Coronavirus outbreak prompts CDC guidance, free ACP resources

The CDC issued interim guidance for treatment of people potentially exposed to 2019 novel coronavirus (2019-nCoV). Travelers who have been in Hubei Province of China within 14 days have a high risk of exposure to 2019-nCoV based on the scope and magnitude of the epidemic. These travelers should be managed as having high-risk exposure, and those who are symptomatic should undergo immediate isolation and diagnostic testing for 2019-nCoV, the agency said.

People with confirmed 2019-nCoV infection should remain in isolation, either at home or in a health care facility, until they are determined by public health authorities and the CDC to be no longer infectious. The location of isolation will be determined by public health authorities and isolation may be compelled by public health order, if necessary.

For most travelers from mainland China outside Hubei province, the exposure risk is unknown but believed to be lower, per the CDC. Travelers with known exposure to a laboratory-confirmed case of 2019-nCoV should be managed similarly to high-risk patients. CDC has assigned a medium-risk level to travelers from mainland China outside Hubei Province who have no known high-risk exposures. Geographic exposures do not apply to people who only moved through an airport.

Much is still unknown about how 2019-nCoV spreads, and recommendations are based on what is known about similar coronaviruses, the CDC said. Person-to-person spread is thought to occur when an infected person coughs, spreading airborne droplets, similar to influenza viruses and other respiratory pathogens. It is currently unclear if a person can get 2019-nCoV by touching a surface or object that has the virus on it and then touching their own mouth, nose, or eyes.

The CDC reported on 2019-nCoV in mainland China. Since then, cases have been reported in 26 additional locations, including the United States.

ACP developed freely available educational content related to the virus as a public service for the health care community. “Novel Coronavirus: A Physician's Guide” is an online learning activity that can be easily accessed on handheld devices and provides a clinical overview of infection control and patient care guidance. A podcast, “Coronavirus: What the Clinician Needs to Know,” was produced by Core IM in collaboration with ACP, and includes an interview with Christina Fiske, MD, an infectious diseases subspecialist at Vanderbilt University Medical Center.

For these coronavirus education activities, ACP members may report their learning time for CME credit without charge. ACP members are asked to share these resources with others in the health care community.

In addition, a letter published by Annals of Internal Medicine on Feb. 5 suggests that 2019-nCoV may not be under control in China despite aggressive control efforts since mid-January. Researchers combined data from publicly available case reports with a computer model of epidemic growth to determine whether China has been able to control the epidemic. Models suggest that case counts reported in the media give a misleading view of the epidemic, the authors said. They created an interactive tool that can be used to estimate the trajectory of the epidemic as new data emerges.