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 the World Health Organization (WHO, March 11 2020). It is a new strain of the virus that has never been previously identified in humans. The government of Canada has issued COVID-19 Pandemic Guidance for the Health Sector for federal, provincial & territorial health sectors.

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

Outside of Canada

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) 

Outside of Canada

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. A great deal has been learned about the transmissibility of this novel coronavirus since it first emerged; it is estimated to have a reproductive number (R0) of 2-3, slightly higher than that of the influenza virus, however, more is being studied. The virus is thought to be transmitted mainly via respiratory droplets when people sneeze, cough, or exhale. We believe that the virus can be transmitted as soon as those infected show flu-like symptoms and we think that there is a possibility of transmission from an asymptomatic carrier but to what extent they are able to contribute to the transmission chain is still being investigated. In addition, this virus has been detected on many objects many days after an infected person has left, but whether another person can get COVID-19 by touching these objects or surfaces is being studied, as the presence of the viral RNA does not mean the virus is viable and able to cause an infection.

Government of Canada-Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings (English & French)

Government of Canada-Infection Prevention & Control for COVID-19: Interim Guidance for Long-term Care Homes (English & French)

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

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

Outside of Canada

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 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)

Government of Canada- Interim National Surveillance Guidelines for Human Infection with Coronavirus Disease (COVID-19) (English & French)

Outside of Canada:

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 & Control for COVID-19: Interim Guidance for Long-term Care Homes (English & French)

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 against human 2019 novel Coronavirus infection.

Outside of Canada

World Health Organization – Coronavirus disease (COVID-19) Technical Guidance on Infection Prevention and Control (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 Healthcare Workers, Having had Contact with COVID-19 Cases in the European Union (English only)

Canada’s response and risks to Canadians

PHAC provides information and guidance for federal, provincial and territorial preparedness and response to the emergence of the 2019-nCoV pandemic.

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)

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

The Government of Canada Supports First Nations and Inuit Communities in Preparing for, Monitoring and Responding to COVID-19 (English & French)

The government of Canada has issued a Risk-Informed Decision Making Guidelines for Workplace and Businesses during COVID-19 Pandemic (English & French)

On March 25th, 2020, the Canadian Pediatric Society has also issued Current Epidemiology and Guidance for COVID-19 caused by the SARS-COV-2 Virus, in Children

Vulnerable populations & COVID-19

Some Canadians are at higher risk of getting the infection and to develop severe complications associated with COVID-19 due to socio-economic and health status. The government of Canada has issued information on how organizations can support vulnerable population during COVID-19

Government of Canada-Infection Prevention & Control for COVID-19: Interim Guidance for Long-term Care Homes (English & French)

The government of Canada has issued interim guidance for clinical management of patients with moderate to severe COVID-19 with endorsement from Canadian Critical Care Society and Association of Medical Microbiology & Infectious Diseases on April, 02, 2020.

Government of Canada-Clinical Management of Patients with Moderate to Severe COVID-19-Interim Guidance (English & French)

The government of Canada has issued guidance documents for organizations that support homeless individuals.

Government of Canada – Guidance for Providers of Services for People Experiencing Homelessness (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)