this time.  CDC has developed several checklists to help healthcare personnel prepare to evaluate patients for 2019 novel coronavirus.  You can find out the latest on this developing novel virus at https://www.cdc.gov/coronavirus/

In late November, the Centers for Medicare and Medicaid Services (CMS) released QSO-20-03-NH (https://www.cms.gov/files/document/qso-20-03-nh.pdf), which highlights infection prevention and control practices.   In addition, CMS released QSO-20-09-all on February 6, 2020, which details healthcare facility expectations including review of CDC’s guidance and encourages review of infection prevention and control policies and practices to prevent the spread of infection.  You can find this QSO at: https://www.cms.gov/files/document/qso-20-09-all.pdf.

Centers should ensure that they have a properly trained infection preventionist who can take the lead on facility risk assessment for this and other infections.  Through the Infection Prevention Control Officer (IPCO) training course, individuals will be specially trained to effectively implement and manage an infection prevention and control program in their nursing center or assisted living community.  It addresses both clinical and organizational systems, processes and cultural aspects of infection prevention and control which are fundamental to effectively leading and administering a center’s infection prevention and control program. 

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