Professional Documents
Culture Documents
Review On Covid-2
Review On Covid-2
Review On Covid-2
COVID-19
The clinical presentation of SARS CoV-2 ranges from a mild common cold-
like illness, to a severe viral pneumonia leading to acute respiratory distress
syndrome that is potentially fatal. Large, retrospective case series from China
have shown that the elderly, those with co-morbidities, and those with
pneumonia, are most at risk (3-6). Treatment is largely supportive, although
in-vitro and early retrospective data regarding the off-label use of several
compounds, such as remdesivir (RD/GS-5734), chloroquine (CQ),
hydroxychloroquine (HCQ), lopinavir-ritonavir (LPV/r) and tocilizumab (TCZ)
show promise.
CoVID-19 and the Workplace
Corona Virus 2019 popularly known as CoVID-19 is a potentially fatal
respiratory disease caused by SARS-CoV-2. Common symptoms include
fever, cough, dyspnea and recently diarrhea. The initially transmitted via
animal reservoir, can now be transmitted from person to person via
droplets and possibly airborne. (Figures 1 and 2). At present, this virus has
reached pandemic levels. Vaccination and treatment are not yet clear.
CoVID-19 and the Workplace
2. Medium exposure risk - include those that require frequent and/or close contact
with (i.e., within 6 feet of) people who may be infected with SARS-CoV-2, but who
are not known or suspected COVID-19 patients. In areas without ongoing
community transmission, workers in this risk group may have frequent contact with
travelers who may return from international locations with widespread COVID-19
transmission. In areas where there is ongoing community transmission, workers in this
category may have contact be with the general public (e.g., in schools, high-
population-density work environments, and some high-volume retail settings).
Classification of Worker and
Workplace Exposures
3. High exposure risk - are those with high potential for exposure to
known or suspected sources of COVID-19. Workers in this category
include:
● Healthcare delivery and support staff (e.g., doctors, nurses, and other hospital staff
who must enter patients’ rooms)
● Mortuary workers involved in preparing (e.g., for burial or cremation) the bodies of
people who are known to have, or suspected of having, COVID-19 at the time of their
death.
Classification of Worker and
Workplace Exposures
4. Very high exposure risk - those with high potential for exposure to known or
suspected sources of COVID-19 during specific medical, postmortem, or laboratory
procedures. Workers in this category include:
● Healthcare workers (e.g., doctors, nurses, dentists, paramedics, emergency medical technicians)
performing aerosol-generating procedures (e.g., intubation, cough induction procedures,
bronchoscopies, some dental procedures and exams, or invasive specimen collection) on known or
suspected COVID-19 patients.
Using the hierarchy of control in selecting the best possible way to reduce if
not eliminate workplace hazard.
Engineering Controls
● Install physical barriers, such as clear plastic sneeze guards, where feasible
● Increasing ventilation or installing air filters, negative pressure ventilation if possible
The aim of ventilation should be directed to move the source of potential contamination to
air-exhaust points or areas where there can be sufficient dilution. For example, the
ventilation should move infectious air away from patients and health workers, replacing
infected air with fresh outside air.
Recommendations and
Implementation on Control
Measures
Recommendations and
Implementation on Control
Measures
Administrative Controls
● Changes in workplace policies and procedures
● Policies on alternative working arrangements, like limiting employee access, consider strategies
to minimize face to face contact, phone based communication, teleconferencing, work from home,
shifting
● Medical evaluation/care, (Fit to work, may go home )
● Provide up to date education and training on risk and protective behaviors etc.
● Information dissemination (e.g.: posting signs, automated messaging etc.)
• Use sterile Dacron or rayon viral swabs for collecting upper respiratory tract specimens
from both the nasopharynx and the oropharynx. Do not use calcium alginate swabs or
cotton swabs with wooden shafts as these will inactivate the virus.
1. Patient must be seated upright, with the head in a straight position (not extended
upwards/ not looking up because the pledget will be directed superiorly towards the
anterior cranial base which can be dangerous)
Collection of respiratory tract
specimens
2. The pledget should be on a long orange stick.
Gently insert flexible wire shaft swab through the nares parallel to the
palate (not upwards) until resistance is encountered or the distance is
equivalent to that from the ear to the nostril of the patient indicating
contact with the nasopharynx. Gently, rub and roll the swab back. Leave
the swab in place for several seconds to absorb secretions before
removing. Do not sample the nostrils.
4. Specimens should be packaged using the triple packaging system detailed below;
• Seal the primary receptacle containing the swabs and viral transport media using a semi-
transparent flexible film (i.e. Parafilm). Wrap the primary receptacle with an absorbent
material e.g., gauze.
• Place the primary receptacle into the second container. The second container should be
durable and leak-proof.
• Place the second container into the outer container e.g., ice box. Ensure that the
required temperature is maintained in the outer container through the use of wet
ice or refrigerant packs.
Collection of respiratory tract
specimens
5. All specimens for COVID-19 testing should be sent to the Research Institute
for Tropical Medicine (RITM) by the health facility or to the designated sub-
national laboratories and accredited private hospital laboratories are. Sending
of specimens for COVID-19 testing should be coordinated with the appropriate
DOH-Regional Epidemiology and Surveillance Unit (RESU). The hotline mobile
number for the RITM Surveillance and Response Unit is +63- 9478706673".
Please refer to latest updates on which subnational laboratories and private
hospital laboratories have available rRT-PCR tests already for SARS-COV-2.
INTERIM
Diagnostic Testing
B. COVID-19 IgG and IgM Rapid Diagnostic Test {RDT) kits - the
Food and Drug Administration
(FDA) approved the use of antibody-based test kits for SARS-CoV2 testing on
March 30, 2020.
Based on the single study by Li et. al., ° the RDT kit has a sensitivity of 88.86%, and
specificity of 90.63%, The seemingly high positive predictive value of the test is
due to the high prevalence of COVID-19 in this study which is greater than 75%.
The true accuracy of immunoassays for COVID-19 has not been established yet.
Diagnostic Testing
• A. Remdesivir
• B. Chloroquine or hydrochloroquine
• C. Lopinavir- ritonavir
• D. Tocilizumab
• E. Vitamins C and Zinc
Adverse Drug Reaction (ADR)
on using Investigational Therpy
for CoVID-19
1. Remdesivir -unknown