Instructions For Completing The Respiratory Medical Action Plan: Fill & Download for Free

Well biochemists are working on a vaccine but making a brand new vaccine is not like going to the grocery store - many levels of design, manufacturing, quality control, shipping, sales, and distribution are involved. Hence it can’t go much faster than what is happening at the moment. A vaccine was attempted several years back but because there was not much of a market - and the initial investment needs hundreds of millions of dollars - and as a result, investors never put interest in the vaccine and it could not get off the ground. People like me who treat patients may be helpful with creative ideas, but we can’t personally fund something like a brand new vaccine.Scientists were close to a coronavirus vaccine years ago. Then the money dried up.Current politics is also causing delays - and the current ease with which fake news and clickbait can be circulated, makes separating scientific fact from politics very difficult.This disease is not completely characterized to the level that we know something like bacterial pneumonia - hence fear of the unknown. Infectious disease teams around the world are doing their best but the fact of the matter is, a new disease takes time to learn about and completely characterize.The best advice right now is to wash your hands very frequently and follow these recommendations from the CDC:Get Your Household Ready for Coronavirus Disease 2019Interim GuidanceEspañol | 中文This interim guidance is based on what is currently known about the Coronavirus Disease 2019 (COVID-19). The Centers for Disease Control and Prevention (CDC) will update this interim guidance as needed and as additional information becomes available.This interim guidance is to help household members plan for community transmission of coronavirus disease 2019 (COVID-19) in the United States. The Centers for Disease Control and Prevention (CDC) encourages household members to prepare for the possibility of a COVID-19 outbreak in their community.COVID-19 is caused by a new virus. There is much to learn about its transmissibility, severity, and other features of the disease. We want to help everyone prepare to respond to this public health threat.In this guidanceBefore a COVID-19 outbreak occurs: PlanDuring a COVID-19 outbreak: ActAfter a COVID-19 outbreak has ended: Follow UpReadiness ResourcesBefore a COVID-19 outbreak occurs in your community: PlanA COVID-19 outbreak could last for a long time in your community. Depending on the severity of the outbreak, public health officials may recommend community actions designed to help keep people healthy, reduce exposures to COVID-19, and slow the spread of the disease. Local public health officials may make recommendations appropriate to your local situation. Creating a household plan can help protect your health and the health of those you care about in the event of an outbreak of COVID-19 in your community. You should base the details of your household plan on the needs and daily routine of your household members.Create a household plan of actioncheck iconTalk with the people who need to be included in your plan. Meet with household members, other relatives, and friends to discuss what to do if a COVID-19 outbreak occurs in your community and what the needs of each person will be.check iconPlan ways to care for those who might be at greater risk for serious complications. There is limited information about who may be at risk for severe complications from COVID-19 illness. From the data that are available for COVID-19 patients, and from data for related coronaviruses such as SARS-CoV and MERS-CoV, it is possible that older adults and persons who have underlying chronic medical conditions may be at risk for more serious complications. Early data suggest older people are more likely to have serious COVID-19 illness. If you or your household members are at increased risk for COVID-19 complications, please consult with your health care provider for more information about monitoring your health for symptoms suggestive of COVID-19. CDC will recommend actions to help keep people at high risk for complications healthy if a COVID-19 outbreak occurs in your community.check iconGet to know your neighbors. Talk with your neighbors about emergency planning. If your neighborhood has a website or social media page, consider joining it to maintain access to neighbors, information, and resources.check iconIdentify aid organizations in your community. Create a list of local organizations that you and your household can contact in the event you need access to information, health care services, support, and resources. Consider including organizations that provide mental health or counseling services, food, and other supplies.check iconCreate an emergency contact list. Ensure your household has a current list of emergency contacts for family, friends, neighbors, carpool drivers, health care providers, teachers, employers, the local public health department, and other community resources.Practice good personal health habits and plan for home-based actionscheck iconPractice everyday preventive actions now. Remind everyone in your household of the importance of practicing everyday preventive actions that can help prevent the spread of respiratory illnesses:Avoid close contact with people who are sick.Stay home when you are sick, except to get medical care.Cover your coughs and sneezes with a tissue.Clean frequently touched surfaces and objects daily (e.g., tables, countertops, light switches, doorknobs, and cabinet handles) using a regular household detergent and water.If surfaces are dirty, they should be cleaned using a detergent and water prior to disinfection. For disinfection, a list of products with Environmental Protection Agency (EPA)-approved emerging viral pathogens claims, maintained by the American Chemistry Council Center for Biocide Chemistries (CBC), is available at Novel Coronavirus (COVID-19) Fighting Productspdf iconexternal icon. Always follow the manufacturer’s instructions for all cleaning and disinfection products.Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Always wash your hands with soap and water if your hands are visibly dirty.check iconChoose a room in your home that can be used to separate sick household members from those who are healthy. Identify a separate bathroom for the sick person to use, if possible. Plan to clean these rooms, as needed, when someone is sick. Learn how to care for someone with COVID-19 at home.Be prepared if your child’s school or childcare facility is temporarily dismissedcheck iconLearn about the emergency operations plan at your child’s school or childcare facility. During a COVID-19 outbreak in your community, local public health officials may recommend temporary school dismissals to help slow the spread of illness. School authorities also may decide to dismiss a school if too many students or staff are absent. Understand the plan for continuing education and social services (such as student meal programs) during school dismissals. If your child attends a college or university, encourage them to learn about the school’s plan for a COVID-19 outbreak.Plan for potential changes at your workplacecheck iconLearn about your employer’s emergency operations plan. Discuss sick-leave policies and telework options for workers who are sick or who need to stay home to care for sick household members. Learn how businesses and employers can plan for and respond to COVID-19.Top of PageDuring a COVID-19 outbreak in your community: ActDuring an outbreak in your community, protect yourself and others by:check iconStaying home from work, school, and all activities when you are sick with COVID-19 symptoms, which may include fever, cough, and difficulty breathing.Keeping away from others who are sick.Limiting close contact with others as much as possible (about 6 feet).Put your household plan into actioncheck iconStay informed about the local COVID-19 situation. Get up-to-date information about local COVID-19 activity from public health officialsexternal icon. Be aware of temporary school dismissals in your area, as this may affect your household’s daily routine.check iconStay home if you are sick. Stay home if you have COVID-19 symptoms. If a member of your household is sick, stay home from school and work to avoid spreading COVID-19 to others.If your children are in the care of others, urge caregivers to watch for COVID-19 symptoms.check iconContinue practicing everyday preventive actions. Cover coughs and sneezes with a tissue and wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use a hand sanitizer that contains 60% alcohol. Clean frequently touched surfaces and objects daily using a regular household detergent and water.check iconUse the separate room and bathroom you prepared for sick household members (if possible). Learn how to care for someone with COVID-19 at home. Avoid sharing personal items like food and drinks. Provide your sick household member with clean disposable facemasks to wear at home, if available, to help prevent spreading COVID-19 to others. Clean the sick room and bathroom, as needed, to avoid unnecessary contact with the sick person.If surfaces are dirty, they should be cleaned using a detergent and water prior to disinfection. For disinfection, a list of products with EPA-approved emerging viral pathogens claims, maintained by the CBC, is available at Novel Coronavirus (COVID-19) Fighting Productspdf iconexternal icon. Always follow the manufacturer’s instructions for all cleaning and disinfection products.check iconStay in touch with others by phone or email. If you live alone and become sick during a COVID-19 outbreak, you may need help. If you have a chronic medical condition and live alone, ask family, friends, and health care providers to check on you during an outbreak. Stay in touch with family and friends with chronic medical conditions.check iconTake care of the emotional health of your household members. Outbreaks can be stressful for adults and children. Children respond differently to stressful situations than adults. Talk with your children about the outbreak, try to stay calm, and reassure them that they are safe.Inform your workplace if you need to change your regular work schedulecheck iconNotify your workplace as soon as possible if your schedule changes. Ask to work from home or take leave if you or someone in your household gets sick with COVID-19 symptoms, or if your child’s school is dismissed temporarily.Take the following steps to help protect your children during an outbreakcheck iconIf your child/children become sick with COVID-19, notify their childcare facility or school. Talk with teachers about classroom assignments and activities they can do from home to keep up with their schoolwork.check iconKeep track of school dismissals in your community. Read or watch local media sources that report school dismissals. If schools are dismissed temporarily, use alternative childcare arrangements, if needed.check iconDiscourage children and teens from gathering in other public places while school is dismissed to help slow the spread of COVID-19 in the community.Top of PageAfter a COVID-19 outbreak has ended in your community: Follow UpRemember, a COVID-19 outbreak could last a long time. The impact on individuals, households, and communities might be great. When public health officials determine the outbreak has ended in your community, take time to improve your household’s plan. As public health officials continue to plan for COVID-19 and other disease outbreaks, you and your household also have an important role to play in ongoing planning efforts.Evaluate the effectiveness of your household’s plan of actioncheck iconDiscuss and note lessons learned. Were your COVID-19 preparedness actions effective at home, school, and work? Talk about problems found in your plan and effective solutions. Identify additional resources needed for you and your household.check iconParticipate in community discussions about emergency planning. Let others know about what readiness actions worked for you and your household. Maintain communication lines with your community (e.g., social media and email lists). Promote the importance of practicing good personal health habits.check iconContinue to practice everyday preventive actions. Stay home when you are sick; cover your coughs and sneezes with a tissue; wash your hands often with soap and water; and clean frequently touched surfaces and objects daily.check iconTake care of the emotional health of your household members. Make time to unwind and remind yourself that strong feelings will fade. Take breaks from watching, reading, or listening to news stories about COVID-19. Connect with family and friends. Share your concerns and how you are feeling with others.check iconHelp your child/children cope after the outbreak. Provide children with opportunities to talk about what they went through or what they think about it. Encourage them to share concerns and ask questions. Because parents, teachers, and other adults see children in different situations, it is important for them to work together to share information about how each child is coping after the outbreak.

NOVEL CORONA VIRUS (nCoV) ACTION PLAN• OPD: put up standees asking patients with recent travel (after Dec 20, 2019) to China to identify themselves at the time of registration.Front office staff- reception and registration: For all patients with fever &/ or respiratory illness1. Give a mask2. Ask about the following:a) A history of travel to Wuhan, Hubei Province China in the 14 days prior to symptom onset; orb) Close contact with nCoV patientc) Health care worker working with nCoV patientIf yes to 2a), 2b) or 2c), take permission of the consultant for transfer to ER immediately.• Doctor’s office- if there is a patient with fever or respiratory problems, ask for air travel history. If yes, transfer to ER, leave room and close door. Clean hands and notify HIC for cleaning (HIC Cleaning protocol – thorough deep cleaning)Infection Prevention and Control strategies in health-care settings:Early recognition and source control:Emergency room / OPD: Awareness to be given to the HCWs in the ER and OPD. Give suspect patient a medical mask Direct patient to triage zone Keep at least 1meter distance between suspected patients and other patients. Instruct all patients to cover nose and mouth during coughing or sneezing with tissue or flexed elbow. Perform hand hygiene after contact with respiratory secretionsStandard Precautions:a. Hand hygiene: 70% alcohol based hand rub or soap and water hand wash when visibly contaminated.b. Standard PPE usage: Gloves, Gown, snug fit surgical mask, and goggles depending on risk of procedure.c. Coughing/sneezing etiquette.Transmission based precautions:Contact and Droplet precaution for suspected nCoV infected patient: Patient placement in adequately ventilated single room In the absence of single room, Cohort at 1 metre distance Cohort HCWs for exclusive care Surgical mask on entering the room (including visitors) Goggles / face shield Gloves Gowns - disposable fluid resistant long sleeve gowns Dedicated patient equipment (BP apparatus, Stethoscope, thermometers etc.) Limit the movement and transport of patient from the room. Restrict visitors. Maintain a record of all persons entering patient’s room. Droplet precaution sign board.Guidelines for aerosol generating procedures:For aerosol generating procedures such as: open suctioning of respiratory tract, tracheal intubation, tracheotomy, non-invasive ventilation, bronchoscopy, cardiopulmonary resuscitation airborne precautions to be strictly followed: N95 particulate respirator mask or equivalent Goggles, long sleeve gown and gloves to be used as PPE Procedure room should have negative pressure with at least 12 air changes per hour. Post procedure cleaning and disinfection of surfaces and equipment to be followed as per standard guidelines.Guidelines for Laboratory specimens:Specimen types:a. Upper respiratory tract – Nasopharyngeal/ oropharyngeal swab.b. Lower respiratory tract – BAL/ Tracheal aspirate.c. Serum: Infant - 1ml, Children and adults – 5 to 10 ml in serum separator tube.Note:a. Do not use pneumatic tube system for transport of specimens.b. Deliver all specimens by hand only.c. Standard leak proof containers to be used as per bio safety requirements.d. Clear documentation of patient details on sample and request form.e. r RT-PCR test samples to be shipped to referral lab as per IATA regulations.Notification: Public Health authority notification to be given promptly without delay as per regional policy.Transfer To other hospitals: Receiving hospital to be intimated at least 6 hours before transfer. Appropriate PPE to be used during transport.  Complete patient records to be given.Linen and laundry management:To be handled as that of infectious linen. The laundry bag is to be placed within the patient room. Linen and soiled / used cloths to be transported to laundry in a leak proof yellow coloured biomedical waste bag, disinfected with sodium hypochlorite and washed in infectious linen washing machine with warm water.Biomedical waste management: Refer local / state regulations for handling and disposal of medical waste.Dishes and eating utensils: No special precautions required beyond Standard Precautions recommended for dishes and eating utensils.Environmental cleaning and disinfection: Standard procedures to be followed. Terminal cleaning after patient discharge to be strictly followed with reference to recommended disinfectant usage (such as sodium hypochlorite), proper dilution, contact time and care in handling. Give special attention to high touch surfaces such as bed rails, bedside tables, TV control, call button, telephone, lavatory surfaces, switches. Spills of blood and body fluids to be disinfected in accordance with recommended Standard Precautions.Handling dead bodies: Person handling the dead body should wear full PPE A body bag should be used for transferring the body Outer surface of the body bag should be decontaminated with 1% sodium hypochlorite immediately before the body bag leaves the anteroom. Trolley carrying the body must be disinfected prior to leaving the anteroom, including the wheels. Staff should remove the PPE in the anteroom and transport the dead body to mortuary. Once in the hospital mortuary, full PPE should be used if the body bag is opened. Mortuary staff must be advised of the biohazard risk. Embalming is not recommended After use, empty body bags to be discarded in yellow color biomedical waste cover.

The results in the US are suggestive of “not much” going right for Trump.. That's a sweeping statement I realise, so let's consider just 2 Trump decisions that were complete game changers and single handedly altered the course of history.I have no doubt that had any other person been leading the United States in the last 12 months that the two critical mistakes made by Trump would not have occurred.In November Trump was presented with a signals directorate Intel briefing that had picked up intranet, email and social media chit chat from doctors practices, medical clinics, laboratories and hospital staff in and around Wuhan that mentioned a serious respiratory condition that on testing was not the flu or pnuemonia. I suspect that US intelligence signal monitoring is more advanced and sophisticated than China's and they saw a pattern that Chinas intelligence was unable to, or was not looking for.This information was included in a presidential Intel briefing because it needed to be actioned, but no action was taken. We may never know what consideration or discussion took place, but let me give you an outline of what I believe an appropriate discourse, intellectually and morally, would have looked like.Having read or been given the briefing;Trump - do we know what the disease or condition is? Any ideas?Intelligence Officer - no Mr President. All we know is it is a very serious unknown respiratory condition that seems to be spreading.Trump - have we picked up any Intel that suggests the Chinese authorities know about it?Intelligence Officer - No Mr President, it appears that the subject matter is limited to social media type posts and correspondence between unconnected individuals that work in distinctly seperate workplaces. What is common are the potentially serious symptoms of the condition being discussed, the fact that the pathogen is unknown and the general location.Trump - so you are telling me that there is a potentially fatal respiratory disease spreading through Wuhan and you don't believe the Chinese government have seen this pattern and are aware of it?Intelligence Officer - that is correct Mr President.Trump - OK, please wait a moment….. Xi, it's Trump. I've just been informed about a respiratory disease that is spreading through Wuhan. What do you know about this? Nothing you say? Can I suggest you get one of your senior health experts on the line. I have our medical Intel officer on the line with me. We will send through everything we have to your office now and hold for you……Had Trump done his job, done what every other nations leader would have done, done the right thing for the US, for the world and for mankind, instead of for himself, covid-19 would not exist.Unfortunately his combatant win/loose mentality would have prevented him doing this. I'm purely speculating now but I wouldn't be surprised if his response to the briefing would have been “good, let them drown in their own respiratory fluids. We might just win the trade war yet. Now back to my impeachment”.Covid 19 could have simply been a footnote in history, the subject confined to some obscure WHO research paper. There would not have been a pandemic. A million lives and counting would not have been lost.Trump had an opportunity to redeem himself on January 30, but instead he did what no other nation's leader did that day. He demanded a coverup on the 30th of January.That day the WHO declared a Public Health Emergency of International Concern.In every other nation around the world it was the headline story, and with little exception each country's government acknowledged and responded to the WHO declaration. They told their citizens what the WHO declaration meant, informed them about the nature of the threat and outlined their initial plans to protect the lives of their citizens.In the next 7 weeks, before the 13th of March, neither Trump nor the White House made a single statement or even acknowledged the WHO emergency declaration. This was not an oversight, a simple failure by a staffer to prepare and post a press release or public statement. Trump didn't inadvertantly forget to mention it at all during his 2 public engagements that day. This could only happen if Trump instructed his staff to not make comment, to not acknowledge it in any way and to do whatever was necessary to keep this off of the US media's radar screen.This coverup has cost 250,000 US lives. This 7 week period was the critical window of opportunity to prevent the spread of the disease, as demonstrated by many dozens of other countries.Trump's intentional suppression of the emergency declaration prevented him taking any action when action needed to be taken.This coverup by Trump is the reason he blames China for a coverup. It's why he withdrew from the WHO. It's why he blames Democrat mayors governers and those in Washington for the US results. It's why he fans doubt about the severity of the virus. It's the reason he accuses US doctors of committing felony fraud filling out death certificates. It's why all the other covid conspiracies have been circulating. It's why he publicly denounces the opinions expressed by the some of the world's most highly respected subject experts, claiming he knows better.All of these bizzare, baseless and dangerous positions, statements and accusations that followed the 30th January served to distance Trump from the US covid 19 problem, responses and results. It's so people hear his dog whistle and go running in the direction he wants you to be sniffing around.Don't believe this. Compare what he had to say about China's efforts and cooperation until January 30, and then after his coverup commenced. Look at how his language about the WHO's role and effectiveness changed after this date.If you want to explore how intentional this deceipt was, and how Trump shapes his rhetoric to create alternative narratives, review his statements on covid 19 in the 2 weeks immediately before and after the 30th January. Whilst he doesn't mention the emergency declaration on the day, his language and position undeniably changes, and does so to support this coverup.He should have publicly acknowledged the emergency declaration, openly discussed it's implications, developed and shared his plans to address it, and taken swift, extensive and effective action to control the virus and stop it's entry into the US, just like dozens of other countries, instead of covering it up and leading the nation to where it is now.If Trump has a conscience, for which the jury is still out on, it is these 2 historic decisions that will haunt him for the rest of his days. Of course he will never publicly acknowledge that.