Last week we sent our customers a new policy on the prevention of the coronavirus COVID-19. The policy was based on Guidance for Social or Community care and Residential Settings on COVID-19 published by the Department of Health 25th February 2020.
According to Public Health England, it remains very unlikely that people receiving care in a care home or the community will become infected. This advice I suggest should be taken with a deal of caution. I would venture to say that it will depend on three conditions:
Awareness and understanding of the virus
Action to be taken to prevent the spread of the virus
Trust in staff, visitors and other professionals who visit the home taking appropriate action if they suspect they are infected by the disease.
It is important that staff gain an understanding of how COVID-19 is spread and what actions to take to prevent it. The coronavirus is spread by coming into close contact with an infected person. Infection can be spread to people who are nearby (within 2 metres) or possibly could be inhaled into the lungs by a person in close proximity.
It is most likely that respiratory secretions are the main source of cross contamination.
Contact infection such as touching surfaces, infected door knob, or hand contact that have become infected is another method of being exposed to the virus. From contact, it is known that the virus can enter the body by the person’s hands touching their mouth, nose or eyes and infecting themselves.
The survival of coronavirus is dependent on a number of conditions.
What surface the virus is on.
Whether it is exposed to sunlight.
Differences in temperature and humidity.
Exposure to cleaning products.
Usually, the threat of infection will significantly decrease after 72 hours of the virus coming into contact with a surface.
Signs and symptoms of the coronavirus
Providers of care services should be aware of the signs and symptoms of coronavirus. Symptoms may be evident in the person, 14 days after exposure. Signs of infection are associated with:
Fever or raised body temperature.
Difficulty in breathing.
The severity of symptoms can be more severe with people who have a weakened immune system. This would typically effect older people or people with complex illness such as cancer, diabetes or lung disease.
Action to prevent the spread of infection
Given that there is currently no vaccine to prevent COVID-19. The best way to prevent infection is to avoid being exposed to the virus.
There are a number of measures people can carry out to reduce the potential for cross contamination. The following are general principles that staff and Service Users can follow to prevent the spread of the virus, including:
Washing your hands often - with soap and water or use alcohol sanitiser that contains at least 60% alcohol if hand washing facilities are not available - this is particularly important after taking public transport.
Covering your cough or sneeze with a tissue, then throwing the tissue in a bin.
People who feel unwell should stay at home and should not attend work.
Properly washing hands
Health Authorities stress the importance of washing hands regularly and properly as the most effective means of preventing the spread of COVID-19.
Staff should wash their hands:
Before leaving home.
On arrival at work.
After using the toilet.
After breaks and sporting activities.
Before food preparation.
Before eating any food, including snacks.
Before leaving work.
On arrival at home.
Avoid touching your eyes, nose, and mouth with unwashed hands.
Clean and disinfect frequently touched objects and surfaces.
See National Patient Safety Agency Hand Cleaning techniques.
If staff are worried about their symptoms or those of a family member or colleague, they must be trusted to take the appropriate action call NHS 111 and report the concern to their line manager. They should not go to their GP or other healthcare environment.
Omissions of the PHE
I would have liked to have seen some guidance from PHE (Public Health England) for providers on a strategy for managing visitors to prevent the spread of infection. Bettal suggest at the very least visitors should be made aware of their responsibilities if they are concerned that they may have the symptoms of the virus.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy