What happened: This has the potential to be the biggest global news story of the week, “trumping” even Donald, Harry and Megan. In ever growing and spreading news, the CDC is closely monitoring an outbreak caused by a new coronavirus strain first identified in Wuhan, China.
Why it’s significant: The number of confirmed infections in China has more than tripled and spread to 13 provinces, including the cities of Beijing and Shanghai. Authorities have reported that 444 people have now contracted the Sars-like, respiratory illness that has killed 13 people (when I started to write this article it was only nine!). Further monitoring has seen more than 2,000 close contacts identified and a further 1,394 under medical watch.
The virus has now been confirmed outside of China, in the U.S., Thailand, South Korea, Taiwan and Japan. The first case in the United States was announced on January 21, in the state of Washington where the patient recently returned from Wuhan. A CDC team has been deployed to support the ongoing investigation in the state and will trace close contacts to determine if anyone else has been infected and become ill.
Jonathan Ball, professor of molecular virology at the UK’s University of Nottingham, today warned that identifying the source of the outbreak is vital. He said, “For a virus outbreak that was identified around a month ago, the number of exported cases and the recent uplift of numbers is concerning; particularly as the suspected source of the outbreak – a fish market that supposedly also traded in live animals – has been closed for some time. This, together with reported chains of human-to-human transmission, means this is an outbreak that the international community needs to take seriously.”
Top takeaways on the Novel coronavirus
Here are my takeaways on the novel coronavirus spread for EMS.
1. Air travel brings global epidemics to our shores
The ease of world travel also simplifies global epidemic transfer and transmission.
Read: Plague in the modern day: Public health outbreaks at home and away
News out of London today is reporting that all incoming flights from China will be first marshalled to an outlying terminal to allow health screening to occur before proceeding to disembark passengers. Advances in technology are assisting Australian ports of entry via thermal scanners to identify those with temperatures higher than the normal range. This outbreak is being taken exceptionally seriously as we await the World Health Organization to declare a possible international public health emergency. The CDC has issued a travel advisory, and what we can clearly see occurring today is that universal precautions are being practiced universally.
2. Prepare dispatch, providers and public health liaisons for the potential spread
Once again, this is a moment where EMS and public health must work hand in hand to make sure we are ready to deal with what may come along. Many have fresh memories of the buildup and preparation to deal with the potential influx of Ebola to our shores, with extra PPE donning and doffing rehearsals, fit testing and the creation of plastic-lined transport vehicles. While this may not require the same potential doomsday scenario mentality, it will require us to be very aware of the spread, understand the signs and symptoms (perhaps a key question in our medical dispatch Q&A systems) and be prepared to look after our patients and preserve the workforce.
3. Use universal precautions; communicate with infection control, local health department
The CDC advises the following: Healthcare providers should obtain a detailed travel history for patients with fever and respiratory symptoms. For patients who traveled to Wuhan on or after Dec. 1, 2019, and had onset of illness within 2 weeks of leaving, consider the novel coronavirus outbreak in China when evaluating a patient with these symptoms and notify infection control personnel and your local health department immediately.
Coronavirus symptoms may include:
- Runny nose
- Headache
- Cough
- Sore throat
- Fever
- A general feeling of being unwell
Although routes of transmission have yet to be definitively determined, CDC recommends a cautious approach to interacting with patients under investigation. Ask such patients to wear a surgical mask as soon as they are identified. Conduct their evaluation in a private room with the door closed, ideally an airborne infection isolation room, if available. Personnel entering the room should use standard precautions, contact precautions and airborne precautions, and use eye protection (goggles or a face shield).
This undoubtedly like every other news story on the world stage this week, will get worse before it gets better and all must remain vigilant and prepared.
Listen: Coronavirus implications
For an audio version of this article, listen below.
Additional resources on coronavirus, infectious disease prevention
For more information about the current outbreak in China, and resources to help EMS prevent the spread of infectious disease, visit:
- 1st novel coronavirus case detected in US; Expert says China outbreak is ‘tip of the iceberg’
- Plague in the modern day: Public health outbreaks at home and away
- What EMS leaders need to know about public health
- Role of EMS in preventing infectious disease transmission
- Infection control: 4 tips to embrace a clean squad culture
- Universal precautions are not just to protect us
- EMS is the first line of defense against spread of infectious diseases
