The risk of severe disease increases steadily as people age. The new coronavirus that causes COVID-19 can be transmitted through saliva droplets coughed into the air. If you're having problems using a document with your accessibility tools, please contact us for help. Accessibility- We aim to provide documents in an accessible format. Prior … droplet precautions, for microorganisms transmitted by the large droplet route (refer to List 4) airborne precautions, for microorganisms transmitted over extended time and distance by small particles (refer to List 5) Additional precautions—Implementing and discontinuing additional precautions. For more information, please contact the It is important to note that COVID-19 is a new disease, therefore there is limited information regarding risk factors for severe disease. Epub 2005 Nov 1. Complete the Person Under Investigation (PUI) Assessment Wear gowns, gloves, eye protection (goggles or face shield), and N95 respirator if the facility has a respiratory protection program. What We Know About Droplets, Aerosols And Fomites : Goats and Soda ... Droplet. In practical terms, this involves all of the following: appropriate patient placement and staff use of the following personal protective equipment (PPE): gloves, gown, facemask, and goggles or a face shield. 2021 Jan 17;13(1):121. doi: 10.3390/v13010121. 2005;5(17):1-52. Respiratory protection program for all HCWs (e.g., N95 respirator fit-testing) 2. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. Strategic Priority IPC Activities for Containment and Prevention, Identification of Healthcare Workers and Inpatients with Suspected COVID-19, Management of Visitors to Healthcare Facilities, Interim Operational Considerations for Public Health Management of Healthcare Workers Exposed to or Infected with COVID-19. During the COVID-19 pandemic, isolation rooms should be used in the A physical distance of at least 1 meter (3 ft) between persons is suggested by the World Health Organization (WHO) to avoid infection, although some WHO member states have recommended maintaining greater distances whenever possible1. 2020 Jul 3:1-22. doi: 10.1017/ice.2020.321. COVID-19 is primarily transmitted from person-to-person through respiratory droplets. Remdesivir, which is also an investigational drug, received Food and Drug Administration (FDA) emergency use authorization for treatment of hospitalized patients. Published by Oxford University Press for the Infectious Diseases Society of America. 5 Put on gloves Ensure gloves are placed over the cu˜ of the gown. Long-term effects (long COVID) Find out about the long-term effects coronavirus can … 2021 Jan 7;149:e16. Policies and procedures should be implemented for the prevention and control of transmission of COVID-19 including: 1. COVID-19: Droplet and Contact Precautions Acute Care 1 of 2 Coronavirus Disease 2019 (COVID-19) Droplet and Contact Precautions Non-Acute Care Facilities This document was adapted from the Routine Practices Additional Precautions for the management of COVID-19 for health care workers. It’s able to travel only a short distance before gravitational forces pull it down. Get a test to check if you have coronavirus, understand your test result and find out what to do if you're contacted by NHS Test and Trace. Of ten studies on horizontal droplet distance, eight showed droplets travel more than 2 m (≈6 ft), in some cases more than 8 meters (≈26 ft). 2-7 In an … 1,023 (49%) deaths were reported among the 2,087 critically ill patients. Critical (respiratory failure, septic shock, and/or multiple organ dysfunction or failure, death) represented 4.7% of confirmed patients with COVID-19 in China. Airborne or aerosol spread on the other hand, is through particles small enough to be bo… Hand Hygiene Hand hygiene is … Thousands of health workers have been infected and outbreaks have occurred in hospitals, aged care facilities and prisons. The 1 - 2 m (≈3 - 6 ft) rule of spatial separation is central to droplet precautions and assumes large droplets do not travel further than 2 m (≈6 ft). o. Standard precautions remain the cornerstone of infection prevention. precautions (droplet and contact) and cohorted into a COVID-19 wing, floor, or building. IPC is a critical part of health system strengthening and must be a priority to protect patients and healthcare workers. There are currently no specific antiviral treatments licensed for COVID-19, however many treatments are under investigation. Controversy around airborne versus droplet transmission of respiratory viruses: implication for infection prevention. Online ahead of print. Transmission-Based Precautions for COVID-19 includes a combination of Contact Precautions and Droplet Precautions with the use of eye protection. A year into the COVID-19 pandemic, our understanding of how and why the coronavirus spreads continues to change, especially as new variants emerge around the world. 3. Syndromic surveillance for persons with new o… Clipboard, Search History, and several other advanced features are temporarily unavailable. These include: The estimated incubation period is between 2 and 14 days with a median of 5 days. Here's the terminology you need to … It is important to note that some people become infected and do not develop any symptoms or feel unwell. Data from several countries suggest that 14%-19% are hospitalized and 3%-5% will need intense care unit admission. If Transmission-Based Precautions are still required, the patient should go to a facility with an ability to adhere to infection prevention and control recommendations for the care of residents with SARS-CoV-2 infection. Do not put stethoscope around neck as there is potential to contaminate PPE and the head and neck region. 10. Signs or symptoms may include: 1.1. COVID-19 Directive #5: Questions and Answers Version 1 – October 8, 2020 ... • Directive 5 continues to identify Droplet and Contact Precautions as the minimum requirement for worker protection when dealing with suspect, probable and confirmed COVID-19 cases where 2 metres cannot be assured. If facilities have dedicated COVID-19 memory units, residents may continue to socialize so long as there are no COVID-19 negative residents or residents with unknown COVID-19 status in these units. However, this cannot easily be distinguished from “droplet” transmission based on epidemiologic patterns. CONTACT AND DROPLET PRECAUTIONS - COVID-19 PERSONAL PROTECTIVE EQUIPMENT (PPE) 2 Put on the gown 3 1 Perform hand hygiene Alcohol based handrub Rub hands for 20–30 seconds. STOP Saskatchewan Health Authority . This module offers a video how-to-guide on putting on and removing PPE according to droplet/contact precautions for COVID-19, as well as two poster resources. Online ahead of print. COVID-19 and Seasonal Influenza: Interim Guidance for Health Care and Public Health Providers Revised: April 27, 2020 Page | 1 . During the COVID-19 pandemic, isolation rooms should be used in the community setting for patients presenting with Influenzalike Illness (ILI)- . These coronaviruses range from the common cold to more severe diseases such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and COVID-19. Airborne precautions; and; Treatment of people who have suspected or confirmed tuberculosis (TB) disease. • Coronavirus disease 2019 (COVID-19) is defined as illness caused by a novel (new) coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; formerly ... Droplet Precautions . Several studies of SARS-CoV-2 support aerosol transmission and one study documented virus at a distance of 4 meters (≈13 ft) from the patient. positive. Advice for people at higher risk from coronavirus, including older people, people with health conditions and pregnant women. This slide deck is a reference for content on this page and can be used for training. The first largest description of patients with COVID-19 came from China, where the outbreak of COVID-19 started, and is described in detail below. If the resident later becomes symptomatic/is a confirmed case of COVID -19, staff contacts not Current data do not support long range aerosol transmission of SARS-CoV-2, such as seen with measles or tuberculosis. NLM droplet nuclei and may remain suspended in the air for significant periods of time and move with air currents. These precautions are used in addition to standard precautions. Impact of population density and weather on COVID-19 pandemic and SARS-CoV-2 mutation frequency in Bangladesh. As enveloped viruses, they are usually not viable in small droplet-nuclei. USA.gov. COVID-19 and Seasonal Influenza: Interim Guidance for Health Care and Public Health Providers Revised: April 27, 2020 Page | 1 . Among the 44,672 confirmed COVID-19 cases reported from December 31, 2019 through February 11, 2020, the clinical presentation was as follow: Mild (non-pneumonia and mild pneumonia cases) represented 80.9% of confirmed patients with COVID-19 in China. Droplet transmission occurs when bacteria or viruses travel on relatively large respiratory droplets that people sneeze, cough, or exhale. Recent data suggest that there can be transmission of COVID-19 through droplets of those with mild symptoms or those who do not feel ill2. Probable case of COVID-19: CDNA case definitions need to be accessed to ensure current criteria are referenced. If no respiratory protection program, or no Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, Tan KS, Wang DY, Yan Y. Mil Med Res. The rest of the document reviews COVID-19 IPC priorities, in non-US healthcare settings. Would you like email updates of new search results? o These residents should be placed in transmission-based precautions (droplet and contact) and cohorted into a COVID-19 wing, floor or building. When single rooms are not available, suspected COVID-19 patients should be grouped together with beds at least 1 meter (3ft) apart based on WHO’s recommendation, although some member states have recommended maintaining greater distances whenever possible. Viruses. •Between inmate/patient contact. • Please check the Ministry of Health (MOH) COVID-19 website regularly for updates to this document, the case definition, testing guidance, and other COVID-19 related information. If you are in contact with an infected person, the virus can enter your body if droplets get into your throat, nose, or eyes. or 4 Put … Additionally, travel-related exportation of cases has occurred. COVID-19: Droplet and Contact Precautions Acute Care 1 of 2 management of Coronavirus Disease 2019 (COVID-19) Droplet and Contact Precautions Acute Care Facilities This document was adapted from the Routine Practices Additional Precautions for COVID-19 for health care workers. WHO is considering "airborne precautions" for medical staff after a new study showed the coronavirus can survive in the air in some settings. Deceased bodies should be placed in a leak-proof bag. Care is given to patients to help relieve symptoms and manage respiratory and other organ failure. , contact and droplet precautions should be observed (PPE includes a gown, surgical mask, protective eyewear, and gloves), though eye protection is optional. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. o Complete the Person Under Investigation (PUI) Assessment Cases of COVID-19 have been reported in over 200 countries. As a reminder, droplet spread is caused by viral particles within small drops of bodily fluids. Overview of TB Infection-Control Measures. When a resident is a confirmed case • Notify NYSDOH Regional Epi Contact • Actively monitor residents on affected … The CDC has not issued guidance to the general public for eye protection wear. Accessibility- We aim to provide documents in an accessible format. There are specific precautions older adults should take to protect their health. COVID-19; Coronavirus; Droplet Transmission; Mask; Respiratory Protection; SARS-CoV-2. Environmental cleaning 4. For healthcare organizations, the CDC recommends airborne, in addition to standard (contact) and droplet precautions, for the care of COVID-19 suspected or confirmed patients. Quinacrine, an Antimalarial Drug with Strong Activity Inhibiting SARS-CoV-2 Viral Replication In Vitro. Supplies of PPE should be readily available and placed outside the room. 2020 Dec 2. doi: 10.1016/j.jaim.2020.11.010. These include: Currently, care for patients with COVID-19 is primarily supportive. Disposable or dedicated patient care equipment (e.g., stethoscopes, blood pressure cuffs) should be used; however, if equipment needs to be shared among patients, then it should be cleaned and disinfected between use for each patient (ethyl alcohol of at least 70%). The risk of COVID-19 spreading is higher in places where these “3Cs” overlap. 10. In addition to wearing a fitted respirator mask, healthcare workers should also wear appropriate PPE including gloves, a gown and eye protection. Droplet precautions include the use of a surgical mask and eye protection. Place the patient in a separate room with contact and droplet precautions. Infection prevention and control (IPC) is the practice of preventing or stopping the spread of infections during healthcare delivery in facilities like hospitals, outpatient clinics, dialysis centers, long-term care facilities, or traditional practitioners. Coronaviruses are a large family of viruses that can cause illness in animals or humans. By the end of this module, participants should be able to demonstrate the correct way to put on personal protective equipment according to the WHO-recommended method for COVID-19 droplet/contact precautions. Healthcare workers should: There is a higher risk of self-contamination when removing PPE. If you're having problems using a … There are three types of transmission-based precautions: contact, droplet and airborne precautions. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. • Public hospitals and long-term care homes, regulated health … For patients with infections such as COVID-19, you will need to use contact and droplet precautions combined to provide the protection required for health workers. Gl… Health-care workers in Ontario will now use what’s known as “droplet precautions” to protect against COVID-19, the name of the disease caused by the coronavirus. If facilities have dedicated COVID-19 memory units, residents may continue to socialize so long as there are no COVID-19 negative residents or residents with unknown COVID-19 status in these units . Modified Contact/Droplet Precautions: COVID-19 . J Ayurveda Integr Med. Infectious droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. APPENDIX 2: DROPLET PRECAUTIONS CHECKLIST Short-range inhalation of aerosols is a possibility for COVID-19, as with many respiratory pathogens. Standard Precautions are a set of practices that apply to the care of patients in all healthcare settings at all times. COVID-19 was identified in Wuhan, China in December 2019. COVID-19 screening criteria outlined in the COVID-19 Healthcare Provider Flowchart (Appendix D) have the patient wear a surgical/procedure mask immediately if they’re not already wearing one. Additional precautions should be implemented as soon as disease or risk factors … Staff caring for residents who have COVID-19 should be kept together as far as possible. Pathophysiology of COVID-19 and Host centric approaches of. Download PDF. Droplet Precautions: Precautions for patients known or suspected to be infected . National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. negative. Aerosol Generating Procedures: Staff and visitors in contact with ill residents must follow standard contact and droplet precautions (see below). 2020 Jun 28. In some cases, people who get COVID-19 can become seriously ill and develop difficulty breathing. There are a number of ways to prevent the spread of COVID-19 infection. This overview was created for healthcare workers in non-US healthcare settings and government officials working on the Coronavirus Disease 2019 (COVID-19) response. 2021 May;170:120983. doi: 10.1016/j.ijheatmasstransfer.2021.120983. COVID-19 Confirmed Precautions Droplet/Contact Plus Resident Placement (Listed in order of preference) • • Private Room (or Airborne Infection Isolation Room (AIIR), if available) Multi -bed Room (Only cohort with other COVID 19 confirmed or recovered/non infectious residents) Repeat Testing Repeat testing is not recommended within days of symptom onset (or date of … COVID-19 infection prevention and control guidance: standard infection prevention control precautions (SICPs) ... Added COVID-19: infection prevention and control dental appendix. Traditionally, droplets are defined as large (>5 microns) aqueous bodies. Not Recommended as a general measure but a lower threshold for use based on 2020 Mar 13;7(1):11. doi: 10.1186/s40779-020-00240-0. CDC twenty four seven. Transportation of patients with COVID-19 should be avoided unless medically necessary. Currently, the definition of a probable case of COVID-19 is: A person who has detection of SARS-CoV-2 neutralising or IgG antibody AND has had a … DROPLET/CONTACT PLUS* PRECAUTIONS Everyone MUST clean their hands before entering and when leaving room . In order to … Standard, contact and droplet precautions when caring for a resident with a respiratory infection. COVID-19 is an emerging, rapidly evolving situation. As more data become available, additional risk factors for severe COVID-19 may be identified. NIH Residents with dementia may need special arrangements to support them in isolation. You will be subject to the destination website's privacy policy when you follow the link. patients and PUIs 2. on required precautions and procedures for health and safety and the use of personal protective equipment. Respiratory viruses, including COVID-19 viruses are usually transported in large particle droplets. By the end of this module, participants should be able to demonstrate the correct way to put on … Bays DJ, Nguyen MH, Cohen SH, Waldman S, Martin CS, Thompson GR, Sandrock C, Tourtellotte J, Pugashetti JV, Phan C, Nguyen HH, Warner GY, Penn BH. For patients with infections such as COVID-19, you will need to use contact and droplet precautions combined to provide the protection required for health workers. Arcangeli A, Ralli M, De-Giorgio F, Soave PM, Ercoli L. Appl Health Econ Health Policy. Any new or worsening respiratory symptoms (cough, shortness of breath, runny nose or sneezing, nasal congestion, hoarse voice, sore throat or difficulty swallowing), OR 1.3. This guide is relevant for primary care providers and specialists within the community setting, as well as their teams. This guide is relevant for primary care providers and specialists within the community setting, as well as their teams. Current WHO guidance for healthcare workers caring for suspected or confirmed COVID-19 patients recommends the use of contact and droplet precautions in addition to standard precautions (unless an aerosol generated procedure is being performed, in which case airborne precautions are needed)1. In health facilities, some medical procedures, called aerosol generating procedures, can produce very small droplets (called ‘droplet nuclei’ or ‘aerosols’) that can stay suspended in the air for longer periods of time. 2019 Aug;32(4):372-379. doi: 10.1097/QCO.0000000000000563. | 10. Short-range transmission is a possibility particularly in crowded medical wards and inadequately ventilated spaces3. Hand hygiene program 3. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. More detailed information regarding the IPC priorities for non-US healthcare settings can be found in the Strategic Priority IPC Activities for Containment and Prevention document. Selection and use of PPE 7. In humans there are several known coronaviruses that cause respiratory infections. PPE See page 5. of COVID-19 Infection Prevention and Control Advice for Health Workers 6 perform hand hygiene. The disease was discovered in China in December 2019 and has since spread around the world. For more information, please contact the Infection Prevention and Control department at Public Health Ontario at ipac@oahpp.ca. Infection Prevention and Control COVID-19 Personal Protective Equipment. Could thermodynamics and heat and mass transfer research produce a fundamental step advance toward and significant reduction of SARS-COV-2 spread? Aerosol Generating Procedures: Procedures that are likely to generate . In: StatPearls [Internet]. Respiratory infections can be transmitted through droplets of different sizes: when the droplet particles are >5-10 μm in diameter they are referred to as respiratory droplets, and when then are <5μm in diameter, they are referred to as droplet nuclei. Air cleaning technologies: an evidence-based analysis. Contact and Droplet Precautions for Isolation Rooms during COVID-19 for Community Physicians and Teams . The weight of combined evidence supports airborne precautions for the occupational health and safety of health workers treating patients with COVID-19. This overview is organized by first presenting a background on coronaviruses and then briefly describes the emergence, transmission, symptoms, prevention and treatment of COVID-19. What it is: A virus-filled particle of breath or … Salas Rojas M, Silva Garcia R, Bini E, Pérez de la Cruz V, León Contreras JC, Hernández Pando R, Bastida Gonzalez F, Davila-Gonzalez E, Orozco Morales M, Gamboa Domínguez A, Sotelo J, Pineda B. Title: Contact and Droplet Precaution Poster Portrait V4 Author: Clinical Excellence Commission Keywords: COVID-19, PPE, Contact and Droplet Precautions Created Date: As enveloped viruses, they are usually not viable in small droplet-nuclei. PPE See page 5. of COVID-19 Infection Prevention and Control Advice for Health Workers 6 perform hand hygiene. Standard precautions include: Transmission-based precautions are a set of practices specific for patients with known or suspected infectious agents that require additional control measures to prevent transmission. droplet precautions, i.e., gown, mask, face shield/eye protection, and gloves. Place the patient in a separate room with contact and droplet precautions. Certain procedures in health facilities can generate fine aerosols and should be avoided whenever possible. COVID-19: Transmission-Based Precautions: Current WHO guidance for healthcare workers caring for suspected or confirmed COVID-19 patients recommends the use of contact and droplet precautions in addition to standard precautions (unless an aerosol generated procedure is being performed, in which case airborne precautions … RCFs should ensure contact and droplet precautions are followed if the deceased person had COVID-19. COVID-19 isolation rooms or wards should have dedicated bathrooms, which should be cleaned and disinfected at least twice daily. Broader use of contact and droplet precautions may however be appropriate at unit level for limited periods based on IPC risk assessment Use of respirator masks for all care of patients with suspected or confirmed COVID-19 . Healthcare workers should also wear the appropriate PPE when transporting patients. Droplet and Contact precautions should be implemented for all residents presenting with new signs or symptoms of possible COVID-19 1. If a patient is deemed medically necessary to be transported, a mask should be placed on the suspected or confirmed COVID-19 patient. ☐ Use standard plus contact and droplet precautions for care of residents with possible, suspect, or confirmed COVID-19; prioritize gowns for close patient contact. Maintain at least a 6-foot distance from others to protect yourself from droplet transmission, and wash your hands thoroughly after touching surfaces that may be contaminated. Many of the recommendations in this infographic are based on the fact that droplet precautions will not be enough to protect against COVID-19 spread during intubation. Twitter; Facebook; Email; Downloads Infection Prevention and Control COVID-19 Personal Protective Equipment. The information in this document draws from the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) guidance documents and Infection Prevention and Control (IPC) priorities for the response to COVID-19 in healthcare settings and includes information that can be used in non-US contexts. For the general public, the CDC describes SARS-CoV-2 transmission as primarily by droplets from coughs or sneezes, which "land in the mouths or noses of people who are nearby or possibly inhaled … For more information, please contact the While you may have spent much of last March wiping down your groceries, research has since shown that the coronavirus that causes COVID-19 is primarily spread through respiratory droplets, not surface … Application of these precautions depends on the nature of the health worker-patient interaction and the anticipated exposure to a known infectious agent. World Health Organization (WHO) has issued guidelines for contact and droplet precautions for Healthcare Workers (HCWs) caring for suspected COVID-19 patients, whilst the US Centre for … All staff will use Droplet and Contact precautions, in addition to Routine Practices, for all care of residents with suspected or confirmed COVID- 19 ; All staff and essential volunteers or visitors must be trained on other IPC measures such as proper hand hygiene and the importance of maintaining a 2 metre spatial distance between residents; All staff must work proactively to … Share. with pathogens transmitted by respiratory droplets that are generated by a patient who is coughing, sneezing, or talking. The Vatican City State Internal Healthcare System Response to COVID-19 Pandemic: Prevention and Control Strategies. | At issue is the constantly shifting interpretation of droplet size with reference to SARS-CoV-2. Droplet, Contact/Droplet or Airborne Precautions: COVID-19 . A wide range of symptoms for COVID-19 have been reported4. | Contact and Droplet Precautions for Isolation Rooms during COVID-19 for Community Physicians and Teams . Please see instructions for putting on and removing PPEpdf icon for guidance. HHS with pathogens transmitted by respiratory droplets that are generated by a patient who is coughing, sneezing, or talking. 2021 Jan 20:1-4. doi: 10.1007/s40258-020-00633-1. Despite the important concerns about case fatality rates, most COVID-19 illnesses are – and we expect will continue to be – mild, and most patients will recover spontaneously with some supportive care, especially children and young adults. Staff handling deceased bodies should wear a gown, surgical mask, protective eyewear and gloves. However, airborne (or aerosolized) transmission of the virus has been proposed as a source of infection almost since the inception of the COVID pandemic. Examples include: pneumonia, COVID-19 influenza, whooping cough, bacterial meningitis. Healthcare workers should be trained on the correct use of PPE, including how to put on and remove PPE. Respiratory droplets can land on hands, objects or surfaces around the person when they cough or talk, and people can then become infected with COVID-19 from touching hands, objects or surfaces with droplets and then touching their eyes, nose, or mouth. Moreover, evidence suggests infections cannot neatly be separated into the dichotomy of droplet versus airborne transmission routes. One or more types of transmission-based precautions may be required, depending on how an infection is spread between people. respiratory aerosols, … Additionally, adequately ventilated single rooms or wards are suggested. Use of contact and droplet precautions by health workers caring for suspected and confirmed COVID-19 patients, and use of airborne precautions when aerosol generating procedures are performed; Continuous use of a medical mask by health workers and caregivers working in all clinical areas, during all routine activities throughout the entire shift; With several new COVID-19 variants now circulating, experts say it's worth being extra cautious. Finally, no vaccine is currently available. COVID-19 guidance, tools, and resources for healthcare workers. This video briefly outlines the steps for putting on and taking off PPE when applying contact and droplet precautions in addition to standard precautions, when caring for patients with some infectious diseases such as COVID … Application of routine practices and additional precautions based on PCRA 5. Available studies also show that SARS-CoV-2 can be detected in the air, 3 hours after aeroslisation. Investigation of Nosocomial SARS-CoV-2 Transmission from Two Patients to Health Care Workers Identifies Close Contact but not Airborne Transmission Events. COVID-19 is a highly infectious respiratory disease caused by a novel coronavirus. NOTE: These cases included a large spectrum of illnesses including but not limited to patients having fever, cough, chest pain, nausea, and body pain. Home; Publications and resources; Resource library Print. Health-care facilities (Outpatient and Emergency Department) should : Any new onset atypical symptoms including but not limited to chills, muscleaches, diarrhea, malaise, or headache 2. World Health Organization (WHO) has issued guidelines for contact and droplet precautions for Healthcare Workers (HCW … Cases of COVID-19 have been reported in over 200 countries. Early in the outbreak, many patients were reported to have a link to a large seafood and live animal market, however, later cases with no link to the market confirmed person-to-person transmission of the disease.