Disease Debrief, News

2019 Novel coronavirus (2019-nCoV) outbreak

NCCID Disease Debriefs provide Canadian public health practitioners and clinicians with up-to-date reviews of essential information on prominent infectious diseases for Canadian public health practice. Information is gathered from key sources including the Public Health Agency of Canada (PHAC), the USA Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC).

This Disease Debrief provides quick links for public health and practitioner use.

***Une mise à jour des Points saillants sur COVID-19 est disponible en anglais (link). La mise à jour en français sera disponible d’ici 24 heures.

Cause

The Coronavirus disease (COVID-19) is a global pandemic as announced by World Health Organization (WHO, March 11 2020). It is a new strain of the virus that has never been previously identified in humans. 

Government of Canada – Novel Coronavirus infection: Frequently Asked Questions (FAQ)  (English & French)

World Health Organization-Coronavirus disease (English & French)

Centers for Disease Control and Prevention-How COVID-19 spreads (English only)

European Centre for Disease Prevention and Control-COVID-19 (English only)

Signs & symptoms

The symptoms of the Coronavirus disease (COVID-19) infection can resemble a cold or flu. These can range from mild symptoms such as fever, cough, runny nose, headache, and general fatigue to more severe such as acute respiratory distress, bilateral pneumonia, sepsis and death. This virus has a rather long incubation period with the signs and symptoms taking up to 2 weeks to appear after exposure to the virus. However, symptoms can appear in as short of a time as two days after exposure.

Government of Canada-Symptoms of COVID-19 (English & French)  

World Health Organization – Coronavirus (English & French)

Centers for Disease Control and Prevention-COVID-19 (English only)

European Centre for Disease Prevention and Control-Q & A on COVID-19 (English only)

Transmission

Like SARS and MERS-CoV coronaviruses, the 2019 Novel Coronavirus initially spread from animals to humans and established human-to-human transmission afterward. Currently, there is not enough epidemiological information to determine how easily and sustainably this virus spreads between people. Researchers are actively looking at this. The virus seems to be transmitted mainly via respiratory droplets when people sneeze, cough, or exhale. At this stage, we know that the virus can be transmitted as soon as those infected show (flu-like) symptoms. There are still uncertainties as to whether mild or asymptomatic cases can transmit the virus. With most respiratory viruses, people are thought to be most contagious when they are most symptomatic (the sickest). This virus can also survive on objects, therefore a person can get COVID-19 by touching these objects or surfaces and then touching their nose, eyes and mouth. 

Government of Canada – For Health professionals-Transmission (English & French)

Government of Canada – Novel Coronavirus infection: Frequently Asked Questions (FAQ) (English & French)

Centers for Disease Control and Prevention-How 2019 Novel Coronavirus spreads (English only)

World Health Organization – Novel Coronavirus (English & French)

European Centre for Disease Prevention and Control – Q & A on Novel Coronavirus (English only)

Laboratory diagnostics and reporting

In Canada, PHAC’s National Microbiology Laboratory (NML) can identify COVID-19 and is the only place of conclusive diagnosis. In each province, provincial public health labs (PHL) initiate testing and coordinate further testing with NML as required. Detailed protocols for microbiological investigations of severe acute respiratory infections are available. They serve as a reference for laboratory diagnosis and testing and specimen transport and shipment of this Novel Coronavirus.

Government of Canada – Detecting and Reporting (English & French)

Government of Canada – Protocol for Microbiological Investigations of Severe Acute Respiratory Infections (SARI) (English & French)

National case definitions

To aid in early detection and containment and to characterize the clinical and epidemiologic features of COVID-19, Public Health of Canada established a national case definition. Surveillance case definitions are provided for standardized case classification and reporting to the Public Health Agency of Canada. They are based on the current level of epidemiological evidence, uncertainty, and public health response goals. They are subject to change as new information becomes available.

Please refer to the document below to obtain information for persons under investigation (PUI), probable and confirmed case definitions, and exposure criteria and mechanism of reporting:

Government of Canada – For interim national case definition: Novel Coronavirus (2019-nCoV) (For Canada)

For additional information:

CDC-Interim guidelines for collecting, handling, and testing clinical specimens from persons for Coronavirus Disease 2019 (COVID-19) (English only)

European Centre for Disease Prevention and Control-Case definition and European surveillance for COVID-19 (updated March 2, 2020)

Infection prevention and control

The Government of Canada published interim guidance for acute healthcare settings. The Public Health Agency of Canada (the Agency) develops infection prevention and control (IPC) guidelines to provide evidence-based recommendations to complement provincial/territorial public health efforts in monitoring, preventing, and controlling healthcare-associated infections. Please read in conjunction with relevant provincial, territorial and local legislation, regulations, and policies. Currently available scientific evidence and expert opinion informs guidance and is subject to change as new information on transmissibility and epidemiology becomes available.

Government of Canada – Infection prevention and control for novel coronavirus (COVID-19) interim guidance for acute healthcare settings (English & French)

Government of Canada-Coronavirus disease (COVID-19): For health professionals-Infection prevention and control (English & French)

Government of Canada-Public health management of cases and contacts associated with novel coronavirus disease 2019 (COVID-19) (English & French)

There are currently no vaccines available to protect you against human Coronavirus infection.

For additional information outside of Canada

World Health Organization – Coronavirus disease (COVID-19) technical guidance on infection prevention and control please view (English only)

CDC – Interim infection prevention and control recommendations for patients with suspected or confirmed Coronavirus disease 2019 (COVID-19) in healthcare settings (English only)

CDC – Strategies to Prevent the Spread of COVID-19 in Long-Term Care Facilities (LTCF) (English only)

CDC: COVID-19 Webinar Update and Information for Long-term Care Facilities (LTCF) (English only)

European Centre for Disease Prevention and Control – Infection prevention and control for the care of patients with 2019-nCoV in healthcare settings (English only)

European Centre for Disease Prevention and Control-Public health management of persons, including health care workers, having had contact with COVID-19 cases in the European Union (English only)

Canada’s response and risks to Canadians

PHAC has activated the Health Portfolio Operations Centre to support effective coordination of federal, provincial and territorial preparedness and response to the emergence of 2019-nCoV. PHAC has also published the F/P/T public health repose plan for biological events, which you can reference for more information. 

Government of Canada – Coronavirus disease (COVID-19): Frequently Asked Questions (FAQ) (English & French)

Government of Canada – Coronavirus disease (COVID-19): Canada’s response (English & French)

Federal/Provincial/Territorial Public Health Response Plan for Biological Events (English & French)

Government of Canada – 2019 Novel Coronavirus: Prevention and risks (English & French)

Travel Advisory for Canadians

The Public Health Agency of Canada (PHAC) issued a Travel Health Notice level 3, outlining the potential dangers to Canadian travellers and the Canadian public. PHAC is recommending that Canadians should avoid all Non-essential travel outside of Canada. If you are a returning traveller, self-isolate for 14 days upon return from travel outside of Canada. Monitor your health for fever, cough or difficulty in breathing, continue to self-isolate and contact public health authority. They also ask that they contact the local public health authority in your province or territory within 24 hours of arriving in Canada from Italy, Iran or Hubei province (China).

Government of Canada-Coronavirus disease (COVID-19): Travel advice (English & French)