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Prevention and Treatment

Prevention

General

General prevention measures for the public include:1

  • Restricting movement and travel
  • Self-monitoring and self-isolating after return from travel
  • Practising social distancing, also referred to as physical distancing, staying at least 2 metres away from others
  • Practising respiratory hygiene
  • Hand washing

Prevention for nurses, health-care providers and health-care settings include all of the above, as well as the following infection prevention and control measures:2

  • Prompt identification of symptomatic persons/possible cases
  • Appropriate risk assessment
  • Management and placement of probable and confirmed cases
  • Investigation and follow-up of close contacts

Administrative controls can assist with preventing exposure:

  • Triage for identification and placement of patients
  • Masks, tissues and alcohol-based hand rub at all entrances
  • Prominent signage instructing symptomatic patients to promptly present to health-care providers
  • Limitation of visitors and movement for symptomatic patients
  • Avoiding cohorting unless absolutely necessary

Personal protective equipment (routine practices and additional precautions):

  • Gloves
  • Long-sleeved gown
  • Facial protection such as surgical mask and eye protection, face shield, or surgical/procedural mask with visor attachment
  • N95 respirator and eye protection should be worn when performing aerosol-generating medical procedures (AGMPs)

Knowledge/resource/practice gaps

See CNA’s position on PPE and related knowledge/resource/practice gaps.

Treatment

There is currently no vaccine, and treatment is limited to supportive therapy. The Public Health Agency of Canada refers clinicians to guidance from WHO on Clinical Management of Severe Acute Respiratory Infection when Novel Coronavirus (nCoV) is suspected. Researchers are working hard to develop a vaccine; the earliest possible date for widespread availability is anticipated to be spring 2021.

Knowledge/practice/resource gaps:

Recent recommendations on the use of hydroxyquinolone/azithromycin as treatment for COVID-19 by some high-profile individuals has led to anecdotal reports of people using this medication combination as prophylaxis to prevent infection.

  • CNA is aware that there may be increased demand or prescribing for hydrocholorquine/azithromycin. There is insufficient evidence that these drugs can prevent and/or treat COVID-19.
  • In addition to its use as an anti-malarial drug, hydrochloroquine is indicated for treatment of rheumatoid arthritis and systemic lupus erythematosus.
  • We have heard of shortages occurring, resulting in patients unable to access medication indicated for their autoimmune disorders.
  • As with all practice around medication administration, regulated nurses are encouraged to use their professional judgment about the appropriateness of administering these medications outside of the usual indications.
  • Likewise, nurse practitioners should use their professional judgment when considering ordering these medications for any purpose other than their current indications.
  • There have been an abundance of anecdotal reports of U.S. clinicians writing prescriptions for this medication, for use by their families, friends, and themselves.
  • Regulated nurses should consider their CNA is aware that there may be increased demand or prescribing for hydrocholorquine/azithromycin. There is insufficient evidence that these drugs can prevent and/or treat COVID-19.
  • In addition to its use as an anti-malarial drug, hydrochloroquine is indicated for treatment of rheumatoid arthritis and systemic lupus erythematosus.
  • We have heard of shortages occurring, resulting in patients unable to access medication indicated for their autoimmune disorders.
  • As with all practice around medication administration, regulated nurses are encouraged to use their professional judgment about the appropriateness of administering these medications outside of the usual indications.
  • Likewise, nurse practitioners should use their professional judgment when considering ordering these medications for any purpose other than their current indications.
  • There have been an abundance of anecdotal reports of U.S. clinicians writing prescriptions for this medication, for use by their families, friends, and themselves.
  • Regulated nurses should consider their ethical practice obligations, as outlined in the Code of Ethics, if they are aware of clinicians prescribing this combination of medications in a manner that appears unethical.