Covid19 Virus presentation NVSSAMT John A Garrard MT

Covid-19 Virus presentation NVSSAMT John A. Garrard MT. MS USA(ret) Informational presentation for healthcare workers on general topics not to be used as legal or medical information outside of advice from physicians, State and CDC guidelines. Does not contain latest WHO or CDC information.

Environmental Factors Public, medical and spread of a pandemic

Basic Disease • Factors that spread disease in Human populations • Contact with objects, persons and animal vectors • Frequency of disease transmission • Means of disease transmission and detection • Immunity factors

• • Basics of Viral Infections Basics of Viral Detection and Testing • • Basics of Viral function Viral Labeling and Families Viral Medications and Treatments of Care Personal Protective Equipment for Healthcare workers • Prevention of Transmission/Disinfection • Basic Pandemic Response

Biological Terrorism Response • Specific Data on COVID-19 • • Basics of Corona Virus Infections Interactions with Healthcare Colleagues and Administrators • • Interaction with the Public, Local Governments and Media • Applying for Additional Supplies and Personnel • Duty Toward Self-Care • List of Websites

Basic Disease • • • Factors TIme of exposure Place of exposure Type of exposure Immunity of exposed patients Virility of exposed agent Disinfection protocols Morbidity and mortality of agent Information Existing testing and treatment

• Basic Vectors of Disease • Contact with infected persons or animals • Contact with infected surfaces or fomites (money, gloves, menus) • Secondary contact such as with infected clothing or specimens • Shared spaces such as cabs, restrooms, hotels, airplanes, food places • Spaces that could sustain or grow the virus such a microbiology or dairy laboratories

• COVID-19 Transmission Specifics • Frequency-High with viability on surfaces and fomites several hours • Mortality- 3. 4% to High as 12% of populations , high age, infants and low immunity largest factors • Respiratory infection primarily with secondary muscle involvement, loss of smell, fever, high white count, eosinophilic response, high blood pressure and bronchial spasms. Gastrointestinal involvement. Chunky sputum. • Testing and detection without a specific kit is minimal maybe it could be a URI or Cancer

Immunity • Having the disease has not been proven to show Immunity at this time • Healthcare workers are at highest risk of disease at this time • Direct patient contact is most transmissible. Doctors , Nurse, RMA, CNA, DT • Laboratorians are most protected with proper PPE and Isolating part of their labs or hospital for Corona Virus only so as to not contaminate other specimens or patients

Basics of Viral Infections • Come with exposure to populations of vital load • Decrease in isolation and good hygiene practices • Can be continuous in a population if the spread is not contained • Can cross infect through clothing, bedding, and fomites. Dogs and horses can carry and die from Covid-19, some have been confirmed in dogs. Service animals should be protected

Basics of Viral Detection and Testing • Currently COVID-19 kits are in short supply • Governments and companies have ramped up production but it currently takes 30 days to make one batch • RNA testing kits are fragile and require special transport with limited viability • Some large laboratory companies can provide some limited batch testing such as Labcorp and Quest Diagnostics • Point of care testing will be limited to quarantine sites in the future and possibly VA or federal testing centers

Viral Labeling and Family • Corona Virus - COVID-19 Viverridae family • Warts - Verrucedae Family • SARS - Viverridae Family • Symptoms and effects of Corona Virus family include fever, lethargy, cough, sore throat, upper respiratory symptoms, muscle aches and pains, decreased sense of smell in 30%, fluid in lungs in later stages with involvement of lymph glands, spleen, and blood leakage into tissues of the heart, kidneys, lungs, liver, adrenal glands and brain. Has biological shock and awe effect. • Decrease in viability in high sunlight, ultraviolet light, hot and dry conditions. • Thrives in dark, damp, and warm conditions and can survive outside the body for hours

Viral Medications and Patient Care • There a limited number of vital medications and the efficacy of the use on COVID-19 is unknown due to the rapid advance of the infection in the body • Possible medications have been proposed such as Rif. Ampin and Cloroquine but there have been no studies we know have been done. The expected earlier vaccine to be put into general production is one year and the virus could mutate up or down by then in virility. Limited vaccines may be ready in 6 months but that is not certain • Ventilators and palliative care the best we can do with reducing fever and assisting respiratory care

PPE and Healthcare Safety • Follow recommended guidelines • Gloves and masks • Face shields that can be disinfected • Portable respiratory units for caregivers • Tyvek suits or similar gowns, lab coats ( DO NOT GO OUTSIDE TO SMOKE ETC IF EXPOSED!) • Washing of clothing, bedding and disinfection of surfaces with strong antiviral Cleaners

Prevention of Transmission/Detection • Viral protocols • Test kits when available • Always assume surfaces or areas exposed are infected and areas accordingly • When in doubt err on the side of caution

Basic Pandemic Response • Local assets and training • County assets and training response • State assets and training response • Federal agencies and military assets • World Health Organization/CDC

Specifics Known of COVID 19 • Originated in China in possible animal crossover from infected or wet meat • Spread through tourism and business trade contacts • Was worse in certain areas due to climate or for profit areas such as cruise ships or highly packed dense towns such as China, Italy, etc. • Expected to level off and decrease as summer hits Northern Hemisphere but my increase in Southern Hemisphere as cold season hits • Social distancing or quarantine orders are the only effective method of reducing spread at this time

Interactions with Healthcare Workers and Administrations • Due to emotional aspects of patient care and long hours, healthcare workers need to maintain professional attitudes in order to deal with patients effectively • Administrators need to watch out for their people and signs of disease or burnout, give more frequent breaks and maintain a good working atmosphere • Family issues may become more prevalent in healthcare workers • Good hygiene and self discipline along with self care very important at this time

Interactions with Public/Government/Media • Maintain ties with local and state governments both for supplies, issues and help • Designate one person in your facility or lab to act as a Liaison and funnel requests and issues through them • Do not take calls from media or give out undocumented information. Use a designated Public Affairs spokesperson • Do not engage in websites or social media because you can be held liable for misinformation

Applying for Extra Supplies or Personnel https: //www. medicare. gov/supplierdirectory/search. html https: //www. dhs. gov/contact-us • NV. gov • CA. gov https: //www. fema. gov/

Duty to Self-Care • Go for a 15 minute walk during a lunch or coffee break. Take other opportunities to be physically active. • Eat sensibly. Avoid excessive use of caffeine and alcohol. Drink plenty of water. • Know and respect your limits. If you feel exhausted and need time off, take it. Respect commitment for regularly scheduled time off. • Spend time with family and friends. Talk to them. Listen to their stories. Listen to them if they become concerned with your health and well-being. • Get some rest. If you have trouble sleeping, get up and do something relaxing or enjoyable. • Be on the lookout for any changes in your habits, attitudes and moods. • Share your own and clients’ reactions and issues with colleagues. Don’t hesitate to ask others for advice. • Include yourself on the list of people you are taking care of. Take some time to do something for yourself every day. • Be self nurturing and don’t forget to laugh. https: //tbrhsc. net/self-care-for-healthcare-workers/

+Information Links+ WEBSITES https: //www. cdc. gov/coronavirus/2019 -ncov/index. html https: //www. fda. gov/emergency-preparedness-and-response/counterterrorism-and-emerging-thre https: //www. who. int/emergencies/diseases/novel-coronavirus-2019 https: //www. osha. gov/SLTC/covid-19/ https: //www. ed. gov/coronavirus https: //www. southernnevadahealthdistrict. org/coronavirus/ https: //www. reno. gov/community/emergency-preparedness/covid-19