On 31 December 2019, the World Health Organisation (WHO) was informed of a cluster of cases of pneumonia of unknown cause detected in Wuhan, Hubei Province, China. A novel coronavirus (2019-nCoV) was subsequently identified from patient samples – since renamed COVID – 2019.
On 12 January 2020 it was announced that a novel coronavirus had been identified in samples obtained from cases and that initial analysis of virus genetic sequences suggested that this was the cause of the outbreak. This virus is referred to as 2019-nCoV, and the associated disease as ‘2019-nCoV acute respiratory disease’ – since renamed COVID – 2019.
As of 13 February 2020 - 59,804 cases and 1,369 fatalities have been officially reported by the Chinese National Health Commission from mainland China.
In addition, as of 13 February 2020 - 569 cases have been diagnosed in other countries or areas. Two fatalities outside of China have been reported.
As of 13 February 2020, 9 cases have been diagnosed in England and a total of 2521 tests have been performed.
The Trust has robust systems in place – including guidelines which can be accessed through Roogle (their staff intranet).
In addition to the guidelines – Action Cards have been produced for the area’s most likely to see patients with suspected COVID – 2019 e.g. ED, EAU, Hascombe, Maternity.
Action Cards have also been provided for Waste management, Mortuary staff.
Grab boxes/trolleys have been provided for areas most likely to see patients with suspected COVID – 2019 e.g. ED, EAU, Hascombe, ITU and Maternity.
All the Action Cards are updated regularly in line with Public Health England Guidance.
In ED there is a dedicated single room available for patients that require a medical review.
We have a designated area at the front of the hospital – called the POD. This is where patients can attend for swabbing. The POD also has a dedicated NHS 111 phone line for those patients that haven’t had an assessment by NHS 111.
Patients (and staff) who feel that they fit the epidemiological criteria i.e. they have travelled to the areas defined by Public Health England and clinical criteria i.e. fever, flu like symptoms etc. are requested to contact NHS 111 for assessment. NHS 111 then refers to the hospital for an appointment in the POD to be reviewed and swabbed. Patients can then go home to continue self-isolating as per Public Health England guidance. The POD is then cleaned before the next patient. Patients that have not been assessed through NHS 111 will not be tested.
If a patient needs to be admitted we have an identified pathway for the patient which is currently Intensive Care.
Diagnosis of COVID – 2019 is similar to flu – a nose and throat (paired) viral swab is sent to the laboratory. Currently testing is undertaken at Public Health laboratories – our nearest labs are Colindale in North London and Southampton. Results can take up to 5 days but normally 72 hours. Public Health England is looking at ways that home testing can be undertaken and we are working with partners e.g. CCG, Secamb to see how this can be provided locally.
Staff protection is paramount and we have been offering additional train the trainer sessions in fit testing for the FFP3 masks. It is imperative that staff in key areas have been fit tested to use the FFP3 masks – this must include medical staff. There is a folder on the staff G drive for areas to update on their departments – this so that we know who has been fit tested if issues arise out of hours etc.
We are following Public Health England guidance on what PPE (personal protective equipment) is required. This currently involves – FFP3 mask, visor, long sleeved fluid repellent gown, long cuffed gloves. We have plenty of stores and are in regular contact with HPL. There is a daily meeting where we look at the international, national and local picture and what the key risks are for Rthe Trust.
No – there have been no confirmed cases at the Trust. If there were, we would be guided by Public Health England and the patient would be transferred to an Infectious Diseases Unit – St Thomas Hospital/Royal Free.
Further information can be obtained from Public Health England - https://www.gov.uk/government/collections/wuhan-novel-coronavirus
This is a rapidly evolving situation and subject to frequent changes. We amend action cards when these changes occur based on the information from Public Health England. Every day at 2pm Public Health England put out a statement detailing how many tests have been undertaken in the UK and how many positive.
COVID – 2019 is here for the foreseeable future and we are doing all we can to keep our staff and patients safe.