EXTRACTED FROM THE CDC CENTERS FOR DISEASE CONTROL AND PREVENTION WEBSITE FOR HEALTHCARE PROFESSIONALS.
A: The clinical spectrum of COVID-19 ranges from mild disease with non-specific signs and symptoms of acute respiratory illness, to severe pneumonia with respiratory failure and septic shock. There have also been reports of asymptomatic infection with COVID-19. See also Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease 2019 (COVID-19).
A: Currently, those at greatest risk of infection are persons who have had prolonged, unprotected close contact with a patient with symptomatic, confirmed COVID-19 and those who live in or have recently been to areas with sustained transmission.
A: The available data are currently insufficient to identify risk factors for severe clinical outcomes. From the limited data that are available for COVID-19 infected patients, and for data from related coronaviruses such as SARS-CoV and MERS-CoV, it is possible that older adults, and persons who have underlying chronic medical conditions, such as immunocompromising conditions, may be at risk for more severe outcomes. See also Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease 2019 (COVID-19).
A: The onset and duration of viral shedding and period of infectiousness for COVID-19 are not yet known. It is possible that SARS-CoV-2 RNA may be detectable in the upper or lower respiratory tract for weeks after illness onset, similar to infection with MERS-CoV and SARS-CoV. However, detection of viral RNA does not necessarily mean that infectious virus is present. Asymptomatic infection with SARS-CoV-2 has been reported, but it is not yet known what role asymptomatic infection plays in transmission. Similarly, the role of pre-symptomatic transmission (infection detection during the incubation period prior to illness onset) is unknown. Existing literature regarding SARS-CoV-2 and other coronaviruses (e.g. MERS-CoV, SARS-CoV) suggest that the incubation period may range from 2–14 days.
A: Very limited data are available about detection of SARS-CoV-2 and infectious virus in clinical specimens. SARS-CoV-2 RNA has been detected from upper and lower respiratory tract specimens, and SARS-CoV-2 has been isolated from upper respiratory tract specimens and bronchoalveolar lavage fluid. SARS-CoV-2 RNA has been detected in blood and stool specimens, but whether infectious virus is present in extrapulmonary specimens is currently unknown. The duration of SARS-CoV-2 RNA detection in upper and lower respiratory tract specimens and in extrapulmonary specimens is not yet known but may be several weeks or longer, which has been observed in cases of MERS-CoV or SARS-CoV infection. While viable, infectious SARS-CoV has been isolated from respiratory, blood, urine, and stool specimens, in contrast – viable, infectious MERS-CoV has only been isolated from respiratory tract specimens. It is not yet known whether other non-respiratory body fluids from an infected person including vomit, urine, breast milk, or semen can contain viable, infectious SARS-CoV-2
A: The immune response to COVID-19 is not yet understood. Patients with MERS-CoV infection are unlikely to be re-infected shortly after they recover, but it is not yet known whether similar immune protection will be observed for patients with COVID-19.
A: Although the transmission dynamics have yet to be determined, CDC currently recommends a cautious approach to persons under investigation (PUI) for COVID-19. Healthcare personnel evaluating PUI or providing care for patients with confirmed COVID-19 should use, Standard Transmission-based Precautions. See the Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation for Coronavirus Disease 2019 (COVID-19) in Healthcare Settings.
A: Patients should receive any interventions they would normally receive as standard of care. Patients with suspected or confirmed COVID-19 should be asked to wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed. Healthcare personnel entering the room should use Standard and Transmission-based Precautions.
A: Not all patients with COVID-19 will require medical supportive care. Clinical management for hospitalized patients with COVID-19 is focused on supportive care of complications, including advanced organ support for respiratory failure, septic shock, and multi-organ failure. Empiric testing and treatment for other viral or bacterial etiologies may be warranted. Corticosteroids are not routinely recommended for viral pneumonia or ARDS and should be avoided unless they are indicated for another reason (e.g., COPD exacerbation, refractory septic shock following Surviving Sepsis Campaign Guidelines).
There are currently no antiviral drugs licensed by the U.S. Food and Drug Administration (FDA) to treat COVID-19. Some in-vitro or in-vivo studies suggest potential therapeutic activity of some agents against related coronaviruses, but there are no available data from observational studies or randomized controlled trials in humans to support recommending any investigational therapeutics for patients with confirmed or suspected COVID-19 at this time. Remdesivir, an investigational antiviral drug, was reported to have in-vitro activity against COVID-19. A small number of patients with COVID-19 have received intravenous remdesivir for compassionate use outside of a clinical trial setting. A randomized placebo-controlled clinical trial of remdesivirexternal icon for treatment of hospitalized patients with COVID-19 respiratory disease has been implemented in China. A randomized open label trialexternal icon of combination lopinavir-ritonavir treatment has been also been conducted in patients with COVID-19 in China, but no results are available to date. trials of other potential therapeutics for COVID-19 are being planned. For information on specific clinical trials underway for treatment of patients with COVID-19 infection, see clinicaltrials.govexternal icon.
A: No. These multi-pathogen molecular assays can detect a number of human respiratory viruses, including other coronaviruses that can cause acute respiratory illness, but they do not detect COVID-19.
A: There is currently no FDA-approved post-exposure prophylaxis for people who may have been exposed to COVID-19. For more information on movement restrictions, monitoring for symptoms, and evaluation after possible exposure to COVID-19
See Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposure in Travel-associated or Community Settings and Interim U.S Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease 2019 (COVID-19).
A: Healthcare providers should consult with local or state health departments to determine whether patients meet criteria for a Persons Under Investigation (PUI). Providers should immediately notify infection control personnel at their facility if they suspect COVID-19 in a patient.
A: Not all patients with COVID-19 require hospital admission. Patients whose clinical presentation warrants in-patient clinical management for supportive medical care should be admitted to the hospital under appropriate isolation precautions. Some patients with an initial mild clinical presentation may worsen in the second week of illness. The decision to monitor these patients in the inpatient or outpatient setting should be made on a case-by-case basis. This decision will depend not only on the clinical presentation, but also on the patient’s ability to engage in monitoring, the ability for safe isolation at home, and the risk of transmission in the patient’s home environment.
For more information, see Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation for Coronavirus Disease 2019 (COVID-19) in a Healthcare Setting and Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for Coronavirus Disease 2019 (COVID-19).
A: Patients can be discharged from the healthcare facility whenever clinically indicated. Isolation should be maintained at home if the patient returns home before the time period recommended for discontinuation of hospital Transmission-Based Precautions described below. Decisions to discontinue Transmission-Based Precautions or in-home isolation can be made on a case-by-case basis in consultation with clinicians, infection prevention and control specialists, and public health based upon multiple factors, including disease severity, illness signs and symptoms, and results of laboratory testing for COVID-19 in respiratory specimens.
Criteria to discontinue Transmission-Based Precautions can be found in: Interim Considerations for Disposition of Hospitalized Patients with COVID-19
As a nurse you are constantly looking for ways to help people out. Travel nurses are no different, especially after a disaster. For any nurse, preparation is crucial. Be prepared by signing up for a state disaster volunteer registry near you or where you are licensed.
If you hold a state license, get registered now as a state disaster volunteer. We recommend doing this, as soon as possible, so there is no delay when a disaster strike’s.
There are several National Agencies that you can pre-register with. These are National Government approved disaster volunteer organizations. To list a few:
In addition to the volunteer organizations listed above, each state has their own State operated volunteer registry for disaster and/or emergency response. You can call your state’s health department for more information on healthcare providers volunteering & registration. There are many other opportunities to volunteer and get involved.
Other Helpful Links:
Everyone knows the medical field is one of the most stressful job fields to be in. Medical professionals are paid to save lives for a living; the expectation to always be at your best for your patients is taxing. Dealing with family members, feeling like you are not in control of your work environment or just the cases you observe can all play a role in the amount of pressure you feel. We have put together a list of a few things you can do to de-stress when you get off work.
The first way to de-stress is working out the stress. There are many benefits of physical exercise other than just improving physical well-being. Exercise is also considered vital for maintaining mental fitness, and it can also reduce stress. Studies have shown that it is very effective at reducing fatigue, improving alertness and concentration, and enhancing overall cognitive function. This can be especially helpful when stress has drained your energy or ability to concentrate.
When stress affects the brain, with all its nerve connections, the rest of the body feels the impact as well. Naturally if your body feels better, so will your mind. Exercise and other physical activities produce endorphins—chemicals in the brain that act as natural painkillers—and improve the ability to sleep, which in turn reduces stress. There are many benefits to working out; add de-stressing to the list.
While just about any walk will help to clear your head and boost endorphins (which in turn, reduces stress hormones), consider walking in a park or by a body of water, which can put your body into a state of meditation. Take it up a notch and bring a yoga mat so if you find a good spot you can do yoga there.
While classical music has a notably soothing effect — it slows heart rate, lowers blood pressure and can even decrease levels of stress hormones — any music that you love will flood your brain with feel-good neurochemicals (like dopamine).
And, while music can soothe everyday anxiety (crank it up on the drive home!), research shows that it’s remarkably beneficial for those in the midst of stressful events, like surgery.
Don’t have your headphones nearby? Try humming or making your own music. One study of stressed-out nursing students found that recreational music-making relieved stress and prevented burnout.
Eating or drinking something sweet is satisfying because it starts the production of the stress hormone, glucocorticoid (which helps explain why we find ourselves staring down the jar of cookies when things don’t go right). While not an excuse to unleash your emotional eating on the hospital vending machine, a Reese’s pieces, peppermint candy or other reasonably-sized treat can help.
Try some of these techniques next time you feel at your breaking point and need to de-stress a little.