Abstract
Much remains unknown about COVID-19. Occupational health nurses must use reliable sources to control misinformation and prevent widespread panic.
The World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020, as increasing numbers of illnesses and deaths that began in China have continued to grow internationally (WHO, 2020), after increasing numbers of illnesses and deaths linked to a novel coronavirus were noted in China and other international locations (WHO, 2020). Common coronaviruses (CoV) include zoonotic viruses that usually cause mild upper respiratory illness, occasionally severe in high-risk populations. Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV) were the first coronaviruses labeled novel, as they were confined to animal vectors. The latest novel coronavirus (COVID-19) was not reported in humans prior to the 2019 Wuhan, China outbreak. Human exposures reportedly were first linked to a seafood market that sold wild game suggesting a vector borne illness; exposures soon began spreading person-to-person. The increased global state of emergency is because sustained person-to-person spread is now occurring internationally; by March 19, 2020, over 209,830 global cases were confirmed with the preponderance of deaths (8778) in China and in the Western Pacific (3,377) and European (4,084) regions (WHO, 2020). The WHO risk assessment for continued spread, has been raised to Very High at the global level. Many countries have now increased travel restrictions and community isolation measures.
Symptoms for COVID-19 are like other upper respiratory illnesses but shortness of breath and in more severe cases, pneumonia, severe acute respiratory syndrome, kidney failure, and death may occur with infants, the elderly, immunocompromised, or those with chronic debilitating health conditions (WHO, 2020). Transmission is thought to occur via respiratory droplets from close contact with people coughing or sneezing. The incubation period is between 2 and 14 days and most contagious when symptoms are worst, yet transmission has occurred after contact with asymptomatic people. Transmission from contacting contaminated surfaces and then touching one’s own face is now suspected. (Centers for Disease Control and Prevention [CDC], 2020). Basic infection control principles for influenza and other respiratory illnesses are recommended for COVID-19 (CDC, 2020; WHO, 2020). Routine housekeeping principles apply; clean and disinfect frequently touched objects and surfaces with regular household cleaning spray or wipes (CDC, 2020).
Interim recommendations for employers recommend allowing employees to work from home if possible to aid in social-distancing. Sick workers should be sent home and remain there until asymptomatic at least 24 hours (oral temperature below 100.4°F [37.8°C]) without symptom-altering medicines (CDC, 2020). Workers need to know sick leave policies, which should be flexible and consistent with public health guidance. CDC encourages employers to omit illness validation or return to work verification because of high volume in health care facilities during flu season; policies with contract agencies need review to assure non-punitive leave policies allow sick workers to remain at home. Flexible policies are also needed that allow employees to stay home and care for sick family (CDC, 2020).
Occupational health nurses can teach workers and families to avoid close contact with people suffering from acute respiratory infections. Frequent handwashing, including after direct contact with ill people or their environment, is paramount especially for workers in day care, schools, faith-based facilities, sports and recreation venues, and public transportation. Within health care facilities, enhanced standard infection prevention and control practices are important, especially in emergency departments and other high-volume traffic areas. Workplace training should include cough etiquette with least 6 feet distance from others, cough and sneeze into the elbow bend or cover with disposable tissues or clothing, wash hands often for 20 seconds with soap and water or use an alcohol-based hand sanitizer with at least 60% alcohol, and avoid touching eyes, nose, and mouth with unwashed hands (CDC, 2020). Like MERS-CoV and SARS-CoV, bats may be the primary animal vector in Wuhan, China; teach workers to avoid unprotected contact with farm or wild animals.
Much remains unknown about COVID-19. Occupational health nurses must use reliable sources including CDC (2020) and WHO (2020) to control misinformation and prevent widespread panic. The CDC has information for public health officials, health professionals, and employers, including travel advisories (CDC, 2020). The WHO provides daily situation reports; guidance for employers; online training; technical advice for laboratories, media, travel, and the public; along with Myth Busters and printable posters (WHO, 2020).
