From SARS CoV-1 2003 to SARS CoV-2 2019 Healthcare Leadership Strategy for a Better Future
“The Bug” • Consider the bug, be it viral or bacterial » Find out how it lives, what is necessary for “life”? » Where does it live, reproduce? What are the transmission mechanisms/agents? How big is it? How can it be killed? • Armed with this information, a facility will be better able to choose its weapons of war
System Sustainability Life Expectancy
Energy Use
Life Cycle Utility Cost
Initial Cost
Maintenance
“The Bug” = SARS CoV-2 (COVID-19) • Bug is viral • Transmission occurs one of three ways 1. Person to person (6 Feet) 2. Airborne transmission (Exposure risk increases during aerosol generating procedures) 3. Transmission from surfaces (Hours to days) • Why is COVID-19 spreading so quickly? On average, a COVID positive person will potentially infect 2-4 people. Compare this to the transmission of the common flu and the average person infects 1.3 people.
Key Control Measure: Prevent Dispersal of Droplets
What can hospitals and other healthcare facilities do? Solve the problem/Get rid of the Hazard/Preserve supplies •
Elective ambulatory provider visits should be delayed
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Inpatient and outpatient elective procedural and surgical cases be delayed
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Routine dental and eye-care visits should be postponed
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Elective and non-urgent admissions should be rescheduled
Routine Care of COVID-19 Positive Patient Minimize Room Entries Ideas: •
Communication with patient »
Nurse call system
»
Walkie talkies
•
Environmental cleaning tasks
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IV pumps outside of room
Aerosol-Generating Procedures Examples of Aerosol-Generating Procedures •
Intubation
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Non-invasive ventilation (e.g. CPAP, BiPAP)
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Manual ventilation
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Bronchoscopy
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Open suctioning
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Nebulizer treatments
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Cardiopulmonary resuscitation
PPE Selection for Hospital Staff Dependent Upon Exposure Routine Care •
Face/eye protection
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Facemask (Critical)
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Gloves
•
Gown
Aerosol Generating Procedures •
Face/eye protection
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Respirator (Critical)
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Gloves
•
Gown
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