It’s likely that you’ve heard of COVID-19 already. These days the world is watching closer than ever, often in real-time, the progression of emerging virus or bacteria strains. 2019-nCOV is the latest viral strain that has caused concern worldwide, due to its high rate of human-to-human spread. Equally concerning are the confirmed cases in other countries, and the presentation being almost identical to other flu-like illnesses.
Edit: This blog post was originally published on the 28th of January, 2019. We’re re-publishing it with some updated data.
Some updated links include:
- World Health Organization’s free coronavirus education module
- World Health Organization’s situation reports (typically updated daily)
- Australian Department of Health coronavirus resources
The unfolding COVID-19 story
2019-nCOV, or Novel Coronavirus, was identified in early January 2020 after a cluster of viral respiratory illness in the city of Wuhan, China. Chinese officials believe it may have originated from an animal reservoir, as many initially infected reportedly had some link to the Huanan Seafood Wholesale Market. This market has since been closed to carry out environmental disinfection. There are currently over 2700 confirmed cases in mainland China, with 50 confirmed cases outside of China in 13 different areas. There have reportedly been 82 deaths so far, with ages ranging from 55–87 years old, and all located within China at this time. (WHO, Situation Report 7, 27th Jan 2020). It is expected that these numbers will grow over the next few weeks.
What is COVID-19?
It is part of a large and diverse family of viruses, the coronaviruses, which includes respiratory illness that can range from the common cold to Severe Acute Respiratory Syndrome (SARS). For 2019-nCOV, the symptoms are mainly high fever and in some cases coughing, shortness of breath and showing invasive pneumonic infiltrates in chest radiographs. For more severe cases, the infection can lead to severe acute respiratory syndrome, kidney failure and death. The CDC believes symptom onset ranges from 2–14 days after exposure, based off viruses from the same family.
This makes it difficult to stop the importing of the new virus, as some travellers may not even present symptoms until many days after they have left China. The current flu season also adds complications to the screening of novel coronavirus, not to mention the added logistical challenges. According to the NZ Ministry of Health’s assessment, there is a recognised risk of importing the virus but a relatively low risk of having a sustained outbreak. There are currently 4 confirmed cases in Australia and none in New Zealand; although a group of tourists who had recently been to Wuhan are being monitored in Rotorua.
So far, the confirmed cases have all shown interaction with Wuhan within 14 days of symptom onset. (Update: On 29 January, The Independent reported that new cases in Japan and Germany were the result of transmission. Those affected had not travelled to China). As such, contact tracing remains the primary method for assessing the likelihood of 2019-nCOV as the root cause for respiratory infection.
The Advice (WHO, CDC, NZMOH, AUMOH)
- There is an expectation that we will see more confirmed cases over the next month. As different governments investigate the virus further, there will be updated recommendations coming out in real time.
- Check your own health ministry for local policies and the CDC for regular updates.
- The mainstay for novel coronavirus surveillance is travel history to Wuhan, China and symptoms of an acute respiratory infection.
- Similar to other flu-like illnesses, good hand hygiene, cough etiquette, avoiding contact with those suffering from a respiratory illness and staying home when unwell will help reduce spread.
- All treatments are being assessed for efficacy against 2019-nCOV but at this time treatment is aimed at symptom management.
- Symptom onset can be anywhere from 2–14 days after initial exposure.
- In facilities, the initiation of CONTACT and DROPLET precautions with immediate isolation is recommended. When performing an aerosol-generating procedure, the advice is also to apply AIRBORNE precautions (preferably in a negative pressure room) as we are still learning about the virus’s means of transmission. This includes use of the N95 mask when collecting samples.
- Routine screening for pneumonia and other influenza should always be performed first, but there is laboratory testing sensitive to the novel coronavirus.
- Due the newness of this virus, there is currently no vaccine available.
- Any confirmed cases should be reported to the local Medical Officer of Health at the Public Health Unit. They will also be able to give advice on any immediate precautions needed and further investigations to be done.
For further information please refer to the following sources.
- NZ Fact sheet for visitors
- NZ Ministry of Health
- Australian Department of Health: Information sheet for primary and community health workers
- Australian Department of Health: Coronavirus Overview and Resources
- World Health Organization Situation Report 7 (27 Jan, 2020)
- World Health Organization coronavirus information page
- World Health Organization coronavirus outbreak information page
- Bug Control’s coronavirus information for Australia
- Bug Control’s coronavirus information for New Zealand
- Center for Disease Control and Prevention: Coronavirus updates and recommendations
If you have any questions about coronavirus, or any other infection prevention and control issues, please contact us. Bug Control offer 20-minute consultations to help you and your facility stop infections in aged care.