This page provides RCN members with the information and resources to support their understanding of and management of COVID-19. Nurses are fundamental to informing the public and reassuring them about this outbreak.
Background
In late December 2019 a new (novel) coronavirus was identified in China causing severe respiratory disease including pneumonia. It was originally named Novel Coronavirus and The World Health Organization (WHO) has advised the following language associated with the current situation.
The virus causing the infection has been named - severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
The disease caused as a result of infection is named - coronavirus disease (COVID-19).
COVID-19 has been categorised as an airborne High Consequence Infections Disease (HCID).
SARS-CoV-2 is spreading between people globally and can be seen on the WHO situation reports dashboard which is updated daily. As of 26th February 2020 an increasing number of cases are being identified in Europe with transmission occurring outside of travel to China.
As a newly identified virus there is currently no human immunity to it and no vaccine is available to prevent infection. As a viral infection, antibiotics are not an effective treatment.
Coronavirus
Coronaviruses are a common family of viruses and one of the main causes of the common cold. In general, someone infected will present with mild to moderate respiratory like symptoms. Including this new strain there are seven different coronaviruses,that we know of, which can infect people and make them sick. Those with underlying illness and co morbidity are the most seriously affected and this appears to be the case with this new strain. Other examples of Coronavirus include MERS Co-V and SARS both of which have prompted global collaboration to reduce spread between people and to protect healthcare workers.
Current situation
We are in a fast moving evolving situation and as with any new strain of virus, the guidance for healthcare workers and health services is being developed and updated frequently. This reflects the need to take a view of the global situation and our growing understanding of infection risk of this new virus; incubation time, infectiousness and severity of the infection.
Nurses and midwives should familiarise themselves with their local policies on emergency planning, infection prevention and control and other relevant guidance in addition to any national guidance issued by the Department of Health and Social Care and the relevant UK Public Health agencies see below for links. This information is updated regularly to reflect the changing situation. It is important that members look on the web sites and check they are looking at the most up to date information.
RCN position
The RCN is not currently planning to develop guidance relating to COVID-19.
The RCN will work with national UK agencies and other key stakeholders such (for example other Royal Colleges) to support preparedness and management of the current situation providing an RCN perspective based on our role as a Royal College and Trade Union. The protection of healthcare workers, development and review of guidance and resilience of healthcare provision is our current key focus. The links to this guidance is below.
Protecting Staff
Employers have a duty of care under the Control of Substances Hazardous Health 2002 (COSHH) to assess and reduce the risks from exposure to biological hazards. Under COSHH employers need to identify who may be harmed by a biological agent and how they may be exposed.
Latest guidance from Public Health England, Health Protection Scotland and the Health and Safety Executive will inform the COSHH assessment and what steps need to be taken including the identification of potential patients with COVID-19, isolation procedures and precautions such as negative pressure ventilation and the provision and safe use of appropriate personal protective equipment (PPE).
Staff may be anxious by what the read in the media and employers should ensure that all nursing staff are provided with factual information on COVID-19, the steps that their employer is taking to identify and manage suspected cases and what nursing staff can do to protect themselves, including reinforcing hand hygiene. Staff who may be required to deliver clinical care to affected patients, should have the necessary skills and experience and be provided with training and information on any additional infection prevention and control measures needed to work in such environments including the safe donning and removal of PPE.
RCN safety representatives should be kept informed of measures being taken to protect staff and there should be mechanisms in place that allow safety representatives to raise concerns with senior managers/health and safety/infection control leads on behalf of staff. To also ensure there are appropriate safeguarding measures in place for staff and patents/ service users.
Members who are concerned should speak to their local safety representative and/or contact RCN Direct on 0345 772 6100.
See PHE guidance for health care providers for staff who have travelled to China or Northern Italy.
For health protection advice, contact your local health protection team:
- Find your local health protection team in England
- Health Protection Scotland: enquiries
- Public Health Wales: contact us
- Health Select Committee Northern Ireland health protection
Patients who are concerned should be advised to contact NHS 111 or their GP.
UK information
- Department of Health and Social Care & Public Health England (PHE): Coronavirus: latest information and advice. This page includes the current situation in the UK and actions taken in the UK and abroad
- GOV.UK: COVID-19: investigation and initial clinical management of possible cases
- PHE: Novel coronavirus: what you need to know. Q&A blog updated by PHE
- Health and Social Care Public Health agency in NI (HSCNI): Health protection guidance
- Health Protection Scotland (HPS) Coronavirus (COVID-19): Novel coronavirus (2019 nCoV
- Public Health Wales statement on Novel Coronavirus (COVID-19) outbreak in China and public advice
- NHS Employers: Joint statement on Covid-19 (published 27 February 2020)
Infection control advice
- PHE: Novel coronavirus: infection prevention and control
- PHE: COVID-19: interim guidance for primary care
Advice for health and care services
- PHE: Guidance for NHS clinicians on home isolation of a patient whilst being tested for SARS-CoV-2
- PHE: Guidance for social or community care and residential settings on COVID-19
- NHS advice: Overview of COVID-19
Other information on COVID-19 for healthcare workers and public
- RCN bulletin (27 February 2020) Coronavirus what you need to know
- DHSC and PHE: COVID-19 guidance for non-clinical settings
- PHE: Public health matters blog – Coronavirus what you need to know
- PHE and Department for Business, Energy & Industrial. COVID-19: guidance for employers and businesses
- World Health Organization (WHO): Novel Coronavirus (2019-nCoV) advice for the public
- European Centre for Disease Prevention and Control (ECDC): COVID-19
- Healthcare Infection Society: Coronavirus resources
Specific travel information
Many cities in China have closed public transport systems.
- The Foreign and Commonwealth Office (FCO) has advised against all travel to Hubei Province
- National association of Travel Health Centres and Networks (NaTHNaC) TravelHealthPro
- Health Protection Scotland
- Health Protection Wales: response to coronavirus outbreak
see PHE guidance for health care providers for staff who have travelled to China.
