From left: Anna Meyer, Liam Hafter and Arabia Kopec debrief after a practice drill in the Emergency Department.

The Brigham is closely monitoring the 2019 Novel Coronavirus (2019-nCoV) outbreak that originated in China. The number of cases continues to grow rapidly worldwide — including five in the U.S. as of Jan. 30 — and more than 100 deaths have occurred in China. No confirmed infections have been reported in Massachusetts, but the situation remains fluid as public health authorities assess, surveil and attempt to prevent the spread of additional infections. Here are five things to know about the virus and the Brigham’s preparation and response efforts.

Symptoms can include fever, muscle pain, cough and shortness of breath.

Most cases of 2019-nCoV are mild, but some patients can develop very severe disease. Many details about the virus are currently unknown, including its level of contagiousness and how best to prevent transmission. Other coronaviruses, such as Middle East Respiratory Syndrome (MERS) and the Severe Acute Respiratory Syndrome (SARS), are thought to have spread mainly via respiratory secretions produced when an infected person coughs or sneezes, similar to influenza and other respiratory illnesses.

Brigham clinicians are screening for 2019-nCoV in the Emergency Department and at ambulatory sites.

Patients with a fever or symptoms of a lower-respiratory illness, such as coughing or difficulty breathing, and who have recently traveled in China are considered at risk for 2019-nCoV infection. For these patients, clinicians have been advised to institute strict isolation precautions (airborne, contact and eye protection) immediately and page the Biothreats attending physician on call (pager 30331).

Robust preparations are underway at the Brigham.

The Brigham has substantial experience evaluating and caring for patients with possible MERS, another type of coronavirus. A multidisciplinary team is collaborating to ensure the hospital is ready to respond if there is a need to test or provide care for patients with possible 2019-nCoV infection. Recent activities include:

• Updating screening protocols to rapidly detect patients with possible 2019-nCoV infections
• Partnering with Massachusetts General Hospital to add a Best Practice Advisory into Epic to flag patients with possible 2019-nCoV
• Educating providers about what to do if they are concerned a patient may have 2019-nCoV
• Updating the Brigham’s Infection Control plan for Emerging Respiratory Viruses to include 2019-nCoV
• Working with Materials Management to ensure adequate stock of personal protective equipment and laboratory supplies

Additional preparedness efforts are ongoing.

The multidisciplinary team is conducting drills on the identification and rooming of patients, developing training materials on safe application and removal of personal protective equipment, and planning for contingencies in case the Brigham receives a large number of 2019-nCoV patients.

New guidance issued on travel to and from China.

The U.S. Centers for Disease Control and Prevention (CDC) has issued a new warning recommending that travelers avoid all nonessential travel to China. Partners HealthCare has modified its travel policy and issued updated travel guidance for those working for Partners and its affiliated institutions, including the Brigham. Effective Jan. 30, Partners has suspended all work-related travel to China. Similarly, all work-related visits by individuals from CDC-defined Level 3 areas, which now include all of China, have been canceled. The CDC may identify other countries and locations as Level 3 areas at any time.

Employees are strongly encouraged to avoid nonessential personal travel to China and any other Level 3 areas until further notice. Those who travel to these locations will be furloughed for 14 days upon their return date and must complete Occupational Health Services’ (OHS) Returning Travel Activity Survey. OHS will review the survey results and determine an appropriate return-to-work date.

Visit BWHPikeNotes.org for more information and the latest updates.

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