2019 Novel Coronavirus

By : Dr. Samson Lee

By now I’m sure you have heard about the Coronavirus coming out of China that has so far claimed the lives of over 1,000 individuals and infected over another 45,000. What do we know so far about this relatively new and little known virus and how does it compare to the flu caused by the influenza virus that we are encouraged to get vaccinated for every year.

2019 Novel Coronavirus also known as 2019-nCoV is a virus identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China. Reported illnesses so far have ranged from people with mild symptoms to people being severely ill and even dying. Symptoms can include:

  • Fever.
  • Cough.
  • Shortness of breath.

Currently, there is no vaccine to prevent 2019-nCoV infection. The best way to prevent infection is to avoid being exposed to this virus. There are everyday preventive actions to help prevent the spread of respiratory viruses, including the flu as well as this 2019-nCoV virus:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
  • Follow CDC’s recommendations for using facemask.
    • CDC does not recommend that people who are well wear facemask to protect themselves from respiratory viruses, including 2019-nCoV.
    • Facemask should be used by people who show symptoms of 2019 novel coronavirus, in order to protect others from the risk of getting infected. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).
  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
    • Use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

Recently Returned Travelers from China

If you were in China in the last 14 days and feel sick with fever, cough, or difficulty breathing, you should:

  • Seek medical advice – Call ahead before you go to a doctor’s office or emergency room. Tell them about your recent travel and your symptoms.
  • Avoid contact with others.
  • Do not travel while sick.
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
  • Wash your hands with soap and water immediately after coughing, sneezing or blowing your nose. If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

According to our Ministry of Health, primary care providers, including dentists and dental offices including Credit River Dental Centre are asked to do passive and active screening.

Passive screening includes:

Signage is posted on entry to Credit River Dental and at reception areas for patients with symptoms to self identify, perform hand hygiene, wear a procedure mask, and have access to tissue and a waste receptacle.

All patients will then be instructed to cover their nose and mouth with a tissue when coughing and sneezing.

The Ministry has recommended that we:

  1. Screen patients over the phone before scheduling appointments at Credit River Dental.
  2. Post signs in our reception area asking patients with symptoms to identify themselves.

We are thus asked to screen for patients with fever and/or cough or difficulty breathing.

AND any of the following:

  • Travel to Hubei Province, China in the 14 days before the onset of illness.
    OR
  • Close contact with a confirmed or probable case of 2019-nCoV
    OR
  • Close contact with a person with acute respiratory illness who has been to or from Hubei Province, China in the 14 days before their symptoms.

If a patient screens positive by phone:

  • Credit River Dental will take a clinical history and travel/exposure assessment by phone to determine if the patient is a Person Under Investigation (PUI)
  • We will have to contact public health to report the suspect case and discuss the best options for testing. Decisions about testing are based on symptoms, exposure history and local resources available.
  • If patients are referred to hospital, Credit River Dental will coordinate with the patient, the hospital and local public health.

If a patient screens positive at the office, we are asked to:

  • Maintain a 2 metre distance from the patient and wear a procedure mask.
  • Isolate the patient and, if possible, have them wear a procedure mask.
  • Take a clinical history and travel/exposure assessment to determine if the patient is a Person Under Investigation (PUI)
  • Contact public health to report the suspect case and discuss the best options for testing. Decisions about testing are based on symptoms, exposure history and local resources available.
  • If patients are referred to hospital Credit River Dental will coordinate with the patient, the hospital and local public health.

If a patient has travelled to or from Hubei Province, China in the last 14 days but has no symptoms we will:

  • Advise the patient to watch for symptoms. If they develop fever, new onset of the cough or difficulty breathing, they should call their primary care provider, TeleHealth Ontario or the local public health unit.

It is important that we keep things in perspective and realize that here in Canada, the chances of contracting the 2019-nCoV is still extremely low, especially if you follow the hygiene guidelines above. So far, there have been 7 reported infections and no reported deaths due to the 2019-nCoV virus in Canada. The flu virus on the other hand has infected over 12000 in Canada and killed at least 10 in that same period of time so it is still very important that anyone over 6 months of age get the flu vaccine.

The Ministry of Health has set up a Health Care Provider Hotline at 1-866-212-2272.