NIOSH-COVID.19.Presentation.22.April.2020apdf
NIOSH-COVID.19.Presentation.22.April.2020apdf
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  1. SARS-CoV-2 in the Construction WorkplaceJohn Howard. M.D. and Scott Earnest, Ph.D.National Institute for Occupational Safety and HealthCenters for Disease Control and PreventionU.S. Department of Health and Human Services22 April 2020Disclaimer: The information contained in this presentationwas accurate on the date it was presented.
  2. Nomenclature•COVID-19is an abbreviation. ‘CO’ stands for “corona,” ‘VI’ stands for ‘virus,’ ‘D’ stands for ‘disease,’‘ and 19’ refers to 2019 when the viral disease was first identified in December. •The virus that causes COVID-19 is referred to as SARS-CoV-2which stands for “severe acute respiratory syndrome—coronavirus—two.”
  3. Coronavirus Family•The family of coronaviruses has seven members that cause disease in humans: –SARS-CoV-1 –SARS-CoV-2 –MERS (Middle Eastern Respiratory Syndrome) –Coronaviruses causing common cold (i.e., 229E; H15U1; NL63; OC43)
  4. What is a Pandemic?•World Health Organization declared COVID-19 to be a pandemic on March 11, 2020.•There are three elements that must exist for a pandemic to be declared:–Novel virus•Virus that has not previously circulated in the population—no one in the population has any immunity to the virus.–Sustained community spread•Virus spreads from person to person •Not associated with travelers entering from a source country–Worldwide distribution
  5. COVID-19 Basics•COVID-19 is a respiratory disease.•Primary presenting symptoms–Fever, cough, and trouble breathing.•Average incubation period = is 5.2 days–99% of individuals exhibiting symptoms within 12.5 days to 14 days.•There are people who get COVID-19, but do not require hospitalization for respiratory distress. •Persons may become infected with SARS-CoV-2, yet not feel sick.–Pre-symptomatic or asymptomatic.
  6. Asymptomatic and Pre-Symptomatic •Symptom Status and SARS-CoV-2 Test Results among 215 Obstetrical Patients Presenting for Delivery•Sutton D et al. NEJM, 16 April 2020•Asymptomatic, but SARS-CoV-2 +–13.5%•Pre-symptomatic–Infectiousness peaks on or before symptom onset•He X et al. Nature, 16 April 2020
  7. Transmission•Droplets–Transmission from person to person occurs primarily between people in close contact with each other (about 6 feet). –Respiratory droplets carrying the virus transmit infection when they travel directly fromthe respiratory tract of the infected individual tothe mucosal surfaces—the eyes, nose and mouth of the uninfected person. –Droplets are produced when infected person coughs, sneezes or speaks forcibly. •Contact–Contact between an uninfected person and surface or object, which has been recently (within hours) contaminated with SARS-CoV-2, can occur. –When a person touches a contaminated surface or object with their hands, and then touches their hands to their mouth, nose, or eyes, contact transmission occurs.
  8. Transmission by Aerosols•Transmission by small particles—called aerosols—which remain airborne for a longer time and over a longer distance than droplets—may occur. •Close Contact Aerosols–Airborne spread can occur especially in a relatively closed environment, involving high concentrations of aerosols over a prolonged period, and where the uninfected person is close to the source. This is especially true in healthcare settings.
  9. Infectious Disease Epidemiology—SEIR Model
  10. Epidemiology—Case Count•Susceptible•Exposed–Asymptomatic (SARS-CoV-2 status unknown)–Asymptomatic + SARS-CoV-2–Symptomatic + SARS-CoV-2•Infectious–At home–Hospitalized–Ventilator-dependent •Recovered•Fatality
  12. Testing•There are now two types of tests:–Diagnostic Test•The more common test you hear about is a nucleic acid amplification testfor SARS-CoV-2 RNA. •The viral test measures current infection with SARS-CoV-2–Antibody Test•The other test is called the antibody detection test
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