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ANZICS Coronavirus Outbreak Update (29/01/2020)

January 30, 2020

Following the significant events surrounding the 2019 novel Coronavirus (2019-nCov) outbreak emanating from Wuhan City in China, ANZICS would like to take the opportunity of advising the critical care community of strategies and resources which may prove useful in managing both potential and actual patients. We have consulted with the Chief Medical Officer of Australia, various local Australian and New Zealand authorities and global agencies, such as the Centers for Disease Control and Prevention (CDC) and the World Health Organisation (WHO) in order to provide our membership with useful guidelines.

As of 29 January, we are aware of over 4,500 infected people in China and several other cases globally – including at least 5 Australian patients with confirmed 2019-nCov. To date, no New Zealand patients have been reported to have contracted the 2019-nCov infection.

As new information becomes available, we will forward this to our membership.

We refer members to the latest advice received from Australia’s Chief Medical Officer (Brendan Murphy) on the 26th January:

What do clinicians need to do?

“The critical thing for Australia is early detection to enable diagnosis, isolation and appropriate contact tracing. We need to ensure that there is no human to human transmission in this country.

To achieve this, I am seeking your ongoing support. If you see someone with relevant symptoms who has come from China (particularly the Hubei province/Wuhan city) in the last 14 days, or who has come into contact with a confirmed case, please contact your State/Territory Public Health Unit/Communicable Disease Branch.

The patient should be isolated and managed in contact/droplet precautions:

• Place a single-use surgical mask on the patient

• Isolate the patient in a single room with door closed

• Any person entering the room should use appropriate droplet and contact precautions personal protective equipment (single-use surgical face mask, eye protection, gown and gloves).

If you are referring the patient to an Emergency Department for assessment and testing (tests are currently available in public health laboratories only) please inform them of the travel history and suspected diagnosis before the patient arrives. Please do ask and take seriously any relevant travel history. It is likely that most people tested will be negative (it is flu season in China at present) but we must be vigilant in our efforts to identify and isolate the small number of patients who may already be in Australia with this virus or who may come in coming weeks.

At this stage, we know that human to human transmission can occur, and some of the early cases have been severe. We do not yet know how transmissible this infection is, nor how many people get mild infection. Because of this uncertainty, we are taking a cautious approach and seek your vigilance in detecting and isolating any cases that may present over the coming weeks to protect Australians. By early detection and quarantine, we can ensure that it does not become a major public health threat here.

So please don’t forget TRAVEL HISTORY is crucial in someone with respiratory/febrile illness who could have come from China”.

We have provided a list of links below to various New Zealand and Australian authorities detailing advice and information specific to on this outbreak:

  1. New Zealand Ministry of Health
  2. Australian Department of Health
  3. Victorian Department of Health and Human Services
  4. New South Wales Ministry of Health
  5. South Australia Health
  6. Western Australian Department of Health
  7. Tasmanian Department of Health
  8. ACT Department of Health
  9. Queensland Health (no advice available as at 25 January)
  10. NT Department of Health (no advice available as at 25 January)

The following global agencies have also published detailed information on this outbreak:

The CDC has provided guidance for healthcare professionals on the criteria for evaluating patients under investigation:

  • Fever AND symptoms of lower respiratory illness (e.g., cough, shortness of breath)
    • and in the last 14 days before symptom onset, history of travel from Wuhan City, China-or-
    • close contact with a person who is under investigation for 2019-nCoV whilst they were ill
  • Fever OR symptoms of lower respiratory illness (e.g., cough, shortness of breath) and in the last 14 days before symptom onset, close contact with an ill laboratory-confirmed 2019-nCoV patient

ANZICS is aware of the potential implications of this outbreak for the intensive care community and will continue to monitor the situation. We will communicate any relevant developments to our membership and would be happy to receive queries or concerns for which we may be able to provide advice from one of our subject matter experts.

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