By Debra A. Cooper, RN, MSN, MBA/HCM, CIC, CPHRM
The virus that eventually became known as severe acute respiratory syndrome-associated coronavirus (SARS-CoV) was first identified in China in November 2002.
The most recent iteration of the coronavirus started in China as a pneumonia outbreak affecting over 40 people in December 2019. At that time, the cause of the outbreak was unknown.1 Chinese officials reported the outbreak, which originated in Wuhan city, Hubei province, China, to the World Health Organization (WHO) on December 31, 2019.2 The report stated, “[M]ost patients in the Wuhan City outbreak have been epidemiologically linked to a large seafood and animal market, suggesting a possible zoonotic origin to the outbreak.”3 A zoonotic disease is a disease that can be transmitted from animals to humans. In addition to seafood, the market sold poultry, snakes, bats, and farm animals.4
Efforts to identify the cause of the illness pointed to a coronavirus, initially dubbed 2019-nCoV by WHO. The name reveals the year the virus was identified (2019), that it is a novel virus (n), and that it is a coronavirus (CoV). Because the virus originated in Wuhan city, it is frequently referred to as simply the “Wuhan virus.” On February 11, 2020, WHO announced a new name for the virus – COVID-19. This change was made to eliminate references to geographic location, animals, specific groups or individuals, and ensure easier pronunciation.5
Authorities across the globe are working to curtail the spread of this illness. In China, Wuhan is under quarantine, and Chinese officials have imposed travel restrictions and banned large gatherings. Despite these efforts, coronavirus has continued to spread rapidly in China. As of February 17, 2020, confirmed global cases of the virus had risen to 71,429, with 70,635 cases in China alone.6 Some experts believe that number to be a “massive underestimate.”7 The CDC has issued a level 3 health warning advising against nonessential travel to Wuhan,8 and airports in the U.S. and other countries are screening individuals for coronavirus.9 Currently, coronavirus has spread to 25 countries and the death toll has risen to 1,775.10 Initially, coronavirus was thought to have an incubation period of 14 days – however, a recent study by Chinese researchers found that the virus’ incubation period can be up to 24 days.11
How can healthcare organizations prepare?
Healthcare organizations can prepare for the possibility that a patient may present to their facility with symptoms that are suggestive of this novel virus. The first step is to identify patients who may have or are at risk of having this illness by modifying existing triage questions. Early recognition of patients infected with the Wuhan virus is essential.
Triage questions can include the following:
1. Have you recently traveled to Wuhan, China?
2. Have you traveled to any geographic location where the virus has been transmitted?
3. Have you had contact with a patient who has or is suspected of having the virus?
If an answer to any of the above questions is “YES,” additional questions should include:
1. Do you have any of the following symptoms?
c. Shortness of breath
Communication is key as the world works to battle this new health threat. It is imperative that healthcare workers remain abreast of the situation. In addition to media reports, the CDC provides up-to-date information about the virus, including disease progression, risk assessment, what to expect, and CDC response at https://www.cdc.gov/coronavirus/2019-nCoV/summary.html
John Hopkins’ Center for Systems Science and Engineering (CSSE) has also developed an interactive World Map that provides constant updates on reported confirmed cases of coronavirus. The World Map can be viewed at https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
Interim guidance documents
The CDC and WHO have published interim guidance documents which may be accessed at the links below:
1. CDC. Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019-nCoV) in Wuhan, China. Page last reviewed January 15, 2020. https://emergency.cdc.gov/han/han00426.asp. Accessed January 24, 2020.
4. CNet. Jackson, R. China locks down cities: Everything we know. Published January 24, 2020. https://www.cnet.com/how-to/coronavirus-death-toll-spikes-china-locks-down-cities-everythingwe-know/. Accessed January 24, 2020.
5. World Health Organization. WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020 [transcript]. Published February 11, 2020. Accessed February 18, 2020.
6. World Health Organization. Coronavirus disease 2019 (COVID-19) situation report – 28. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200217-sitrep-28-covid-19.pdf?sfvrsn=a19cf2ad_2. Published 17 February 2020. Accessed February 18, 2020.
7. MacKenzie, D. New Coronavirus looks set to cause a pandemic-how do we control it? NewScientist. Published January 29, 2020. https://www.newscientist.com/article/2231864-new-coronavirus-looks-set-to-cause-a-pandemic-how-do-we-control-it/. Accessed January 29, 2020.
8. CDC. Traveler’s Health. Novel Coronavirus in Hubei Province, China. Published January 23, 2020. Page last reviewed January 24, 2020. https://wwwnc.cdc.gov/travel/notices/warning/novel-coronavirus-wuhan-china. Accessed January 24, 2020.
9. Cripps, K. Airport screenings for the coronavirus increase around the world. CNN. Updated January 22, 2020. https://www.cnn.com/travel/article/coronavirus-airport-screenings/index.html. Accessed January 24, 2020.
10. World Health Organization. Coronavirus disease 2019 (COVID-19) situation report – 28.
11. Pharmaceutical Technology. Coronavirus incubation period could be 24 days, say researchers. Published February 11, 2020. https://www.pharmaceutical-technology.com/news/coronavirus-study-incubation-period/. Accessed February 18, 2020.
No legal or medical advice intended. This post includes general risk management guidelines. Such materials are for informational purposes only and may not reflect the most current legal or medical developments. These informational materials are not intended, and must not be taken, as legal or medical advice on any particular set of facts or circumstances.