Sharing a few key points presented on March 17th’s CDC Clinician Outreach and Communication Activity (COCA) Webinar:
- Additional resources, recording of this call and upcoming webinar (Monday) announcements at coca@cdc.gov
- Ongoing updates and resources: https://www.cms.gov/outreach-education/partner-resources/coronavirus-covid-19-partner-toolkit
Presenters:
Dr Brendan Jackson
Medical Epidemiologist
CDC COVID-19 Response Clinical Team (CDC)
LCDR Kara M Jacobs Slifka, MD
Medical Officer
CDC COVI -19 Infection Prevention and Control Response Team
Recognizing COVID-19:
Incubation period on average is 4-5 days but can be as little as 2 and as long as 14 days
Signs and Symptoms:
- Fever, cough, fatigue, diarrhea, nausea, respiratory symptoms
- 80% experience mild symptoms
- Most do not experience a runny nose
- Often conditions take a quick decline after a week or so when the lungs begin to fill with fluid – may not have had shortness of breath prior to the downturn
- 20-30% require ICU for respiratory support
- Often combined with influenza and may present with a normal chest x-ray early on
- Mortality Rate: (worsened by underlying chronic health conditions and obesity)
– 30 y.o. – 1/500
– 60 y.o. – 1/12
– 80 y.o. – 1/7
Long Term Care Special Considerations:
- Higher mortality rate
- Not all present with fever – may experience confusion and malaise
- Educate all team members on signs and symptoms, Vital Signs and Pulse Oximetry
- Check all residents upon admission and at least twice daily for signs and symptoms – check temp, Pulse Oximetry and signs/symptoms
- Infection control KEY
- If COVID-19 is found in the building – increase frequency of checks for all residents
Management and Treatment:
- There are no treatments specific to COVID-19
- Use caution with IV fluids – do not want to overload system and end up with increased fluid on the lungs
- Watch for secondary infections which may be present
Strategies to Decrease Risk (utilize CDC Preparedness checklist on the CDC webpage):
- Restrict visitation of all Non-Essential personnel
- Immediate restriction of all visitation
- Screening at the door – no one ill allowed in. Temp Check and Questionnaire Required.
- Template letter available from CDC explaining actions to be taken for family and visitors
- Post notification outside of the building
- Group Distancing – 6’ apart – communal dining and activities cancelled
- Staff health a priority – stay home if ill. Regularly monitor for fever and symptoms.
- Staff health – avoid groupings of 10 or more people, eliminate unnecessary travel
- If symptoms arise for staff members: mask, notify facility and go home
- PPE Shortage is real: Assess inventory now, Know health department and coalition contact #’s
- Clean between patients: blood pressure cuffs, hoyer lifts, pulse oximeters… any multi pt devices used
- Preserve supply of PPE – check the CDC website for tips – mentioned, utilizing same face mask and eye wear per caregiver -do not touch – sanitize hands before and after putting on and taking off
If symptoms arise in patients:
- Isolate in single room with private bath if possible – close the door
- All staff mask, gown and glove, eye protection & sanitize
- Decision to Hospitalize determined based on clinical assessment – if needs can be met – care for in place
- Airborne Infection Isolation rooms are not required to care for COVID-19 cases
Let’s Get to the Point:
Thank you for caring for our highest risk population!
Information is continually being updated. Please keep your questions and helpful ideas coming!
