What is the 2019-nCoV
coronavirus outbreak?
The 2019-nCoV is a novelstrain of corona virus that was first detected in the city of Wuhan,
in the province of Hubei, in the People’s Republic of China – a city with a population of 11
million. The outbreak started as a pneumonia of unknown causal agent at the end of
December 2019.
How is 2019-nCoV
coronavirus
transmitted?
The transmission of 2019-nCoV occurs by the following mechanisms:
a. Most often, spread from person to person among close contacts (about 6
feet/1.8 metres).
b. Person-to-person spread is thought to occur mainly via respiratory droplets
produced when an infected person coughs or sneezes, similar to how influenza
and other respiratory pathogens spread.
c. These droplets can land in the mouths, noses or eyes of people who are nearby
or possibly be inhaled into the lungs.
d. It is currently unclear if a person can get 2019-nCoV by touching a surface or
object that has the virus on it (fomites) and then touching their own mouth, nose
or possibly their eyes.
e. Typically, with most respiratory viruses, people are thought to be most
contagious when they are most symptomatic (the sickest). With 2019-nCoV,
however, there have been reports of spread from an asymptomatic infected patient to a close contact.
Onset
The 2019-nCoV acute respiratory disease has an incubation period of 2 to 14 days before
the onset of symptoms.
Note: If a person has been exposed to the virus but has not developed symptoms within
14 days, they can be considered as not infected.
Symptoms
For confirmed 2019-nCoV infections, reported illnesses have ranged from people with
little to no symptoms to people being severely ill and dying. Symptoms can include (on
admission to hospital) (Nanshan Chen, 2020):
• Fever (>80% of the patients)
• Cough (>80%)
• Shortness of breath (31%)
• Muscle ache (11%)
Treatment
- Currently, there is no specific medicine or vaccine for coronavirus 2019-nCoV and no medicines or vaccines have been fully tested for safety and efficacy.
- Presently, treatment is symptomatic and will be based on the patient’s clinical condition and supportive care. Supportive treatment includes oxygen therapy, hydration and fever/pain management and antibiotics if bacterial co-infection is present.
- Specific treatment might include intravenous remdesivir (a novel nucleotide analogue prodrug in development) which has been tested in the first patients hospitalised in the USA
Prevention
The WHO’s standard recommendations for the general public to reduce exposure to and
transmission of this and other respiratory illnesses are as follows, which include hand and
respiratory hygiene, and safe food practices:
1. Frequently clean hands by using alcohol-based hand rub or soap and water;
2. When coughing and sneezing cover the mouth and nose with a flexed elbow or
tissue – throw the tissue away immediately and wash hands;
3. Avoid close contact with anyone who has fever and cough;
4. If you have fever, cough and difficulty breathing seek medical care early and
share previous travel history with your healthcare provider;
5. When visiting live markets in areas currently experiencing cases of novel
coronavirus, avoid direct unprotected contact with live animals and surfaces in
contact with animals;
6. The consumption of raw or undercooked animal products should be avoided.
Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods, as per good food safety practices. (World
Health Organization, 2020)
Self-isolation by persons with symptoms and/or persons who may have been in contact
with infected persons
Self-isolation means avoiding situations where you could infect other people. This means
all situations where you may come in contact with others, such as social gatherings,
workplaces, schools, child care/pre-school centres, universities, faith-based gatherings,
aged care and health care facilities, prisons,sports gatherings,supermarkets, restaurants,
shopping malls, and all public gatherings. (Ministry of Health of New Zealand, 2020
Responsibilities and role of community pharmacy
Community pharmacies in outbreak-affected and unaffected countries are often the first
point of contact with the health system for those with health-related concerns or simply in
need of information and reliable advice.
Community pharmacists have the shared responsibility of:
• Storing appropriate stocks of pharmaceutical products (medicines, masks, etc) to
supply the demand
• Informing and educating the public
• Counselling
• Referring
• Promoting disease prevention
• Promoting infection control
Responsibilities and role
of hospital pharmacy
Hospital pharmacies in outbreak-affected and unaffected countries play an important role
in:
• Storing appropriate stocks of relevant medicines and other medical products and
devices to supply the demand
• Collaborating with other healthcare professionals in providing patient care and
support
• In-hospital prevention and infection control
• Informing and counselling
• Ensuring the responsible use of the pharmaceutical products supplied. For
example, ensuring that healthcare professionals consistently wear their masks
correctly.
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