Infection Prevention and Control for 2019 Novel Coronavirus (2019 nCoV) in Acute Healthcare Settings: The Canadian Response

Abstract

Background: Severe acute respiratory coronavirus virus 2 (SARS-CoV-2), able to cause pneumonia in humans, was discovered in Wuhan, Hubei Province, China. Investigations related to transmissibility are ongoing, but human-to-human transmission involving healthcare workers providing patient care and close contacts of infected patients have been confirmed. Infection control procedures are necessary to prevent transmission during delivery of health care in healthcare settings. Public health in Canada is a shared responsibility among municipal, provincial, territorial, and federal governments. Significant public health events require coordination between all levels of government and a consistent approach across jurisdictions. The objective of this summary is to describe the Public Health Agency (PHAC)’s Infection Prevention and Control (IPC) guideline on SARS-CoV-2. Methods: The PHAC’s interim guideline for infection prevention and control of 2019-nCoV in acute healthcare settings was informed by the currently limited evidence available, and adapted to the context of healthcare delivery in Canada. The guideline is based upon Canadian guidance developed for previous coronavirus outbreaks (eg, SARS and MERS), as well as the World Health Organization (WHO)’s interim guidance. Technical advice was provided by the National Advisory Committee on Infection Prevention and Control (NAC-IPC) of the Government of Canada. Interjurisdictional collaboration and decision making between multiple authorities and levels of government was facilitated using PHACs federal/provincial/territorial (FPT) Public Health Response Plan for Biological events (Fig. 1). Results: In the absence of effective drugs or vaccines, IPC strategies to prevent or limit SARS-CoV-2 transmission in healthcare settings include the following: prompt identification of signs, symptoms and exposure criteria, implementation of appropriate IPC measures (eg, contact and droplet precautions, patient isolation, N95 respirator plus eye protection when performing aerosol-generating medical procedures on a person under investigation), and etiologic diagnosis. Guideline recommendations are informed by collective expert interpretation of available evidence. Recommendations cover all relevant areas including screening and assessment, public health surveillance and notification, laboratory testing and reporting, respiratory hygiene, hand hygiene, patient placement and flow, management of visitors, use of personal protective equipment, environmental cleaning and discontinuation of precautions. Conclusions: This guideline is an ever-changing document. Changes in recommendations provided may be warranted with new evidence, changes in WHO guidelines, or other identified concerns. FPT governments continue to work collaboratively to ensure that Canada is ready to respond to public health events and is prepared to protect the health of Canadians. Opportunities for international collaboration on IPC products, as well as knowledge exchange and mobilization, continue to thrive.

Funding: None

Disclosures: None