Doctor in hallway talks to two residents in scrubs.
Dr. Jason Parham makes rounds in University Hospital with Dr. Martha Magnuson, left, second-year internal medicine resident, and Dr. Anna Hinton Owings, second-year internal medicine resident.
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ID staff explain what UMMC employees need to know about COVID-19

Published on Thursday, February 20, 2020

By: Ruth Cummins

Chances are good that at some point, you have had some sort of coronavirus.

Chances are extremely slim, however, that any University of Mississippi Medical Center employees have had contact with the novel coronavirus strain making news headlines, a new coronavirus that’s the cause of a worldwide outbreak of respiratory illness first detected in late 2019 in Wuhan City in China’s Hubei Province.

The Medical Center wants its health care providers to have up-to-date information on this specific  new strain, referred to as COVID-19, and to be educated on how to answer questions from patients, families and friends, said Dr. Jason Parham, director of the Department of Medicine’s Division of Infectious Diseases.

As of Feb. 19, 15 cases of COVID-19 had been reported in the United States, none of them in Mississippi. The Medical Center is actively preparing should it receive a patient with COVID-19, said Dr. Bhagyashri Navalkele, medical director of Infection Prevention.

Portrait of Dr. Bhagyashri Navalkele

“There will be more specific instruction and recommendations for employees if that happens,” she said. “Infection Prevention, along with the Mississippi Center for Emergency Services and other key leaders, are making sure that if we identify a case, we will take the proper steps to minimize risk to other patients and staff.”

Officials with the Centers for Disease Control and Prevention alerted clinicians in this country Jan. 8 to be on the lookout for patients with both respiratory symptoms and a history of travel to Wuhan. The CDC prepared proactively for the virus’ spread to this country by developing guidance for clinicians for testing and managing COVID-19, as well as guidance for home care for patients who have it.

There is no specific antiviral treatment for COVID-19, which has symptoms that include fever, cough and shortness of breath. Most sufferers experience mild illness and recover with supportive care, Parham said. “There have been cases with severe respiratory illness, mostly pneumonia, requiring hospitalization,” he said. “Severe illness appears to be most frequently seen in those with underlying chronic conditions.”

Worldwide, COVID-19 has killed more than 2,000 people, all but six of them in mainland China. It’s infected more than 75,000 people, with more than 1,000 of those cases outside mainland China.

If you have had a cold or cough, it could have been caused by a coronavirus – just not the COVID-19 strain.

“Coronaviruses are a large family of viruses. Some cause respiratory illness in humans,” Parham said.

“Numerous other coronaviruses circulate among animals, including camels, cats and bats,” Parham said. And in rare situations, animal coronaviruses can evolve and infect people and then spread from person to person, he said. That was the case with the coronaviruses Sudden Acute Respiratory Syndrome, or SARS, in 2003 and Middle East Respiratory Syndrome, or MERS, in 2012.

The earliest patients diagnosed with COVID-19 in Wuhan City reportedly had a link to a large seafood and animal market, suggesting animal-to-person spread.

The Medical Center is following CDC recommendations to identify patients who should be screened for COVID-19. Currently in this country, only the CDC is conducting testing, using multiple specimens from sites including lower respiratory, upper respiratory and blood serum. The Mississippi State Department of Health is expected to be equipped for laboratory testing for COVID-19 in coming weeks.

Screenings should take place on someone experiencing fever and signs/symptoms of lower respiratory illness, AND in the last 14 days before symptoms onset, had either:

  • A history of travel from Hubei Province, China
  • A required hospitalization and a history of travel to mainland China
  • Close contact with a laboratory-confirmed COVID-19 patient

The CDC defines close contact as being within about 6 feet, or within the room or care area, of a patient with COVID-19 for a prolonged period of time while not wearing recommended personal protective equipment, or PPE. That PPE could be gowns, gloves, a NIOSH-certified disposable N95 respirator or eye protection.

Close contact also entails having direct contact, while not wearing PPE, with infectious secretions, such as droplets from coughing, from someone diagnosed with 2019-n-CoV.

If providers suspect a patient has COVID-19, Navakele said, they should follow these immediate step:

  • Put a regular face mask on the patient and transfer them to a private room, preferably a negative pressure room.
  • Initiate airborne and contact isolation. If the patient isn’t in a negative pressure room, use a HEPA filter and make arrangements to transfer the patient to a negative pressure room.
  • Contact Infection Prevention and the state Department of Health.
  • Use dedicated equipment for the patient room, and limit patient movement outside the room.
  • Avoid any unnecessary diagnostic tests, and allow no visitors with the exception of a child with a single parent, or an end-of-life situation.
  • Put on PPE prior to entering a patient room.

If an employee receives a call from a patient who fits the screening criteria for COVID-19, employees should tell those with an ongoing fever or cough or shortness of breath to call the doctor’s office or emergency department before they visit. Patients will receive special instructions before arrival to avoid the risk of exposing others in the office or waiting room.

Although the risk of COVID-19 infection in Mississippi is very low, Navalkele said, employees, students, patients and families at the Medical Center should follow the same precautions that they would for flu prevention:

  • Wash hands often with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer containing at least 60 percent alcohol if soap and water isn’t available.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Stay home if you’re sick.
  • Cover your cough or sneeze with a tissue, and then throw the tissue in the trash, and clean and disinfect frequently touched objects and surfaces.

“We have a high number of flu cases in Mississippi, and we are continuing to see an uptick,” Navalkele said. “If you are sick with the flu, you need to make sure you are staying home and taking appropriate precautions.”

Employees as of now have no reason to be fearful, Navalkele said. “This particular coronavirus from China is a new infection. Limited information is available, and that results in anxiety and fear,” she said. “Because it’s new, not everyone has immunity against it. It’s another virus, but one where you would need to take the same precautions as you would with the flu.”