What is COVID-19?
COVID-19 is an infectious respiratory disease first detected in December 2019 in Wuhan, Hubei Province, China. These viruses are zoonotic, which means the virus can be transmitted between people and animals. COVID-19 is a virus that arises from a large family of coronaviruses that cause illness ranging from the common cold to diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). Globally, there are more than 372,757 confirmed cases in 196 countries as of Tuesday, March 24th. The death toll has reached 16,231 worldwide. On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization declared an international public health emergency. In the United States, there are 44,183 confirmed cases in 50 states and 544 people have passed away from the virus. These statistics are up to date as of March 24, 2020. Most cases are in California and Illinois, Arizona, Massachusetts, Washington, Texas, and Wisconsin. The Centers for Disease Control (CDC) stated on February 25, 2020, that spreading via community outbreaks in the United States is expected. Travel restrictions have been implemented, such as screening everyone traveling from China into the United States.
How is COVID-19 transmitted?
The virus is transmitted through small respiratory droplets from the nose or mouth. This can occur when a person infected with COVID-19 coughs, sneezes, or exhales. Droplets land on objects where other people may contract the disease through touching the surface, then touching their face. The amount of time the virus survives on surfaces has not been determined at this point and may vary under differing conditions. The disease spreads mainly through respiratory droplets expelled by the act of coughing. The incubation period for this virus ranges from 1 to 14 days, with an average of five days before symptom-onset. Ongoing research on the period of transmission of COVID-19 is necessary, and the World Health Organization will continue to provide updates as discoveries arise.
What are the symptoms of COVID-19?
The presentation of a COVID-19 infection is mild for many cases. Some who become infected do not become ill or symptomatic during the course of the viral disease. Furthermore, a majority of people with COVID-19 overcome the illness without specialized care. When symptomatic, COVID-19 can cause respiratory symptoms such as fever, dry cough, sore throat, shortness of breath, and difficulty breathing. Other symptoms that have been documented include aches and pains, nasal congestion, runny nose, and diarrhea. The most severe cases may cause pneumonia, severe acute respiratory syndrome, kidney failure, and possibly death. Elderly people and people living with medical conditions such as hypertension, heart disease, or diabetes are at a higher risk of developing a more severe infection than healthy people. The World Health Organization recommends that people experiencing fever, cough, and difficulty breathing should seek medical care.
What can I do to prepare if an outbreak was to occur?
In case of a community outbreak in the United States, healthcare providers and hospitals should have a plan to obtain supplies from the strategic national stockpile of protective equipment and have a protocol in place. If this were to happen and shortages of protective equipment ensue, a back-up measure for healthcare facilities is to contact their regional healthcare preparedness
coalition. The regional healthcare coalition helps institutions share information about existing supplies and equipment. In the event of an outbreak, it is imperative to ensure professional preparedness. This can be accomplished by actions such as establishing continuity of operations in areas of the supply chain, ordering supplies ahead of time, running experimental tests and performing procedures in advance, assuring employees have means to take sick days and paid time off, and importantly, not going to work when sick.
How do I manage a patient with a suspected COVID-19 infection?
Best practices for severe acute respiratory infection when the 2019-nCoV infection is suspected include infection prevention and control and optimized supportive care for severely ill patients. Recommended steps for the management of a patient with a suspected or confirmed COVID-19 infection are:
- Prioritize patients based on the severity of their infection and begin treatment.
- Initiate the facility’s infection prevention and control measures for suspected or confirmed cases of 2019-nCoV infection.
- Provide early supportive care based on the patient’s needs.
- Perform diagnostic testing using blood cultures and upper and lower respiratory tract specimens.
- Control hypoxemic respiratory failure in acute respiratory distress syndrome (ARDS) per facility protocol.
- Identify and manage septic shock.
- Avoid complications that may worsen illness per evidence-based guidelines.
- Stay up to date with anti-Novel-CoV therapies and clinical research.
What are the current treatment options for COVID-19?
A vaccine is in the early phases of human testing; however, the National Institute of Health advises not to depend on a vaccine to stop the current spread of COVID-19. Currently, there are no specific treatments that have been approved by the(FDA) to cure COVID-19. Nonetheless, studies are currently underway to test potential treatment options. The University of Nebraska Medical Center is conducting a randomized, controlled trial to determine the safety and efficacy of an investigational broad-spectrum antiviral treatment for humans living with COVID-19. The antiviral drug, remdesivir, created by Gilead Sciences Inc., has been tested in the past for the treatment of Ebola viral disease. This antiviral therapy has also shown encouraging outcomes in animal models to treat diseases caused by other forms of coronavirus, such as Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). However, the clinical trial is in its early stages and there is presently no concrete data to show that remdesivir can improve outcomes for patients infected with COVID-19.
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