Novel Corona Virus Disease (COVID-19) 20 th March 2020 Dr Solome - PowerPoint PPT Presentation

Novel Corona Virus Disease (COVID-19) 20 th March 2020 Dr Solome Okware Infectious Diseases Institute College of Health Sciences, Makerere University, Uganda Investing In The Future – Impacting Real Lives

Outline  Background  Current situation  Clinical presentation  Prevention measures  Question and answer 2

Background  31 December, China notified World Health Organization of an outbreak of respiratory disease of unknown origin  First cases reported connected to a seafood and animal market in Wuhan, China.  On 7th January 2020, Chinese government identified the novel corona virus  30 th January 2020, The World Health Organization (WHO), declared the current 2019-nCoV outbreak as a Public Health Emergency of International Concern (PHEIC)  March 2020 – Pandemic 3

Current situation Total countries affected : 176 Total cases: 191,000 Total deaths: 7807 4 https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/

Introduction  Corona viruses are a large family  Cause illness ranging from the common cold to more severe respiratory diseases among humans.  2019 Novel Coronavirus (SARS-CoV2) is a new virus that has not been previously identified in humans. • Severe Acute Respiratory Syndrome (SARS-CoV), 2002 and Middle East Respiratory Syndrome (MERS-CoV), 2012  Coronaviruses are primarily diseases of animals (zoonotic),once humans are infected, Person-to-person transmission. 5

Transmission  Human-to-human transmission can occur through droplets or contact.  Incubation period: 2- 14 days  Average age affected: 59 years(range 15-89 years) (Children 2.4% of all cases) 6

Transmission  Ro: each individual with Corona can infect up to 2-3 new cases 7

Signs and symptoms 8 WHO

Case definition Case definitions for surveillance  The case definitions are based on the current information available and will be revised as new information accumulates. The case definition is used to identify 3 types of cases - Suspect case : Symptoms + Link to cases - Probable case - Confirmed case (laboratory confirmation) 9

Diagnostics  Samples; • Collected from the nose or back of the throat  Diagnosis is by use of PCR 10

Management strategy: Control at source Detect: Early detection Infection Prevent: Interrupt transmission Prevention and Control Respond : Aggressive supportive care 11

Infection prevention and control (IPC)  Is a discipline that aims to prevent or control the spread of infections in healthcare facilities and the community  Goals of IPC Protect yourself Protect your community Protect your patients 12

Principles of Infection Prevention and control associated with COVID-19 1. Ensure triage, early recognition and source control 2. Apply standard precautions 3. Implement droplet precaution 4. Administration controls 13

Triage, early recognition and source control  Triage: process of sorting according to severity and presenting symptoms  Have a high index of clinical suspicion using case definition  Establish well-equipped triage station at entrance of facility  Recognise ill person and immediately isolate in designated area (source control) 14

Apply standard precautions  Hand hygiene  Respiratory hygiene  Appropriate personal protective equipment  Safe waste management  Decontamination 15

Travel advisory Category Countries Action Category 1 Italy, San Marino, Iran, South Postpone travel Korea, France, China, Self-isolate for 14 Germany, Spain, Belgium, days USA, United Kingdom, Netherlands, Sweden, Norway, Austria, Switzerland and Malaysia Category 2 Finland, Philippines, Indonesia Observe travellers and Pakistan Category 3 Rest of countries General preventive measures 16

Administration controls  Develop COVID -19 institutional policy  Designate isolation facilities with clear staffing protocols  Provision of adequate supplies  Establish surveillance system for the health workers responding  Monitor compliance to set practice 17

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Respiratory or cough etiquette Cover mouth and nose when coughing and sneezing Maintain social distance (1.5metres) from others Cover mouth and nose with tissue and dispose of the used tissues in the nearest waste bin Health workers must put on fit Offer a face mask to patients with tested N95 masks before suspected 2019-nCoV infection while they are in waiting/public entering the patient area or 19 areas or in isolation rooms . patient care

Personal protective equipment  Additionally worn depending on the risk of transmission Face Mask N95 Mask Face shield Goggle Eyes + nose + Eyes Nose + Nose + mouth mouth mouth Gown Gloves Head Apron cover Head + Hands Body 20 hair Body

Infection Prevention and control  Apply droplet precautions to prevent direct and indirect transmission • Maintain a 1 m distance • Apply respiratory etiquette • Perform hand hygiene • Use appropriate PPE • Decontaminate surfaces with chlorine • Use administrative controls 31

Do’s and Don’t  Avoid hand-shaking and hugging at all times  Avoid close contact with people who are visibly sick with flu-like symptoms (fever, cough, sneeze)  When sick with flu-like symptoms avoid going to public gatherings. Remain at home to avoid infecting others.  You do not need to wear medical masks if you do not have respiratory symptoms such as coughing, sneezing, or running nose  Don’t take self -medication such as antibiotics  Do not spit in public. Find a secluded place like a toilet or latrine in which to spit.  Delay travel to countries that currently have many patients with COVID 19. if you MUST travel, please follow the protective measures  Avoid travel if you have flu-like symptoms 32

Under self isolation: 14 days  Stay in a well ventilated room away from other people with separate hygiene and toilet facilities  Stay at home the entire duration of the quarantine (14 days)  Ensure you have adequate food, water, hygiene provisions and medication in case of co-morbidity  ALWAYS WASH YOUR HANDS with soap and water or use alcohol based hand rub  Cover your nose and mouth with a handkerchief or tissue when coughing or sneezing . Through tissue away. Wash hands  Clean and disinfect frequently touched surfaces such as doorknobs, handles, bedside tables  Clean and disinfect bathrooms and toilets  If you develop symptoms call the MOH immediately 33

Suggested measures for corona prevention in the workplace • Mounting alcohol dispensers at strategic points • Advise sick employees and clients (fever and respiratory symptoms) to stay home and seek medical attention • Screening procedures at the entrance both staff and clients (temp >37.5) in case of an outbreak in Uganda • If cleared then then hand hygiene • Minimise hand security checks • Modify operational structures to encourage social distance • Must perform hand hygiene before and after using ATMs and thumb print machines • Encourage contactless marketing 36

Contact  PHEOC 0800203033  PHEOC 0800100066  Text 6767 begin with ‘alert’  Atek Kagirita – 0782909153  Dr Allan Muruta – 0772460297 37