Fraser Health has identified the first cases of COVID-19 in the region. The first case is a woman in her 30s residing in the Fraser Health region who travelled to Iran, and the second case – a male in his 40s - is a close contact of the first case.
Since these cases have been reported, there has been an increased number of patients presenting to Emergency Departments requesting COVID-19 testing. Please make all efforts to test patients promptly at the location where they present in order to limit transmission of the virus. Forwarding patients elsewhere for assessment and testing puts additional stress on the Emergency Department and can put others at risk for exposure.
Physicians can test for COVID-19 without consulting a Medical Health Officer. Physicians should notify a Medical Health Officer for cases where there is a high index of suspicion (see “When to notify the Medical Health Officer” section). The epidemiology of coronavirus continues to evolve, as such we recommend physicians:
- Fraser Health COVID-19 cases: First two cases in the region
- Change in affected areas: Consider testing symptomatic individuals with travel to “affected areas”
- BCCDC Coronavirus Hotline: Patients can call 1-833-707-2792 to receive testing results
- Information on coronavirus reporting: Public Health will follow-up on positive COVID-19 results
(**NEW**) Consider testing for COVID-19 for:
- Patients with compatible symptoms (e.g., fever, cough, or difficulty breathing) AND
- History of travel to affected areas (as of Feb. 24, 2020, affected areas include: China, Japan, Italy, Iran, South Korea, and Singapore) within 14 days prior to illness onset OR other index of suspicion (e.g., contact with an ill person with travel to affected areas, contact with a confirmed or probable case of COVID-19)
We do not recommend COVID-19 testing for asymptomatic patients. We are developing a patient handout on this recommendation and we will include this document in our next MHO update.
For patients meeting testing criteria:
- Give the patient a surgical mask to wear and place the patient in a separate room
- Use contact and droplet precautions (gloves, gowns, surgical mask and eye protection) particularly during sample collection
- Obtain a NP swab and throat swab (red top or blue top COPAN with UNIVERSAL TRANSPORT MEDIA (UTM)) and send both swabs to the BCCDC Provincial Laboratory. Ensure that the requisition indicates testing for “novel coronavirus” (for testing consultation, call the BCCDC PHL Medical Microbiologist on-call at 604-661-7033)
- Advise the patient to self-isolate and provide “Home Isolation” instructions – Home Isolation instructions attached in English, Chinese (Simplified), Chinese (Traditional) and Punjabi.
- (**NEW**) Inform the patient they can call the BCCDC Coronavirus Hotline (1-833-707-2792) for testing results
(**NEW**) Note that you may receive results on other common coronaviruses that cause mild illness. The following common coronaviruses do not need to be discussed with Public Health: Coronavirus 229E, Coronavirus OC43, Coronavirus NL63, Coronavirus HKU1.
The BCCDC will notify Public Health in the event of a positive COVID-19 result. Public Health will follow-up on all confirmed COVID-19 results.
When to notify the Medical Health Officer:
Notify the Medical Health Officer for cases where there is a high index of suspicion. This includes patients with:
- Severe respiratory presentations (particularly lower respiratory symptoms) and travel to affected areas (as of Feb. 24, 2020, affected areas include: China, Japan, Italy, Iran, South Korea, and Singapore) in the last 14 days before illness onset
- Respiratory symptoms AND
- Travel to Hubei province in the 14 days before onset of illness OR
- Close contact with a confirmed or probable case of COVID-19 within 14 days before their illness onset
Notifying the MHO ensures tracking of specimens at the BCCDC and early public health intervention.
- If the patient is well enough to return home, discharge the patient with a surgical mask and advise the patient to isolate at home
- Provide the “Home Isolation” document to the patient (English version attached to this alert. Translated versions are available soon at www.fraserhealth.ca/coronavirus
- Confirm the patient’s contact information. (**NEW**) Clinicians should inform patients that they can call the BCCDC Coronavirus Hotline to receive their results and guidance regarding self-isolation if swab results are negative. Should the swab results be positive, Public Health provides follow-up.
Home Isolation - While Waiting For Novel Coronavirus (COVID-19) Results
New Self-Isolation Instructions Document: Document provides self-isolation instructions in simpler language