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Year : 2020  |  Volume : 64  |  Issue : 3  |  Page : 242-243  

The 2019 novel corona virus outbreak – An institutional guideline


Department of Anaesthesiology, Government Medical College, Thiruvananthapuram, Kerala, India

Date of Submission30-Jan-2020
Date of Decision26-Feb-2020
Date of Acceptance29-Feb-2020
Date of Web Publication11-Mar-2020

Correspondence Address:
Dr. Varun Suresh
Department of Anaesthesiology, Government Medical College, Thiruvananthapuram, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ija.IJA_104_20

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How to cite this article:
Suresh V. The 2019 novel corona virus outbreak – An institutional guideline. Indian J Anaesth 2020;64:242-3

How to cite this URL:
Suresh V. The 2019 novel corona virus outbreak – An institutional guideline. Indian J Anaesth [serial online] 2020 [cited 2020 Jul 13];64:242-3. Available from: http://www.ijaweb.org/text.asp?2020/64/3/242/280384



Emerging and re-emerging diseases are always a potential challenge to the healthcare system worldwide. The 2019-novel corona virus (2019-nCoV) is an RNA virus, which emerged in a seafood wholesale market in Wuhan, China at the end of 2019 and gradually spread to Thailand, Japan, South Korea, Singapore, Vietnam, Taiwan, Nepal, Italy, France, United States and other countries.[1],[2] The first cases in India were reported in Kerala, and recently, cases have been reported in parts of India. This needs be viewed up as a serious health emergency.

Several thousand individuals are on surveillance in India due to reasons of fever, recent travel to China and concordant entries in the relevant surveillance questionnaires. The present strain of 2019-nCoV is the seventh member of the corona virus family that infects humans.[1] The previous serious CoV outbreaks were the 2002 Severe Acute Respiratory Syndrome (SARS) CoV and the 2012 Middle East Respiratory Syndrome (MERS) CoV.[1] A significant knowledge gap in the present outbreak is that the proportion of mild and asymptomatic cases to fatal cases, often described as surveillance pyramid, is unknown for the2019-nCoV; a situation, which is seriously hampering the assessment of the epidemicand complicating the response for the outbreak.

The 2019-nCoV spreads human to human through droplet and contact spread.[3] Although sensitive to disinfection measures, it can live in the environment for hours. We as health care personnel are always at a risk of aerosol associated infections. In addition, hospital populations with various co-morbid illnesses are more vulnerable to viral infections. Existing infection control recommendations are often a blanket statement to all types of infections.[4] A considerable number of individuals are under surveillance for 2019-nCoVin our geographical area. Elective surgery is always postponed in fever scenarios; however, anaesthesiologists can anytime confront a situation wherein a 2019-nCoV quarantined individual will be presented for an emergency surgery. This mandates a structured, focussed and outbreak specific anaesthesia personnel protection instructions to be followed.

We developed a structured set of instructions to be followed by the anaesthesiologist attending to the 2019-nCoV quarantine individual [Table 1]. The available recommendations after the 2002 SARS outbreak were appended to the requirements of the present outbreak.[5] The instructions were circulated among the anaesthesiologists of our hospital, on social media platforms like WhatsApp, and also a printed set of instructions were made available at the emergency operating room as a ready reckoner. Apart from this, health care personnel protection instructions periodically published by the World Health Organisation were also made readily available to all the anaesthesiologists. None of the 2019-nCoVquarantine individual has reported for an emergency surgery to our hospital till the time of writing this manuscript.
Table 1: Personal Protection Practice to be adhered by the anaesthesiologist while handling 2019-novel coronavirus (2019-nCoV) surveillance individuals in the Emergency Operation Theatre

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The state of Kerala in India has acclaimed worldwide applause for its efforts in controlling the recent Nipah virus outbreak. We positively hope that our effort shall reinforce the outbreak response to the present 2019-nCoV in coalition with the efforts of public health authorities.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Munster VJ, Koopmans M, van Doremalen N, van Riel D, de Wit E. Anovel Coronavirus emerging in China-Keyquestions for impact assessment. N Engl J Med2020;382:692-4.  Back to cited text no. 1
    
2.
Who.int. (2020). Novel Coronavirus (2019-nCoV) situation reports. [online] Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports. [Last accessed on 2020 Feb 26].  Back to cited text no. 2
    
3.
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y,et al. Early transmission dynamics in Wuhan, China, ofnovel Coronavirus infected pneumonia. N Engl J Med 2020. doi: 10.1056/NEJMoa2001316. [Epub ahead of print].  Back to cited text no. 3
    
4.
Association of Anaesthetists of Great Britain and Ireland. Infection control in anaesthesia. Anaesthesia 2008;63:1027-36.  Back to cited text no. 4
    
5.
Kamming D, Gardam M, Chung F. Anaesthesia and SARS. Br J Anaesthesia 2003;90:715-8.  Back to cited text no. 5
    



 
 
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