Health Alert: Novel Coronavirus (2019-nCoV) Respiratory Infection Updated Guidance for Health Care Providers
February 7, 2020—Re-issue with Addendum
- 18 days have passed since 2019-nCoV was confirmed in a Snohomish Country traveler returning from Wuhan, China.
- 33 Snohomish County residents potentially exposed to the recent 2019-nCoV case have passed through the 14-day monitoring period with no secondary cases diagnosed to-date. 10 additional individuals who were involved in follow-up care under isolation precautions (lower risk) remain under active monitoring until their 14-day monitoring period is completed.
- There are currently no Snohomish County residents under investigation for possible 2019-nCoV illness. Three others have already tested negative.
- Nationwide, 11 cases of 2019-nCoV have been reported, including the Snohomish County case (plus California , Illinois , Arizona, Massachusetts, and Wisconsin). The second case in Illinois was acquired locally from the first case there.
- As of February 5, 28,000 cases have been counted worldwide, with the vast majority in mainland China (especially but not limited to Wuhan, Hubei Province). Smaller numbers of cases (about 250 total) have been reported from east and South-east Asia (the hardest hit nonChina region), Europe, North America, the Arabian Peninsula, and south Asia (in roughly descending order of magnitude). 565 deaths have been reported worldwide.
- As the epidemic spreads to involve most of mainland China.
- airport screening has been expanded to all returning travelers from China, includes SeaTac Airport, and imposes a 14-day quarantine for all who are asymptomatic and have been in China during the past 14 days; and
- the criteria for suspecting 2019-nCoV have been expanded to add patients hospitalized for a febrile respiratory illness who in the preceding 14 days were in China (even though not in Wuhan).
- Post signage at facility entries to direct patients to mask and immediately report travel to China in the prior 14 days if they have cough or fever.
- Use the attached, updated assessment tool when evaluating patients for suspicion of 2019-nCoV (discard the prior version we distributed on January 24).
- Follow the infection control guidelines on that tool; they have not changed since the prior edition. In brief, place a face mask on the patient of concern and put them in a single-patient exam room (an airborne isolation room would be ideal, if available; otherwise any private room is acceptable). If they meet the criteria for suspected 2019-nCoV on the tool, limit the number of staff having contact with the patient. Health care providers entering the room should don gown, gloves, N-95 or PAPR respiratory protection, and eye protection before entering the room.
- Immediately notify infection control personnel at your healthcare facility AND the Snohomish Health District (SHD) Communicable Disease Program at 425-339-5278 (24hrline) in the event of a suspected case of 2019-nCoV.
- Among suspected cases, please collect specimens for influenza and viral respiratory panel testing through your clinical laboratory. Also prepare to collect upper respiratory (nasopharyngeal and oropharyngeal swabs) and lower respiratory (sputum or BAL) specimens for 2019-nCoV testing upon direction by public health. Such specimens should be refrigerated. SHD will provide further guidance and facilitation regarding specimen collection, storage, and shipping at the time of your telephone consultation with them.
- Note that this is a rapidly evolving situation. Information and guidelines are likely to change as time passes. Stay tuned for ongoing updates and guidance.
Please note the following additional information, guidance and resources.