Updated: February 19

World Health Organization (WHO) Public Health Emergency

WHO declared the COVID-19 outbreak a public health emergency of international concern on January 30, 2020, after they identified that the novel coronavirus is expected to continue spreading internationally and may appear in any country.

WHO defines a public health emergency of international concern as “an extraordinary event” that identifies a “public health risk to other States through the international spread of disease” and “to potentially require a coordinated international response.” Previous public health emergencies have included Ebola, Zika and H1N1.

Thus, this declaration is for a global call rather than an individual call. They are asking all countries to be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and preventing the spread of COVID-19 infections.


United States Public Health Emergency

The Secretary of the Department of Health and Human Services (DHHS) declared a public health emergency in the United States on January 31, 2020. The emergency declaration gives state, tribal and local health departments the ability to request that DHHS provide funding, supplies and resources to respond to COVID-19.

LOCATIONS WITH CONFIRMED COVID-19 CASES

This declaration does not change anything in respects to response or treatment of members, it is more of a call to be prepared that this outbreak may become more widespread. To be prepared, refer to our preparation section below and take the necessary steps to ensure your department is prepared if COVID-19 becomes a serious concern in the United States.


United States COVID-19 Cases

All individuals brought back to the United States through repatriation trips are quarantined for 14 days on various military bases or medical facilities. If they show no signs or symptoms, they can return home. These actions are being taken to protect your health, the health of other travelers and the health of U.S. communities from spreading COVID-19.

International Travel Screening

American citizens, lawful permanent residents and their families who have been in China in the past 14 days will be allowed to enter the United States, but will be redirected to one of 11 airports to undergo health screening. Depending on their health and travel history, they will have some level of restrictions on their movements for 14 days from the time they left China.

If you do not have symptoms: You will be allowed to reach your final destination but asked to monitor your health for a period of 14 days from the time you left China. You will receive a health information card that tells you what symptoms to look for and what to do if you develop symptoms. During that time, you should stay home and limit interactions with others as much as possible.

Diamond Princess Cruise Ship

There were approximately 400 U.S. citizens onboard the Diamond Princess cruise ship. The U.S. government disembarked the majority of the U.S. citizens from the ship and brought them back to the United States on February 18, 2020. Of those brought back, 14 passengers tested positive for COVID-19 and are being treated at a medical facility in Omaha, Nebraska. The other passengers will be subject to a 14-day, federal quarantine and be housed at two existing federal quarantine sites for repatriated travelers:

  • Travis Air Force Base in California
  • Joint Base San Antonio-Lackland in Texas

 

Preparation and Protection for First Responders

Recommendations for 911 PSAPs

  • Municipalities and local EMS authorities should coordinate with state and local public health, PSAPs and other emergency call centers to determine the need for modified caller queries about COVID-19.
  • Development of modified caller queries should be closely coordinated with an EMS medical director and informed by local, state and federal public health authorities, including the city or county health department(s), state health department(s) and the CDC.
  • PSAPs or Emergency Medical Dispatch (EMD) centers (as appropriate) should question callers and determine the possibility that this call concerns a person who may have signs or symptoms and risk factors for COVID-19.
  • More information: Guidance for Emergency Medical Services Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States

Preparation

  • Review your department’s exposure control plan.
  • Plan to meet or connect with local and state health departments to discuss policies, procedures and precautions in case COVID-19 becomes widespread.
  • Maintain an adequate supply of N-95 and surgical masks and monitor the availability of both masks with your medical supply vendor.
  • Routinely check the IAFF website for more information about COVID-19.

Potential Exposure

  • If you treat a patient who shows signs and symptoms addressed below, document potential exposures according to your exposure control plan.
  • Notify your infection control officer.
  • If you present signs and symptoms, immediately follow up with your healthcare provider and identify your exposure.

Protection

  • The CDC recommends N-95 or P100 with eye protection
    • N-95 and higher levels of respiratory protection require fit testing
    • Eye protection should be face shield or goggles
    • Surgical masks with plastic eye lenses are inappropriate PPE
  • If possible and tolerated, place a surgical mask on patients to minimize exposure
  • Use a clean, non-sterile, long-sleeved, fluid-resistant gown
  • Gloves
  • Use either single-use, disposable equipment or dedicated equipment to decontaminate. If equipment needs to be shared among patients, clean and disinfect between each patient using ethyl alcohol (70%) or bleach solution (ratio of ¼ cup of bleach in a gallon of water)
  • Hand washing
  • Minimize patient contact in poorly ventilated areas
  • Disinfect the ambulance with bleach solution
    • Routinely clean and disinfect patient-contact areas

Decontaminating Gear and Equipment

  • Dispose of disposable respirator, respirator filters, gloves and other disposable equipment/supplies used at the scene as bio-hazardous waste.
  • If the turnout gear or station uniform is visibly contaminated by bodily fluid, it should be placed in a biohazard bag at the scene and washed following prescribed laundry procedures. Chlorinated bleach shall not be used with any fire fighter protective clothing. Fire departments should follow the decontamination guidelines in National Fire Protection Association (NFPA) 1851, Standard on Selection, Care, and Maintenance of Structural Fire Fighting Protective Ensembles.
  • Non-disposable respirators shall be cleaned and disinfected in accordance with manufacturer’s recommendation.
  • For decontamination of non-disposable equipment, follow manufacturer and departmental standard operating procedures.
  • Vehicles used to transport persons suspected of having COVID-19 should be cleaned by staff wearing protective equipment, using a bleach solution as a disinfectant cleanser.

Background of COVID-19

The recent outbreak of the novel coronavirus COVID-19 originated in Wuhan City, Hubei Province, China, and was first identified by Chinese authorities in mid-December 2019. Since then, the outbreak has resulted in hundreds of confirmed human infections and dozens of reported deaths. Currently, COVID-19 has spread to several countries – including the United States – and cases of infection are expected to rise.

Coronaviruses are a large family of viruses, some of which cause illness in people and others that circulate among animals, including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people, as seen with Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). However, COVID-19 has clearly progressed to human-to-human transmission.

Individuals who have traveled to Wuhan City, China, in the last 14 days before symptoms or have had close contact with a person who has tested positive for or is being observed for symptoms of COVID-19 should be screened for Coronavirus.


Transmission

Human coronaviruses are most commonly spread from an infected symptomatic or mildly symptomatic person to others through:

  • The air by coughing and sneezing
  • Close personal contact, such as touching or shaking hands
  • Touching objects or surfaces with the virus on it, then touching your mouth, nose or eyes before washing your hands
  • Rarely, fecal contamination

Signs and Symptoms

Common human coronaviruses usually present as mild to moderate upper-respiratory-tract illnesses, such as the common cold. These illnesses usually only last for a short time; symptoms may include:

  • Runny nose
  • Headache
  • Cough
  • Sore throat
  • Fever
  • A general feeling of being unwell

Human coronaviruses can sometimes cause lower-respiratory-tract illnesses, such as pneumonia or bronchitis. This is more common in people with cardiopulmonary disease, people with weakened or compromised immune systems, infants and older adults.


Travel Advisory

Effective January 17, 2020, travelers from Wuhan to the United States will undergo entry screening for symptoms associated with COVID-19 at U.S. airports that receive travelers from Wuhan, China. The Centers for Disease Control (CDC), working with the Department of Homeland Security (DHS), also will direct all travelers arriving in the United States from Wuhan, China, to airports conducting entry health screenings.

On January 27, 2020, the CDC has raised the travel advisory to a Level 3 warning: Avoid all nonessential travel to China. Chinese authorities are imposing quarantines and restricting travel throughout the country.

There is also a Level 4 warning to not travel to the Hubei province, China, due to novel coronavirus first identified in Wuhan, China.


Follow Up

The IAFF is continuing to monitor news sources and agency updates from the CDC, the World Health Organization (WHO) and the Occupational Safety and Health Administration (OSHA) for the latest information and guidance.


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