Coronavirus – What Nurses Need to Know
The Centers for Disease Control and Prevention (CDC) are closely monitoring an on-going outbreak of Coronavirus Disease (COVID-19) in Wuhan, China. Cases have been identified in multiple countries, including the United States. Coronaviruses are not a new family of viruses and are common in different species of animals including camels, cattle, cats, and bats. In humans, there are multiple strains that can cause mild respiratory symptoms or even the common cold. The COVID-19 has not been previously reported in humans. In years’ prior, other strains have been associated with SARS and MERS.
2019-nCoV presents with typical symptoms of a respiratory tract infection such as a runny nose, general malaise, sore throat, cough and fever. Most patients will have upper respiratory tract symptoms but those with pre-existing cardiorespiratory conditions are more likely to have symptoms in the lower respiratory tract and those who are immunocompromised might present in an atypical way.
Nurses must remain alert to the possibility that a patient may have the coronavirus. The following should be considered when assessing your patients:
Epidemiological criteria – In the 14 days before the onset of illness the patient must have either:
- Traveled to China, Hong Kong, Japan, Macau, Malaysia, Republic of Korea, Singapore, Taiwan, or Thailand
- Had contact with a confirmed case of 2019-nCoV. A contact is defined as someone who is living in the same household or has been within six feet of the infected person.
- Within the healthcare setting, a contact is further defined as someone who has direct contact with the infected person or their bodily fluids or laboratory specimens or has been in the same room when an aerosol generating procedure has been carried out.
- Severe acute respiratory infection with clinical or radiological evidence of pneumonia or
- Acute respiratory infection of any degree of severity which includes at least one of fever, shortness of breath or cough or
- Fever with no other symptoms
It’s thought that after exposure to the virus, symptoms can develop in as few as two days, or as long as two weeks. The virus can prove fatal when it leads to other complications, such as pneumonia and kidney failure.
- What is known: Human-to-human transmission is confirmed.
- What is unknown: Whether the disease is transmitted via contact, droplet, or aerosol. It is also unknown whether asymptomatic cases are infectious.
In the event that you do have a patient that meets the criteria for evaluation for 2019-nCoV, the CDC recommends that you follow these steps:
- Have the patient wear a mask and be moved to a private room with the door closed.
- Use an airborne infection isolation room if available.
- Any healthcare personnel in the room should follow standard precautions, contact precautions, airborne precautions; gown, gloves, N95 respirator as well as eye protection.
- Notify infection control department. Local health department should be contacted.
For the Most Up-to-date Information:
- World Health Organization (WHO)’s Situation Reports at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
- U.S. Centers for Disease Control and Prevention (CDC)’s webpage on the novel coronavirus at https://www.cdc.gov/coronavirus/2019-nCoV/
Public Health England. Novel coronavirus (2019-nCoV): epidemiology, virology, and clinical features. 2020. https://www.gov.uk/government/publications/wuah-novel-coronavirus-background-information/wuhan-novel-coroavirus-epidemiology-virology-and-clinical-features
CCoronavirus symptoms and diagnosis. CDC. http://www.cdc.gov/coronovirus/about/symptoms.html
2019 Novel Coronavirus, Wuhan China Transmission. (2020, January 24). Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html
Public Health England. Investigation and initial clinical management of possible cases of novel coronavirus (2019-nCoV) infection. https://www.gov.uk/government/publications/wuhan-novel-coroavirus-initial-investigation-of-possible-cases/investigation-and-initial-clinical-management-of-possible-cases-of-wuhan-novel-coronavirus-wn-cov-infection#interim-definition-possible-cases