Novel Coronavirus Spreads: What Nurses Need to Know
By Debra Wood, RN, Contributor
With international travel a way of life, the 2019 Novel Coronavirus, first detected in Wuhan, China, in December 2019, has now spread to 28 countries in Asia, Europe and North America.
China’s Health Commission reported on February 2, 2020, that there had been 361 deaths from the virus nationwide, and 475 recoveries.
On Monday, February 3, the U.S. Centers for Disease Control and Prevention (CDC) announced 11 patients in the United States have tested positive for the virus, and 82 have pending lab tests. The agency reports that 167 have tested negative. Most people with the disease in the United States had traveled to China, and a couple had close contact with someone who was ill.
“We expect to find additional cases of novel coronaviruses infections in the United States and expect to find additional cases among close contacts,” said Nancy Messonnier, MD, director of the National Center for Immunization and Respiratory Diseases at CDC.
Coronaviruses are a large family of viruses; a novel coronavirus means that it is a strain of coronavirus that has not been previously reported in humans.
The United States announced new travel policies, suspending entry of foreign nationals who have been in mainland China in the past 14 days, the expected incubation period; exempt are immediate family members of United States citizens and legal residents. All allowed passengers from China to the United States are directed to one of 11 airports and will be screened for symptoms.
Those coming from Hubei providence will be isolated for 14 days and if symptomatic will receive medical treatment. The same goes for those returning on special flights arranged by the government. All of those individuals will be quarantined for 14 days, with medical checks and care if they become symptomatic. Coming from other parts of China, people will be advised to stay home for 14 days.
Messonnier warned this will not stop novel coronavirus in the United States. The goal is to catch the majority of cases and slow the entry of the virus into the country. She added the public health system remains on high alert.
“Given the heightened threat of the novel coronavirus now in the U.S., all health care workers should be aware of the risk of a larger outbreak,” said Tener Veenema, PhD, MPH, MS, RN, at Johns Hopkins University School of Nursing in Baltimore.
The 2019 Novel Coronavirus (2019-nCoV)
Coronaviruses are responsible for a range of illnesses in people and animals, everything from the common cold to Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome Coronavirus.
The 2019-nCoV virus likely crossed from an animal to humans in a live animal market Wuhan, China. In the past, that has included bats and camels. The source has not been identified for the 2019 novel coronavirus.
The virus spreads by respiratory or saliva droplets. Close contact is considered being within about six feet of someone with the novel coronavirus for a prolonged period of time, while not wearing a gown, gloves, N95 respirator and eye protection.
What nurses need to know
Nurses should remain alert to the possibility a patient may have the novel coronavirus.
Coronavirus symptoms are often mild and similar to other respiratory illnesses, including cough, sore throat, nasal discharge and fever.
These symptoms are similar to influenza and colds, also circulating in the United States at this time, making a diagnosis more difficult clinically. Laboratory tests are needed to confirm the disease. The CDC has developed a test for the 2019 novel coronavirus and is sharing it with state health departments and international public health officials.
In some people, novel coronavirus can progress to pneumonia or respiratory distress. People with pre-existing conditions seem more vulnerable to becoming seriously ill.
Nurses and the coronavirus
Nurses and other healthcare workers should ask patients about travel outside of the United States in the past 14 days or exposure to someone else who has respiratory symptoms.
However, the World Health Organization (WHO) reports disease transmission to a second person may be possible before a person with the coronavirus develops significant symptoms.
If a patient presents with fever or symptoms of lower respiratory illness and travel to China or close contact with a person known to have the 2019 novel coronavirus illness, the CDC recommends isolating the person, putting a face mask on the patient, and wearing appropriate personal protective equipment.
How nurses are helping with the coronavirus
Nurses may be the first to note a person with the disease and can start the isolation precautions. The clinical assessment includes assessing for fever, cough and shortness of breath. The health department should be notified of at-risk patients.
The CDC states, depending on the severity of illness, patients may be discharged home with home isolation and home care guidance, including requesting the patient return to the clinic if symptoms worsen or fever increases.
Currently, no treatment exists for novel coronavirus. Nursing care remains supportive.
Safety tips regarding the coronavirus
WHO considers health workers caring for persons with the novel coronavirus to be at higher risk than other people and recommends they follow infection prevention and control procedures. Additionally, WHO states people should not take vitamin C, smoke, drink traditional herbal teas, wear multiple masks, or take antibiotics to try to protect themselves from the coronavirus.
The organization recommends performing basic hand and respiratory hygiene, safe food handling, avoiding live animal markets, and staying away from individuals exhibiting respiratory symptoms.
“While consistently maintaining standard infection control procedures in their workplace, health care workers must be prepared to respond to a large-scale public health emergency,” Veenema said.
Stay tuned as we update this page with more resources for nurses and other healthcare professionals.
American Nurses Association (ANA): 2019 Novel Coronavirus (2019 nCoV) Update
Centers for Disease Control and Prevention (CDC): 2019 Novel Coronavirus
CDC Flowchart to Identify and Assess 2019 Novel Coronavirus
World Health Organization (WHO): Novel Coronavirus (2019-nCoV)
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