Similar to the MERS (Mers-CoV) and SARS (Sars-CoV) insurgence and hysteria experienced in the past, the newest version of the coronavirus, COVID-19, has unfolded rapidly, receiving much attention. With all this attention, are you ready to respond to questions and, more importantly, do you know what do to with a patient who presents with signs and symptoms of this disease?

The Facts

The coronaviruses, novel pathogens, are a frequent cause of the common cold and other respiratory infections including pneumonia.^1,2 Health officials in China reported this outbreak in Wuhan in December 2019. Apparently the coronaviruses are found in different species of animals and can evolve to infect and spread among humans.¹ As this is published, the Centers for Disease Control and Prevention (CDC) has so far confirmed 423 cases detected in the United States.² More, of course, are sure to be on the way as the virus spreads. Because of the uptick in the infected numbers in China, authorities there have imposed an unprecedented lockdown on travel, affecting more than a dozen cities in China (a combined population of at least 50 million).¹ 

Though there are many cases already reported, a lot of the infections are not as severe as influenza.³ The recovery period only generally lasts for just a few days, but the young, elderly and those who have a compromised immune state are the most vulnerable. They can surface in as few as two days and up to two weeks after exposure.^1-3 Symptoms range from fever, cough and shortness of breath to diarrhea and vomiting.^2-4

A recent alert from the American Academy of Ophthalmology suggests the virus can cause conjunctivitis and may be transmitted by aerosol contact to the ocular surface.⁴ The coronavirus spreads via respiratory droplets. Patients may be infectious to others prior to experiencing their own symptoms, although asymptomatic transmission has not been confirmed.⁴ 

You might just be the first provider to evaluate an infected person with a co-morbid conjunctivitis and respiratory infection.⁴ Review infection control practices for patients under investigation and obtain adequate travel or other exposure history including travel dates and cities visited in the past 14 days.⁵ Check your inventory for any needed office items such as masks, gloves, gowns, goggles and disinfectant.

Safety Measures

It’s key for healthcare providers to immediately notify their state or local health department if they suspect COVID-19 infection. Public health officials can then decide whether patients should be admitted to airborne isolation or monitored at home with appropriate precautions.⁵ 

In the absence of a viable vaccine, the CDC recommends these tips to minimize exposure and risk to the virus.^1-4

Avoid touching your eyes, nose and mouth with unwashed hands. 
Keep a distance from those who are sick, especially those who recently traveled internationally—to China in particular.
Stay home when sick.
Clean and disinfect exposed surfaces.

This infection can have implications for the cornea, and the Global Alliance of Eye Bank Associations (GAEBA) has consolidated responses related to ocular tissue donation for transplants and lamellar surgery. They advise precautionary measures. “Exclude or defer potential donors for ocular tissue who resided or traveled to mainland China (regardless of symptoms) or to other geographical areas designated as areas of active transmission by the CDC,” the GAEBA says.⁶

Continue to monitor your state and local health department alerts for any viral activity in your area, be prepared for questions your patients might ask regarding the coronavirus.     

1. Greenhaigh T. What you should know about the coronavirus outbreak. Pulmonary Advisor. www.pulmonologyadvisor.com/home/topics/lung-infection/what-you-should-know-about-the-coronavirus-outbreak. January 30, 2020. Accessed February 6, 2020. 2. Centers for Diseases Control and Prevention. 2019 novel coronavirus: information for healthcare professionals. www.cdc.gov/coronavirus/2019-ncov/hcp/index.html. Accessed March 9, 2020.  3. Palus S. How worried should you be about the new coronavirus? (Update: still not time to panic). Slate. slate.com/technology/2020/01/coronavirus-outbreak-china-sars-worry-level.html. January 24, 2020. Accessed February 6, 2020. 4. American Academy of Ophthalmology. Alert: important coronavirus context for ophthalmologists. www.aao.org/headline/alert-important-coronavirus-context. January 28, 2020. Accessed February 19, 2020. 5. Pavia AT. Novel coronavirus (2019-nCoV): frequently asked questions for clincians. Medscape Infectious Diseases. www.medscape.com/viewarticle/924555. January 30, 2020. Accessed February 6, 2020. 6. Global Alliance of Eye Bank Associations. Alert: coronavirus (COVID-2019) and ocular tissue donation. www.gaeba.org/2020/alert-coronavirus-2019-ncov-and-ocular-tissue-donation. February 3, 2020. Accessed February 19, 2020.