2019 Novel Coronavirus (2019-nCoV)

Information from the CDC and Ohio Department of Health:

The CDC and the Ohio Department of Health are closely monitoring an outbreak of respiratory illness caused by a novel (new) coronavirus that was first detected in Wuhan City, China and which continue to expand. The United States reported the first confirmed instance of person-to-person spread with this virus on January 30, 2020. 

Coronaviruses are a large family of viruses that are common in many difference species of animals. Rarely, animal coronaviruses can infect people and then spread between people.

In Ohio, two possible cases are being monitored in Miami University students in Butler County. The students have been isolated and ODH is awaiting test results from the CDC.

Risk to the general public remains low and the CDC recommends Americans use typical infectious disease precautions, just as those used to prevent the cold or flu. 

Criteria to Guide Evaluation of Patients Under Investigation (PUI) for 2019-nCoV

Patients in the United States who meet the following criteria should be evaluated as a PUI for 2019-nCoV.

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Healthcare providers should immediately notify their localexternal icon or stateexternal icon health department in the event of a PUI for 2019-nCoV.

Clinical features and epidemiologic risk
Clinical Features & Epidemiologic Risk
Fever1 or signs/symptoms of lower respiratory illness (e.g. cough or shortness of breath) AND Any person, including health care workers, who has had close contact2 with a laboratory-confirmed3,4 2019-nCoV patient within 14 days of symptom onset
Fever1 and signs/symptoms of a lower respiratory illness (e.g., cough or shortness of breath) AND A history of travel from Hubei Province, China within 14 days of symptom onset
Fever1 and signs/symptoms of a lower respiratory illness (e.g., cough or shortness of breath) requiring hospitalization4 AND A history of travel from mainland China within 14 days of symptom onset

The criteria are intended to serve as guidance for evaluation. Patients should be evaluated and discussed with public health departments on a case-by-case basis if their clinical presentation or exposure history is equivocal (e.g., uncertain travel or exposure).

Visit the CDC’s website for recommendations for reporting, testing, specimen collection and more information.

Interim Guidance for Healthcare Professionals

Limited information is available is available to characterize the spectrum of clinical illness association with 2019-nCoV. No vaccine or specific treatment for 2019-nCoV infection is available; care is supportive. 

The CDC clinical criteria for a 2019-nCoV patient under investigation (PUI) have been developed based on what is known about MERS-CoV and SARS-CoV and are subject to change as additional information becomes available.

Health care providers should obtain a detailed travel history for patients being evaluated with fever and acute respiratory illness. CDC guidance for evaluating and reporting a PUI for MERS-CoV remains unchanged.

SEE BELOW FOR RECOMMENDATIONS FOR NURSES FROM ANA.

What Nurses Need to Know – From ANA

Preparedness, Early Identification, and Notification

Develop and educate all staff on a preparedness plan that provides infection control procedures and protocols used within your healthcare facility for the early identification, containment, and care of patients with symptoms associated with 2019 Novel Coronavirus (2019-nCoV) to prevent spread within your healthcare facility.

    • Develop inpatient, ambulatory, and home care policies and procedures that are in line with current CDC guidelines for 2019-nCoV
    • Provide training to all personnel on screening and isolation procedures
    • Provide updated training and guidelines on the use of Personal Protective Equipment (PPE), such as the use of gloves, gowns, masks, eye protection, and a face shield
    • Display clear signage with instructions for the use of PPE
    • Ensure consistent use of proper hand hygiene, standard precautions, contact precautions, and airborne precautions, along with the proper use of a National Institute for Occupational Safety and Health (NIOSH)-Approved N-95 respirator or higher
    • Clearly display signage for patients that lists symptoms and instructions to wear a face mask before entering the healthcare facility if symptoms are present.
    • Incorporate assessment questions to document a detailed travel history when patients present with fever, cough, or respiratory illness. Consider 2019-nCoV if the patient traveled to Wuhan, China on or after 12/1/19.
    • Identify, in advance, airborne infection isolation rooms (AIIR) or negative pressure rooms, for quarantine and screening
    • Outline staffing protocols to facilitate care of patients with 2019-nCoV and to minimize patient-to-patient transmission
    • Have available for immediate notification of suspected cases the infection control personnel at your facility and the local and state health department. Click here for additional Recommendations for Reporting, Testing, and Specimen Collection and the fillable 2019-nCov PUI case investigation form
    • For Patients Under Investigation (PUI), follow the Criteria to Guide Evaluation of PUI for 2019-nCoV
Isolation, Quarantine, Monitoring, and Hospitalization

The CDC recommends several steps for identification and maintenance of 2019-nCoV PUI along with detailed guidelines for isolation precautions to prevent transmission. At this time, the exact mode(s) of transmission remain undetermined, but person-to-person transmission has been identified.

    1. Have masks available for PUI to don before entering the healthcare facility
    2. Once identified, isolate the patient to airborne infection isolation rooms (AIIR) or negative pressure room and keep the door closed. Conduct the assessment in this room.
    3. Healthcare personnel entering the room should use standard precautions, contact precautions, airborne precautions, and eye protection (goggles or a face shield)
    4. Don Personal Protective Equipment (PPE) before entering the room
    5. Have guidelines for the proper use of PPE displayed throughout the healthcare facility
    6. Notify your infection control personnel and the local and state health department of suspected cases
Community Interaction

Per the CDC, it is known that coronavirus is part of a large family of viruses that can cause illness in people and animals.1 While the mode(s) of transmission of 2019 Novel Coronavirus remain under investigation, the CDC provides the following interim guidance to help prevent 2019-nCoV from spreading among people in homes and communities4:

    • Stay home except to get medical care, do not use public transportation or taxis
    • Call first before visiting your healthcare provider to notify of the need for evaluation for 2019-nCoV. Follow the instructions provided by your healthcare team.
    • Separate yourself from other people in your home, utilize a separate bathroom
    • Wear a facemask
    • Cover your coughs and sneezes
    • Wash your hands frequently with soap and water for at least 20 seconds
    • Avoid sharing household items
    • Monitor your symptoms
    • For a full list of guidelines and recommended actions for preventing the spread of Coronavirus visit https://www.cdc.gov/coronavirus/2019-ncov/guidance-prevent-spread.html