Last updated 3/19/2020
Globally, there are more than 218,000 cases of novel coronavirus and almost 10,000 deaths — and both these numbers are on the rise outside China.
With the latest data showing more than 10,000 U.S. cases in all 50 states, COVID-19, the disease caused by the virus, is already spreading exponentially; the U.S.’s first case of community spread was confirmed less than three weeks ago. At the Center for Disease Control and Prevention’s last count, 150 people have died from the virus.
“At this moment, we just don’t know how widespread the virus is in the community,” William Schaffner, MD, professor of infectious diseases at Vanderbilt University, tells Florence Health. “Some states have cases of community-acquired coronavirus. This suggests that the virus is in that community and has been circulating person to person for awhile. How extensive this is and if it involves all parts of the country or just a few places has yet to be determined.”
As the outbreak grows within our borders, healthcare providers should be focused on protecting their patients — and themselves. “Their risk is highest for infection,” Eric Cioe-Pena, MD, director of global health at Northwell Health in New York, tells Florence Health.
These are the most important actions for HCPs to combat SARS-CoV-2, the official name for the novel coronavirus.
Ask patients about their exposure to COVID-19 before testing.
Clinicians should ask patients if they’ve traveled internationally in the past two weeks and whether they’ve had direct contact with someone who has coronavirus. If they have symptoms, they should first be tested for influenza, Dr. Schaffner says.
“Resources are limited at the moment, and attention is focused on cases that are likely to be positive,” he explains. “It would be wasteful to test everyone with a cough for coronavirus.”
Test patients who meet the clinical guidelines.
Health professionals who have a patient with apparent symptoms of COVID-19 should follow the CDC guidelines, Dr. Cioe-Pena says. This includes testing people with: symptoms and known exposure to COVID-19; and with severe and unexplained respiratory infections.
Testing guidelines may expand soon, though. The Food and Drug Administration recently gave hospitals and labs across the country the go-ahead to conduct testing using their own validated kits, which should vastly improve the nation’s testing capabilities. Previously, the CDC conducted all testing at its headquarters.
Wear personal protective equipment.
“Healthcare workers should make sure to wear adequate personal protective equipment like gowns, masks and gloves, and to be careful in how they put on and take off this equipment so they don’t contaminate themselves while removing the equipment,” says Dr. Cioe-Pena.
Wash your hands — and tell patients to do the same.
The best protection against coronavirus, for anyone, is hand-washing. “Good and frequent hand hygiene is important,” Dr. Schaffner says. This means washing your hands with hand sanitizer that’s 60-to-95-percent alcohol or using soap and water for at least 20 seconds. If your hands are visibly soiled, start with soap and then go to sanitizer.
In general, you should clean your hands before and after all patient contact, contact with potentially infectious material, and before putting on and after removing PPE, including gloves. This is especially important when treating COVID-19 patients.
Give masks to possible COVID-19 patients, and wear one yourself.
Give simple, surgical masks to coughing and sneezing patients, but also know these do not always stop coronavirus from spreading, Dr. Schaffner says. To avoid potential shortages, the FDA also recently approved certain types of industrial and construction masks for use in healthcare settings.
If used correctly, N95 masks are extremely effective. Make sure there’s a strong seal around the nose, cheeks and chin. “You can continue to use the same one unless it becomes visually soiled or in some way damaged,” Dr. Schaffner adds. After you use it, hang it on a hook or put it into another safe place, and then wash your hands.
Masks should be reserved for patients who test positive for COVID-19 and for the providers taking care of them, says Rodney Rohde, PhD, chair and professor of the Clinical Laboratory Science (CLS) Program and associate dean of research at the College of Health Professions at Texas State University.
“Outside of these circumstances, there is no formal recommendation from the CDC to wear a mask in public,” Dr. Rohde adds.
Be aware of high-touch surfaces.
Research shows SARS-CoV-2 behaves like other coronaviruses, which can survive on surfaces for as long as nine days under ideal conditions. Therefore, HCPs should practice hand hygiene before and after coming in contact with surfaces where the virus may live, and try to reduce the amount you touch your eyes and mouth.
Use critical drugs carefully, in case of a shortage.
Make sure they’re not just “being handed out,” Dr. Rohde says, and ask your employer if there’s a plan in place should a drug shortage happen. If it does, “look at other sources for the drugs or whether there are other drugs that could work in a certain situation until the drug in short supply is available again,” he adds.
Share accurate information with patients.