Novel Coronavirus (COVID-19) Updated Recommendations
12 February 2020
Case definition: suspected cases require BOTH epidemiological AND clinical criteria
- Epidemiological criteria: at least one of the following
- Travel to (including transit through) mainland China in the 14 days before the onset of illness OR
- Close or casual contact in the 14 days before illness onset with a confirmed case of COVID-19
- Clinical criteria: at least one of the following
- Fever OR acute respiratory infection
- For “case” or “close contact” definition see CDNA National Guidelines for Public Health Units
It is recommended that:
- All travellers from mainland China on or after 1 February 2020 must be isolated at home for 14 days after leaving mainland China (other than for seeking medical care).
- All travellers who have been in Hubei Province must be isolated at home for 14 days after leaving mainland China (other than for seeking medical care).
- Close contacts of a confirmed case (i.e. persons exposed while unprotected e.g. no PPE, including healthcare workers) are not to work in a healthcare setting and must be isolated at home for 14 days following the last possible contact with the confirmed case (other than for seeking medical care).
- Those seeking medical care must notify the medical provider of their impending arrival and wear a surgical mask if leaving home isolation.
Infection control advice has changed - medical practitioners are advised to:
- Assess patients with suspected COVID-19 infection using contact and droplet precautions:
- The patient is to wear a surgical mask. Ask them to observe respiratory (cough) etiquette.
- Isolation: move patient from the waiting area to a single room or at least 1 metre away from others.
- Wear PPE when examining the patient: gloves, long-sleeved gown, surgical mask and eye protection.
- Perform hand hygiene: alcohol gel, or if hands visibly soiled using soap and water.
For patients meeting the suspected case definition (see above):
- Determine if respiratory symptoms are absent, mild or severe and consider specimen collection.
- If absent/mild respiratory symptoms use contact and droplet precautions for specimen collection:
- PPE i.e. gloves, long sleeved gown, surgical mask and protective eye wear.
- Use a single room with the door closed and stand slightly to the side of the patient whilst collecting.
- If severe respiratory symptoms (suggestive of pneumonia) send to hospital for assessment (after informing emergency department). Airborne precautions should be used for specimen collection:
- PPE i.e. gloves, long sleeved gown, fit checked P2/N95 mask and protective eye wear.
- Use a single room with the door closed (left vacant for 30 minutes) or a negative pressure room.
- Swab both throat and nose using the same swab. Request respiratory viruses including coronavirus. See specimen collection guide
- Send specimens to SA Pathology.
- Where appropriate PPE and/or facilities are not available for specimen collection, SA Pathology can provide a domiciliary service for in home testing OR a coronavirus specimen collection centre in metropolitan Adelaide. Both are by appointment only; doctors must ring 82223000 to arrange this service. These need to be pre-approved by CDCB (phone 1300 232 272).
- Do not send patients to a general pathology specimen collection centre.
- Isolate any patient with suspected COVID-19 (either in a healthcare facility or at home).
- Clean and disinfect potentially contacted/contaminated environmental surfaces and general equipment with detergent followed by disinfectant (either use bleach or alcohol).
- Discuss testing with CDCB medical officer if you suspect COVID-19 but case does not meet the suspected case definition. Testing of asymptomatic persons is generally not recommended.
- Notify cases by phone to CDCB on 1300 232 272.
Refer to the Australian Government web pages for further information (includes a fact sheet on home isolation)
Dr Louise Flood – Director, Communicable Disease Control Branch