The Coronavirus, officially named COVID-19 by the World Health Organization (WHO), has become a global concern. GIFTED Healthcare is committed to keeping nurses and other healthcare professionals up to date with the latest information on this public health issue.
The information below has been provided by the World Health Organization and the Centers for Disease Control and Prevention. Read on for a COVID-19 overview, along with a list of resources to help nurses and healthcare professionals prevent transmission while providing their patients with exceptional care.
According to WHO, Coronaviruses (CoV) are a family of viruses that cause illnesses ranging from mild (common cold) to severe. COVID-19 is a new strain in the Coronavirus family that has not been previously contracted by humans.
WHO states that Coronaviruses can be transmitted between animals and people, and several known coronaviruses are circulating in animals that have not yet infected humans.
Signs & Symptoms
According to the CDC, common signs of infection include:
- Shortness of breath
The CDC recommends seeking medical advice if you develop symptoms and have been in close contact with a person known to have COVID-19, or if you live in or have recently been in an area with ongoing spread of COVID-19.
According to WHO, in more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and death.
How to Protect Yourself from Coronavirus (COVID-19)
To prevent infection, the CDC recommends:
- Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
- Stay home when you are sick.
- Cover your coughs and sneezes with a tissue, then throw the tissue in the trash.
- Avoid close contact with people showing symptoms of respiratory illness (coughing and sneezing).
To help spread awareness of Coronavirus (COVID-19) and prevent the spread of illness, share the CDC’s Coronavirus Fact Sheet.
Know the Facts: Prevent the Spread of Rumors about Coronavirus (COVID-19)
Public fear and the spread of misinformation are common during a global health emergency. However, the CDC urges individuals to help stop the spread of rumors about the Coronavirus.
The CDC states 3 facts about the Coronavirus that will help you prevent the spread of misinformation:
- Diseases can make anyone sick regardless of their race or ethnicity.
- People who have been in close contact with a person known to have COVID-19 or people who live in or have recently been in an area with ongoing spread are at an increased risk of exposure.
- Someone who has completed quarantine or has been released from isolation does not pose a risk of infection to other people.
You can help prevent the spread of misinformation about Coronavirus by sharing the CDC’s Coronavirus Fact Sheet.
Frequently Asked Questions for Nurses & Healthcare Professionals
The information below is provided by the CDC for nurses and healthcare professionals.
Q: What are the clinical features of COVID-19?
A: The clinical spectrum of COVID-19 ranges from mild disease with non-specific signs and symptoms of acute respiratory illness, to severe pneumonia with respiratory failure and septic shock. There have also been reports of asymptomatic infection with COVID-19. See also Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease 2019 (COVID-19).
Q: Who is at risk for COVID-19?
A: Currently, those at greatest risk of infection are persons who have had prolonged, unprotected close contact with a patient with symptomatic, confirmed COVID-19 and those who live in or have recently been to areas with sustained transmission.
Q: Who is at risk for severe disease from COVID-19?
The available data are currently insufficient to identify risk factors for severe clinical outcomes. From the limited data that are available for COVID-19 infected patients, and for data from related coronaviruses such as SARS-CoV and MERS-CoV, it is possible that older adults, and persons who have underlying chronic medical conditions, such as immunocompromising conditions, may be at risk for more severe outcomes. See also See also Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease 2019 (COVID-19).
Q: When is someone infectious?
A: The onset and duration of viral shedding and period of infectiousness for COVID-19 are not yet known. It is possible that SARS-CoV-2 RNA may be detectable in the upper or lower respiratory tract for weeks after illness onset, similar to infection with MERS-CoV and SARS-CoV. However, detection of viral RNA does not necessarily mean that infectious virus is present. Asymptomatic infection with SARS-CoV-2 has been reported, but it is not yet known what role asymptomatic infection plays in transmission. Similarly, the role of pre-symptomatic transmission (infection detection during the incubation period prior to illness onset) is unknown. Existing literature regarding SARS-CoV-2 and other coronaviruses (e.g. MERS-CoV, SARS-CoV) suggest that the incubation period may range from 2–14 days.
Q: Which body fluids can spread infection?
A: Very limited data are available about detection of SARS-CoV-2 and infectious virus in clinical specimens. SARS-CoV-2 RNA has been detected from upper and lower respiratory tract specimens, and SARS-CoV-2 has been isolated from upper respiratory tract specimens and bronchoalveolar lavage fluid. SARS-CoV-2 RNA has been detected in blood and stool specimens, but whether infectious virus is present in extrapulmonary specimens is currently unknown. The duration of SARS-CoV-2 RNA detection in upper and lower respiratory tract specimens and in extrapulmonary specimens is not yet known but may be several weeks or longer, which has been observed in cases of MERS-CoV or SARS-CoV infection. While viable, infectious SARS-CoV has been isolated from respiratory, blood, urine, and stool specimens, in contrast – viable, infectious MERS-CoV has only been isolated from respiratory tract specimens. It is not yet known whether other non-respiratory body fluids from an infected person including vomit, urine, breast milk, or semen can contain viable, infectious SARS-CoV-2.
Q: Can people who recover from COVID-19 be infected again?
A: The immune response to COVID-19 is not yet understood. Patients with MERS-CoV infection are unlikely to be re-infected shortly after they recover, but it is not yet known whether similar immune protection will be observed for patients with COVID-19.
Q: How should healthcare personnel protect themselves when evaluating a patient who may have COVID-19?
A: Although the transmission dynamics have yet to be determined, CDC currently recommends a cautious approach to persons under investigation (PUI) for COVID-19. Healthcare personnel evaluating PUI or providing care for patients with confirmed COVID-19 should use Standard Precautions, Contact Precautions, Airborne Precautions, and use eye protection (e.g., goggles or a face shield). See the Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation for Coronavirus Disease 2019 (COVID-19) in Healthcare Settings.
Q: Should any diagnostic or therapeutic interventions be withheld due to concerns about transmission of COVID-19?
A: Patients should receive any interventions they would normally receive as standard of care. Patients with suspected or confirmed COVID-19 should be asked to wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed, ideally an airborne infection isolation room, if available. Healthcare personnel entering the room should use Standard Precautions, Contact Precautions, Airborne Precautions, and use eye protection (e.g., goggles or a face shield).
Q: How do you test a patient for SARS-CoV-2, the virus that causes COVID-19?
A: See recommendations for reporting, testing, and specimen collection at Interim Guidance for Healthcare Professionals.
Q: Will existing respiratory virus panels, such as those manufactured by Biofire or Genmark, detect SARS-CoV-2, the virus that causes COVID-19?
A: No. These multi-pathogen molecular assays can detect a number of human respiratory viruses, including other coronaviruses that can cause acute respiratory illness, but they do not detect COVID-19.
Q: How is COVID-19 treated?
Not all patients with COVID-19 will require medical supportive care. Clinical management for hospitalized patients with COVID-19 is focused on supportive care of complications, including advanced organ support for respiratory failure, septic shock, and multi-organ failure. Empiric testing and treatment for other viral or bacterial etiologies may be warranted.
Corticosteroids are not routinely recommended for viral pneumonia or ARDS and should be avoided unless they are indicated for another reason (e.g., COPD exacerbation, refractory septic shock following Surviving Sepsis Campaign Guidelines).
There are currently no antiviral drugs licensed by the U.S. Food and Drug Administration (FDA) to treat COVID-19. Some in-vitro or in-vivo studies suggest potential therapeutic activity of some agents against related coronaviruses, but there are no available data from observational studies or randomized controlled trials in humans to support recommending any investigational therapeutics for patients with confirmed or suspected COVID-19 at this time. Remdesivir, an investigational antiviral drug, was reported to have in-vitro activity against COVID-19. A small number of patients with COVID-19 have received intravenous remdesivir for compassionate use outside of a clinical trial setting. A randomized placebo-controlled clinical trial of remdesivirexternal icon for treatment of hospitalized patients with COVID-19 respiratory disease has been implemented in China. A randomized open label trialexternal icon of combination lopinavir-ritonavir treatment has been also been conducted in patients with COVID-19 in China, but no results are available to date. trials of other potential therapeutics for COVID-19 are being planned. For information on specific clinical trials underway for treatment of patients with COVID-19 infection, see clinicaltrials.govexternal icon.
Q: Should post-exposure prophylaxis be used for people who may have been exposed to COVID-19?
A: There is currently no FDA-approved post-exposure prophylaxis for people who may have been exposed to COVID-19. For more information on movement restrictions, monitoring for symptoms, and evaluation after possible exposure to COVID-19 See Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposure in Travel-associated or Community Settings and Interim U.S Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease 2019 (COVID-19).
Q: Whom should healthcare providers notify if they suspect a patient has COVID-19?
A: Healthcare providers should consult with local or state health departments to determine whether patients meet criteria for a Persons Under Investigation (PUI). Providers should immediately notify infection control personnel at their facility if they suspect COVID-19 in a patient.
Q: Do patients with confirmed or suspected COVID-19 need to be admitted to the hospital?
A: Not all patients with COVID-19 require hospital admission. Patients whose clinical presentation warrants in-patient clinical management for supportive medical care should be admitted to the hospital under appropriate isolation precautions. Some patients with an initial mild clinical presentation may worsen in the second week of illness. The decision to monitor these patients in the inpatient or outpatient setting should be made on a case-by-case basis. This decision will depend not only on the clinical presentation, but also on the patient’s ability to engage in monitoring, the ability for safe isolation at home, and the risk of transmission in the patient’s home environment. For more information, see Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation for Coronavirus Disease 2019 (COVID-19) in a Healthcare Setting and Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for Coronavirus Disease 2019 (COVID-19).
Q: When can patients with confirmed COVID-19 be discharged from the hospital?
A: Patients can be discharged from the healthcare facility whenever clinically indicated. Isolation should be maintained at home if the patient returns home before the time period recommended for discontinuation of hospital Transmission-Based Precautions described below.
Decisions to discontinue Transmission-Based Precautions or in-home isolation can be made on a case-by-case basis in consultation with clinicians, infection prevention and control specialists, and public health based upon multiple factors, including disease severity, illness signs and symptoms, and results of laboratory testing for COVID-19 in respiratory specimens.
Criteria to discontinue Transmission-Based Precautions can be found in: Interim Considerations for Disposition of Hospitalized Patients with COVID-19
Q: What do I need to know if a patient with confirmed or suspected COVID-19 asks about having a pet or other animal in the home?
A: See COVID-19 and Animals.