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Novel Coronavirus Information
Robert Healy, M.D discusses the latest information for providers on 2019 Novel Coronavirus. He helps us to understand the 2019 novel Coronavirus timeline, what hospitals can do to screen patients, the symptoms and complications that Novel Coronavirus 2019 can cause and what public health departments are doing about this situation.
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Learn more about Robert Healy, MD
Robert Healy, MD
Robert Healy, MD is the Chief Medical Quality Officer.Learn more about Robert Healy, MD
Transcription:
Melanie Cole, MS (Host): Expert Insights is an ongoing medical education podcast. The Carle Division of continuing education designates that each episode of this enduring material is worth a maximum of .25 AMA PRA Category 1 credit. To collect credit, please click on the link and complete the episode’s post-test.
Welcome. This is Expert Insights with the Carle Foundation Hospital. I'm Melanie Cole and today we’re discussing the coronavirus, the latest updates. Joining me is Dr. Robert Healy, he’s an adult medicine physician with the Carle Foundation Hospital. Dr. Healy before we get into what we’re seeing right now, tell us what the 2019 novel coronavirus is. What does novel mean and what are the coronaviruses?
Robert Healy, MD (Guest): We've had some people around here in our hospitals saying, “Oh my goodness. We have coronavirus.” There are many coronaviruses out there. The coronavirus family causes a lot of common colds that we have routinely throughout the year in our system, in our environment. If people get sick enough from them, they can be admitted. We've been testing for a long time on people that need it what virus is causing pneumonia. There are some coronaviruses that cause pneumonia. The novel coronavirus—novel just means new. So it’s something that we haven’t seen before in human populations. They know a lot about it since it started just a little over about six weeks ago in China. They know that it’s one of the coronavirus family. It’s the same family but a different virus that caused SARS and MERS about five or ten years ago. Novel just means new. So it’s one more coronavirus that probably passed from bats to humans like SARS did. MERS passed from camels to humans. Now we’re stuck with this new virus that’s going up through our species essentially.
Host: So how are you differentiating the symptoms or complications that the novel coronavirus can cause if also coronaviruses cause the cold, or we’ve seen pneumonia? If somebody comes up with some respiratory symptoms, how are we even differentiating these from others?
Dr. Healy: So the most important point is to find out if the person has been exposed to this new virus. Through public health measures what we’re doing is we’re asking everyone when they come into our system at the ED or convenient care or at a regular office if they’ve traveled—now we’ve expanded just asking if they traveled from China in the last 14 days. If they have symptoms, we’re asking them to mask themselves right away. We isolate them and then go in and ask a detailed set of questions. You're right that the symptoms themselves don’t really tell you whether this is the new coronavirus or one of the older ones, but it’s that important factor of either being from a place where the new coronavirus is active or having been exposed to someone who has this new coronavirus.
Host: So you mentioned a little bit about how it’s spread and maybe from bats. So are we now seeing that it’s spread from person to person? Is it airborne? How is it spreading?
Dr. Healy: Good question because that dictates how much we might see in the future. So what’s got to happen now, there’s been a lot of papers already written about this because it’s such an important topic. They’ve been getting out into the medical journals. The World Health Organization and CDC are sending us information all the time. What's known now is that it’s spread by airborne droplets. So measles, as an example, you can get infected with measles if you haven’t had the virus if you go in the same airspace, the same room, as someone who had measles that sneezed four hours ago. So measles hangs around in the air and we can breathe it in. With this novel coronavirus and other types of coronavirus, it’s thought that we have to be exposed to droplets in the air or to surfaces where someone’s coughed onto and the virus is there. So it’s not as contagious as something like measles. It’s more along the lines of getting the flu.
Host: So that’s an important point in that you mentioned that by knowing how it’s spread and what the exposure is, that will give us the best ways to know how to treat it or reduce the infection spreading. So tell us about hospitals and ambulatory settings. What should they be doing not only to screen patients but what should they be doing to protect the situation in case somebody does come in?
Dr. Healy: Like I said earlier, we really need to screen people so if they’ve had any travel from China or if they’ve been exposed to someone, we should mask them right away with not a regular mask that you think of like you’d see a surgeon wear. It’s called an N95 mask, which is a step up from a normal mask you could buy at Walgreens or somewhere else. So we put this mask on the patient and keep them in an enclosed room. If they come to the emergency department, we have negative airflow rooms. So we have rooms that will protect everyone else and will keep the virus in that room. In the office setting, we don’t have such rooms. We will put them in a room far away from other patients as we can. We’ll evaluate them in that room. If they turn out to be someone who we suspect to have the novel coronavirus—and we can talk later about how we would come to that conclusion. If so, CDC recommends we leave the room empty for two full hours and then go in and clean the surfaces as usual. It’s also recommended, and we enforce that our providers who are going into the room to talk to the patient wear an N95 mask, gown, gloves, and a face shield. So we’re wearing airborne protection to interview the patient and talk to them and assess them and the patient has this N95 mask on at the same time.
Host: So you’ve given us some very good precautionary measures. We’ve talked about the symptoms and how it differentiates and the exposure and how it’s spread, even the screening. How do you diagnose it? How are you sure?
Dr. Healy: So the only way to diagnose it now is by sending samples to the CDC. They're the only ones doing the test so far in the U.S. So what we do is if a patient comes in and they're screened that they're a potential case then we—through our infection prevention colleagues of Carle—we would call the Champaign Urbana public health district. So it’s recommended you call your local public health district. They have a form that we fill out. It says the travel history of the patient, what their symptoms are, what their vital signs are. If there's any testing that’s been done so far, we’ll put that on the form. Then that goes from our local public health department to the state public health department. If the state thinks that the person would fit the criteria for a person under investigation then they would give us the okay to collect samples to send to the state who would then send out to the CDC the material that would get tested. So far they tell us that that would all happen within 24 hours. So if we suspected someone today in the office, if we collected samples from their nose or throat and blood, we would send that off and have a result by tomorrow.
Host: So what is the state of Illinois, for example, doing about the situation alerting healthcare providers and healthcare systems about this coronavirus and what they want them to know?
Dr. Healy: We’ve been on calls with our local public health for sure and also the state public health. Early on, which means basically seven to ten days ago, we had a case of a patient who had been to Wuhan, China, the epicenter of this epidemic. Came back to the states and ultimately the Champaign Urbana and had a sore throat. No other symptoms, but it was enough to alert us. The patient was masked and put in the appropriate isolation room in the emergency department, and then we got on the phone with our local and state public health. We realized that that person didn’t fit the criteria with just a sore throat. So in that case, they were just able to go home and monitor themselves. So we’re on the phone with the local and state public health if we need to be. Otherwise there is a lot of information being sent out by email, put on their website from both the local and the state public health as well as from the CDC.
Host: So before we wrap up, what would you like us to know—you and I spoke a little bit before off the air and you said it’s ever changing. So what would you like people to know, other providers, about keeping up with these changes and the precautionary measures you want healthcare settings to take. All of these things, including the N95 mask, all of it. What would you like them to know about keeping up with this?
Dr. Healy: I think the important thing is to keep up to date with your infection prevention team. They’ll give information like at Carle, for instance, we have an internet called Click. There’ll be information on Click. There’ll be emails that are sent out. Providers, probably the best thing to do is check the CDC website, cdc.gov. There's a section for the novel coronavirus they can go to and learn pretty much all they want to know about this virus. So I think keeping up to date with what the CDC recommends, what emails come out from your system, and just being vigilant about cases that might be coming in that have travelled through areas that have had epidemic is crucial. We have many more cases of influenzas, both influenza A and B. We’re seeing it a lot. It’s been going up lately, probably because people are worried about the new coronavirus. They're coming in and we’re testing and finding they have influenza, but there's tens of thousands of deaths in the United States alone every year from influenza. So getting your flu shot would be the best thing I could recommend for you. Also basic hygiene. Washing your hands and coughing into your elbow or shoulder. That will go a long way towards preventing influenza as well as this novel coronavirus from spreading.
Host: Thank you so much Dr. Healy. It’s a pleasure, as always. You're such a great guest and this was really an important topic for listeners and other healthcare providers in settings to hear. So thank you so much. That concludes this episode of Expert Insights with the Carle Foundation Hospital. For a listing of Carle providers and to view Carle sponsored education activities, please visit our website at carleconnect.com for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other Carle Foundation Hospital podcasts. We hope the information gained will be applicable to your work and life. I'm Melanie Cole.
Melanie Cole, MS (Host): Expert Insights is an ongoing medical education podcast. The Carle Division of continuing education designates that each episode of this enduring material is worth a maximum of .25 AMA PRA Category 1 credit. To collect credit, please click on the link and complete the episode’s post-test.
Welcome. This is Expert Insights with the Carle Foundation Hospital. I'm Melanie Cole and today we’re discussing the coronavirus, the latest updates. Joining me is Dr. Robert Healy, he’s an adult medicine physician with the Carle Foundation Hospital. Dr. Healy before we get into what we’re seeing right now, tell us what the 2019 novel coronavirus is. What does novel mean and what are the coronaviruses?
Robert Healy, MD (Guest): We've had some people around here in our hospitals saying, “Oh my goodness. We have coronavirus.” There are many coronaviruses out there. The coronavirus family causes a lot of common colds that we have routinely throughout the year in our system, in our environment. If people get sick enough from them, they can be admitted. We've been testing for a long time on people that need it what virus is causing pneumonia. There are some coronaviruses that cause pneumonia. The novel coronavirus—novel just means new. So it’s something that we haven’t seen before in human populations. They know a lot about it since it started just a little over about six weeks ago in China. They know that it’s one of the coronavirus family. It’s the same family but a different virus that caused SARS and MERS about five or ten years ago. Novel just means new. So it’s one more coronavirus that probably passed from bats to humans like SARS did. MERS passed from camels to humans. Now we’re stuck with this new virus that’s going up through our species essentially.
Host: So how are you differentiating the symptoms or complications that the novel coronavirus can cause if also coronaviruses cause the cold, or we’ve seen pneumonia? If somebody comes up with some respiratory symptoms, how are we even differentiating these from others?
Dr. Healy: So the most important point is to find out if the person has been exposed to this new virus. Through public health measures what we’re doing is we’re asking everyone when they come into our system at the ED or convenient care or at a regular office if they’ve traveled—now we’ve expanded just asking if they traveled from China in the last 14 days. If they have symptoms, we’re asking them to mask themselves right away. We isolate them and then go in and ask a detailed set of questions. You're right that the symptoms themselves don’t really tell you whether this is the new coronavirus or one of the older ones, but it’s that important factor of either being from a place where the new coronavirus is active or having been exposed to someone who has this new coronavirus.
Host: So you mentioned a little bit about how it’s spread and maybe from bats. So are we now seeing that it’s spread from person to person? Is it airborne? How is it spreading?
Dr. Healy: Good question because that dictates how much we might see in the future. So what’s got to happen now, there’s been a lot of papers already written about this because it’s such an important topic. They’ve been getting out into the medical journals. The World Health Organization and CDC are sending us information all the time. What's known now is that it’s spread by airborne droplets. So measles, as an example, you can get infected with measles if you haven’t had the virus if you go in the same airspace, the same room, as someone who had measles that sneezed four hours ago. So measles hangs around in the air and we can breathe it in. With this novel coronavirus and other types of coronavirus, it’s thought that we have to be exposed to droplets in the air or to surfaces where someone’s coughed onto and the virus is there. So it’s not as contagious as something like measles. It’s more along the lines of getting the flu.
Host: So that’s an important point in that you mentioned that by knowing how it’s spread and what the exposure is, that will give us the best ways to know how to treat it or reduce the infection spreading. So tell us about hospitals and ambulatory settings. What should they be doing not only to screen patients but what should they be doing to protect the situation in case somebody does come in?
Dr. Healy: Like I said earlier, we really need to screen people so if they’ve had any travel from China or if they’ve been exposed to someone, we should mask them right away with not a regular mask that you think of like you’d see a surgeon wear. It’s called an N95 mask, which is a step up from a normal mask you could buy at Walgreens or somewhere else. So we put this mask on the patient and keep them in an enclosed room. If they come to the emergency department, we have negative airflow rooms. So we have rooms that will protect everyone else and will keep the virus in that room. In the office setting, we don’t have such rooms. We will put them in a room far away from other patients as we can. We’ll evaluate them in that room. If they turn out to be someone who we suspect to have the novel coronavirus—and we can talk later about how we would come to that conclusion. If so, CDC recommends we leave the room empty for two full hours and then go in and clean the surfaces as usual. It’s also recommended, and we enforce that our providers who are going into the room to talk to the patient wear an N95 mask, gown, gloves, and a face shield. So we’re wearing airborne protection to interview the patient and talk to them and assess them and the patient has this N95 mask on at the same time.
Host: So you’ve given us some very good precautionary measures. We’ve talked about the symptoms and how it differentiates and the exposure and how it’s spread, even the screening. How do you diagnose it? How are you sure?
Dr. Healy: So the only way to diagnose it now is by sending samples to the CDC. They're the only ones doing the test so far in the U.S. So what we do is if a patient comes in and they're screened that they're a potential case then we—through our infection prevention colleagues of Carle—we would call the Champaign Urbana public health district. So it’s recommended you call your local public health district. They have a form that we fill out. It says the travel history of the patient, what their symptoms are, what their vital signs are. If there's any testing that’s been done so far, we’ll put that on the form. Then that goes from our local public health department to the state public health department. If the state thinks that the person would fit the criteria for a person under investigation then they would give us the okay to collect samples to send to the state who would then send out to the CDC the material that would get tested. So far they tell us that that would all happen within 24 hours. So if we suspected someone today in the office, if we collected samples from their nose or throat and blood, we would send that off and have a result by tomorrow.
Host: So what is the state of Illinois, for example, doing about the situation alerting healthcare providers and healthcare systems about this coronavirus and what they want them to know?
Dr. Healy: We’ve been on calls with our local public health for sure and also the state public health. Early on, which means basically seven to ten days ago, we had a case of a patient who had been to Wuhan, China, the epicenter of this epidemic. Came back to the states and ultimately the Champaign Urbana and had a sore throat. No other symptoms, but it was enough to alert us. The patient was masked and put in the appropriate isolation room in the emergency department, and then we got on the phone with our local and state public health. We realized that that person didn’t fit the criteria with just a sore throat. So in that case, they were just able to go home and monitor themselves. So we’re on the phone with the local and state public health if we need to be. Otherwise there is a lot of information being sent out by email, put on their website from both the local and the state public health as well as from the CDC.
Host: So before we wrap up, what would you like us to know—you and I spoke a little bit before off the air and you said it’s ever changing. So what would you like people to know, other providers, about keeping up with these changes and the precautionary measures you want healthcare settings to take. All of these things, including the N95 mask, all of it. What would you like them to know about keeping up with this?
Dr. Healy: I think the important thing is to keep up to date with your infection prevention team. They’ll give information like at Carle, for instance, we have an internet called Click. There’ll be information on Click. There’ll be emails that are sent out. Providers, probably the best thing to do is check the CDC website, cdc.gov. There's a section for the novel coronavirus they can go to and learn pretty much all they want to know about this virus. So I think keeping up to date with what the CDC recommends, what emails come out from your system, and just being vigilant about cases that might be coming in that have travelled through areas that have had epidemic is crucial. We have many more cases of influenzas, both influenza A and B. We’re seeing it a lot. It’s been going up lately, probably because people are worried about the new coronavirus. They're coming in and we’re testing and finding they have influenza, but there's tens of thousands of deaths in the United States alone every year from influenza. So getting your flu shot would be the best thing I could recommend for you. Also basic hygiene. Washing your hands and coughing into your elbow or shoulder. That will go a long way towards preventing influenza as well as this novel coronavirus from spreading.
Host: Thank you so much Dr. Healy. It’s a pleasure, as always. You're such a great guest and this was really an important topic for listeners and other healthcare providers in settings to hear. So thank you so much. That concludes this episode of Expert Insights with the Carle Foundation Hospital. For a listing of Carle providers and to view Carle sponsored education activities, please visit our website at carleconnect.com for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other Carle Foundation Hospital podcasts. We hope the information gained will be applicable to your work and life. I'm Melanie Cole.