covid-19 sensitization for knh staff

2019 Novel Coronavirus (2019-nCoV)

for HCWs 1

COVID-19

SENSITIZATION FOR KNH

STAFF

Latest statistics

• Infected -182,609

• Dead- 7,171

• Case fatality increasing- 3.9%

• Recovered – 79,883 (China 84%)

• Mortality mean age 73

• Has affected more than 70% countries in the world

• There are 3 cases in Kenya 28 being processed

PPE: Respiratory Infection Control in

Health Care Facilities 2

COVID-19 Map



The rest of the world infection and death patterns

Latest Epicurve of cases

Case fatality with age

AGE DEATH RATE*

80+ years old 14.8%

70-79 years old 8.0%







0-9 years old no fatalities PPE: Respiratory Infection Control in


COVID-19 and comorbidities

PRE-EXISTING CONDITION DEATH RATE*

Cardiovascular disease 10.5%

Diabetes 7.3%

Chronic respiratory disease 6.3%

Hypertension 6.0%

Cancer 5.6%

no pre-existing conditions 0.9%



Definition & Background

One of a large group of coronaviruses

Seven coronaviruses that can infect humans

Common HCoV-associated with mild illness:

Other CoVs- highly pathogenic: SARS-CoV (beta)

MERS-CoV (beta)

2019-nCoV*

*2019 Novel Coronavirus

Identified in Wuhan, China in 2019

Initial case reported had association with an animal/seafood market exposure

Travel-related exportation of cases reported

Investigations ongoing

Other CORONA VIRUSES SARS-CoV (Severe Acute Respiratory Syndrome CoronavirusViral

respiratory illness) First recognized in November 2002 in China

2002-2003 global outbreak – 8,098 probable cases • 774 deaths (CFR-9.6)

No known human cases since 2004

Spread by close person-to-person contact

Symptoms often include: • Fever, chills, sore throat, and body aches progressing to pneumonia

MERS-CoV [Middle East Respiratory Syndrome Coronavirus (MERS)] Viral respiratory illness

First reported in 2012 in Saudi Arabia • Human illnesses in dozens of countries (in or near Arabian Peninsula)

As of October 3, 2019 • >2400 lab-confirmed cases

• >850 deaths (CFR-35%)

COVID-19 COVID-19

• Initial cases all linked to Huanan Seafood Market in Wuhan City, China. The Market was closed 01.01.20 for environmental sanitation and disinfection

• On 10 January, WHO launched a website with updated general and travel guidance https://www.who.int/health-topics/coronavirus

• On 11 January, China shared the genetic sequence of nCoV enabling the rapid development of diagnostic tests

• The cases in Thailand, Japan and Republic of Korea were all travelers from Wuhan City



https://www.who.int/health-topics/coronavirus



COVID-19

What is known about the disease identified in Wuhan China?

It is caused by a novel coronavirus (called COVID-19) Infection with this virus causes respiratory disease ranging from

mild to severe disease

Some infected patients have died from infection (people with serious underlying medical conditions are more at risk for severe disease and death)

What is NOT known about the disease?

Where it came from?

How easily is it spreads between people?

Who is vulnerable to infection?

Background

What is known COVID-19 (2019-nCoV

Identified in Wuhan, China in 2019

Initial case reported had association with an animal/seafood market exposure



Common signs and symptoms of COVID-19

• Fever

• Cough

• Runny nose

• Sore throat

• Difficulties in breathing (in severe cases)

Body ache

Head ache

The incubation period is 2 -14 days



Mode of transmission

• Droplet- through coughing or sneezing of an infected person

• Contact with contaminated surfaces or fomites with COVID-19

• Contaminated hands



Diagnosis of COVID-19

Positive clinical presentation

Epidemiological link

Take appropriate samples for testing

Or pharyngeal swab

Nasopharyngeal swab

Serum samples

Suspected case definition for COVID-19

Any person with history of travel/ or residence to a country /area or territory reporting local transmission of COVID-19 disease during the last 14 days prior to symptoms onset

Any person with history of contact with a confirmed or probable (Providing care without PPE, staying in same close environment, Travelling at close proximity ( 1m) COVID-19 case in the last 14 days prior to symptoms onset

A person with severe acute respiratory infection (fever and at least one sign /symptom of respiratory disease) AND requiring hospitalization AND with no other etiology that fully explains the clinical presentations

Probable case

A suspect case for whom testing for COVID-19 is inconclusive or for whom testing was positive on a pan-coronavirus RT-PCR assay

Confirmed Case

A person with laboratory confirmation of COVID-19 infection irrespective of clinical signs and symptoms

Zoonotic diseases and human spread

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1. Transmission

between animal

hosts

2. Transmission

from animal

host to humans

3.Transmission

between

humans

Zoonotic transmission Amplification

What is being done to control the outbreak?

What are affected countries doing? Remaining vigilant for new cases and providing care

for existing cases Implementing screening of travelers Sharing information with WHO and other countries

What is WHO doing? Supporting affected countries and providing

guidance on how to manage the outbreak Working with global networks of researchers and

experts to deliver accurate, updated information Delivering accurate, timely information to the world

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Management of COVID-19

General Therapy

Supportive management of critically ill patients

• Acute respiratory failure

• Septic shock

As is the case with MERS-CoV infections,

No virus-specific prevention or treatment (e.g. vaccine

or antiviral drugs) of proven value for COVID-19

Management of COVID-19

Various options had been explored for MERS CoV, e.g.

Interferon, and protease inhibitors

Intravenous immune globulin,

Corticosteroids

Ribavirin +/- interferon have no evidence or either in

vitro or clinical effect and have associated serious

side-effects, and should not be considered for use

outside of an appropriately planned evaluation of

effectiveness.

PREVENTION

standard precautions

1. Hand hygiene

2. Appropriate use of personal protective equipment. (PPE)

3. Prevention of needle stick and injuries from other sharp instruments

4. Respiratory hygiene and cough etiquette

5. Environmental cleaning

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Cont: of standard precautions

6.Used linen processing

7.Health care Waste management

8.Reprosesing of Patient care re-usable

equipment /devices

9.Isolation precaution and patient placement

10.Health education to patient and Visitors

11.Staff health

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BREAKING THE CHAIN OF

INFECTION INFECTIOUS AGENT

Bacteria , Fungi,

Viruses &Parasites

RESERVOIRS

People

Equipment

Environment

Water

SUSCEPTIBLE HOST

Low immune status,

Diabetes, Surgery, Burns,

Neonates, foreign bodies,

length of hosp. stay,

PORTAL OF

ENTRY

Mucous

membrane GI

/ urinary /

Respiratory track

Broken skin

PORTAL OF EXIT

Thro. The body

systems- Skin, urinary,

Resp. system.

MEANS OF

TRANSMISSION

Direct Contact

Fomites

- Injection /

Ingestion - Airborne

INVOLVES ALL

HEALTH

PROFESSIONALS

Air flow control

Food handling

Isolation

Trash &

waste

disposal

Control of

excretions

and

secretions

Hand-

hygiene

Disinfection/

sterilization

Environmental

sanitation

Employee

health

Care

Rapid accurate

identification of

organism Treatment of

underlying

disease

Recognition of

high risk

patients

Aseptic

Technique

Catheter

Care

Wound

Care

Hand-

hygiene

Sterilization

TRANSMISSION-BASED PRECAUTIONS (must understand how the organism is transmitted)

Airborne Precautions: spread of microbes on small

droplet nuclei through the air (< 5 microns)

Droplet Precautions: large particle droplets , (> 5

microns); which transmit 1- 3 feet in air

Contact Precautions: for prevention of disease

transmitted by either direct / or indirect contact.

27

HAND HYGIENE

Is a major component of standard precautions and one of the most effective methods to prevent transmission of pathogens associated with health care

Includes-two methods

◦ Hand hygiene: use of soap &running water to mechanically remove/kill bacteria, viruses and debris

◦ Hand sanitizer: use of waterless hand gels, sprays & solutions to kill bacteria & viruses on the hands

◦ NB:Use friction to remove debris.

27

Your 5-Moments For Hand Hygiene

28

Hand Hygiene Technique (Infection Control Unit- KNH)

Rub hands Palm to palm

Right palm over left dorsum

and left palm over right

dorsum

Backs of fingers to opposing

palms with fingers interlocked

Rotational rubbing,

backwards and forwards

with clasped fingers of right

hand in left palm and vice

versa.

Rotational rubbing of right thumb

clasped in left palm and vice versa Palm to palm fingers

interlaced

Rotational rubbing of the

wrist right palm and vice

versa

Rinse hands with water

Dry hands thoroughly with a single

use towel

Apply enough soap to cover all

hand surfaces

Wet hands with water

water

3

2 1

5 4

6

7 9 8

Hand sanitizer put adequate

amount (2-5mls) in the Palm start

techn. from number .1-7

Hand

sanitizer

PERSONAL PROTECTIVE EQUIPMENT (PPE )

• A personal protective equipment is a device that is worn by a worker in order to prevent any part of his body from coming into contact with hazards present at his or her place of work

• Choice of PPEs should be guided by risk assessment and the extent of contact anticipated with blood and body fluids, or pathogens

• Perform hand hygiene before handling and putting on PPE

• Immediately remove PPE after completing the procedure to avoid contaminating other surfaces and areas

• Properly discard all single use PPE immediately after use

• Perform hand hygiene immediately after removing and discarding any item of PPE

General principles when using PPE

RESPIRATORY HYGIENE AND COUGH ETIQUETTE

• Persons with respiratory symptoms should apply source control measures

Cover their nose and mouth when coughing/sneezing with tissue or mask,

Dispose off used tissues and masks, and

perform hand hygiene after contact with respiratory secretions

• Place acute febrile respiratory symptomatic patients at least 1 meter (3 feet) away from others in common waiting areas, if possible.

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32

Environmental Cleaning

• Friction cleaning

• High dusting

• Dump dusting

• Decontamination of blood spills

• Decontamination, cleaning & air-drying of cleaning equipment

• Color coding of cleaning equipment for different areas

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Health care waste (HCW)

• Healthcare waste is a potential reservoir of

pathogenic micro- organisms and requires

appropriate ,safe and reliable handling.

• Poor HCWM can lead to infections and injuries

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Staff health

Observe the standard precautions

• Standard precaution with each patient

• Personal hygiene

• Vaccinations

• Periodical screening and re-deployment

Incase you come across a suspected case:-MOH-Contact -719

Notify the hospitals surveillance officer/infection prevention and control focal person

The officer will notify the Ministry of Health

Outbreak investigation forms supplied by MoH should be filled

NP/OP swabs and sputum specimen should be collected (VTM for NP/OP swabs and sputum cups supplied by MoH)

At this early stages, also collect serum samples

KNH-IDU -43545

What to do incase of suspected cases

36

WHO- https://www.who.int/health-topics/coronavirus

CDC

Pharmaceutical Technology

CCDC

Sources

.

37 Data are Provisional Until Officially Released by the CDC Internal Use Only (FIUO)---For Official Use Only (FOUO) -Sensitive But Unclassified (SBU) - NOT FOR FURTHER DISTRIBUTION





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covid-19 sensitization for knh staff

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