To the SWHR Physician Community:

As part of our commitment to providing you support in caring for our communities, we wanted to give you important information about the coronavirus infection that began in China and is spreading globally and is receiving growing media coverage. This potential risk is relevant today as a Texas A&M student was tested for the infection over the weekend. Although the test results were negative, cases have been reported in Washington, Illinois, California and Arizona.

This novel coronavirus, thought to be transmitted from an unknown animal source to humans, is now believed to be spreading from person-to-person causing an outbreak of respiratory illness. The initial outbreak emerged from the city of Wuhan in the Hubei province of China, with first reports on 12/31/19 of 59 patients being affected. Since that initial report, thousands have now been reported to be infected in an expanding international footprint. Similar to influenza, coronavirus is thought to be spread by respiratory droplets produced during coughing or sneezing.

Coronaviruses are well-known causes of the common cold, but can evolve into novel strains as with SARS and MERS-CoV. Intensive, ongoing investigation to learn more about this latest virus, such as the source of infection, populations at risk, and manifestation of symptoms is on-going.

There is currently no preventive vaccine or specific antiviral treatment for 2019-nCoV, so prevention is a key strategy. To protect yourself:

  • Wash your hands with soap and water or use alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose, and mouth.
  • Avoid close contact with sick people.
  • Cover your mouth when you cough or sneeze.
  • Stay home when you are sick.
  • Get your influenza vaccine.

The CDC has issued interim recommendations for screening for patients at risk for having an infection with coronavirus. Click here to review the issued interim recommendations.

The current CDC recommendation is to screen upon checking in (see below).
Criteria to Guide Evaluation of Patients Under Investigations (PUI) for 2019-nCoV

Patients in the United States who meet the following criteria should be evaluated as a PUI in association with the outbreak of 2019-nCoV in Wuhan City, China.
The criteria are intended to serve as guidance for evaluation. Patients should be evaluated and discussed with public health departments on a case-by-case basis if their clinical presentation or exposure history is equivocal (e.g., uncertain travel or exposure).
Recommendations for Reporting, Testing, and Specimen Collection

Updated January 17, 2020

Healthcare providers should immediately notify both infection control personnel at their healthcare facility and their local or state health department in the event of a PUI for 2019-nCoV. State health departments that have identified a PUI should immediately contact CDC’s Emergency Operations Center (EOC) at 770-488-7100 and complete a 2019-nCoV PUI case investigation form available below.
For those patient screening positive, they should be given a mask and placed in an isolation room. For additional guidance, contact the Texas State Department at (512) 776-7676.
Andy Ziskind, M.D.
Senior Executive Officer
Southwestern Health Resources
Jason Fish, M.D.
Chief Medical Officer (Interim)
Southwestern Health Resources
Footnotes:
1 Fever may not be present in some patients, such as those who are very young, elderly, immunosuppressed, or taking certain fever-lowering medications. Clinical judgment should be used to guide testing of patients in such situations.

2 Close contact is defined as—
a) being within approximately 6 feet (2 meters), or within the room or care area, of a novel coronavirus case for a prolonged period of time while not wearing recommended personal protective equipment or PPE (e.g., gowns, gloves, NIOSH-certified disposable N95 respirator, eye protection); close contact can include caring for, living with, visiting, or sharing a health care waiting area or room with a novel coronavirus case.– or –
b) having direct contact with infectious secretions of a novel coronavirus case (e.g., being coughed on) while not wearing recommended personal protective equipment.