Preventing Pandemics: Strategies for Protection, Prevention, and Containment
March 09, 2020
For the last month or so the world has watched anxiously as news of a new virus emerged from Wuhan, China. The novel Corona Virus or COVID-19 has now been reported in a growing number of global locations including the United States.
The Centers for Disease Control (CDC) has assessed the public health threat as high (globally and in the U.S.); however, individual risk is dependent on exposure. Based on current outbreak data, the CDC predicts that COVID-19 will become a pandemic. Exposure risk is potentially higher for healthcare workers, some of whom have already been infected with some of those exposures resulting in death.
How Do Viruses Start?
The origins of COVID-19 are still somewhat of a mystery. However, it is known that coronaviruses are common in many species of animals including cats, cattle, camels and bats. While it is somewhat rare, animal coronaviruses can infect people and then be spread by people as was the case with the MERS and SARS viruses. All three of these viruses have their origin in bats. The earliest patients in Wuhan reported connections to a large seafood and live animal market suggesting animal to human spread. Later cases had no such connection to the market or to possibly infected animals suggesting person to person spread had begun.
How Do Viruses Spread?
While COVID-19 is new virus and epidemiologists are still trying to understand precisely how it is spread, we can learn from how similar coronaviruses are spread. Currently, person-to-person transmission and transmission from infected surfaces are thought to be the primary means of the spread of the virus.
- Person-to-person transmission can happen when two people are standing within 6-feet of one another. Typically, this transmission will occur when respiratory droplets are produced when an infected person coughs or sneezes. These droplets may then be inhaled into the lungs of people who are nearby when they land in or near their mouths, noses or eyes.
- The CDC does not currently believe that surface-to-person transmission is the primary means of transmission for COVID-19, but do believe that it may be possible for a person to contract the virus by touching a surface that has the virus on it and then touching the eyes, mouth or nose.
The CDC believes that people are the most contagious when they are the most ill and exhibiting symptoms such as fever and cough, although they also believe that it may be possible for an infected person to transmit the disease before they exhibit symptoms. COVID-19 appears to spread fairly easily and sustainably making pandemic levels of the virus more likely.
Preventing the Spread of Viruses
Public health threats from contagious diseases have been dealt with through quarantines from the earliest of times. The book of Leviticus has explicit instructions to prevent the spread of leprosy – priests could quarantine those believed to have the disease for seven days. Medieval plaques resulted in quarantines as well as edicts preventing people and goods from infected countries from entering the city.
Currently the CDC advises 14-day quarantines for people who believe that they may have been exposed to COVID-19.
Protecting Healthcare Providers
Data on how the virus is spread is still emerging, but the CDC has issued some preliminary guidance on how healthcare workers should protect themselves.
- Use personal protective equipment (PPE) when within 6 feet of a patient who is infected or who may be infected.
- Use caution when assessing or triaging patients with acute respiratory symptoms that might be COVID-19. Place a face mask on the patient and, if one is available, place them in an Airborne Infection Isolation Room (AIIR).
- Follow procedures for Standard Precautions, Airborne Precautions and Contact Precautions as well as using protective eye gear when treating patients with possible or confirmed COVID-19. Review these practices with staff.
- Practice rigorous hand hygiene.
- Use alcohol-based hand sanitizer before and after contact with the patient and any other infected material such as linens and medical devices.
- Use alcohol-based hand sanitizer before putting on and removing PPE.
- Use soap and water when hands are visibly soiled.
- Remind staff of proper procedures for putting on, using, removing and discarding PPE.
- Perform aerosol-generating procedures, including specimen collections, in an AIIR while following infection prevention and control procedures.
Learn more from a HealthStream white paper, What Healthcare Professionals Need to Know About the Coronavirus, about the global healthcare threat posed by the coronavirus COVID-19. It includes references that will provide you with detailed information that you need should you suspect COVID-19 or must manage confirmed cases. HealthStream put together this basic high-level information as an initial primer for healthcare professionals who want to know more about the coronavirus threat. As with any emerging infection, make sure that you become familiar with the resources available on the CDC website. The CDC updates information there as they learn it, so checking in daily and setting up an email notification for updates is strongly recommended.