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Coronavirus: What you need to know

A Guardsmen with the 341st Military Intelligence Battalion conducts translation work on a safety message regarding the best practices for avoiding the novel coronavirus for the Washington Department of Health on Feb. 9, 2020 at the Information Operations Readiness Center, Joint Base Lewis-McChord, Wash. (Courtesy Photo) A Guardsmen with the 341st Military Intelligence Battalion conducts translation work on a safety message regarding the best practices for avoiding the novel coronavirus for the Washington Department of Health on Feb. 9, 2020 at the Information Operations Readiness Center, Joint Base Lewis-McChord, Wash. (Courtesy Photo)

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JOINT BASE LEWIS-McCHORD, Wash. -- Novel coronavirus, known as COVID-19, continues to spread worldwide.

As COVID-19 spreads, so does information about the disease. If one surfs the Internet, everything from scientifically-proven medical information about the virus to debunked conspiracy theories can be found.

More than 95,000 cases have been reported worldwide, and COVID-19 has killed more than 3,300 people, mostly in mainland China.

The disease has spread wider in Washington state, where ten people have died. A 71-year-old-man in California with underlying health conditions passed away from the disease this week, bringing the nationwide death total to 11.

Washington Gov. Jay Inslee declared a state of emergency on Feb. 29, a number of school districts have cancelled classes, and more than 50 people in a Seattle-area nursing facility are being tested for the virus.

According to the Centers for Disease Control, there were 205 confirmed cases of COVID-19 in the U.S. as of March 5. The disease has spread to 17 U.S. states. The Washington State Department of Health reported 70 cases in the state as of March 5.

Among the information circulating online are lists of items people "should buy" -- surgical masks, exam gloves, gallons of disinfectant -- but epidemiologists and preventive medicine practitioners say that's not exactly the case.

While there is currently no vaccine to protect against COVID-19 and no specific antiviral treatment for the disease, Lt. Gen. Ronald J. Place, director of the Defense Health Agency, stated in a March 5 email to the force that "Each of you can take actions to help respond to this emerging public health threat."

Place's email also stated, "The CDC has produced more than 23 guidance documents on infection control, hospital preparedness assessments, personal protective equipment supply planning, and clinical evaluation and management."

According to the CDC, symptoms of COVID-19 can include fever, cough, and shortness of breath. The CDC believes that symptoms of the disease may appear in as little as two days or up to 14 days after someone has been exposed.

The CDC based this estimate on previous incubation periods for Middle East Respiratory Syndrome, another type of coronavirus, first reported in 2012.

The CDC said there are simple actions people can take to prevent contracting or spreading COVID-19.

The best way to keep from getting sick, according to the CDC, is to avoid being exposed to the virus that causes COVID-19.

The Department of Defense issued guidance in January, mirroring that of the CDC. The DoD guidance recommended that people should also avoid close contact with those who are sick; avoid touching your eyes, nose and mouth with unwashed hands; and washing your hands often with soap and water.

The CDC recommends washing hands for at least 20 seconds, especially after going to the bathroom, before eating, after blowing one's nose, coughing or sneezing.

Although news stories and images contain many reports of people wearing surgical masks to ward off the virus, that's not recommended, according to top officials of the U.S. Public Health Service.

The U.S. Surgeon General, Dr. Jerome Adams, even went so far as to post a message on Twitter last weekend.

"Seriously people- STOP BUYING MASKS!" Jerome tweeted. "They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can't get them to care for sick patients, it puts them and our communities at risk!"

The CDC and DoD also recommend using an alcohol-based hand sanitizer that is at least 60 percent alcohol if soap and water aren't available.

The spread of coronavirus has led to a shortage of hand sanitizers and disinfectants in stores, and Army and Air Force Exchange Service locations haven't been spared.

Chris Ward, senior public affairs manager at AAFES headquarters in Dallas, said in an email that the entire supply chain for hand sanitizer products and masks has been severely constrained.

"Like other retailers, the Exchange has experienced shortages of hygiene items due to a surge in demand due to COVID-19," the email stated.

Ward's email went on to state that AAFES is "aggressively working to procure additional inventory to expedite shipment to locations impacted by COVID-19," and recommended following the CDC guidance stating that hand washing is the best defense to preventing the spread of infection.

But what if someone contracts COVID-19? What should they do?

Above all, said the CDC, anyone sick with COVID-19, or if one suspects they are infected, should follow these steps:

  • Stay home, except to get medical care: Restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas. Avoid using public transportation, ride-sharing, or taxis.
  • Separate yourself from other people and animals in your home: As much as possible, stay in a specific room and away from other people in the home. Also, use a separate bathroom, if available.
  • Call ahead before visiting your doctor: Call the healthcare provider and tell them that you have or may have COVID-19. This will help the healthcare provider's office take steps to keep other people from getting infected or exposed.
  • Cover your coughs and sneezes: Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues in a lined trash can. Immediately wash your hands with soap and water for at least 20 seconds.
  • Clean your hands often: Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
  • Avoid sharing personal household items: Don't share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home. After using these items, they should be washed thoroughly with soap and water.
  • Clean all "high-touch" surfaces every day: High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also, clean any surfaces that may have blood, stool, or body fluids on them. Use a household cleaning spray or wipe, according to the label instructions.
  • Monitor your symptoms: Seek prompt medical attention if your illness is worsening, such as if you have difficulty breathing). Before seeking care, call your healthcare provider and tell them that you have, or are being evaluated for, COVID-19.

The CDC also said that those patients with confirmed COVID-19 should remain under home isolation precautions until the risk of secondary transmission to others is thought to be low. The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments.

For the most up-to-date information on COVID-19, visit the CDC's website. Specific Military Health System information about COVID-19 can be found at health.mil/News/In-the-Spotlight/Coronavirus.

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DoD COVID-19 Practice Management Guide Version 7

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This Practice Management Guide does not supersede DoD Policy. It is based upon the best information available at the time of publication. It is designed to provide information and assist decision making. It is not intended to define a standard of care and should not be construed as one. Neither should it be interpreted as prescribing an exclusive course of management. It was developed by experts in this field. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of this guideline is responsible for evaluating the appropriateness of applying it in the setting of any particular clinical situation. The Practice Management Guide is not intended to represent TRICARE policy. Further, inclusion of recommendations for specific testing and/or therapeutic interventions within this guide does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found at www.tricare.mil or by contacting your regional TRICARE Managed Care Support Contractor.

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