Experts: COVID-19 is ‘Approaching Pandemic’

By Jay Kumar, PSQH

As worldwide panic over the COVID-19 crisis ramps up, a group of U.S. healthcare experts on Friday stressed the importance of taking an all-hazards approach to responding to the situation, about which much is still unknown.

In a webinar hosted by the Patient Safety Movement Foundation (PSMF), patient safety experts discussed the latest developments in the global response to COVID-19. Coronavirus concerns led PSMF to postpone its 8th annual World Patient Safety, Science & Technology Summit, which was scheduled to begin last Thursday.

Richard H. Carmona, MD, MPH, FACS, former U.S. Surgeon General and chief of health innovations for Canyon Ranch, said as COVID-19 starts to spread across the U.S., hospitals need to have an all-hazards approach to response. Surge capacity needs to be considered in the event of a local outbreak that would require treatment of a larger number of patients.

“We’re approaching pandemic,” he said. “You can argue we’re there already with all the countries involved.”

Carmona said each and every one of us could be a vector, but it’s primarily of concern to older people or those with compromised immune systems.

“For most of us, this will be a bad cold,” he said. “But it could take a week or two for you to recover.”

Carmona said the hope is “this will just burn out by the summer…we can help it burn out by doing proper handwashing.”

According to the dashboard developed by Johns Hopkins University to track the progress of COVID-19, there were 111,363 total confirmed cases worldwide as of 10:30 a.m. Eastern on Monday. Of that total, 566 were in the U.S. There are 3,892 total deaths (3,008 in Hubei Mainland China) and 22 in the U.S., 17 of those in King County, Washington state. There have been cancellations of conferences and other events, travel restrictions, shortages of medical supplies and items such as hand sanitizer, and record drops on the stock market.

What we know

The incubation period of COVID-19 is estimated to be two to 14 days, said Robin Betts, MBA-HM, RN, CPHQ, VP of quality, clinical excellence & regulatory services, Kaiser Foundation Hospitals and Health Plan.

Coronavirus is spread via droplets that can travel 3 to 6 feet from one person to another, she said. Asymptomatic people have been documented to transmit the virus. One infected person will, on average, spread the virus to two to four people.

COVID-19 is more transmissible than the standard influenza and more similar to SARS, Betts noted. The CDC has determined that viral shedding may occur for 15-30 days after onset of infection.

“We really don’t know how many people have had it, and we probably will never know,” she said.

Although COVID-19 may be officially considered a pandemic soon, it’s important remain calm about the situation, said Donna Prosser, DNP, RN, NE-BC, FACHE, BCPA, chief clinical officer at the PSMF.

“We do anticipate the pandemic classification shortly,” she said, adding that 16% of those infected will get seriously ill.

“There is no need to panic at this point because most people are not going to get seriously ill from COVID,” Prosser said.

COVID-19 has some similarities to influenza, but flu treatments such as Tamiflu won’t work  for this particular virus, she noted.

The response strategy of containment isn’t going to work anymore, Prosser said. “We’re kind of past the point of containment now,” she added. “The virus is out and we have to look at mitigation.”

Although the treatment needs to be different, Betts said you should use the same precautions for COVID as you would to avoid a cold or the flu.

Hand washing is the key, said Mike Durkin, MBBS, FRCA, FRCP, DSc, senior advisor on patient safety policy and leadership, Institute of Global Health Innovation, Imperial College, London.

“It’s absolutely vital to recognize the importance of hand washing” and that we should avoid touching our faces, he noted.

“It’s difficult to go five minutes without touching our face,” Durkin said. “After we touch our face, that’s when we should wash our hands.”

Experts have spotted the trend of a three- to eight-week period of increasing numbers, he said. After that initial rise in China, the number of diagnosed cases has dropped.

“If this coronavirus does react like the others, it may wither in the summer months,” said Durkin.