The Centers for Disease Control (CDC) issued a warning this week about the potential for spread of novel coronavirus illness, COVID-19, in the United States. This was not unexpected, and the NCH infection control and emergency preparedness teams have been preparing for this possibility since we first learned of the outbreak in China. The outbreak has been continuing with rapidly increasing case counts in a growing number of countries. As part of the announcement this week, the CDC also broadened its highest level of travel advisory to include South Korea in addition to China.

Preparedness

Nantucket Cottage Hospital activated its Hospital Incident Command system in response to the coronavirus outbreak one month ago on Jan. 27^th. Since then, the Emergency Management team has implemented a series of actions to prepare NCH, including:

• N95 fit testing: 187 NCH staff members have been fit-tested for N95 masks
• Pre-identified care areas: Identified ED rooms with negative air flow and perimeter of six-feet for donning and doffing personal protective equipment (PPE)
• Review donning and doffing PPE: educate/reviewed with ED staff donning and doffing techniques
• Flow chart for initial encounter: developed and distributed a guide for front office staff in both ED and ambulatory clinic areas
• EPIC update: created a best practice alert in EPIC (the NCH electronic medical record system)
• Systemwide coordination: participation in ongoing Partners Emergency Management and Infection Control meetings by phone
• Communication: Ongoing staff and community information distribution via e-mail, social media, and media partners

Prevention:

There is currently no vaccine to prevent coronavirus disease. The best way to prevent illness is to avoid being exposed to this virus. It should be emphasized that at this time there is only one confirmed case of coronavirus in Massachusetts and the state Department of Public Health advises that the risk to Massachusetts residents is low. So what should you be doing as an island community member? Below are the CDC recommendations for everyday preventive actions to help prevent the spread of respiratory diseases like coronavirus, including:

• Avoid close contact with people who are sick.
• Avoid touching your eyes, nose, and mouth.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
• Follow the CDC’s recommendations for using a facemask.
  • CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19.
  • Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).
• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.