Prepared by Dr John Low
An outbreak of novel coronavirus (2019-nCoV) was detected in Wuhan, Hubei Province, China in late December 2019. Coronaviruses are a type of virus that can affect humans and animals. Some coronaviruses cause illness similar to the common cold while other coronaviruses cause more serious illness.
Symptoms of 2019-nCoV may include fever, cough, vomiting, sore throat and difficulty breathing. Difficulty breathing is a sign of possible pneumonia that requires immediate medical attention.
The coronavirus is most likely to spread from person to person through:
- direct close contact with a person whilst they are infectious;
- close contact with a person with a confirmed infection coughs or sneezes; or
- touching objects or surfaces (such as door knobs or tables) contaminated from a cough or sneeze from a person with a confirmed infection, and then touching your mouth or face.
Most infections are only transmitted by people when they have symptoms. There is now some evidence that people could be contagious before showing symptoms. It can take up to 14 days for symptoms to show after a person has been infected.
There is no specific treatment for coronaviruses.
Risk Assessment
As at 4 March 2020, there were 93164 confirmed cases globally; 77 countries with cases; In China 80422 confirmed; Republic of Korea 5328, Italy 2502, Iran 2336, Japan 284. For up-to-date global numbers, please press ctrl+click the link below.
Click here for WHO Situational Dashboard.
People most risk of serious infection are:
- People with compromised immune systems, such as people with cancer
- Elderly people
- Aboriginal and Torres Strait Islander people
- People with diagnosed chronic medical conditions.
Suspected Case Criteria
If the patient satisfies the epidemiological AND clinical criteria (listed below), they are classified as a suspected case:
Epidemiological Criteria
Travel to (including transit through) a country considered to pose a risk of transmission (listed below) in the 14 days before the onset of illness.
OR
Close contact* within 14 days before illness onset with a confirmed or suspected case of 2019-nCoV.
Clinical Criteria
Fever
OR
Acute respiratory infection (respiratory infection with at least one of: shortness of breath, cough or sore throat) with or without fever or history of fever.
High risk countries:
- Mainland China
- Iran
- Italy
- South Korea
Moderate Risk:
- Cambodia
- Hong Kong
- Indonesia
- Japan
- Singapore
- Thailand
A close contact is defined as requiring:
Greater than 15 minutes face-to-face contact in any setting with a confirmed case in the period extending from 24 hours before onset of symptoms in the confirmed case, or
Sharing of a closed space with a confirmed case for a prolonged period (e.g. more than 2 hours) in the period extending from 24 hours before onset of symptoms in the confirmed case.
Risk Management
Fitness for work
Advice should be sent to workers not to attend work and isolate themselves at home if:
- The worker has left and transmitted through high risk countries less than 14 days ago (until 14 days after leaving).
- The worker has been identified as close contacts of proven cases of novel coronavirus (until 14 days after last contact with the confirmed case)
- The worker has left, or transited through, mainland China on or after 1 February 2020 (until 14 days after leaving China).
In addition, we recommend advising workers who suffer symptoms such as fever, cough, sore throat or tiredness or any symptoms associated with a cold or other respiratory illness not to attend work irrespective of the above 3 criterion.
Workers should be provided the following links for up-to-date advice:
https://www.healthdirect.gov.au/coronavirus
Preventing the spread
If unwell, the worker should avoid contact with others including attending the work facility, gatherings and especially close contact such as (touching, kissing, hugging, and other intimate contact).
In well and unwell persons, practising good hand hygiene and sneeze/cough hygiene is the best defence:
- Wash hands often with soap and water, or alcohol-based hand gel, before and after eating as well as after attending the toilet;
- Avoiding contact with others; and
- Cough and sneeze into the elbow.
If a worker develops or reports mild symptoms at the workplace
- They should either leave the workplace or be isolated from others. They should use a separate bathroom if available
- Put on a surgical mask and practise good sneeze/cough hygiene
- Practise good hand hygiene
- Call a doctor or hospital or OccuMED and advise on recent travel itinerary or close contact history.
With good food preparation as well as good food hygiene (hand washing etc), and when food is properly cooked it is highly unlikely that workers will become infected with novel coronavirus through food.
Cleaning staff should minimise their risk of being infected with novel coronavirus by wearing gloves while cleaning and using alcohol hand rub before and after wearing gloves. As an added precaution, cleaning staff may wish to wear a surgical mask while cleaning rooms or areas of the workplace where person with a confirmed case of novel coronavirus or a person in self-isolation has frequented. If a confirmed case of novel coronavirus or a person in self-isolation is in a room that cleaning staff need to enter, they may inquire if people are well, and ask them to put on a surgical mask if they have one available.
Face Masks
The use of facemasks can help to prevent transmission of disease from infected patients to others. Face masks are not currently recommended for use by healthy members of the public for the prevention of infections like novel coronavirus.
Actions for work who meet suspected case criteria
- Place a surgical mask on the worker
- Place patient in isolated room and/or arrange for the worker to leave the work site.
- Please refer to:
- https://www.health.gov.au/resources/publications/coronavirus-covid-19-isolation-guidance
- https://www.health.gov.au/sites/default/files/documents/2020/02/coronavirus-covid-19-information-for-drivers-and-passengers-using-public-transport_0.pdf
- https://www.health.gov.au/sites/default/files/documents/2020/02/coronavirus-covid-19-information-for-the-airline-industry-including-flight-crew.pdf
- Contact the OccuMED Poison’s Permit 24/7 Medical Support Service or OccuMED’s clinics for risk assessment and management plan including fitness for work assessment and Corona Virus testing referral.
For sites with medical centres, use standard plus contact plus droplet precautions including a disposable fluid resistant gown, gloves, surgical mask, and eye protection while reviewing the patient
Airborne precautions, i.e. a P2/N95 mask and eye protection must also be used while collecting specimens.
Seek Advice
OccuMED Clinic (clients only).
OccuMED 24/7 Remote Medical Support and Poison’s Permit Service (subscribers only).
Immediately contact the state/territory public health unit/communicable disease branch if a suspected case is encountered on site/ at the workplace.
Coronavirus Health Information Line on 1800 020 080.
Public Health Authority WA 08 9328 0553, NT call 08 8922 8044.
References:
- World Health Organisation https://www.who.int/
- Australian Government Department of Health https://www.health.gov.au/health-topics/novel-coronavirus-2019-ncov