To All Faculty and Staff:
As reported by multiple media sources today and confirmed by the CDC, a person currently hospitalized at Providence Regional Medical Center Everett was diagnosed yesterday with a respiratory tract infection due to the 2019 Novel Coronavirus. This is the new virus that is responsible for the outbreak in Wuhan, China. As of January 21st , there are approximately 400 cases and 6 deaths worldwide. Reports also indicate an outbreak in at least 1 healthcare facility leading to more than 12 additional cases.
Key points about the 2019 novel coronavirus outbreak:
- The exact mechanism of transmission is unclear, but likely similar to or the same as other respiratory coronaviruses (coughing, sneezing, and hands contaminated by touching surfaces).
- Although initial cases were linked to animal exposures, it is now clear that human-to-human transmission is ongoing.
- Infection with this coronavirus can lead to pneumonia. As is the case for many viral infections, care is mainly supportive.
- Cases have been reported in China, Japan, Thailand, The Republic of Korea and the United States, but all were likely infected while in China. It is very likely that additional cases will be diagnosed and reported in the coming days.
- Both exit health screening (in Wuhan, China) and arrival screening (Los Angeles International, San Francisco International and JFK in New York) were initiated at the end of last week. The CDC expanded the number of airports to ~14 over the weekend.
- There are no direct flights from Wuhan to Seattle-Tacoma International Airport.
- The patient in Everett had no symptoms on the day of arrival. When he developed symptoms, he contacted his healthcare provider and was admitted for care and testing quickly. A contact investigation is on-going.
Actions at UWMC:
Emergency Department and Clinics
- All patients presenting with a respiratory illness (coughing, sneezing, runny nose) will be given a surgical mask to wear and will be moved to a private space as soon as possible.
- All patients presenting with a respiratory illness will under go travel screening specifically for travel to China in the last 2 weeks.
- If there are clinical features (fever, respiratory illness) and epidemiological risk (travel to China), the patient will be placed in AIRBORNE RESPIRATOR/CONTACT PRECAUTIONS immediately (N95 mask and eye protection or PAPR unit plus gown and gloves).
- The ED or clinic team will immediately contact UWMC IPC and Public Health Seattle & King County for next steps, including testing for the virus.
- Standard respiratory viral testing can be performed per protocol but a positive result for another virus (e.g. influenza) does not automatically preclude infection with the novel coronavirus. A negative coronavirus does not rule out novel coronavirus. All admissions and discharges of patients meeting clinical and epidemiological criteria must be discussed with public health and UWMC IPC.
- If a patient contacts a clinic or the ED with concern for infection prior to arrival, contact UWMC IPC to assist with coordination of entry and precautions.
Screening for 2019 Novel Coronavirus:
FRONT DESK and PHONE TRIAGE STAFF for Acute Appointments:
1) “Do you have fever or symptoms of lower respiratory illness (e.g., cough, difficulty breathing)?”
2) “Have you been to Wuhan City, China or had contact with anyone from Wuhan City in the last 14 days?”
If “NO”: Proceed with check-in as usual
If “YES” to 1: instruct the patient to put on a mask on the way into clinic.
If “YES” to both:
If by PHONE advise the patient to remain in the car until clinic staff comes to escort them
- Contact provider
- Have the patient don a surgical mask
- Clinic staff don, gown, gloves, and mask with face shield and escort patient
- Use backdoor or unoccupied elevator if available
- Preferentially schedule appointment at the end of the day
If at FRONT DESK and suspect a possible Coronavirus
- Mask the patient immediately
- Discuss immediately with provider and room the patient ASAP
- Staff don gown, gloves, and mask with face shield
Isolate the patient and any person accompanying the patient if not already done so. Put Infection Control sign on door of exam room where patient is isolated. If a negative pressure room is not available, use HEPA tower if available. Door to remain closed. Staff and provider should wear mask with face shield until patient is cleared by the provider.
If Concern for Possible Novel Coronavirus:
Notify King County Public Health (206-296-4774) or Snohomish County (425-339-5278), and UWMC Northwest Infection Control (206-668-1705) or UWMC Montlake Infection Control (206-598-6122). Notify the Medical Director and Manager for the clinic. Do not use the exam room for at least 2 hours after patient is discharged. Call for terminal cleaning after 2 hours