Novel Coronavirus Update- March 2, 2020

February 28, 2020

On February 28, 2020, the North Carolina Department of Health and Human Services sent a memo providing updates on the criteria to guide evaluation of patients under investigation (PUI) for COVID-19.

Granville Health System presently screens patients at points of intake in the hospital and clinics, with questions of travel outside the US or contact with anyone ill that has traveled outside the US in the last 14 days.

In light of the recent evidence, both inside the US and abroad, of person to person spread of COVID-19 in persons without travel history or contact with ill travelers, the Centers for Disease Control (CDC) has expanded their screening process. Updated screening questions include if the patient has traveled to affected geographical areas within 14 days of symptom onset, or if the patient has come in close contact with a person with COVID-19. The definition of a PUI has also expanded to include a person with severe acute lower respiratory illness (e.g. pneumonia, ARDS) requiring hospitalization and without other explanatory diagnosis (e.g. influenza) in a person in which no source of exposure has been identified. Physicians and laboratories are required to immediately report to local or public health when novel coronavirus infection is reasonably suspect to exist.

It is reasonable to expect the number of cases of COVID-19 will increase greatly solely due to the expanded definition of the illness, not necessarily due to an actual increase in the number of persons with the illness. The CDC warns people against panic, reminding that so far, over 80% of the infections are classified as mild (cough, possible fever) and do not require medical treatment. The elderly and those older with pre-existing heart and lung disease or diabetes are most at risk.

As always, the best way to prevent the spread of any type of coronavirus is to cover your cough or sneeze with a tissue or your sleeve, frequent hand hygiene, and keeping your hands away from your face.

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