Article

What to Know About the Wuhan Novel Coronavirus

February 6, 2020
Man with medical mask on train

As of Jan. 28, 2020, 12 cases of Wuhan novel coronavirus, or 2019-nCoV, have been confirmed in the U.S. To date, none have been fatal. Globally, over 40,000 cases have been confirmed, with 591 reported outside of mainland China, according to Johns Hopkins University Center for Systems Science and Engineering, which is monitoring the spread of the virus in real time. The virus outbreak has now been declared a global emergency. 

Provista members have many questions about what the illness is, how it spreads and the role of healthcare providers in preparing for it.

ASSESSING THE WUHAN NOVEL CORONAVIRUS

According to the World Health Organization (WHO), almost all confirmed cases of the novel coronavirus have a travel history to Wuhan City in China or had direct contact with an individual who had traveled there. The WHO’s Jan. 27 Situation Report provides a risk assessment:

  • Very high in China.
  • High at the regional level.
  • High at the global level.

Human coronaviruses are most frequently associated with an upper respiratory tract infection characterized by rhinorrhea, nasal congestion, sore throat, sneezing and cough that may be associated with a mild fever.

HOW DOES THE NOVEL CORONAVIRUS SPREAD?

Coronavirus is a family of viruses that includes the common cold and viruses such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). According to the Centers for Disease Control and Prevention (CDC), genetic sequencing information does not provide any information about the severity of associated illnesses or the transmissibility of the virus. However, there is evidence that person-to-person spread of the virus is occurring. In fact, a case of the virus spreading from human-to-human was reported in Illinois. 

The CDC’s “Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Patients Under Investigation (PUIs) for 2019 Novel Coronavirus (2019-nCoV)” says that at this time, diagnostic testing for Wuhan coronavirus can be conducted only at the CDC.

The CDC website provides guidance on the prevention and treatment for human coronavirus, which applies to the Wuhan novel coronavirus strain. The CDC advises people to wash their hands with soap and water for at least 20 seconds rather than using hand sanitizers. Other protocols for prevention include avoiding touching the eyes, nose or mouth with unwashed hands, and avoiding close contact with people who are sick.

RECOMMENDATIONS FOR HANDLING THE NOVEL CORONAVIRUS

Nashville’s Vanderbilt University Medical Center changed its electronic prompts so any patients entering the hospital, emergency department or clinics presenting with a fever or respiratory symptoms will be asked if they’ve been to China recently or had contact with anyone who has, according to a Modern Healthcare article. Patients at risk of having the virus will be placed in isolation.

If a healthcare provider suspects a patient has the virus, the CDC advises notifying state public health laboratories for further instructions. Reference laboratories have notified customers to not send patients suspected of the virus for specimen collection until laboratory testing is completed by the CDC and 2019-nCoV has been ruled out.

Providers are advised to assess pandemic safety stocks, including possible low inventories of gowns affected by the recent recall of Cardinal AAMI Level 3 Surgical Gowns. The recall may have caused facilities to consume pandemic stocks to meet urgent needs over recent weeks.

PREPARING INVENTORY FOR POSSIBLE HIGH DEMAND ITEMS

WHO has identified categories of products necessary for the diagnosis and treatment of potential Wuhan novel coronavirus patients. Many of these products may see a surge in demand, so they should be assessed. Vizient, Provista’s contracting partner, has prepared a cross reference of the WHO listing of supplies, equipment, contracted suppliers and contract numbers within the Provista contract portfolio.

Provista continues to ask each contracted supplier to provide their plans for dealing with a potential surge in demand either as a result of preemptive purchasing or because of escalating caseloads. Possible mitigation tactics include distribution of available stocks, ramping up production and placing products on protective allocation.

Essential products include personal protection equipment (PPE) and apparel, such as surgical masks (duckbill, cup-shaped), gowns (AAMI Level 3 performance or above), examination gloves (length to mid-forearm) and surgical gloves (length to mid-forearm). PPE also includes face shields, fit test kits (to evaluate the seal for tight fitting respiratory protection devices), particulate respirators (grade N95 or higher, duckbill, cup-shaped), scrub tops and pants, and protective goggles.

Facilities will also need respiratory products like oxygen concentrators, flow splitters, oxygen prongs (nasal, non-sterile, single use) and oxygen tube extensions. Additional respiratory products include portable ventilators, pulse oximeters, laryngoscopes and stainless steel depressors. Other necessary products in this category include endotracheal tubes (with and without cuffs), carbon dioxide detectors (compatible with child and adult endotracheal tube), resuscitators (adult and child) and range of sizes for airways (Guedel, sterile single use).

Other case management products and supplies include portable ultrasound scanners and probes, compound sodium lactate solutions, infusion sets, bio-hazardous bags (for disposal of bio-hazardous waste) and body bags. For symptom-specific classes of drugs for general supportive care, facilities should have acetaminophen, cough suppressants, antihistamines, decongestants and IV fluids. Disinfection supplies will also be critical. Hand hygiene products, including soaps and alcohol-based hand rubs, along with surface disinfectants and supplies, will be needed.

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