Coronavirus outbreak: What physicians need to know

Medical Economics sat down with Christina Tan, MD, the state epidemiologist for New Jersey, to discuss the latest on the Coronavirus outbreak (COVID-19) and how to answer patient questions about the disease.

Introduction:

Many physicians are getting questions from their patients about the corona virus outbreak that has dominated the news in recent weeks. While the outbreak is not a public health crisis in the United States, many patients are fearful about the virus.

So, what can physicians do to provide accurate information for their patients?

Michaela Fleming of Contagion Live sat down with Dr. Christina Tan to discuss what physicians need to know about the corona virus outbreak and how they can ease their patients concerns.

Fleming: What do we know so far about the origins of this novel coronavirus?

Tan: Well, we're still learning a lot about this virus that causes COVID-19. We saw the emergence of an unusual cluster of pneumonia was in China at the end of 2019. And then subsequently as more information became available. Now we know a little bit more about this COVID-19 situation.

So what is making this virus so concerning to public health officials is that with any sort of emerging infection we don't have a lot of room for information preliminarily, so we don't know whether there's the potential for widespread community transmission. So right now we're in the process of just gathering more information. We know that with an emerging infection that most individuals have not been exposed to, there's always concerned that, you know, we're going to see serious illnesses, we're going to see the potential for pandemic spread. But again, we're cautiously watching what's going on.

Fleming: What symptoms and other considerations should physicians look out for when they're evaluating a patient for a potential case?

Tan: Well, first and foremost, we ask that clinicians keep in touch and with the CDC websites, with the state health department websites, which have the most up to date information about the progress and the evolution of this COVID-19 illness, just make sure that they're up to date with any sort of changes in this illness, but we just Do want to let clinicians know that right now, we are concerned about individuals with severe respiratory illness. It's individuals who present with a fever with shortness of breath, cough, and who have exposure to the province, which is the epicenter of the hot zone of where we're seeing these COVID-19 illnesses, or if these individuals with these severe respiratory presentations are also have any sort of close contact with individuals with confirmed COVID-19.

Fleming: What protocols should these physicians be following if they suspect that their patient does have COVID-19?

Tan: We want to ensure that clinicians first and foremost, exercise appropriate infection control processes within the facility that they're evaluating these individuals, but also if clinicians are suspecting that they are seeing a covert illness to make sure that you consult with your infection. Prevention is at your facility, but also to contact your health department to report that individual's illness so that there could be potential further workup if necessary.

Fleming: So continuing on with this theme of infection prevention, are there any special precautions that you know clinicians should be taking beyond the normal steps and normal procedures of disinfection and cleaning their you know practice?

Tan: We definitely recommend that clinicians always refer to the Centers for Disease Control and Prevention's updated guidance about infection control, but currently based on the information that we know right now, about the virus that causes COVID-19. We recommend standard droplet and airborne precautions along with eye protection. And then from a hospital perspective, what steps should hospital be taking in order to prepare in the event of patient arriving with a case of COVID-19. We remind hospitals to review their infection control protocols, the Whether it's for the preparation for COVID-19 illness coming into your hospital, or whether you're talking about measles or your seasonal influenza, that the review of those infection control probe protocols are really important to ensuring that you have the first step in preventing these types of infectious illnesses. So, primary care physicians are probably seeing the most patients. And I think a lot of patients right now have a lot of worry about COVID-19, and how it could affect them potentially.

Fleming: So what prevention activities can  primary care physicians communicate to their patients about this?

Tan: It is really important that primary care physicians keep up to date on their knowledge base on the evolution of COVID-19 illness, because having the facts from trusted sources is probably the best thing that you can do to manage not only the worried well that come into your office But also in the event that you are suspicious that the individual who's sitting in front of you might have COVID-19 illness, you'll know what to do. And we also want to remind primary care physicians that the other steps that they can take are to remember that this COVID-19 outbreak is occurring in the midst of our seasonal flu outbreak.

We want to remind physicians, please, we're in the middle of flu season, remind patients if they haven't gotten the flu vaccine yet, it's not too late to get the flu vaccine. Remind your patients to take common sense steps to prevent illness, you know, the washing the hands, you know, staying home when you're sick, covering your cough and sneeze, that these are all really important steps that your patients can do. And this is something that you can encourage.

Fleming: So my last question for you is, I think our primary topic right now that we're focusing on is we want to dispel the myths and rumors from this situation. So what are the best sources for physicians to tap into to make sure that they're getting accurate information?

Tan: About the emergence of coronavirus, with all the newness of this novel coronavirus, there's so many different misinformation that's out there and it's really important that physicians go to trusted sources. Go to your state health department's websites go to the federal Centers for Disease Control and Prevention's website, go to the World Health Organization's website. You know, this information is changing minute by minute right now, whether it's the case counts, or whether it's the science behind covert illness, so we encourage you go to those trusted resources. Keep yourself abreast of this information, because that's probably the most valuable thing you could do to help dispel the myths.