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welcome
INDRESH GUPTA
M.Sc TUTOR J.S. UNIVERSITY
SHIKOHABAD .FIROZABAD. UTTER PRADESH
CORONA VIRUS
COVID-19
INTRODUCTION
Corona virus disease (COVID-19) is an infectious disease caused
by a new virus.
The disease causes respiratory illness (like the flu) with
symptoms such as a cough, fever, and in more severe cases,
difficulty breathing. You can protect yourself by washing your
hands frequently, avoiding touching your face, and avoiding
close contact (1 meter or 3 feet) with people who are unwell
Corona virus disease spreads primarily through contact with an
infected person when they cough or sneeze. It also spreads
when a person touches a surface or object that has the virus
on it, then touches their eyes, nose, or mouth
INTRODUCTION
Corona viruses are a large family of viruses which may cause
illness in animals or humans. In humans, several corona
viruses are known to cause respiratory infections ranging from
the common cold to more severe diseases such as Middle East
Respiratory Syndrome (MERS) and Severe Acute Respiratory
Syndrome (SARS). The most recently discovered corona virus
causes corona virus disease COVID-19
STRATEGIC OBJECTIVES
1) Interrupt human-to-human transmission including reducing secondary
infections among close contact sand health care workers, preventing
transmission amplification events, and preventing further international
spread.
2) Identify, isolate and care for patients early, including providing
optimized care for infected patients.
3) Identify and reduce transmission from the animal source.
4) Address crucial unknowns regarding clinical severity, extent of
transmission and infection, treatment options, and accelerate the
development of diagnostics, therapeutics and vaccines.
5) Communicate critical risk and event information to all communities
and counter misinformation.
6) Minimize social and economic impact through multisectoral
partnerships.
Statistics
WORLDWIDE
Corona virus Cases:
• 1,631,457
Deaths:
• 97,563
Recovered:
• 366,469
Note :this data is till 10 April.
Statistics
INDIA
Corona virus Cases
• 7062
Deaths
• 692
Recovered
• 244
Note :this data is till 10 April.
CASE DEFINITION
SUSPECT CASE
A patient with acute respiratory tract infection (sudden onset of
at least one of the following: cough, fever, shortness of breath)
AND with no other etiology that fully explains the clinical
presentation AND with a history of travel or residence in a
country/area reporting local or community transmission during
the 14 days prior to symptom onset.
 A patient with any acute respiratory illness AND having been in
close contact with a confirmed or probable COVID-19 case in the
last 14 days prior to onset of symptoms.
CASE DEFINITION
 A patient with severe acute respiratory infection (fever and at
least one sign/symptom of respiratory disease (e.g., cough,
fever, shortness breath)) AND requiring hospitalization (SARI)
AND with no other etiology that fully explains the clinical
presentation.
CASE DEFINITION
PROBABLE CASE
A suspected case for whom testing for virus causing COVID-19
is inconclusive (according to the test results reported by the
laboratory) or for whom testing was positive on a pan-corona
virus assay.
CONFIRMED CASE
A person with laboratory confirmation of virus causing COVID-
19 infection, irrespective of clinical signs and symptoms
How long does the virus survive on surfaces?
Studies suggest that corona viruses (including preliminary
information on the COVID-19 virus) may persist on surfaces for
a few hours or up to several days. This may vary under
different conditions (e.g. type of surface, temperature or
humidity of the environment). If you think a surface may be
infected, clean it with simple disinfectant to kill the virus and
protect yourself and others. Clean your hands with an alcohol-
based hand rub or wash them with soap and water. Avoid
touching your eyes, mouth, or nose.
HOW TO SPREAD CORONA
• People can catch COVID-19 from others who
have the virus. The disease can spread from
person to person through small droplets from
the nose or mouth which are spread when a
person with COVID-19 coughs or exhales. These
droplets land on objects and surfaces around
the person. Other people then catch COVID-19
by touching these objects or surfaces, then
touching their eyes, nose or mouth. People can
also catch COVID-19 if they breathe in droplets
from a person with COVID-19 who coughs out
or exhales droplets.
HOW TO SPREAD CORONA
Studies to date suggest that the virus that causes COVID-19 is
mainly transmitted through contact with respiratory droplets
rather than through the air.
HOW TO SPREAD CORONA
Can I catch COVID-19 from the feces of someone with the disease?
• The risk of catching COVID-19 from the feces of an infected person
appears to be low. While initial investigations suggest the virus may
be present in feces in some cases, spread through this route is not
a main feature of the outbreak. WHO is assessing ongoing research
on the ways COVID-19 is spread and will continue to share new
findings. Because this is a risk, however, it is another reason to
clean hands regularly, after using the bathroom and before eating.
HOW TO SPREAD CORONA
Can CoVID-19 be caught from a person who has no symptoms?
• The main way the disease spreads is through respiratory
droplets expelled by someone who is coughing. The risk of
catching COVID-19 from someone with no symptoms at all is
very low. However, many people with COVID-19 experience
only mild symptoms. This is particularly true at the early stages
of the disease. It is therefore possible to catch COVID-19 from
someone who has, for example, just a mild cough and does not
feel ill.
HOW TO SPREAD CORONA
Can I catch COVID-19 from my pet?
• While there has been one instance of a dog being infected in
Hong Kong, to date, there is no evidence that a dog, cat or any
pet can transmit COVID-19. COVID-19 is mainly spread through
droplets produced when an infected person coughs, sneezes,
or speaks. To protect yourself, clean your hands frequently and
thoroughly.
HOW TO SPREAD CORONA
Can humans become infected with the COVID-19 from an
animal source?
• Corona viruses are a large family of viruses that are common in
animals. For example, SARS-CoV was associated with civet cats
and MERS-CoV is transmitted by dromedary camels. Possible
animal sources of COVID-19 have not yet been confirmed.
INCUBATION PERIOD
COVID-19 Incubation Period
The incubation period (time from exposure to the development of
symptoms) of the virus is estimated to be between 2 and 14 days based
on the following sources:
According to...The World Health Organization (WHO) reported an
incubation period for COVID-19 between 2 and 10 days. [1]
According to... China’s National Health Commission (NHC) had initially
estimated an incubation period from 10 to 14 days [2].
INCUBATION PERIOD
According to... United States' CDC estimates the incubation period for
COVID-19 to be between 2 and 14 days [3].
According to...DXY.cn, a leading Chinese online community for
physicians and health care professionals, is reporting an incubation
period of "3 to 7 days, up to 14 days".
The estimated range will be most likely narrowed down as more data
becomes available.
Incubation period of up to 24 days?
The incubation period has been found to be as long as 24 days (range:
0-24 days; median: 3.0 days) in a study published on February 9
INCUBATION PERIOD
• A Chinese study published in the New England Journal of
Medicine on Jan. 30[7], has found the incubation period to be
5.2 days on average, but it varies greatly among patients. The
Chinese team conducting the study said their findings support
a 14-day medical observation period for people exposed to the
pathogen.
Comparison with other viruses
Virus(typical cases) Incubation Period
Novel Coronavirus
(COVID-19)
2-14 or 0-24 days *
SARS 2-7 days,as long as 10 days
MERS 5 days (range: 2-14)
Swine Flu 1-4 days,as long as 7 days
Symptoms
• The most common symptoms of COVID-19 are fever, breathing
difficulty tiredness, and dry cough. Some patients may have
aches and pains, nasal congestion, runny nose, sore throat or
diarrhea. These symptoms are usually mild and begin
gradually. Some people become infected but don’t develop any
symptoms and don't feel unwell. Most people (about 80%)
recover from the disease without needing special treatment.
Around 1 out of every 6 people who gets COVID-19 becomes
seriously ill and develops difficulty breathing.
Typical Symptoms
COVID-19 typically causes flu-like symptoms including a fever and
cough.
In some patients - particularly the elderly and others with other
chronic health conditions - these symptoms can develop into
pneumonia, with chest tightness, chest pain, and shortness of
breath.
After a week, it can lead to shortness of breath, with about 20% of
patients requiring hospital treatment.
Notably, the COVID-19 infection rarely seems to cause a runny
nose, sneezing, or sore throat (these symptoms have been
observed in only about 5% of patients). Sore throat, sneezing, and
stuffy nose are most often signs of a cold
Symptoms
Findings from the Wang et al study published on JAMA and based on 138 hospitalized
patients
Common symptoms included:
(Wang et al study) [2]
Fever 98.6%
Fatigue 69.6%
Dry cough 59.4%
from first symptom to → Dyspnea (Shortness of breath) = 5.0 days
from first symptom to → Hospital admission = 7.0 days
from first symptom to → ARDS (Acute Respiratory Distress Syndrome) = 8.0 days
(when occurring
Symptoms
Findings from the Huang et al study published on The Lancet and based on
41 hospitalized patients
COMMON SYMPTOMS AT ONSET OF ILLNESS (Huang et al study) [3]
Fever 98%
Cough 76%
Myalgia (muscle pain) or Fatigue 44%
LESS COMMON SYMPTOMS:
Sputum production (coughing up material) 28%
Headache 8%
Haemoptysis (coughing up blood) 5%
Diarrhea 3%
Symptoms
Findings from the Chen et al study published on The Lancet and based on
99 hospitalized patients
Signs and symptoms at admission (Chen et al study) [4]
Fever 83%
Cough 82%
Shortness of breath 31%
Muscle ache 11%
Confusion 9%
Headache 8%
Sore throat 5%
Rhinorrhoea (runny nose) 4%
Chest pain 2%
Diarrhea 2%
Nausea and vomiting 1%
More than one signor symptom 90%
Fever, cough,and shortnessof breath 15%
Symptoms
Canadian public health agency
1. Fever
2. Cough
3. Difficulty breathing
4. Pneumonia in both lungs
UK Government and National health service (NHS)
1. A cough
2. A high temperature
3. Shortness of breath
Diagnosis
 Virus isolation in cell culture
 Polymerase chain reaction(PCR) assay that are more practicle
and available commercially.
Serological testing for antibodies to human coronavirus
 Nose and throat swabs are best specimens
 Serological testing requires collection of blood specimens
Age of Coronavirus Deaths
COVID-19 Fatality Rate by AGE:
Death Rate = (number of deaths / number of cases) = probability of
dying if infected by the virus (%). This probability differs depending
on the age group. The percentages shown below do not have to
add up to 100%, as they do NOT represent share of deaths by age
group. Rather, it represents, for a person in a given age group, the
risk of dying if infected with COVID-19
AGE DEATH RATE confirmed cases DEATH RATEall cases
80+ years old 21.9% 14.8%
70-79years old 8.0%
60-69years old 3.6%
50-59years old 1.3%
40-49years old 0.4%
30-39years old 0.2
20-29years old 0.2
10-19years old 0.2
0-9years old NO Fatalities
Sex ratio
COVID-19 Fatality Rate by SEX:
*Death Rate = (number of deaths / number of cases) =
probability of dying if infected by the virus (%). This probability
differs depending on sex. When reading these numbers, it must
be taken into account that smoking in China is much more
prevalent among males. Smoking increases the risks of
respiratory complications.
SEX DEATH RATE (confirmed case) DEATH RATE (all cases)
MALE 4.7% 2.8%
FEMALE 2.8% 1.7%
PRE-EXISTING MEDICAL CONDITIONS
(COMORBIDITIES)
• Patients who reported no pre-existing ("comorbid") medical
conditions had a case fatality rate of 0.9%. Pre-existing illnesses that
put patients at higher risk of dying from a COVID-19 infection are.
• COVID-19 Fatality Rate by COMORBIDITY:
• *Death Rate = (number of deaths / number of cases) = probability of
dying if infected by the virus (%). This probability differs depending
on pre-existing condition. The percentage shown below does NOT
represent in any way the share of deaths by pre-existing condition.
Rather, it represents, for a patient with a given pre-existing condition,
the risk of dying if infected by COVID-19.
PRE-EXISTING CONDITION DEATH RATEconfirmed cases DEATH RATEall cases
Cardiovascular disease 13.2% 10.5%
Diabetes 9.2% 7.3%
Diabetes 9.2% 7.3%
hypertention 8.4% 6.0%
Cancer 7.6% 5.6%
no pre-existing conditions 0.9%
MORTALITY RATE OF COVID-19
☺ 3.4% Mortality Rate estimate by the World Health
Organization (WHO) as of March 3
☺In his opening remarks at the March 3 media briefing on
Covid-19, WHO Director-General Dr Tedros Adhanom
Ghebreyesus stated:
☺“Globally, about 3.4% of reported COVID-19 cases have died.
By comparison, seasonal flu generally kills far fewer than 1% of
those infected.
MORTALITY RATE OF COVID-19
Mortality Rate as of Feb. 20 in China (findings from the Report of the
WHO-China Joint Mission
• "As of 20 February, 2,114 of the 55,924 laboratory confirmed cases have
died (crude fatality ratio [CFR: 3.8%) (note: at least some of whom were
identified using a case definition that included pulmonary disease).
• The overall CFR varies by location and intensity of transmission (i.e.
5.8% in Wuhan vs. 0.7% in other areas in China).
• In China, the overall CFR was higher in the early stages of the outbreak
(17.3% for cases with symptom onset from 1-10 January) and has
reduced over time to 0.7% for patients with symptom onset after 1
February. "
MORTALITY RATE OF COVID-19
• Preliminary study providing a tentative 3% estimate for case fatality
rate
Death rate among patients admitted to hospital
• A study on 138 hospitalized patients with 2019-nCoV infection,
published on February 7 on JAMA, found that 26% of patients
required admission to the intensive care unit (ICU) and 4.3% died,
but a number of patients were still hospitalized at the time. [9]
• A previous study had found that, out of 41 admitted hospital
patients, 13 (32%) patients were admitted to an ICU and six (15%)
died
Sources .... A novel coronavirus outbreak of global health concern - Chen Wang et
al., The Lancet. January 24, 2020
HOW TO CALCULATE THE MORTALITY RATE DURING
AN OUTBREAK
• At present, it is tempting to estimate the case fatality rate by
dividing the number of known deaths by the number of confirmed
cases. The resulting number, however, does not represent the true
case fatality rate and might be off by orders of magnitude.
sources ....2019-Novel Coronavirus (2019-nCoV): estimating the case
fatality rate – a word of caution - Battegay Manue et al., Swiss Med
Wkly, February 7, 2020
PREVENTION AND CONTROL
COVID-19
STANDARD PRECAUTIONS
Standard precaution are control guidelines designed to protect
workers from exposure to Diseases spread by Blood and other
Body fluids
CDC
1-HAND HYGIENE
Hand hygiene has been recognized as the single most
important way to prevent the transmission of infection agent.
• Summary technique:
• Hand washing (40–60 sec): wet hands and apply soap; rub all
surfaces; rinse hands and dry thoroughly with a single use
towel; use towel to turn off faucet.
• Hand rubbing (20–30 sec): apply enough product to
• cover all areas of the hands; rub hands until dry.
STEPS OF HAND WASHING
HAND WASHING INDICATOR
2.PERSONAL PROTECTIV EQUIPMENT
1). Gloves
Wear when touching blood, body fluids, secretions, excretions,
mucous membranes, non intact skin.
Change between tasks and procedures on the same patient
after contact with potentially infectious material.
Remove after use, before touching non-contaminated items
and surfaces, and before going to another patient. Perform hand
hygiene immediately after removal.
Nitrile gloves are performed over latex gloves because they resist
chemicals, including certain disinfectants such as chlorine
2). Facial protection (eyes, nose, and mouth)
Wear usual facial protection includes a triple –layer surgical mask and
and eye protection face shield and goggles
They should be used while providing care to patient with respiratory
symptoms such as to coughing and sneezing body fluids, secretions,
and excretions.
3). Gown
Wear to protect skin and prevent soiling of clothing during activities
that are likely to generate splashes or sprays of blood, body fluids,
secretions, or excretions.
Remove soiled gown as soon as possible, and perform hand hygiene.
It possible to create a barrier to eliminate or reduce contact and droplet
exposure ,both known to transmit COVID-19
4).Mask
Types of mask
5).Footwear
3. Prevention of needle stick and injuries from other sharp
instruments2
Use care when:
• Handling needles, scalpels, and other sharp instruments or
devices.
• Cleaning used instruments.
• Disposing of used needles and other sharp instruments.
Hair cover
Donning of PPE
PREPARATION
-Donning should be performed only in the designated area.
-they health care worker should be prepared by
Taking meal
Using the washroom
Drinking water
Remove all the jewelry
Perform hand hygiene with soap and water
Step 1: Hand hygiene with alcohol hand rub
Step2 : Wear the first pair of gloves –may be sterile or clean
Step 3 : Examine the coverall suit and wear them.
Step 4: Wear shoe cover
Step 5: Wear N95 mask and hood
Step 6:wear face shield /eye goggles
Step 7: wear 2nd pair gloves
Doffing of PPE
Preparation
Perform doffing only in the designated area.
Check any leaking or soiling in PPE before doffing If so disinfect
that area.
Doffing room should have 2 chairs –dirty and clean
Discard all PPE in red bin
Perform hand hygiene after every stage
Step 1: Call your colleague or observer and check your PPE
Step 2: disinfect your gloves
Step 3: Remove and discard shoes covers
Step 4: Disinfect and remove outer pair of gloves
Step 5: Disinfect inner pair of gloves
Step 6: Remove face shield /eye goggle
Step 7: Disinfect inner gloves
Step 8: Remove hood and cover all
Step 9: Disinfect and remove the inner gloves
Step 10: perform hand hygiene and wear a new pair of gloves
Step 11: remove and discard the N95 mask
Step 12: Disinfect the gloves
Step 13: Sit clean chair and disinfect shoes
Step 14:Disinfect the remove gloves
Step 15: Perform hand hygiene
Step 16: Exit the doffing are and take a shower
POINT REMEMBER -PPE
1. PPEs are not alternative to basis preventive public health
measure such as hand hygiene, respiratory etiquettes which
most of the followed at all time.
2. Always (if possible )maintain a distance of at least 1meter
from contacts/suspect /confirmed COVID-19 cases .
More about masks...
How to put mask ?-6 steps.
Before touching the mask ,wash your hand with an alcohol –based rub
(ABHR) or soap and water if your hand are visibly soiled.
Take a face mask and inspect it for tears or holes
Orient which side is the top side (where the meter strip is )
Ensure the proper side of the mask faces outwards (the coloured side)
Place the mask to your face .pinch the metal strip or stiff edge of the mask
so it moulds to the shape of your nose.
Pull down the mask’s bottom so it covers your mouth and your chin.
While wearing a mask, make sure you
• Unfold the pleats of the mask; make sure that they are facing
down.
• Place the mask over your nose, mouth and chin and ensure
there are no gaps on either side of the mask, adjust to fit.
• Avoid touching the mask, while using it.
• Do not leave the mask hanging from the neck.
• Change the mask after six hours or as soon as they become
wet.
While wearing a mask, make sure you
• Never reuse disposable masks and dispose the used masks into
closed bins after disinfecting them.
• Do not touch the potentially contaminated outer surface of the
mask, while removing it.
• After removal of mask, clean your hands with soap and water
or use alcohol-based hand rub disinfectant
3. RESPIRATORY HYGIENE AND COUGH ETIQUETTE
• Persons with respiratory symptoms should apply source
control measures:
• Cover their nose and mouth when coughing/sneezing with
tissue or mask, dispose of used tissues and masks,and perform
hand hygiene after contact with respiratory secretions.
• Health-care facilities should:
• Place acute febrile respiratory symptomatic patients at least 1
metre (3 feet) away from others in common waiting areas, if
possible.
4. RESPIRATORY HYGIENE AND COUGH ETIQUETTE
• Post visual alerts at the entrance to health-care facilities
instructing persons with respiratory symptoms to practise
respiratory hygiene/cough etiquette.
• Consider making hand hygiene resources, tissues and masks
available in common areas and areas used for the evaluation of
patients with respiratory illnesses.
Droplet precautions
-Keep a minimum of 1-2 meter distance.
-explain the importance of respiratory hygiene and cough
etiquette to patients.
-Wear a triple –layered surgical mask within1-2 meters of the
patient .it is advisable to use the mask when entering the
patient’s room. For aerosol-generating procedures, N95 masks
should be used.
-Patient should wear a triple –layered surgical mask during
transport
EDUCATION FOR PATIENT,STAFF,VISITOR AND THE
PUBLIC
Avoid close contact with people who are sick.
Stay at home when you are sick.
Cover your mouth and nose with a tissue or handkerchief when you
cough or sneeze.
In the absence of handkerchief of tissues,cover your nose.
In the absence of handkerchief or tissues ,cover your nose and mouth
with your arm during coughing and sneezing
Wash your hands often with soup and water .If soup and water are
not available,use and hund rub.
Avoid touching your nose,ear,eye or mouth
Practice other good health habit
4.Prevention of injuries from sharp
• This is very important especially in prevention of blood borne
infection.
• Used needles must be recapped by hand if necessary, used the
single hand “scoop “method.
• Used needles should not be bent or broken after use.
• Used sharps should be disposed of immediately in designated
puncture-proof containers.
• Sharps should be used only once. A handful of sharp
instruments must be picked up simultaneously.
• While handling sharps ,the sharp end of instruments shall be
positioned away from on self and other.
• If injured by sharps ,contact the ward ,clinic or unit supervisor
immediately for further management .
• Sharps should be disposed of in a puncture froof container ,as
recommended by BMW guidelines
5.Safe handling of patient-care equipment
• Equipment that has been in contact with a patient should be
disinfected or sterilized as appropriate before use for another
patient.
• Carefully decontaminate and clean equipment after use for each
patient
• Personnel should be trained for this.
• Have a hospital disinfection policy and monitor its implementation
• Heavy duty or strong utility gloves must be worn.
• Disposable patient-care equipment should not be reused and must
be discarded
• Patient –care supplies (e.g.lotion,cream,soap) shall not be shared
by patient.
7. Environmental cleaning
Use adequate procedures for the routine cleaning and
disinfection of environmental and other frequently touched
surfaces.
Patient placement:
Space between the beds should be at least 1 to2 meters.
Single room with hand washing and bathroom facilities are
preferred.
Isolation room should have changing rooms to support the use
of PPE
7. Environmental cleaning
Room cleaning
-Before admitting the patient
-After discharge.
-All patient care equipment should be replaced /disinfected as
per the hospital policy
8. Linens
Handle, transport, and process used linen in a manner which:
Prevents skin and mucous membrane exposures and
contamination of clothing.
Avoids transfer of pathogens to other patients and or the
environment.
9. Waste disposal
Ensure safe waste management.
Treat waste contaminated with blood, body fluids, secretions
and excretions as clinical waste, in accordance with local
regulations.
Human tissues and laboratory waste that is directly associated
with specimen processing should also be treated as clinical
waste.
Discard single use items properly.
COVID-19
HOME CARE PATIENTS
Introduction
• Home care is vital to curb pandemic respiratory infection
• This reduces strain in the health system and effective use of
advanced health care facilities.
• It has been observed that COVID-19 is best managed at home
in the early stages and for people with minor illness ,without
complication.
• 80% of the disease can be managed at home.
1.Wash your hands frequently
• Regularly and thoroughly clean your
hands with an alcohol-based hand
rub or wash them with soap and
water.
• Why? Washing your hands with soap
and water or using alcohol-based
hand rub kills viruses that may be on
your hands.
DO’s
• Practice frequent hand washing. Wash hands with soap and
water or use alcohol based hand rub. Wash hands even if they
are visibly clean.
• Cover your nose and mouth with handkerchief/tissue while
sneezing and coughing.
• Throw used tissues into closed bins immediately after use.
• Avoid participating in large gatherings.
DO’s
• See a doctor if you feel unwell (fever, difficult breathing and
cough). While visiting doctor wear a mask/cloth to cover your
mouth and nose.
• f you have these signs/symptoms please call State helpline
number or Ministry of Health & Family Welfare’s 24X7 helpline
at 011-23978046.
• Avoid participating in large gatherings
Dont’s
Do not touch your face.
Do not panic.
Do not travel unless necessary.
Do not spit in the open always use a spittoon or wash basin for
spitting
2.Maintain social distancing
• Maintain at least 1 metre (3 feet) distance between
yourself and anyone who is coughing or sneezing.
• Do not use public transport
• Why? When someone coughs or sneezes they spray
small liquid droplets from their nose or mouth which
may contain virus. If you are too close, you can
breathe in the droplets, including the COVID-19 virus
if the person coughing has the disease.
3.Avoid touching
• Eye ,nose and mouth
• Surface like door knobs and door bells, elevator buttons,hand
rails,support handles,chair, backATM mobile ,jeep handles
• Because contaminated hand can transfer the virus to your eye
,nose or mouth
4.Mask and personal protective equipment
• They are useful if you are sick
• Use when caring for someone who is sick
• Use in a healthcare setting
5.Stay informed and stay at home
• Stay informed and follow advice given by your healthcare provider
• Stay informed on the latest developments about COVID-19. Follow
advice given by your healthcare provider, your national and local
public health authority or your employer on how to protect
yourself and others from COVID-19.
• Why? National and local authorities will have the most up to date
information on whether COVID-19 is spreading in your area. They
are best placed to advise on what people in your area should be
doing to protect themselves.
6.Take care of high risk group
• Older adults
• People who have underlying conditions like-heart disease,
diabetes, lung disease kidney disease, on cancer medication
• Pregnant women
7.Prevention –Elderly
Do’s
• Stay at home. Avoid meeting visitors at home. If meeting is
essential, maintain a distance of one meter.
• Wash your hands and face at regular intervals with soap and water.
• Sneeze and cough either into your elbow or into tissue
paper/handkerchief .after coughing or sneezing dispose off the
tissue paper/wash your handkerchief.
• Ensure proper nutrition through home cooked fresh hot meals
hydrate frequently and take fresh juices to boost immunity
• Exercise and meditate
Prevention –Elderly
QUARANTINE PERSON
Advisor for contact
ASYMPTOMATIC CONTACT
Advisor for contact
IF SYMPTOMATIC
• If symptoms develop (fever, cough ,difficulty of breathing),use
mask
• Self isolate immediately inform ANM/ASHA
Home quarantine
• Home quarantine is applicable to all contacts of a suspect or
confirmed case of COVID-19
• It is isolating the person at home to prevent the spread of
infection within the house as wellas in the community
• It is usally for 14 days from the time of contacts
For home quarantine…
• Stay in a well-ventilated single-room preferably with an
attached/separate toilet.
• maintain a distance of at least 1 meter between the two.
• stay away from elderly people, pregnant women, children and
persons with co-morbidities.
• Restrict his/her movement within the house.
• Under no circumstances attend any social/religious gathering
e.g. wedding, condolences, etc
For home quarantine…
• If suffering from cough or fever or breathing difficulty and
suspecting contact ,wear a mask and notify nearest health
facility/ASHA/ANM immediately .
• Avoid visitor because it can spreas infection to others
• Wear a mask correctly when around other people and
whenever entering a health care provider.
Follow public health measure
• Wash hand as often thoroughly with soap and water or with
alcohol-based hand sanitizer
• Avoid sharing household items e.g. dishes, drinking glasses,
cups, eating utensils, towels, bedding, or other items with
other people at home.
• Wear a surgical mask at all the time. The mask should be
changed every 6-8 hours and disposed off Disposable masks
are never to be reused.
For home quarantine…
For home quarantine…
Follow public health measure
• Masks used by patients / care givers/ close contacts during
home care should be disinfected using ordinary bleach solution
(5%) or sodium hypochlorite solution (1%) and then disposed
of either by burning or deep burial.
• Used mask should be considered as potentially infected.
• If symptoms appear (cough/fever/difficulty in breathing),
he/she should immediately inform the nearest health centre or
call 011-23978046.
For home quarantine…
Instruction to the family member
• Avoid shaking the soiled linen or direct contact with skin
• Use disposable gloves when cleaning the surfaces or handling
soiled linen
• Wash hands after removing gloves
For home quarantine…
Instruction to the family member
• Wash hand as often thoroughly with soap and water for 40
seconds or with 70% alcohol-based hand sanitizer before you
tough anything else.
• Avoid sharing household item.
• Wear triple layered mask at all the time when in contact with
infected person .disposable masks are never to be reused.Mask
to be disposed safely.
For home quarantine…
Instruction to the family member
• Visitors should not be allowed
• If symptoms appear (fever/cough/difficulty in breathing )
he/she should immediately inform the nearest health center or
call your local phone number
For home quarantine…
Environment control
a) Clean and disinfect frequently touched surfaces in the
quarantined person’s room (e.g. bed frames, tables etc.) daily
with 1%Sodium Hypochlorite Solution.
b) Clean and disinfect toilet surfaces daily with regular household
bleach solution/phenolic disinfectants.
c) Clean the clothes and other linen used by the person
separately using common household detergent and dry.
Safe practices at home
1.Stay away from other
• Stay in a specific room and away from other people in your
home.
• Maintain distance of at least 1 meter.
• Restrict all movement so that others in the house stay safe
from infection
• If available, use a separate bathroom.
Safe practices at home
2.Seek health care and notify
• If suffering from fever,cough,or having difficulty in breathing
,wear a mask to protect other and immediately get in touch
with your nearest health facility or ASHA or ANM
Safe practices at home
Safe practices at home
4.Avoid going to public area
• Do not go to work ,school,or public areas
• If you are infected, you could transmit infection to other
Safe practices at home
5.Avoid visitor or support staff coming to the house
• a.) you may likely pass infection unknowingly
• b.) support staff like maids, drivers,etc should be asked to stay
away.
Role of ANM
Role of ANM
Precaution for health workers
Precaution during community visit.
1.Maintain distance of 1 meter from people and avoid close
physical contact when you are communicating.
Precaution for health workers
Precaution during community visit.
2.Use a three layered mask to cover your face.make sure it is
properly worm
Precaution for health workers
Precaution during community visit.
3.Avoid touching your face(eyes,nose,mouth) at all times
Precaution for health workers
Precaution during community visit.
4.Frequently Wash hand as often thoroughly with soap and
water for 40 seconds or with 70% alcohol-based hand sanitizer
Precaution for health workers
Precaution during community visit.
5.Surface like door knobs and door bells, elevator buttons,hand
rails, support handles, chair, mobile ,jeep handles
Precaution for health workers
Precaution on reaching your home.
1.Carefully remove your face mask and gloves using the correct
method, avoid touching front of your mask at all time,untie
lace from behind and do not not let the mask hang low around
your neck.
Precaution for health workers
Precaution on reaching your home
2.Dispose used mask and gloves by throwing them in a covered
dustbin
Precaution for health workers
Precaution on reaching your home
3.if you have carried your bag/register,mobile etc.wipe them
down with the disinfectant solution
Precaution for health workers
Precaution on reaching your home
4.Frequently Wash hand as often thoroughly with soap and
water for 40 seconds or with 70% alcohol-based hand sanitizer
before you tough anything else.
Protect from animal also….
• Avoid direct contact with animals and surfaces in contact with
animals.
• Ensure good food safety practices at all times.
• Handle raw meat, milk or animal organs with care to avoid
contamination of uncooked foods and avoid consuming raw or
undercooked animal products.
OTHER PREVENTION
• Don’t Spit in public place.
• Have a close contact with anyone, if you’re experiencing cough
and fever
Treatment
• No specific treatments
• Most people with illness will recover on their own
• Something can be done to relieve symptoms such as
• Taking pain and fever medications (caution: Aspirin should not be
given to children)
• Using a room humidifider or taking a hot shower to help ease a
sore throat and cough
• During sick,drink plenty of liquids ,stay home and rest
• Contact health care provider
Global Surveillance for human infection with
coronavirus disease (COVID-19)
• This document provides guidance to Member States on implementation of
global surveillance of COVID-19. The objectives of this global surveillance
are:
• To monitor trends of the disease where human to human transmission
occurs;
• Rapidly detect new cases in countries where the virus is not circulating;
• Provide epidemiological information to conduct risk assessments at the
national, regional and global level; and
• Provide epidemiological information to guide preparedness and response
measures.
Is COVID-19 the same as SARS?
• No. The virus that causes COVID-19 and the one that caused
the outbreak of Severe Acute Respiratory Syndrome (SARS) in
2003 are related to each other genetically, but the diseases
they cause are quite different. SARS was more deadly but
much less infectious than COVID-19. There have been no
outbreaks of SARS anywhere in the world since 2003.
for further information
• Call at Ministry of Health, Govt. of India’s 24X7 control room
number +91-11-2397 8046
• Email at ncov2019@gmail.com
• Whatsapp 9013151515
covid-19 corona virus
covid-19 corona virus

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covid-19 corona virus

  • 1. welcome INDRESH GUPTA M.Sc TUTOR J.S. UNIVERSITY SHIKOHABAD .FIROZABAD. UTTER PRADESH
  • 3. INTRODUCTION Corona virus disease (COVID-19) is an infectious disease caused by a new virus. The disease causes respiratory illness (like the flu) with symptoms such as a cough, fever, and in more severe cases, difficulty breathing. You can protect yourself by washing your hands frequently, avoiding touching your face, and avoiding close contact (1 meter or 3 feet) with people who are unwell Corona virus disease spreads primarily through contact with an infected person when they cough or sneeze. It also spreads when a person touches a surface or object that has the virus on it, then touches their eyes, nose, or mouth
  • 4. INTRODUCTION Corona viruses are a large family of viruses which may cause illness in animals or humans. In humans, several corona viruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered corona virus causes corona virus disease COVID-19
  • 5. STRATEGIC OBJECTIVES 1) Interrupt human-to-human transmission including reducing secondary infections among close contact sand health care workers, preventing transmission amplification events, and preventing further international spread. 2) Identify, isolate and care for patients early, including providing optimized care for infected patients. 3) Identify and reduce transmission from the animal source. 4) Address crucial unknowns regarding clinical severity, extent of transmission and infection, treatment options, and accelerate the development of diagnostics, therapeutics and vaccines. 5) Communicate critical risk and event information to all communities and counter misinformation. 6) Minimize social and economic impact through multisectoral partnerships.
  • 6. Statistics WORLDWIDE Corona virus Cases: • 1,631,457 Deaths: • 97,563 Recovered: • 366,469 Note :this data is till 10 April.
  • 7. Statistics INDIA Corona virus Cases • 7062 Deaths • 692 Recovered • 244 Note :this data is till 10 April.
  • 8. CASE DEFINITION SUSPECT CASE A patient with acute respiratory tract infection (sudden onset of at least one of the following: cough, fever, shortness of breath) AND with no other etiology that fully explains the clinical presentation AND with a history of travel or residence in a country/area reporting local or community transmission during the 14 days prior to symptom onset.  A patient with any acute respiratory illness AND having been in close contact with a confirmed or probable COVID-19 case in the last 14 days prior to onset of symptoms.
  • 9. CASE DEFINITION  A patient with severe acute respiratory infection (fever and at least one sign/symptom of respiratory disease (e.g., cough, fever, shortness breath)) AND requiring hospitalization (SARI) AND with no other etiology that fully explains the clinical presentation.
  • 10. CASE DEFINITION PROBABLE CASE A suspected case for whom testing for virus causing COVID-19 is inconclusive (according to the test results reported by the laboratory) or for whom testing was positive on a pan-corona virus assay. CONFIRMED CASE A person with laboratory confirmation of virus causing COVID- 19 infection, irrespective of clinical signs and symptoms
  • 11. How long does the virus survive on surfaces? Studies suggest that corona viruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature or humidity of the environment). If you think a surface may be infected, clean it with simple disinfectant to kill the virus and protect yourself and others. Clean your hands with an alcohol- based hand rub or wash them with soap and water. Avoid touching your eyes, mouth, or nose.
  • 12.
  • 13.
  • 14. HOW TO SPREAD CORONA • People can catch COVID-19 from others who have the virus. The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets.
  • 15. HOW TO SPREAD CORONA Studies to date suggest that the virus that causes COVID-19 is mainly transmitted through contact with respiratory droplets rather than through the air.
  • 16. HOW TO SPREAD CORONA Can I catch COVID-19 from the feces of someone with the disease? • The risk of catching COVID-19 from the feces of an infected person appears to be low. While initial investigations suggest the virus may be present in feces in some cases, spread through this route is not a main feature of the outbreak. WHO is assessing ongoing research on the ways COVID-19 is spread and will continue to share new findings. Because this is a risk, however, it is another reason to clean hands regularly, after using the bathroom and before eating.
  • 17. HOW TO SPREAD CORONA Can CoVID-19 be caught from a person who has no symptoms? • The main way the disease spreads is through respiratory droplets expelled by someone who is coughing. The risk of catching COVID-19 from someone with no symptoms at all is very low. However, many people with COVID-19 experience only mild symptoms. This is particularly true at the early stages of the disease. It is therefore possible to catch COVID-19 from someone who has, for example, just a mild cough and does not feel ill.
  • 18. HOW TO SPREAD CORONA Can I catch COVID-19 from my pet? • While there has been one instance of a dog being infected in Hong Kong, to date, there is no evidence that a dog, cat or any pet can transmit COVID-19. COVID-19 is mainly spread through droplets produced when an infected person coughs, sneezes, or speaks. To protect yourself, clean your hands frequently and thoroughly.
  • 19. HOW TO SPREAD CORONA Can humans become infected with the COVID-19 from an animal source? • Corona viruses are a large family of viruses that are common in animals. For example, SARS-CoV was associated with civet cats and MERS-CoV is transmitted by dromedary camels. Possible animal sources of COVID-19 have not yet been confirmed.
  • 20. INCUBATION PERIOD COVID-19 Incubation Period The incubation period (time from exposure to the development of symptoms) of the virus is estimated to be between 2 and 14 days based on the following sources: According to...The World Health Organization (WHO) reported an incubation period for COVID-19 between 2 and 10 days. [1] According to... China’s National Health Commission (NHC) had initially estimated an incubation period from 10 to 14 days [2].
  • 21. INCUBATION PERIOD According to... United States' CDC estimates the incubation period for COVID-19 to be between 2 and 14 days [3]. According to...DXY.cn, a leading Chinese online community for physicians and health care professionals, is reporting an incubation period of "3 to 7 days, up to 14 days". The estimated range will be most likely narrowed down as more data becomes available. Incubation period of up to 24 days? The incubation period has been found to be as long as 24 days (range: 0-24 days; median: 3.0 days) in a study published on February 9
  • 22. INCUBATION PERIOD • A Chinese study published in the New England Journal of Medicine on Jan. 30[7], has found the incubation period to be 5.2 days on average, but it varies greatly among patients. The Chinese team conducting the study said their findings support a 14-day medical observation period for people exposed to the pathogen.
  • 23. Comparison with other viruses Virus(typical cases) Incubation Period Novel Coronavirus (COVID-19) 2-14 or 0-24 days * SARS 2-7 days,as long as 10 days MERS 5 days (range: 2-14) Swine Flu 1-4 days,as long as 7 days
  • 24. Symptoms • The most common symptoms of COVID-19 are fever, breathing difficulty tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don't feel unwell. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing.
  • 25.
  • 26. Typical Symptoms COVID-19 typically causes flu-like symptoms including a fever and cough. In some patients - particularly the elderly and others with other chronic health conditions - these symptoms can develop into pneumonia, with chest tightness, chest pain, and shortness of breath. After a week, it can lead to shortness of breath, with about 20% of patients requiring hospital treatment. Notably, the COVID-19 infection rarely seems to cause a runny nose, sneezing, or sore throat (these symptoms have been observed in only about 5% of patients). Sore throat, sneezing, and stuffy nose are most often signs of a cold
  • 27. Symptoms Findings from the Wang et al study published on JAMA and based on 138 hospitalized patients Common symptoms included: (Wang et al study) [2] Fever 98.6% Fatigue 69.6% Dry cough 59.4% from first symptom to → Dyspnea (Shortness of breath) = 5.0 days from first symptom to → Hospital admission = 7.0 days from first symptom to → ARDS (Acute Respiratory Distress Syndrome) = 8.0 days (when occurring
  • 28.
  • 29. Symptoms Findings from the Huang et al study published on The Lancet and based on 41 hospitalized patients COMMON SYMPTOMS AT ONSET OF ILLNESS (Huang et al study) [3] Fever 98% Cough 76% Myalgia (muscle pain) or Fatigue 44% LESS COMMON SYMPTOMS: Sputum production (coughing up material) 28% Headache 8% Haemoptysis (coughing up blood) 5% Diarrhea 3%
  • 30. Symptoms Findings from the Chen et al study published on The Lancet and based on 99 hospitalized patients Signs and symptoms at admission (Chen et al study) [4] Fever 83% Cough 82% Shortness of breath 31% Muscle ache 11% Confusion 9% Headache 8% Sore throat 5% Rhinorrhoea (runny nose) 4% Chest pain 2% Diarrhea 2% Nausea and vomiting 1% More than one signor symptom 90% Fever, cough,and shortnessof breath 15%
  • 31. Symptoms Canadian public health agency 1. Fever 2. Cough 3. Difficulty breathing 4. Pneumonia in both lungs UK Government and National health service (NHS) 1. A cough 2. A high temperature 3. Shortness of breath
  • 32. Diagnosis  Virus isolation in cell culture  Polymerase chain reaction(PCR) assay that are more practicle and available commercially. Serological testing for antibodies to human coronavirus  Nose and throat swabs are best specimens  Serological testing requires collection of blood specimens
  • 33. Age of Coronavirus Deaths COVID-19 Fatality Rate by AGE: Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). This probability differs depending on the age group. The percentages shown below do not have to add up to 100%, as they do NOT represent share of deaths by age group. Rather, it represents, for a person in a given age group, the risk of dying if infected with COVID-19
  • 34. AGE DEATH RATE confirmed cases DEATH RATEall cases 80+ years old 21.9% 14.8% 70-79years old 8.0% 60-69years old 3.6% 50-59years old 1.3% 40-49years old 0.4% 30-39years old 0.2 20-29years old 0.2 10-19years old 0.2 0-9years old NO Fatalities
  • 35. Sex ratio COVID-19 Fatality Rate by SEX: *Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). This probability differs depending on sex. When reading these numbers, it must be taken into account that smoking in China is much more prevalent among males. Smoking increases the risks of respiratory complications.
  • 36. SEX DEATH RATE (confirmed case) DEATH RATE (all cases) MALE 4.7% 2.8% FEMALE 2.8% 1.7%
  • 37. PRE-EXISTING MEDICAL CONDITIONS (COMORBIDITIES) • Patients who reported no pre-existing ("comorbid") medical conditions had a case fatality rate of 0.9%. Pre-existing illnesses that put patients at higher risk of dying from a COVID-19 infection are. • COVID-19 Fatality Rate by COMORBIDITY: • *Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). This probability differs depending on pre-existing condition. The percentage shown below does NOT represent in any way the share of deaths by pre-existing condition. Rather, it represents, for a patient with a given pre-existing condition, the risk of dying if infected by COVID-19.
  • 38. PRE-EXISTING CONDITION DEATH RATEconfirmed cases DEATH RATEall cases Cardiovascular disease 13.2% 10.5% Diabetes 9.2% 7.3% Diabetes 9.2% 7.3% hypertention 8.4% 6.0% Cancer 7.6% 5.6% no pre-existing conditions 0.9%
  • 39. MORTALITY RATE OF COVID-19 ☺ 3.4% Mortality Rate estimate by the World Health Organization (WHO) as of March 3 ☺In his opening remarks at the March 3 media briefing on Covid-19, WHO Director-General Dr Tedros Adhanom Ghebreyesus stated: ☺“Globally, about 3.4% of reported COVID-19 cases have died. By comparison, seasonal flu generally kills far fewer than 1% of those infected.
  • 40. MORTALITY RATE OF COVID-19 Mortality Rate as of Feb. 20 in China (findings from the Report of the WHO-China Joint Mission • "As of 20 February, 2,114 of the 55,924 laboratory confirmed cases have died (crude fatality ratio [CFR: 3.8%) (note: at least some of whom were identified using a case definition that included pulmonary disease). • The overall CFR varies by location and intensity of transmission (i.e. 5.8% in Wuhan vs. 0.7% in other areas in China). • In China, the overall CFR was higher in the early stages of the outbreak (17.3% for cases with symptom onset from 1-10 January) and has reduced over time to 0.7% for patients with symptom onset after 1 February. "
  • 41. MORTALITY RATE OF COVID-19 • Preliminary study providing a tentative 3% estimate for case fatality rate Death rate among patients admitted to hospital • A study on 138 hospitalized patients with 2019-nCoV infection, published on February 7 on JAMA, found that 26% of patients required admission to the intensive care unit (ICU) and 4.3% died, but a number of patients were still hospitalized at the time. [9] • A previous study had found that, out of 41 admitted hospital patients, 13 (32%) patients were admitted to an ICU and six (15%) died Sources .... A novel coronavirus outbreak of global health concern - Chen Wang et al., The Lancet. January 24, 2020
  • 42. HOW TO CALCULATE THE MORTALITY RATE DURING AN OUTBREAK • At present, it is tempting to estimate the case fatality rate by dividing the number of known deaths by the number of confirmed cases. The resulting number, however, does not represent the true case fatality rate and might be off by orders of magnitude. sources ....2019-Novel Coronavirus (2019-nCoV): estimating the case fatality rate – a word of caution - Battegay Manue et al., Swiss Med Wkly, February 7, 2020
  • 44. STANDARD PRECAUTIONS Standard precaution are control guidelines designed to protect workers from exposure to Diseases spread by Blood and other Body fluids CDC
  • 45. 1-HAND HYGIENE Hand hygiene has been recognized as the single most important way to prevent the transmission of infection agent. • Summary technique: • Hand washing (40–60 sec): wet hands and apply soap; rub all surfaces; rinse hands and dry thoroughly with a single use towel; use towel to turn off faucet. • Hand rubbing (20–30 sec): apply enough product to • cover all areas of the hands; rub hands until dry.
  • 46. STEPS OF HAND WASHING
  • 48.
  • 49. 2.PERSONAL PROTECTIV EQUIPMENT 1). Gloves Wear when touching blood, body fluids, secretions, excretions, mucous membranes, non intact skin. Change between tasks and procedures on the same patient after contact with potentially infectious material. Remove after use, before touching non-contaminated items and surfaces, and before going to another patient. Perform hand hygiene immediately after removal. Nitrile gloves are performed over latex gloves because they resist chemicals, including certain disinfectants such as chlorine
  • 50. 2). Facial protection (eyes, nose, and mouth) Wear usual facial protection includes a triple –layer surgical mask and and eye protection face shield and goggles They should be used while providing care to patient with respiratory symptoms such as to coughing and sneezing body fluids, secretions, and excretions. 3). Gown Wear to protect skin and prevent soiling of clothing during activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions. Remove soiled gown as soon as possible, and perform hand hygiene. It possible to create a barrier to eliminate or reduce contact and droplet exposure ,both known to transmit COVID-19
  • 54. 3. Prevention of needle stick and injuries from other sharp instruments2 Use care when: • Handling needles, scalpels, and other sharp instruments or devices. • Cleaning used instruments. • Disposing of used needles and other sharp instruments.
  • 56. Donning of PPE PREPARATION -Donning should be performed only in the designated area. -they health care worker should be prepared by Taking meal Using the washroom Drinking water Remove all the jewelry Perform hand hygiene with soap and water
  • 57. Step 1: Hand hygiene with alcohol hand rub Step2 : Wear the first pair of gloves –may be sterile or clean
  • 58. Step 3 : Examine the coverall suit and wear them.
  • 59. Step 4: Wear shoe cover Step 5: Wear N95 mask and hood
  • 60. Step 6:wear face shield /eye goggles Step 7: wear 2nd pair gloves
  • 61. Doffing of PPE Preparation Perform doffing only in the designated area. Check any leaking or soiling in PPE before doffing If so disinfect that area. Doffing room should have 2 chairs –dirty and clean Discard all PPE in red bin Perform hand hygiene after every stage
  • 62. Step 1: Call your colleague or observer and check your PPE
  • 63. Step 2: disinfect your gloves
  • 64. Step 3: Remove and discard shoes covers
  • 65. Step 4: Disinfect and remove outer pair of gloves
  • 66. Step 5: Disinfect inner pair of gloves
  • 67. Step 6: Remove face shield /eye goggle
  • 68. Step 7: Disinfect inner gloves
  • 69. Step 8: Remove hood and cover all
  • 70. Step 9: Disinfect and remove the inner gloves
  • 71. Step 10: perform hand hygiene and wear a new pair of gloves
  • 72. Step 11: remove and discard the N95 mask
  • 73. Step 12: Disinfect the gloves
  • 74. Step 13: Sit clean chair and disinfect shoes
  • 75. Step 14:Disinfect the remove gloves
  • 76. Step 15: Perform hand hygiene Step 16: Exit the doffing are and take a shower
  • 77. POINT REMEMBER -PPE 1. PPEs are not alternative to basis preventive public health measure such as hand hygiene, respiratory etiquettes which most of the followed at all time. 2. Always (if possible )maintain a distance of at least 1meter from contacts/suspect /confirmed COVID-19 cases .
  • 78. More about masks... How to put mask ?-6 steps. Before touching the mask ,wash your hand with an alcohol –based rub (ABHR) or soap and water if your hand are visibly soiled. Take a face mask and inspect it for tears or holes Orient which side is the top side (where the meter strip is ) Ensure the proper side of the mask faces outwards (the coloured side) Place the mask to your face .pinch the metal strip or stiff edge of the mask so it moulds to the shape of your nose. Pull down the mask’s bottom so it covers your mouth and your chin.
  • 79. While wearing a mask, make sure you • Unfold the pleats of the mask; make sure that they are facing down. • Place the mask over your nose, mouth and chin and ensure there are no gaps on either side of the mask, adjust to fit. • Avoid touching the mask, while using it. • Do not leave the mask hanging from the neck. • Change the mask after six hours or as soon as they become wet.
  • 80. While wearing a mask, make sure you • Never reuse disposable masks and dispose the used masks into closed bins after disinfecting them. • Do not touch the potentially contaminated outer surface of the mask, while removing it. • After removal of mask, clean your hands with soap and water or use alcohol-based hand rub disinfectant
  • 81. 3. RESPIRATORY HYGIENE AND COUGH ETIQUETTE • Persons with respiratory symptoms should apply source control measures: • Cover their nose and mouth when coughing/sneezing with tissue or mask, dispose of used tissues and masks,and perform hand hygiene after contact with respiratory secretions. • Health-care facilities should: • Place acute febrile respiratory symptomatic patients at least 1 metre (3 feet) away from others in common waiting areas, if possible.
  • 82. 4. RESPIRATORY HYGIENE AND COUGH ETIQUETTE • Post visual alerts at the entrance to health-care facilities instructing persons with respiratory symptoms to practise respiratory hygiene/cough etiquette. • Consider making hand hygiene resources, tissues and masks available in common areas and areas used for the evaluation of patients with respiratory illnesses.
  • 83. Droplet precautions -Keep a minimum of 1-2 meter distance. -explain the importance of respiratory hygiene and cough etiquette to patients. -Wear a triple –layered surgical mask within1-2 meters of the patient .it is advisable to use the mask when entering the patient’s room. For aerosol-generating procedures, N95 masks should be used. -Patient should wear a triple –layered surgical mask during transport
  • 84. EDUCATION FOR PATIENT,STAFF,VISITOR AND THE PUBLIC Avoid close contact with people who are sick. Stay at home when you are sick. Cover your mouth and nose with a tissue or handkerchief when you cough or sneeze. In the absence of handkerchief of tissues,cover your nose. In the absence of handkerchief or tissues ,cover your nose and mouth with your arm during coughing and sneezing Wash your hands often with soup and water .If soup and water are not available,use and hund rub. Avoid touching your nose,ear,eye or mouth Practice other good health habit
  • 85. 4.Prevention of injuries from sharp • This is very important especially in prevention of blood borne infection. • Used needles must be recapped by hand if necessary, used the single hand “scoop “method. • Used needles should not be bent or broken after use. • Used sharps should be disposed of immediately in designated puncture-proof containers.
  • 86. • Sharps should be used only once. A handful of sharp instruments must be picked up simultaneously. • While handling sharps ,the sharp end of instruments shall be positioned away from on self and other. • If injured by sharps ,contact the ward ,clinic or unit supervisor immediately for further management . • Sharps should be disposed of in a puncture froof container ,as recommended by BMW guidelines
  • 87. 5.Safe handling of patient-care equipment • Equipment that has been in contact with a patient should be disinfected or sterilized as appropriate before use for another patient. • Carefully decontaminate and clean equipment after use for each patient • Personnel should be trained for this. • Have a hospital disinfection policy and monitor its implementation • Heavy duty or strong utility gloves must be worn. • Disposable patient-care equipment should not be reused and must be discarded • Patient –care supplies (e.g.lotion,cream,soap) shall not be shared by patient.
  • 88. 7. Environmental cleaning Use adequate procedures for the routine cleaning and disinfection of environmental and other frequently touched surfaces. Patient placement: Space between the beds should be at least 1 to2 meters. Single room with hand washing and bathroom facilities are preferred. Isolation room should have changing rooms to support the use of PPE
  • 89. 7. Environmental cleaning Room cleaning -Before admitting the patient -After discharge. -All patient care equipment should be replaced /disinfected as per the hospital policy
  • 90. 8. Linens Handle, transport, and process used linen in a manner which: Prevents skin and mucous membrane exposures and contamination of clothing. Avoids transfer of pathogens to other patients and or the environment.
  • 91. 9. Waste disposal Ensure safe waste management. Treat waste contaminated with blood, body fluids, secretions and excretions as clinical waste, in accordance with local regulations. Human tissues and laboratory waste that is directly associated with specimen processing should also be treated as clinical waste. Discard single use items properly.
  • 93. Introduction • Home care is vital to curb pandemic respiratory infection • This reduces strain in the health system and effective use of advanced health care facilities. • It has been observed that COVID-19 is best managed at home in the early stages and for people with minor illness ,without complication. • 80% of the disease can be managed at home.
  • 94. 1.Wash your hands frequently • Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water. • Why? Washing your hands with soap and water or using alcohol-based hand rub kills viruses that may be on your hands.
  • 95. DO’s • Practice frequent hand washing. Wash hands with soap and water or use alcohol based hand rub. Wash hands even if they are visibly clean. • Cover your nose and mouth with handkerchief/tissue while sneezing and coughing. • Throw used tissues into closed bins immediately after use. • Avoid participating in large gatherings.
  • 96. DO’s • See a doctor if you feel unwell (fever, difficult breathing and cough). While visiting doctor wear a mask/cloth to cover your mouth and nose. • f you have these signs/symptoms please call State helpline number or Ministry of Health & Family Welfare’s 24X7 helpline at 011-23978046. • Avoid participating in large gatherings
  • 97. Dont’s Do not touch your face. Do not panic. Do not travel unless necessary. Do not spit in the open always use a spittoon or wash basin for spitting
  • 98. 2.Maintain social distancing • Maintain at least 1 metre (3 feet) distance between yourself and anyone who is coughing or sneezing. • Do not use public transport • Why? When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease.
  • 99. 3.Avoid touching • Eye ,nose and mouth • Surface like door knobs and door bells, elevator buttons,hand rails,support handles,chair, backATM mobile ,jeep handles • Because contaminated hand can transfer the virus to your eye ,nose or mouth
  • 100. 4.Mask and personal protective equipment • They are useful if you are sick • Use when caring for someone who is sick • Use in a healthcare setting
  • 101. 5.Stay informed and stay at home • Stay informed and follow advice given by your healthcare provider • Stay informed on the latest developments about COVID-19. Follow advice given by your healthcare provider, your national and local public health authority or your employer on how to protect yourself and others from COVID-19. • Why? National and local authorities will have the most up to date information on whether COVID-19 is spreading in your area. They are best placed to advise on what people in your area should be doing to protect themselves.
  • 102. 6.Take care of high risk group • Older adults • People who have underlying conditions like-heart disease, diabetes, lung disease kidney disease, on cancer medication • Pregnant women
  • 103. 7.Prevention –Elderly Do’s • Stay at home. Avoid meeting visitors at home. If meeting is essential, maintain a distance of one meter. • Wash your hands and face at regular intervals with soap and water. • Sneeze and cough either into your elbow or into tissue paper/handkerchief .after coughing or sneezing dispose off the tissue paper/wash your handkerchief. • Ensure proper nutrition through home cooked fresh hot meals hydrate frequently and take fresh juices to boost immunity • Exercise and meditate
  • 107. Advisor for contact IF SYMPTOMATIC • If symptoms develop (fever, cough ,difficulty of breathing),use mask • Self isolate immediately inform ANM/ASHA
  • 108. Home quarantine • Home quarantine is applicable to all contacts of a suspect or confirmed case of COVID-19 • It is isolating the person at home to prevent the spread of infection within the house as wellas in the community • It is usally for 14 days from the time of contacts
  • 109. For home quarantine… • Stay in a well-ventilated single-room preferably with an attached/separate toilet. • maintain a distance of at least 1 meter between the two. • stay away from elderly people, pregnant women, children and persons with co-morbidities. • Restrict his/her movement within the house. • Under no circumstances attend any social/religious gathering e.g. wedding, condolences, etc
  • 110. For home quarantine… • If suffering from cough or fever or breathing difficulty and suspecting contact ,wear a mask and notify nearest health facility/ASHA/ANM immediately . • Avoid visitor because it can spreas infection to others • Wear a mask correctly when around other people and whenever entering a health care provider.
  • 111. Follow public health measure • Wash hand as often thoroughly with soap and water or with alcohol-based hand sanitizer • Avoid sharing household items e.g. dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with other people at home. • Wear a surgical mask at all the time. The mask should be changed every 6-8 hours and disposed off Disposable masks are never to be reused. For home quarantine…
  • 112. For home quarantine… Follow public health measure • Masks used by patients / care givers/ close contacts during home care should be disinfected using ordinary bleach solution (5%) or sodium hypochlorite solution (1%) and then disposed of either by burning or deep burial. • Used mask should be considered as potentially infected. • If symptoms appear (cough/fever/difficulty in breathing), he/she should immediately inform the nearest health centre or call 011-23978046.
  • 113. For home quarantine… Instruction to the family member • Avoid shaking the soiled linen or direct contact with skin • Use disposable gloves when cleaning the surfaces or handling soiled linen • Wash hands after removing gloves
  • 114. For home quarantine… Instruction to the family member • Wash hand as often thoroughly with soap and water for 40 seconds or with 70% alcohol-based hand sanitizer before you tough anything else. • Avoid sharing household item. • Wear triple layered mask at all the time when in contact with infected person .disposable masks are never to be reused.Mask to be disposed safely.
  • 115. For home quarantine… Instruction to the family member • Visitors should not be allowed • If symptoms appear (fever/cough/difficulty in breathing ) he/she should immediately inform the nearest health center or call your local phone number
  • 116. For home quarantine… Environment control a) Clean and disinfect frequently touched surfaces in the quarantined person’s room (e.g. bed frames, tables etc.) daily with 1%Sodium Hypochlorite Solution. b) Clean and disinfect toilet surfaces daily with regular household bleach solution/phenolic disinfectants. c) Clean the clothes and other linen used by the person separately using common household detergent and dry.
  • 117. Safe practices at home 1.Stay away from other • Stay in a specific room and away from other people in your home. • Maintain distance of at least 1 meter. • Restrict all movement so that others in the house stay safe from infection • If available, use a separate bathroom.
  • 118. Safe practices at home 2.Seek health care and notify • If suffering from fever,cough,or having difficulty in breathing ,wear a mask to protect other and immediately get in touch with your nearest health facility or ASHA or ANM
  • 120. Safe practices at home 4.Avoid going to public area • Do not go to work ,school,or public areas • If you are infected, you could transmit infection to other
  • 121. Safe practices at home 5.Avoid visitor or support staff coming to the house • a.) you may likely pass infection unknowingly • b.) support staff like maids, drivers,etc should be asked to stay away.
  • 124. Precaution for health workers Precaution during community visit. 1.Maintain distance of 1 meter from people and avoid close physical contact when you are communicating.
  • 125. Precaution for health workers Precaution during community visit. 2.Use a three layered mask to cover your face.make sure it is properly worm
  • 126. Precaution for health workers Precaution during community visit. 3.Avoid touching your face(eyes,nose,mouth) at all times
  • 127. Precaution for health workers Precaution during community visit. 4.Frequently Wash hand as often thoroughly with soap and water for 40 seconds or with 70% alcohol-based hand sanitizer
  • 128. Precaution for health workers Precaution during community visit. 5.Surface like door knobs and door bells, elevator buttons,hand rails, support handles, chair, mobile ,jeep handles
  • 129. Precaution for health workers Precaution on reaching your home. 1.Carefully remove your face mask and gloves using the correct method, avoid touching front of your mask at all time,untie lace from behind and do not not let the mask hang low around your neck.
  • 130. Precaution for health workers Precaution on reaching your home 2.Dispose used mask and gloves by throwing them in a covered dustbin
  • 131. Precaution for health workers Precaution on reaching your home 3.if you have carried your bag/register,mobile etc.wipe them down with the disinfectant solution
  • 132. Precaution for health workers Precaution on reaching your home 4.Frequently Wash hand as often thoroughly with soap and water for 40 seconds or with 70% alcohol-based hand sanitizer before you tough anything else.
  • 133. Protect from animal also…. • Avoid direct contact with animals and surfaces in contact with animals. • Ensure good food safety practices at all times. • Handle raw meat, milk or animal organs with care to avoid contamination of uncooked foods and avoid consuming raw or undercooked animal products.
  • 134. OTHER PREVENTION • Don’t Spit in public place. • Have a close contact with anyone, if you’re experiencing cough and fever
  • 135. Treatment • No specific treatments • Most people with illness will recover on their own • Something can be done to relieve symptoms such as • Taking pain and fever medications (caution: Aspirin should not be given to children) • Using a room humidifider or taking a hot shower to help ease a sore throat and cough • During sick,drink plenty of liquids ,stay home and rest • Contact health care provider
  • 136. Global Surveillance for human infection with coronavirus disease (COVID-19) • This document provides guidance to Member States on implementation of global surveillance of COVID-19. The objectives of this global surveillance are: • To monitor trends of the disease where human to human transmission occurs; • Rapidly detect new cases in countries where the virus is not circulating; • Provide epidemiological information to conduct risk assessments at the national, regional and global level; and • Provide epidemiological information to guide preparedness and response measures.
  • 137. Is COVID-19 the same as SARS? • No. The virus that causes COVID-19 and the one that caused the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003 are related to each other genetically, but the diseases they cause are quite different. SARS was more deadly but much less infectious than COVID-19. There have been no outbreaks of SARS anywhere in the world since 2003.
  • 138. for further information • Call at Ministry of Health, Govt. of India’s 24X7 control room number +91-11-2397 8046 • Email at ncov2019@gmail.com • Whatsapp 9013151515