02/03/2020

2019 Novel Coronavirus

Information for Ohio EMS providers, EMS agencies, and EMS medical directors

The 2019 novel coronavirus (2019-nCoV) was first identified in Wuhan, Hubei Province, China in December 2019 and has caused an outbreak of severe respiratory illnesses and a number of reported deaths.  The initial source of 2019-nCoV is suspected to be from an animal.  Other coronaviruses are transmitted from an infected person to others via respiratory droplets, close personal contact with an infected person or an object with the virus on it, or, in rare cases, contact with feces.  While the Centers for Disease Control and Prevention (CDC) is continuing to gather factual information regarding this new strain, the first case of person-to-person transmission of 2019-nCoV in the United States was confirmed today.

Recently, there have been patients with confirmed 2019-nCoV illness identified in the United States, all of whom recently traveled from Wuhan.  There have been no confirmed cases in the State of Ohio.  On January 27, 2020, Miami University of Ohio reported two possible cases of 2019-nCoV in two students who recently returned from China, and they have been isolated and tested and are awaiting results from the CDC, the only agency that can currently test for the virus.

EMS is a valuable sector within our healthcare system.  EMS providers play a critical role, as both first responders and healthcare providers, in the triage, treatment, and transport of patients.  The symptoms exhibited by people infected with 2019-nCoV include fever, cough, and difficulty breathing, and the incubation period is 2 to 14 days.  During the assessment of patients with these symptoms, the important screening information that should be obtained includes:

• A history of travel to Wuhan City, China within 14 days prior to the onset of symptoms
• Within 14 days prior to symptom onset, any close contact with a person who is under investigation for 2019-nCoV while that person was ill
• Within 14 days prior to symptom onset, any close contact with an ill patient with laboratory-confirmed 2019-nCoV

This information should be documented on the patient care report and communicated to the receiving healthcare facility prior to arrival.

The measures to be taken to prevent transmission of 2019-nCoV include, but are not limited to, the following:

• Don the personal protective equipment (PPE) for contact, droplet, and airborne precautions that has been recommended for healthcare providers by the CDC for 2019-nCoV

• N-95 mask or higher-level respirator
• Disposable gloves
• Eye protection (goggles or face shield)
• Disposable gown

• Engage in frequent handwashing
• Place a surgical mask on the patient before and during transport
• Avoid the administration of nebulized bronchodilators if possible
• Don the recommended PPE while cleaning the transport vehicle with bleach or the disinfectant agent routinely used by your EMS agency

The Ohio Department of Health has issued an Interim Infection Control Guidance for Prehospital Emergency Medical Services (EMS) that can be accessed at https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/novel-coronavirus/resources-lhd/infection-control-ems-services

The CDC will release more information as it becomes available and we will share any new or additional recommendations that are generated.

Currently, there is no vaccine for 2019-nCoV and the treatment is supportive.  As we have stated many times in the past, PPE only works if you wear it.  Don the appropriate PPE for every patient encounter.

Thank you for your dedicated service to the residents and visitors of Ohio and stay safe!

Carol A. Cunningham, M.D., FAAEM, FAEMS
State Medical Director
Ohio Emergency Medical Services