Coronavirus disease (COVID-19): For health professionals

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:

fever
cough
breathing difficulty (in some cases)

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

Familiarize yourself with the interim national case definition for COVID-19 to consider the possibility of COVID-19 in persons with relevant clinical and exposure history.
Familiarize yourself with the Interim National COVID-19 Case Report Form, to facilitate case reporting of confirmed and probable COVID-19 cases.
- Provincial/territorial public health authorities should report confirmed and probable COVID-19 cases to PHAC within 24 hours of their own notification.
- PHAC must report events that meet the requirements for International Health Regulations Articles 6 and 7 to the WHO within 24 hours of assessment of public health information.
- The Protocol for Microbiological Investigations of Severe Acute Respiratory Infections (SARI) will help to facilitate the diagnosis of severe respiratory infections due to both unknown and known respiratory pathogens that have the potential for large-scale epidemics.
Familiarize yourself with the interim guidance on the public health management of cases and contacts associated with COVID-19.

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:

prompt identification
appropriate risk assessment
management and placement of probable and confirmed cases
investigation and follow up of close contacts

Early recognition and source control

To facilitate early recognition and source control:

triage for identification and appropriate placement (source control) of patients
masks, tissues and alcohol-based hand rubs (AHBR) should be available at entrances
signage should be posted to instruct symptomatic patients to alert healthcare workers, thus prompting completion of a patient screening questionnaire

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:

place the patient in a designated separate waiting area or space
encourage the patient with signs and symptoms of an acute respiratory infection to perform respiratory hygiene/cough etiquette, and provide tissues, AHBR and a waste receptacle
limit visitors to only those who are essential
do not cohort with other patients (unless necessary, in which case cohort only with patients confirmed to have COVID-19)

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):

gloves
a long-sleeved gown
facial protection, such as surgical/procedural mask and eye protection, face shield, or surgical/procedural mask with visor attachment
an N95 respirator (plus eye protection) should be used when performing aerosol-generating medical procedures (AGMPs) on a person under investigation (PUI) for COVID-19

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:

Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected

Language selection

Search