Coronavirus disease (COVID-19): For health professionals

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What health professionals need to know

Health professionals in Canada have a critical role to play in identifying, reporting and managing potential cases of COVID-19.

The World Health Organization (WHO) has identified COVID-19 as causing an outbreak of respiratory illness, including pneumonia, in Wuhan, China, in late 2019 and early 2020.

Coronaviruses are a large family of viruses, some of which infect only animals, and others that can infect humans. Seven strains of coronavirus are now known to cause illness in humans.

The strain of coronavirus found in Wuhan is the most recent of 7 known strains. Of the 6 others, 4 cause only minor respiratory symptoms similar to those of a cold, and 2, severe acute respiratory syndrome (SARS CoV) and Middle East respiratory syndrome (MERS CoV), have been associated with more serious and life-threatening diseases.

Significant additional information is still required to identify the cause of the outbreak, to fully understand how the disease is transmitted, and the severity of illness it causes in humans.

The Public Health Agency of Canada (PHAC) is monitoring the COVID-19 situation closely and will provide updates as new information becomes available.

The WHO is actively monitoring the situation and has issued updated information on the outbreak, including a risk assessment, advice on public health measures and infection prevention and control, and enhanced surveillance.

Spectrum of illness

Symptoms of COVID-19 (originating in Wuhan, China) include:

These symptoms are similar to those related to other respiratory viruses circulating during the winter months. All cases have been isolated in hospital, but detailed information about disease severity in China has not been reported. Information on the full spectrum of disease is not yet available.

Transmission

Current epidemiologic information suggests that limited human-to-human transmission of COVID-19 may have occurred in some reported instances where individuals were in close contact with symptomatic cases. Until more definitive information becomes available, appropriate infection prevention and control measures (contact and droplet precautions) should be implemented to prevent onward transmission of the virus.

Detecting and reporting

Diagnostics

PHAC’s National Microbiology Laboratory (NML) has capacity to identify the COVID-19, and is developing and implementing new diagnostic tests, based on the genetic sequence of COVID-19 made available by China on January 10, 2020. Laboratory testing should be initiated in consultation with the respective provincial Public Health Laboratory (PHL). The PHL will then coordinate the submission of specimens to the National Microbiology Laboratory for further testing, as necessary. Refer to Protocol for Microbiological Investigations of Severe Acute Respiratory Infections for details on specimen collection and handling, and regarding consultation with the PHL microbiologist on-call. Refer also to additional laboratory guidance provided by PHLs.

Reporting

Health care professionals can refer to the Interim National Surveillance Guidelines for Coronavirus Disease (COVID-19), and the Interim National COVID-19 Case Report Form, to aid with the detection and reporting of COVID-19 in Canada.

Recommendations to public health care professionals

Infection prevention and control

In the absence of effective drugs or vaccines, infection prevention and control (IPC) strategies to prevent or limit transmission of COVID-19 in healthcare facilities include:

Early recognition and source control

To facilitate early recognition and source control:

If a person presents with symptoms of influenza-like illness and within 14 days before the onset of illness, has travelled to an area where the virus is known to be circulating, and/or been in close contact with a probable or confirmed case of COVID-19 or someone who has travelled to an affected area:

Application of routine practices and additional precautions

The application of routine practices and additional precautions (RPAP) is based on a point-of-care risk assessment (PCRA). Health care workers (HCWs) should use a risk assessment approach before and during each patient interaction to evaluate the likelihood of exposure.

In addition to the consistent application of routine practices, follow contact and droplet precautions. This includes the appropriate selection and use of all the following personal protective equipment (PPE):

Hand hygiene should be performed whenever indicated, paying particular attention to during and after removal of PPE, and after leaving the patient care environment.

Infection prevention and control guidelines

Treatment

There is currently no vaccine against or specific treatment for COVID-19. Treatment is supportive and should be tailored to the patient's condition.

The WHO has published guidance on the clinical management of severe acute respiratory infection when novel coronavirus infection is suspected:

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