Novel Coronavirus Infection COVID-19

Total cases of COVID-19 in the

Philippines as of Feb 28, 2020
◦621 cases
◦30 PUIs admitted
◦588 discharged
PUIs
◦3 confirmed cases
◦2 recovered
◦1 death
Breakdown of PUI cases as of Feb 28,
2020
◦NCR – 18 ◦CAR -2
◦Central Luzon -4 ◦Ilocos Region - 1
◦Central Visayas – 1
◦Western Visayas -1
◦Cagayan Valley -2
Updates on COVID-19
Background
• On 31 December 2019, WHO was alerted to several cases of
pneumonia in Wuhan City, Hubei Province of China
• The virus did not match any other known virus
• One week later, on 7 January, Chinese authorities confirmed
that they had identified a new virus
• The new virus is a coronavirus, which is a family of viruses
that include the common cold, and viruses such as SARSCoV
and MERSCoV.
• This new virus was temporarily named “2019-nCoV” and
later to COVID-19 by WHO
Epidemiology
◦Novel (new) Coronavirus (2019-2019-nCov) is a new strain of coronavirus
that was first identified in a cluster of pneumonia cases in Wuhan City,
Hubei Province of China
◦Most of the cases have had exposure to a large seafood and animal market
◦Coronavirus are a large family of viruses, some causing illness in people
and others that circulate among animals, including camels, cats and bats
◦Rarely, animal coronavirus can evolve and infect people and then spread
between people such as has been seen with Middle East Respiratory
Syndrome (MERSCoV) and Severe Acute Respiratory Syndrome (SARS-
CoV)
◦Most coronaviruses are not dangerous, but some are
What is Coronavirus?
◦ A coronavirus is a type of common virus that can infect your nose, sinuses, or
upper throat
◦ They can spread much like cold viruses
◦ Coronaviruses are zoonotic (transmitted between animals and people)
◦ Detailed investigations found that SARS-CoV was transmitted from civet cats to
humans and MERS-CoV from dromedary camels to humans
◦ Several known coronaviruses are circulating in animals that have not yet infected
humans
◦ Almost everyone gets a coronavirus infection at least once in their life, most likely
as a young child
 How is COVID-19 transmitted?
◦The mode(s) of transmission of the 2019-nCov are currently
unknown
◦Available information suggests that the 2019-nCov is zoonotic and
causes infections in humans through contact with infected animals
◦Contact and Droplet Transmission
◦ disease can spread from person to person through small droplets from
the nose or mouth which are spread when a person with COVID-19
coughs or exhales
◦ other people then catch COVID-19 by touching these objects or
surfaces, then touching their eyes, nose or mouth
 What is the incubation period?
◦Studies suggest that coronaviruses (including preliminary
information on the COVID-19 virus) may persist on surfaces for a
few hours or up to several days
◦ it is not certain how long the virus that causes COVID-19 survives on
surfaces, but it seems to behave like other coronaviruses
◦ may vary under different conditions (e.g. type of surface, temperature
or humidity of the environment)
◦The explosive nature of the outbreak in China is probably due to
the mild presentation in most of the population at the beginning
of the outbreak, thus diagnosis was not immediately identified
leading to extensive spread of the infection
 How is COVID-19 transmitted?
◦People can also catch COVID-19 if they breathe in droplets from
a person with COVID-19 who coughs out or exhales droplets
◦ important to stay more than 1 meter (3 feet) away from a person
who is sick
◦Studies to date suggest that the virus that causes COVID-19 is
mainly transmitted through contact with respiratory droplets
rather than through the air
◦risk of catching COVID-19 from someone with no symptoms at all
is very low
◦ it is therefore possible to catch COVID-19 from someone who has just a
mild cough and does not feel ill
 How is COVID-19 transmitted?
◦The risk of catching COVID-19 from the feces of an infected
person appears to be low
◦ spread through this route is not a main feature of the outbreak
◦Because this is a risk, however, it is another reason to clean
hands regularly, after using the bathroom and before eating
 What is the incubation period?
◦incubation period for COVID-19 range from 1-14 days, most
commonly around five days
◦about 24 hours prior to onset of symptoms when the sick person
may also be shedding the virus already, but this is believed to be
insignificant at this time
◦in general the virus is shed in significant amounts, and thus
communicable, at the time that the infected individual show
symptoms and signs of illness
 What is the incubation period?
◦The likelihood of an infected person contaminating commercial
goods is low
◦risk of catching the virus that causes COVID-19 from a package
that has been moved, travelled, and exposed to different
conditions and temperature is also low
What are the signs
and symptoms?
Most of the cases have shown respiratory symptoms:
1. Fever
2. Shortness of breath
3. Cough
4. Colds
5. Pneumonia
6. Difficulty breathing
 What are the signs and
symptoms?
◦Other signs and symptoms
◦ aches and pains
◦ nasal congestion
◦ runny nose
◦ sore throat
◦ diarrhea
◦These symptoms are usually mild and begin gradually
◦Some people become infected but don’t develop any symptoms
and don't feel unwell
IPCC Health Policies about
management of COVID-19
patients
◦An effective triaging mechanism to screen patients for nCoV must be in
place
◦✓ The triage area can be designed so that it is easy to access by patients
who may be PUIs but also far enough from general people traffic
◦✓ Ventilation must be adequate (means at least 12 air exchanges per hour)
◦✓ The distance between patients must be at least 3 feet apart to prevent
contamination of infected and non-infected patients
◦✓ The triage area should have posters for PUIs and PUMs with instructions
about respiratory etiquette such as how to properly wear facemasks, proper
use of tissues to cover nose and mouth when coughing or sneezing, proper
disposal of tissues and contaminated items in waste receptacles, and how
and when to perform hand hygiene.
IPCC Health Policies
about management of
COVID-19
◦The identified nCOV area should be a safe area with adequate
ventilation to ensure smooth admission of patients under
investigation (PUI)
◦✓ The PUIs should be admitted to single rooms
◦✓ If airconditioned, the air system must be isolated and not centralized
◦✓ Adequate ventilation means at least 12 air exchanges per hour
◦This can be achieved by mechanical system such as electric fan or
exhaust
◦Negative pressure system is ideal but not required for the PUI areas
◦✓ Visitors should be limited to at most one selected family member only
◦✓ Only essential HCWs should enter these rooms
◦Keep to the minimum the number of HCWs needed for the care of the
PUIs
IPCC Health Policies about
management of COVID-19
patients
◦ Once confirmed, a patient with nCoV infection should be managed in a
single room
◦ ✓ The door which connects the room to the corridor should always be
closed
◦ ✓ The identified nCoV rooms should have adequate ventilation
◦ ✓ If the health facility has a negative pressure room, this is the room
most ideal to place confirmed nCoV cases
◦ ✓ If negative pressure rooms are not available, the identified room
should have ventilatory capacity that allows at least 12 air exchanges
◦ Based on previous experiences, this ventilation requirement can be
achieved by manipulating the windows and exhaust fans:
IPCC Health Policies about
management of COVID-19
patients
◦ Open windows or use of electric fans or exhaust fans allow for the
rapid dilution of contaminated air into the surrounding areas and
the open air
◦ ✓ The airflow should be directed to areas where no people stay or
pass by
◦ it will be necessary to reroute usual traffic movement of persons in the
hospital vicinity so that the public is not exposed to contaminated air
from the nCoV patient rooms
◦ ✓ If the number of single rooms are not sufficient for the number of
confirmed nCoV cases, it is possible to cohort these patients
IPCC Health Policies about
management of COVID-19
patients
◦ A distance of 1 meter is maintained between patients within the
cohort area
◦ Despite cohorting, equipments should not be shared as much as
possible or should be decontaminated properly if sharing is
unavoidable
◦ Ideally, a dedicated experienced and trained personnel should be
assigned for that area (at least one person per shift)
◦ Limit entry to the area to personnel who are vital for patient care
and support only
Specimen Collection

Laboratory Result turn

Collect Nasopharyngeal
RESU will facilitate - around time is 48 –
(NPS) and
sending of specimen to 72 hours from the
Oropharyngeal Swab
RITM receipt of specimen by
(OPS)
RITM
Collection and Transport of
Specimens
◦ The necessary nasopharyngeal and oropharyngeal specimens as
well as other body fluids for diagnostic workup such as blood tests,
sputum GS CS and others should be handled as potentially
infectious
◦ HCWs who collect these specimens should use appropriate PPE (i.e.,
eye protection, at least a surgical mask, a longsleeved gown,
gloves)
◦ If the specimen is collected with an aerosol-generating procedure
(bronchoscope, intubation), HCW should wear an N95 mask
Collection and Transport of
Specimens
◦ Ensure that all personnel who transport specimens to the RITM
laboratories are trained in safe handling practices and spill
decontamination procedures
◦ The specimen should be transported in leak-proof specimen bags (i.e.,
secondary containers) that have a separate sealable pocket for the
specimen (i.e., a plastic biohazard specimen bag), with the patient’s
label on the specimen container (i.e., the primary container), and a
clearly written laboratory request form
◦ To avoid confusion, the process of getting the test medium and the
arrangement for staff to transport to the RITM should have been pre-
arranged already for weekday and weekend specimen collections.
Disinfection of Patient areas
after discharge
◦ The WHO recommended alcohol and bleach for decontamination
◦ Ethyl alcohol (70%)
◦ powerful broad-spectrum germicide and is considered generally superior
to isopropyl alcohol
◦ used to disinfect small surfaces (e.g. rubber stoppers of multiple-dose
medication vials, and thermometers) and occasionally external surfaces
of equipment (e.g. stethoscopes and ventilators)
◦ since alcohol is flammable, limit its use as a surface disinfectant to small
surface-areas and use it in well-ventilated spaces only
◦ Prolonged and repeated use of alcohol as a disinfectant can also cause
discoloration, swelling, hardening and cracking of rubber and certain
plastics.
Disinfection of Patient areas
after
◦ Bleach discharge
◦ strong and effective disinfectant with sodium hypochlorite as the active
ingredient
◦ effective in killing bacteria, fungi and viruses, including influenza virus –
but it is easily inactivated by organic material
◦ Diluted household bleach disinfects within 10–60 minutes contact time,
is widely available at a low cost, and is recommended for surface
disinfection in health-care facilities
◦ irritates mucous membranes, the skin and the airways
◦ decomposes under heat and light
◦ reacts easily with other chemicals
Disinfection of Patient areas
after
◦ Bleach discharge
◦ ventilation should be adequate and consistent with relevant occupational
health and safety guidance
◦ improper use of bleach, including deviation from recommended dilutions
(either stronger or weaker), may reduce its effectiveness for disinfection
and can injure HCWs
◦ In decontaminating environmental surfaces:
◦ A 1:10 – 1:100 dilution of 5.25% - 6.15% sodium hypochlorite has been
recommended for environmental decontamination (Guidelines for
Disinfection and Sterilization in Healthcare Facilities, 2019 Update)
Disinfection of
Patient areas after
discharge
◦Clean horizontal surfaces in isolation rooms or areas – focusing
particularly on surfaces where the patient has been lying or has
frequently touched, and immediately around the patient’s bed –
regularly and on discharge.
◦To avoid the possible generation of infectious aerosols, use damp
cleaning (moistened cloth) rather than dry dusting or sweeping
◦During wet cleaning, cleaning solutions and equipment soon become
contaminated; change cleaning solutions, cleaning cloths and mop
heads frequently, according to health-care facility’s policies
◦Ensure that equipment used for cleaning and disinfection is cleaned
and dried after each use
Disinfection of
Patient areas after
discharge
◦Launder mop heads daily and dry them thoroughly before storage or reuse
◦To facilitate daily cleaning, keep areas around the patient free of
unnecessary supplies and equipment
◦Do not spray (i.e. fogging) occupied or unoccupied rooms with disinfectant
◦If equipment is reused, follow general protocols for disinfection and
sterilization
◦If not visibly soiled, wipe external surfaces of large portable equipment
(e.g. X-ray machines and ultrasound machines) that has been used in the
isolation room or area with an approved hospital disinfectant upon removal
from the patient’s room or area
Disinfection of
Patient areas after
discharge
◦ If a room is used for a procedure it should be left for 20
minutes, cleaned before it can be ready for re-use
◦because the large particles will fall out within seconds and the
small aerosol particles will behave almost as a gas
◦Clearance of any aerosol is dependent on the ventilation of the
room
◦In hospitals this is usually around 12-15 air changes per hour,
and so after about 20 minutes there would be less than 1 per
cent of the starting level (assuming cessation of aerosol
generation)
◦to allow the removal of 99.9% airborne contaminants in the air
Isolation Precautions
and PPEsshould be observed for all
◦Standard precautions
patients
◦Its most important component is hand hygiene
◦using alcohol or alcohol-based hand rub before and after
all patient contact, contact with potentially infectious
material, and before putting on and upon removal of PPE,
including gloves
◦Hand hygiene in healthcare settings also can be performed
by washing with soap and water for at least 20 seconds
specially when hands are visibly soiled
Isolation Precautions
and PPEs
◦Contact and Droplet Precautions
◦In addition to using standard precautions, all individuals, including family
members, visitors and HCWs, should use contact and droplet precautions
before entering the room where suspected or confirmed nCoV patients are
admitted
◦HCWs should use N95, wear eye protection (goggles) or facial protection (face
shield) to avoid contamination of mucous membranes, wear clean, non-
sterile, long-sleeved gowns, and gloves
◦The use of boots, coverall and apron is NOT required during routine care
◦After patient care, appropriate doffing and disposal of all PPEs and hand
hygiene should be carried out
◦A new set of PPEs is needed, when care is given to a different patient
Isolation Precautions
and PPEs
◦Equipment should be either single-use and disposable or dedicated equipment
(e.g. stethoscopes, blood pressure cuffs and thermometers)
◦If equipment needs to be shared among patients, clean and disinfect it between
use for each individual patient (e.g., by using 70% ethyl alcohol)
◦HCWs should refrain from touching eyes, nose or mouth with potentially
contaminated gloved or bare hands
◦Avoid moving and transporting patients out of their room or area unless
medically necessary
◦Use designated portable X-ray equipment and/or other designated diagnostic
equipment
◦If transport is required, use predetermined transport routes to minimize
exposure for staff, other patients and visitors, and have the patient use a
medical mask
Isolation Precautions
and PPEs
◦Ensure that HCWs who are transporting patients perform hand
hygiene and wear appropriate PPE as well
◦Notify the area receiving the patient of any necessary precautions
as early as possible before the patient’s arrival
◦Routinely clean and disinfect surfaces which the patient has come
in contact with
◦Limit the number of HCWs, family members and visitors who are
in contact with a suspected and confirmed 2019-nCoV patient
◦It’s important to maintain a record of all persons entering the
patient’s room, including all staff and visitors
Isolation Precautions
and PPEs
◦The minimum required PPEs depend on the tasks of the
persons involved in the process
◦Routine care for the suspected and confirmed nCoV patients
requires standard, droplet and contact precautions from triage
to inpatient care
◦Care of confirmed cases where aerosols are generated requires
step-up to airborne precautions
Isolation Precautions
and PPEs
◦Unless changed in future date, PPEs are single use and disposed after
use in one patient
◦The usage of the PPEs must be balanced between the HCW safety and
the resources available
◦If a sufficient supply of respirators is not available, healthcare facilities
may consider extended use or reuse as long as the device has not
been obviously soiled or damaged (eg. creased or torn
◦ Data on reuse of respirators for 2019 novel coronaviruses are not available
◦ Reuse may increase the potential for contamination; however, this risk
must be balanced against the need to fully provide respiratory protection
for healthcare personnel
Isolation Precautions
and PPEs
◦ Extended use
◦ refers to the practice of wearing the same N95 respirator for repeated
close contact encounters with several patients, without removing the
respirator between patient encounters
◦ may be implemented when multiple patients are infected with the same
respiratory pathogen and patients are placed together in dedicated
waiting rooms or hospital wards
◦ recommended as an option for conserving respirators during previous
respiratory pathogen outbreaks and pandemics
Isolation Precautions
and PPEs
◦ Reuse
◦ using the same N95 respirator for multiple encounters with patients but
removing it (‘doffing’) after each encounter
◦ Even when N95 respirator reuse is practiced or recommended,
restrictions are in place which limit the number of times the same N95
mask can be reused
◦ Respirator reuse is often referred to as “limited reuse”
◦ Limited reuse has been recommended and widely used as an option for
conserving respirators during previous respiratory pathogen outbreaks
and pandemics
Isolation Precautions
and PPEs
◦ Extended use is favored over reuse because it is expected to involve less
touching of the respirator and therefore less risk of contact transmission
◦ A key consideration for safe extended use is that the respirator must maintain
its fit and function
◦ Workers in other industries routinely use N95 respirators for several hours
uninterrupted
◦ Experience in these settings indicates that respirators can function within their
design specifications for 8 hours of continuous or intermittent use
◦ the maximum length of continuous use in non-dusty healthcare workplaces is
typically dictated by hygienic concerns (e.g., the respirator was discarded
because it became contaminated) or practical considerations (e.g., need to
use the restroom, meal breaks, etc.), rather than a predetermined number of
hours
Isolation Precautions
and PPEs
◦ Discard N95 respirators following use during aerosol generating
procedures
◦ Discard N95 respirators contaminated with blood, respiratory or nasal
secretions, or other bodily fluids from patients
◦ Discard N95 respirators following close contact with, or exit from, the care
area of any patient co-infected with an infectious disease requiring contact
precautions
◦ Consider use of a cleanable face shield (preferred) or a surgical mask over
an N95 respirator and/or other steps (e.g., masking patients, use of
engineering controls) to reduce surface contamination
Isolation Precautions
and PPEs
◦ Perform hand hygiene with soap and water or an alcohol-based hand
sanitizer before and after touching or adjusting the respirator (if necessary
for comfort or to maintain fit)
◦ Extended use alone is unlikely to degrade respiratory protection. However,
healthcare facilities should develop clearly written procedures to advise
staff to: o Discard any respirator that is obviously damaged or becomes
hard to breathe through
Close Contact
◦ Greater than 15 minutes face-to-face contact in any setting with a
confirmed case in the period extending from 24 hours before onset of
symptoms in the confirmed case
◦ Sharing of a closed space with a confirmed case for a prolonged period (ie.
more than 2 hours) in the period extending from 24 hours before onset of
symptoms in the confirmed case
◦ Living in the same household or household-like setting (ie. in a boarding
school or hostel)
◦ Direct contact with the body fluids or laboratory specimens of a case
without recommended PPE or failure of PPE
Close Contact
◦ A person who spent 2 hours or longer in the same room (such as a GP or ED
waiting room)
◦ A person in the same hospital room when an aerosol generating procedure is
undertaken on the case, without recommended PPE.
◦ Aircraft passengers/long bus trip passengers who were seated in the same row
as the case, or in the two rows in front or two rows behind a confirmed 2019-
nCoV case
◦ All crew-members on an aircraft who worked in the same cabin area as a
confirmed case of 2019-nCoV
◦ Note that healthcare workers and other contacts who have taken recommended
infection control precautions, including the use of full PPE, while caring for a
symptomatic confirmed 2019-nCoV case are not considered to be close contacts
Isolation and
Restriction
◦ Asymptomatic close contacts should be advised to selfquarantine at home for 14
days following the last contact with the case, and to monitor their health for 14
days after the last possible contact with a confirmed 2019-nCoV case
◦ Persons who will be cared for in the community must be educated accordingly by
the institutions which send them home ie BOQ, hospital, physician;
◦ Monitoring of close contacts in the community should likewise be efficient,
systematic and documented by DOH RESU;
◦ Updating the public in a timely manner will improve their adherence to
recommendations and reduce excessive anxiety and fear (PSMID/DOH)
◦ Information from other agencies or individuals should get clearance from the DOH
before release
◦ Sources of fake news will not be tolerated
 What is the
prognosis?
◦Most people (about 80%) recover from the disease
without needing special treatment
◦1 out of every 6 people becomes seriously ill and
develops difficulty breathing
◦Older people
◦underlying medical problems like high blood pressure,
heart problems or diabetes, are more likely to develop
serious illness
◦2% of people with the disease have died
 How to prevent spread of COVID-19?
◦Clean your hands with an alcohol-based hand rub or wash
them with soap and water regularly and thoroughly to kill
the viruses
◦Avoid touching your eyes, mouth, or nose
◦Hands touch many surfaces and can pick up viruses and
can transfer the virus to your eyes, nose or mouth
◦the virus can enter your body and can make you sick
◦If you think a surface may be infected, clean it with simple
disinfectant to kill the virus
 How to prevent spread of COVID-19?
◦Avoid close contact with anyone showing symptoms of
respiratory illness such as coughing and sneezing (at
least 1 meter distance)
◦they spray small liquid droplets from their nose or
mouth which may contain virus
◦if you are too close, you can breathe in the droplets,
including the COVID-19 virus if the person coughing
has the disease
◦Stay home if you feel unwell
 How to prevent spread of COVID-19?
◦To protect yourself, such as when visiting live animal
markets, avoid direct contact with animals and surfaces
in contact with animals
◦Ensure good food safety practices at all times
◦Thoroughly cooking meat and eggs
◦Handle raw meat, milk or animal organs with care to
avoid contamination of uncooked foods
◦Avoid consuming raw or undercooked animal products
 How to prevent spread of COVID-19?
◦If you have a fever, cough and difficulty breathing, seek
medical attention and call in advance
◦Follow the directions of your local health authority
◦National and local authorities will have the most up to
date information on the situation in your area
◦Calling in advance will allow your health care provider
to quickly direct you to the right health facility
◦This will also protect you and help prevent spread of
viruses and other infections
 How to prevent spread of COVID-19?
◦Stay informed on the latest developments about
COVID-19
◦Follow advice given by your healthcare provider, your
national and local public health authority or your
employer on how to protect yourself and others from
COVID-19
How to prevent spread of COVID-19?
persons who are in or have
recently visited (past 14
days) areas where COVID-19
◦Stay at home if you begin to feel unwell, even with mild symptoms
is
suchspreading
as headache and slight runny nose, until you recover
◦If you develop fever, cough and difficulty breathing, seek medical
advice promptly as this may be due to a respiratory infection or
other serious condition
◦Call in advance and tell your provider of any recent travel or contact
with travelers
◦allow your health care provider to quickly direct you to the right health
facility
◦also help to prevent possible spread of COVID-19 and other viruses
persons who are in or have
recently visited (past 14
days) areas where COVID-19
◦People with no respiratory symptoms, such as cough, do not
is
needspreading
to wear a medical mask
◦WHO recommends the use of masks for people who have
symptoms of COVID-19 and for those caring for individuals who
have symptoms, such as cough and fever
◦The use of masks is crucial for health workers and people who are
taking care of someone (at home or in a health care facility)
◦WHO advises rational use of medical masks to avoid
unnecessary wastage of precious resources and mis-use of
masks
persons who are in or have
recently visited (past 14
days) areas where COVID-19
◦A suspected COVID-19 infection is linked to travel in areas
is spreading
where cases have been reported, or close contact with
someone who has travelled in these areas and has become ill
◦protect yourself and others against COVID-19 by:
◦frequent cleaning your hands
◦cover your cough with the bend of elbow or tissue
◦maintain a distance of at least 1 meter (3 feet) from people who are
coughing or sneezing
◦The risk depends on where you live or where you have travelled recently
persons who are in or have
recently visited (past 14
days) areas where COVID-19
◦The risk of infection is higher in areas where a number people
is
havespreading
been diagnosed with COVID-19
◦ More than 95% of all COVID-19 cases are occurring in China, with
the majority of those in Hubei Province
◦ For people in most other parts of the world, your risk of getting
COVID-19 is currently low, however, it’s important to be aware of the
situation and preparedness efforts in your area.
◦WHO is working with health authorities in China and around the
world to monitor and respond to COVID-19 outbreaks
persons who are in or have
recently visited (past 14
days) areas where COVID-19
◦For people in most other parts of the world, your risk of
is spreading
getting COVID-19 is currently low, however, it’s
important to be aware of the situation and
preparedness efforts in your area
◦WHO is working with health authorities in China and
around the world to monitor and respond to COVID-19
outbreaks
What to do and give
patients with COVID-
19?
◦those affected should receive supportive care to relieve symptoms
◦People with serious illness should be hospitalized
◦COVID-19 is caused by a virus, so antibiotics do not work
◦Antibiotics should not be used as a means of prevention or treatment of
COVID-19
◦They should only be used as directed by a physician to treat a
bacterial infection
◦there is no vaccine and no specific antiviral medicine to prevent or treat
COVID-2019
◦Possible vaccines and some specific drug treatments are under
investigation
What to do and give
patients with COVID-
19?
◦The following measures ARE NOT effective against
COVID-2019 and can be harmful:
◦Smoking
◦Taking traditional herbal remedies
◦Wearing multiple masks
◦Taking self-medication such as antibiotics  
What to do and give
patients with COVID-
19?
◦For patients who have mild illness, e.g., low-grade fever,
cough, malaise, rhinorrhoea, sore throat without any warning
signs, such as shortness of breath or difficulty in breathing,
increased respiratory (i.e. sputum or haemoptysis), gastro-
intestinal symptoms such as nausea, vomiting, and/or
diarrhoea and without changes in mental status,
hospitalization may not be required unless there is concern for
rapid clinical deterioration
◦All patients discharged home should be instructed to return to
hospital if they develop any worsening of illness
 KEY MESSAGES
• Keep yourself healthy through proper nutrition and
enough rest
• Stay away from crowded places if not feeling well
• Practice at all times proper handwashing and
coughing etiquette.
• Seek early consultations if experiencing any
symptom like fever, cough and colds
• Refrain from sharing unverified information that may
cause undue panic and concern
 References
• www.doh.gov.ph/2019-nCov
• World Health Organization
• Philippine Society for Microbiology and Infectious Diseases (PSMID)
• Department of Health