Coronavirus Resource & Information

About the Virus: Fast Facts

What it is

Coronaviruses are a large family of viruses that cause illness ranging from the common cold to more severe infections such as pneumonia. Members of the Coronavirus family are also responsible for the Severe Acute Respiratory Syndrome (SARS) and the Middle East Respiratory syndrome (MERS) that have occurred in the recent past.

The scientific name for this new Coronavirus is still not given – so it has been labelled 2019-nCoV (‘n’ or ‘novel’ coronavirus). It is believed to have mutated and passed from an animal host, though the exact transmission is still being investigated.

Colloquially called

Wuhan Coronavirus

Disease name

On February 11, 2020 – the World Health Organization (WHO) named this disease (not the virus) as COVID – 19.

Incubation period

Still being verified – believed to be between two (2) to fourteen (14) days, partially based on past experience with SARS and MERS.

Symptoms

Mild symptoms
• Fever
• Flu-like symptoms such as – cough, sore throat, headaches
• Difficulty Breathing

Serious symptoms
• Pneumonia
• Respiratory Failure
• Kidney failure
• Death

Spread
  • Respiratory – sneezing, coughing – i.e. aerosol route via droplets
  • Touching contaminated surfaces and then touching your mouth, nose or eyes before washing your hands
  • Person-to-person spread
Prevention

Personal Preventative Measures are essential in reducing the risk of contracting the illness and in minimising spread of disease – see in detail below

Treatment

There is no specific antiviral treatment recommended for 2019-nCoV infection. People infected with 2019-nCoV should receive supportive care to help relieve symptoms

Contact

Australia 

Geographical Spread

The Centre for Systems, Science and Engineering at John Hopkins have built a tool aggregating data from the WHO as well as centres for disease control in the USA, China and Europe. It has all Coronavirus confirmed, suspected and recovered patient statistics and deaths associated with the disease. It provides a convenient overview of consolidated reporting but links are provided below to WHO and CDC sites that also provides statistics.

At Risk Factors

The full clinical spectrum of illness is currently unknown and as such, the Australian Government has advised healthcare workers to exercise clinical and public health judgement in determining the need for testing of suspected patients. Compounding the difficulty is that the influenza season has started in China and symptoms of both illnesses are the same.

To allow better targeting of testing towards higher risk travellers, epidemiological and clinical criteria have been provided to assess against. If a patient satisfies the epidemiological AND clinical criteria, they are classified as a suspected case.

 

Epidemiological Risk Factors

Travel to Wuhan City (Hubei Province, China) in the 14 days before the onset of illness.
OR
Travel to an area with evidence of sustained human-to-human transmission, or a declared outbreak, within 14 days before onset of illness.
OR
Close contact in 14 days before illness onset with a confirmed case of 2019-nCoV.

Clinical Risk Factors

Fever or history of fever (≥38 °C) and acute respiratory infection (sudden onset of respiratory infection with at least one of: shortness of breath, cough or sore throat).

OR
Severe acute respiratory infection requiring admission to hospital with clinical or radiological evidence of pneumonia or acute respiratory distress syndrome (i.e. even if no evidence of fever).

The WHO have also released an Interim Data reporting form outlining at risk epidemiological and clinical factors.

WHO Medical Reporting Form
https://www.who.int/docs/default-source/coronaviruse/20200121-2019-ncov-reporting-form.pdf?sfvrsn=96eff954_4

Australian Government – Department of Health guidelines
https://www.health.gov.au/sites/default/files/documents/2020/01/novel-coronavirus-information-sheet-for-primary-and-community-health-workers_0.pdf

 

Personal Preventative Measures (PPM)

Prevent yourself from getting sick

Prevent yourself from getting sick

Wet markets

  • “Wet Markets” are markets which sell both live and dead animals (as opposed to “Dry Markets” which sell goods like electronics and clothing).
  • They are so named because of the practice of large quantities of water being used to wash down the floors of the market.
  • This allows the mixture of bodily fluids and blood from live, wild creatures to mix with the blood from slaughtered animals thereby providing an ideal medium for bacteria and viruses to flourish.
  • It is believed that the novel coronavirus originated in a wet market in Wuhan, China though this is still being investigated.

Prevent yourself from getting sick

Summary

Clean.
Wash hands frequently with soap and water, or alcohol-based hand gel
Prevent.
Aerosol transmission by covering your mouth when you sneeze or cough with a tissue – discard tissue immediately and wash hands as per above
Avoid.
Consider avoiding others with cough and fever and wet markets

Masks and Respirators

Face Masks

A face mask is a loose-fitting disposable device whose purpose is to create a physical barrier between the wearer’s mouth and nose and potential contaminants in the immediate surrounds. They come in different thicknesses and may help block large-particle droplets as well as sprays and splatter that may contain bacteria and viruses. They also help prevent your saliva from contaminating others.

Does wearing a surgical face mask help reduce the risk of Coronavirus infection?
This is a tricky question to definitively answer.

The CDC doesn’t currently recommend that the general public wear face masks to prevent viral infections however it does recommend its use for those people who have been confirmed to have a 2019-nCoV infection or those being evaluated for a potential infection.

 

Reasons to possibly wear face masks:
• The use of surgical face masks may reduce the risk of infection from many respiratory infections that are spread through droplets and aerosol routes and that includes coronavirus and influenza viruses.
• It helps prevent you touching your face and mouth

Reasons to not wear face masks:
• Unless worn correctly, they do not provide an adequate seal around the face and mouth. Especially if the user has a moustache or beard;
• Wearing a mask continually can be uncomfortable and exhausting as they are not designed to be used for prolonged periods of time.
• Depending on the type of mask used, the coronavirus virus may be smaller than those filtered by most of the masks so won’t necessarily be blocked by them.

P2/N95 Masks (Respirators)

Enquiries have been received about the potential use of P2/N95 respirators in preventing infection.

A N95 respirator is a respiratory protective device which is generally used in the healthcare setting by healthcare professionals who require a very close facial fit and very efficient filtration of airborne particles. They are not designed for children or those with facial hair.

The “N95” designation refers to the fact that at least 95% of very small particles (0.3 microns) are blocked by the respirator. They do, however, need to be properly fitted but even then, they do not completely eliminate the risk of illness as coronaviruses are generally smaller than 0.3 microns. Different manufacturers have different ‘collection efficiencies’ below this 0.3 micron cut-off so provide varying protection to filtering coronaviruses.

It has been noted however that the coronavirus transmission is often on larger particles (e.g. droplets) thereby making it easier to filter.

 

The FDA in America has cleared certain N95 for use by the public however the CDC do not recommend respirators for use to prevent infection by the coronavirus for the general public, rather they are recommended for use by healthcare professionals who are directly exposed to suspected and confirmed cases of respiratory illnesses.

People with chronic respiratory, cardiac and other chronic disease that make breathing difficult should not use a N95 respirator unless approved by a doctor as it can make breathing more difficult for the wearer.

If a Fullerton Health Assistance client requires N95 respirators for occupational reasons, we would strongly recommend that users are trained in their use and a fit check protocol undertaken.

 

 

 

Fit checking
Fit checking involves a quick check – each time the N95 mask is put on – to ensure that the respirator is properly applied, that a good seal is achieved over the bridge of the nose and mouth and there are no gaps between the respirator and face. Fit checking is the appropriate minimum standard at the point of use for any person using P2/N95 respirators.

A presentation of how to perform this is provided in the following link:
https://www.health.qld.gov.au/__data/assets/powerpoint_doc/0024/844341/fit-check.pptx

 

Travel Advice

Travel Advice to FHA Clients

People at risk 
Australian domiciled travellers intending to travel to Asia 
Australian domiciled travellers in-country in Asia 
Australian domiciled travellers returning to Australia from Asia 
Non-Australian domiciled travellers travelling to Australia 
Contact Information 

Useful Links

Universities  

Travel and Aviation

Travel and Aviation

Airport Health Screenings

Starting 17 January 2020, travellers from Wuhan to the United States commenced entry screening for symptoms associated with 2019-nCoV at three U.S. airports that receive most of the travellers from Wuhan, China: San Francisco (SFO), New York (JFK), and Los Angeles (LAX) airports. This is expected to dramatically increase as the days progress.

Other airports around Asia and Australia are similarly implementing symptom based entry screening for high risk travellers in an effort to utilise entry screening as one of the public health measures to limit the spread of the disease.

All aircraft entering Australian territory are legally required to report ill passengers and crew on the pre-arrival report. A biosecurity officer will then meet the aircraft to screen for 2019-nCoV and other listed human diseases. Biosecurity officers do this by administering the Traveller with Illness Checklist (TIC) to the ill passenger or crew member. A biosecurity officer or human biosecurity officer may then issue directions for the management of a suspected case of 2019-nCoV which are legally required to be followed. Enhanced biosecurity protocols are now in place in all Australian airports for flights from China.

WHO – Coronavirus page
https://www.who.int/emergencies/diseases/novel-coronavirus-2019

To substantially reduce the volume of travellers coming from mainland China, the Australian Health Protection Principal Committee has recommended additional border measures be implemented to deny entry to Australia to people who have left or transited through mainland China from 1 February 2020, with the exception of Australian citizens, permanent residents and their immediate family and air crews who have been using appropriate personal protective equipment.

 

Preventative measures when flying

The risk of sitting next to someone infected with the 2019-nCoV is low but some general sanitary principles recommended by aviation authorities and the CDC to be used with travelling and flying include:

  Personal environment  
1 Washing of hands with soap and water for at least 20 seconds
This remains the single most important infection control measure. Use alcohol-based hand rub (containing at least 60% alcohol) if soap and water are not available.
 
2 Carry alcohol-based hand sanitizer
(the CDC recommends at least 60% alcohol in case water isn’t nearby).
 
3 Do NOT fly if you feel sick or have symptoms.  
  In-Flight environment
The best preventative measure in-flight is not to sit within one to two rows of a sick traveller however this is hard to determine in advance and often impossible to change seats. Other general in-flight measures you can use to minimise the risk of contact with unwell passengers are:

 

 
1 Ask for a window seat.
One study which modelled the behaviour of airline passengers found the window seat provided the least contact with other people;
 
2 Turn on your air vent.
This could help reduce the risk from airborne pathogens. Turn the air vent on low or medium and direct the air to your lap;
 
3 Wipe down your tray table, armrest and seat with hand wipes.
These have been found to harbour some of the highest concentrations of germs;
 
4 Avoid in-flight magazines, blankets and pillows,
as there is no guarantee that they have been recently cleaned and also harbour high concentrations of germs.