As healthcare professionals and supportive team members, we have a commitment to ensure the best possible care and experience for the patients we encounter. In providing comfort, we hope for the best and prepare for the worst. Pandemic illnesses like seasonal influenza and the novel (new) coronavirus demand our attention professionally and personally. Respiratory viral infections have the potential to touch all of us yet present an opportunity for prevention and preparedness for the expected (seasonal flu) and unexpected (novel coronavirus).
Coronaviruses are a large family of viruses that are common in many different species of animals, including camels, cattle, cats, and bats. Although rare, animal coronaviruses can infect people and then spread between people. The novel virus has been named SARS-CoV-2 (Severe Acute Respiratory Syndrome caused by a coronavirus, 2nd of this type) and the disease it causes has been named “coronavirus disease 2019,” or COVID-19. SARS-CoV-2 is a betacoronavirus, like the ones that caused MERS-CoV (Middle East Respiratory Syndrome), first reported in Saudi Arabia in 2012, and SARS-CoV, first reported in Asia in 2003. All three viruses have their origins in bats.1
As of March 3, there were over 92,000 total confirmed cases globally including over 3,100 deaths and over 48,000 cases recovered.2 Earlier this month, the Centers for Disease Control and Prevention (CDC) announced the detection of the virus in the U.S. among returned travelers from Hubei Province, China (where the virus originated) and among their close contacts.
Community transmission has been confirmed in several US states, but the CDC advises that “most people in the United States will have little immediate risk of exposure to this virus” despite the very high risk of a public health threat emerging1.
Overall, reported illnesses have ranged from mild symptoms to severe illness and death. Symptoms can include fever, cough and/or shortness of breath appearing 2-14 days after exposure.1
Based on initial studies from the epicenter of the epidemic in China, overall case-fatality rate (CFR) was 2.3%. No deaths occurred in the group aged 9 years and younger, but cases in those aged 70 to 79 years had an 8.0% CFR and cases in those aged 80 years and older had a 14.8% CFR. CFR was elevated among those with preexisting comorbid conditions—10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for hypertension, and 5.6% for cancer.3
At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it. Prevention is the most important response to slow the spread.1
SEASONAL FLU (INFLUENZA)
Despite the current low risk for COVID-19 spread, we face the more immediate risk of the current flu and respiratory disease season. Overall, hospitalization rates remain similar to this time during recent flu seasons, but rates among children and young adults are higher. So far this season, the CDC estimates at least 29 million flu illnesses, 280,000 hospitalizations and 16,000 deaths from the flu.3
Signs and symptoms of the flu usually come on suddenly – people often feel some or all of these symptoms: Fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue (tiredness). Children may have vomiting and diarrhea. Symptoms begin an average of 2 days after exposure.4
The influenza vaccine is the primary measure to prevent the flu. In addition, if started within two days after the first sign of symptoms, antiviral treatment can lessen fever and other symptoms and may shorten sick time by approximately one day. For people at high risk of serious flu complications (adults ≥ 65 years of age, pregnant women and those with asthma, heart disease, stroke, diabetes, HIV/AIDS and/or cancer), treatment with an antiviral drug can mean the difference between having a milder illness versus a very serious illness that could result in a hospital stay.4
Getting the flu vaccine1,4 and ensuring appropriate patients are vaccinated as well.
- Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications.
- Nearly all (>99%) of the influenza viruses tested this season are susceptible to the four FDA-approved influenza antiviral medications recommended in the U.S.
- Flu peaks annually between the months of December and February but may continue as late as May. Vaccination should be offered by the end of October; however, vaccination should be offered as long as influenza viruses are circulating, and unexpired vaccine is available.3
For a summary of seasonal influenza vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP) (United States, 2019-20), click here
When prescribed, taking flu antivirals.1,4
- Antiviral medications are an important adjunct to flu vaccine in the control of influenza. There are four FDA-approved antiviral drugs recommended by CDC this season:
- Oseltamivir phosphate (Tamiflu®)
- Zanamivir (Relenza®)
- Peramivir (Rapivab®)
- Baloxavir marboxil (Xofluza®)4
Taking everyday preventive actions to help stop the spread of germs.1,4
- COVID-19 and the seasonal flu are spread mainly through droplets made when people with flu cough, sneeze or talk. Droplets can be inhaled or land on the mouth, nose or eyes directly or by contact with hands that have touched a virus-contaminated surface.
Everyday preventative actions include:
- Regular hand washing
- Covering mouth and nose when coughing and sneezing
- Avoid touching your face, mouth, eyes or nose with unwashed hands
- Avoiding close contact with anyone showing symptoms of respiratory illness, such as coughing and sneezing.1,4
Being on the look-out for common signs of infection in yourself and others and seeking medical attention promptly. Common signs include:
- Coughing and sneezing
- Shortness of breath and breathing difficulties1,4
In addition to antiviral therapy in select people, treatment of respiratory viral infection includes prevention of spread to others and symptom management. It’s advised that those with symptoms stay home and avoid contact with others except to get medical care.2,4 Use acetaminophen or ibuprofen to reduce fever, muscle or body aches and headache, throat lozenges or spray to soothe a sore throat and a cough suppressant such as dextromethorphan (Delsym) to suppress a dry cough. Stay hydrated with fluids and get plenty of rest. If symptoms worsen or do not resolve after about 1 week, seek medical care.
The COVID-19 situation is changing daily. Enclara is monitoring the situation and will send additional updates as warranted. We recommend that all healthcare professionals actively follow the latest information and guidance from the CDC through the regularly-updated Coronavirus Disease 2019 (COVID-19) Situation Summary.
For additional information on the seasonal flu and COVID-19 and for emergency preparedness resources, access the following:
- Influenza (Flu) Summary and Updates, CDC: Click here
- Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP)—United States, 2019-20: Click here
- Coronavirus Disease 2019 (COVID-19) – Information for Healthcare Professionals CDC: Click here
- Information for Healthcare Facilities Concerning 2019 Novel Coronavirus Illness (2019-nCoV) Memo, CMS Center for Clinical Standards and Quality/Quality Safety and Oversight Group: Click here (PDF)
- Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE. Updated March 3, 2020. Accessed March 3, 2020. Site link
- Centers for Disease Control and Prevention (CDC). Coronavirus Disease 2019 (COVID-19) Situation Summary. Updated February 27, 2020. Accessed February 27, 2020. Site Link
- Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. Published online February 24, 2020. doi:10.1001/jama.2020.2648 Site Link
- Centers for Disease Control and Prevention (CDC). Influenza (Flu) Summary and Updates. Updated February 27, 2020. Accessed February 27, 2020. Site Link