>COVID-19 – SJRH and New Brunswick

This post is provided as an information resource specifically for HealthCare Professionals within the Saint John Region and New Brunswick Emergency Departments

This post is updated regularly

SJRHEM COVID-19 Pages


COVID-19

New Brunswick Public Health – Link

Trauma New Brunswick Program

WorkSafe New Brunswick


Academic Activity – Dal, DMNB, Residents, News, Cancellations


Staff Wellness

 


What is COVID-19

  • A novel betacoronavirus first reported in Wuhan, China on December 31st 2019
  • Symptoms for the novel coronavirus are similar to those for influenza or other respiratory illnesses.
  • New Brunswick Case Definition – see below– Note this continues to evolve
  • Current assumptions are that spread is via droplet and/or fomite to face
  • Infection Prevention and Control = Contact and Droplet precautions

COVID-19 – SOURCES OF INFORMATION

SJRHEM GRAND ROUNDS

 


SJRHEM Activity During the Pandemic


NB Health Screening Tool and Referral forms to Community Assessment Centres – 27 May 2020 

For community referral for COVID-19 screening and testing:

Referral Form – Combined Referral and Order Form

FAX Number = 506 462-2040

 


Horizon Screening Questions – May 29

Download pdf

 


Self-Isolation Information Leaflet for Patients

Self-Isolate and Alternative Self-Isolate Leaflet

Self Management COVID

 

 


 

COVID-19 Testing – Public Health Advice and Viral Swabs 

Summary of Current Guidance (May 26)

“Every New Brunswicker should remain vigilant,” said Dr. Jennifer Russell, chief medical officer of health. “Please continue to limit your close contacts to prevent the chance of spreading the virus, especially to those who are more vulnerable to complications of COVID-19. Although community transmission has not been confirmed, it is important to be aware that it remains a possibility.”

Up-to-date information about COVID-19, including the latest data on confirmed cases and laboratory testing in New Brunswick is available online.

New Brunswick is currently in Phase 3 (Yellow) of the COVID-19 recovery. Information on public health recovery phases, measures and guidelines is available online.

Dr. Jennifer Russell, chief medical officer of health, announced that testing would now be recommended for people exhibiting at least two of the following five symptoms:

  • fever above 38°C or signs of fever;
  • a new cough or worsening chronic cough;
  • sore throat;
  • runny nose;
  • headache:
  • New onset fatigue;
  • New onset muscle pain;
  • Diarrhea;
  • Loss of sense of taste or smell; and
  • In children, purple markings on fingers or toes

Those who are exhibiting at least two of these symptoms are advised to immediately self-isolate and contact 811 or their family physician for further direction. Symptoms can range from relatively mild (runny nose and sore throat) to severe such as difficulty breathing.

Summary of Current Guidance  (April 2):

The COVID-19 pandemic is rapidly evolving around the world and within Canada. At variable points in the last few weeks, many parts of Canada including Quebec have started seeing community transmission. This had led to additional concern and control measures applied to travel outside of the province. In addition, New Brunswick is now also entering the community transmission phase.

Because of these dynamics, we will be transitioning from focusing on identifying cases imported into the province as a control measure to focusing testing priorities in our province on protecting our most vulnerable populations/settings and maintaining critical health system capabilities.

Given this transition, the following are key points when clinically evaluating patients (virtually or in person) and deciding on testing:

  • Conduct a clinical assessment – clinical case definition still includes fever/history of fever and/or new onset/exacerbation of chronic cough. Other symptoms may include headache, sore throat or coryza.
    • Test those with moderate to severe symptoms (such as signs of pneumonia, dyspnea, blood O2 saturation <94%) including those who require hospitalization.
    • Recommend testing patients with risk factors such as age 60 +, hypertension, cardiovascular disease, chronic respiratory disease, diabetes, and cancer.
    • People living in crowded settings or limited capacity to self-isolate due to same

Assessment centers will be testing all referrals moving forward, and not providing secondary screening, so please ensure referrals have been clinically assessed appropriately, virtually or in person, prior to completing a referral form.

  • Test Priority groups (even with mild symptoms) – to maintain the integrity of the health care system and prevent transmission in clinical and other vulnerable group settings
    • Symptomatic health care professionals, such as physicians, nurse practitioners, nurses, pharmacists, laboratory technologists, Ambulance NB, first responders, emergency medical dispatchers, Extra Mural program
    • Staff in hospitals, nursing homes, and other institutional or group living settings with direct patient care/contact
    • Patients/residents in institutional and group living settings with vulnerable populations (including within RHA, long term care, shelters, correctional facilities, adult residential facilities)
  • Consider and inquire about exposure criteria (travel outside New Brunswick or close contact/group exposure setting (ie gathering, work setting), either within the last 14 days), but absence of such no longer excludes a patient from testing. Identification of exposure risks and clusters remains a critical public health strategy in managing COVID-19 even in the context of community transmission.
  • There are no specific directives to NOT test certain individuals or groups of individuals at this time, continue to use your professional judgement but please be aware that the situation may change quickly in the coming days to weeks, depending on capacity.
  • Full Document Here – April 2
  • 5 Hospitals across NB, only SJRH in R2
  • 5 per day of those being discharged
  • 5 per day of those being admitted
  • Use pre labeled ‘sentinel swab’
  • Fever or Cough but NO travel or contact hx

 

How to Collect NP Swab

 


Case Definition – New Brunswick

based on the Canada Public Health  –  NB Interim national case definition  – March 24

Person under investigation (PUI)

A person with fever and/or cough who meets the exposure criteria and for whom a laboratory test for COVID-19 has been or is expected to be requested.

Probable

A person:

  • with fever (over 38 degrees Celsius) and/or new onset of (or exacerbation of chronic) cough
    AND
  • who meets the COVID-19 exposure criteria
    AND
  • in whom laboratory diagnosis of COVID-19 is inconclusive,negative (if specimen quality or timing is suspect), or
    positive but not confirmed by the National Microbiology Laboratory (NML)

Confirmed

A person with laboratory confirmation of infection with SARS-CoV-2 as a result of nucleic acid amplification testing (NAAT).

 

SJRHEM ADVICE – 19 March 2020

Consider any patient who presents with an Influenza Like Illness – irrespective of above case definition as being suspicious for COVID-19 and take appropriate PPE precautions.


Exposure Criteria

In the 14 days before onset of illness, a person who:

  • Traveled to an affected area i.e. anyone who travelled outside New Brunswick. OR
  • Had close contact with a person with acute respiratory illness who has been to an affected area (anyone who travelled outside NB within 14 days prior to their illness onset) OR
  • Had laboratory exposure to biological material (e.g. primary clinical specimens, virus culture isolates) known to contain COVID-19.

Close contact = A close contact is defined as a person who provided care for the patient, including healthcare workers, family members or other caregivers, or who had other similar close physical contact or who lived with or otherwise had close prolonged contact with a probable or confirmed case while the case was ill.


Affected Areas

Public Health Canada Affected Area List

UPDATEAll travel outside New Brunswick


 

 

 

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