COVID FAQS Safety and Health

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COVID19 Safety and Health

Safety and Health

 

Phased Return-To-Campus in the COVID-19 Environment pdf.

Q1: What is COVID-19?

A1: A novel coronavirus is a new coronavirus that has not been previously identified. The virus causing coronavirus disease 2019 (COVID-19) is not the same as the coronaviruses that commonly circulates among humans and causes mild illnesses like the common cold. 

A diagnosis with coronavirus 229E, NL63, OC43, or HKU1 is not the same as a COVID-19 diagnosis. Patients with COVID-19 will be evaluated and cared for differently than patients with common coronavirus diagnosis. https://www.co.monterey.ca.us/government/departments-a-h/health/diseases/2019-novel-coronavirus-2019-ncov/2019-novel-coronavirus-2019-ncov-the-facts

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/share-facts.html


COVID-19: An Illustrated Scientific Summary 


Video Created and Produced by Yale Neuroscience Ph.D. Student Clara Liao 

Q2: What’s the difference between COVID-19 and influenza?

A2: Both are transmitted in similar ways. Mild or severe symptoms for both may include fever, cough, body aches, fatigue, diarrhea, vomiting and pneumonia. Influenza is caused by different strains of the flu virus, but COVID-19 is caused by one virus, the novel 2019 coronavirus, also called severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2.

Q3: Who is most at risk to contract COVID-19?

A3: Groups at higher risk include older adults and people of any age who have serious underlying medical conditions such as heart disease, diabetes and/or lung disease which can lead to more serious complications. See:  https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html. 

Q4: How can I lessen the risk of contracting COVID-19?

A4: Per the CDC, to lessen the risk of contracting COVID-19:

Soap and water, as well as common alcohol and chlorine-based cleaners, hand sanitizers, and disinfectants are effective at inactivating SARS-CoV-2 on hands and surfaces.

Alcohol-based hand rubs are effective at inactivating SARS-CoV-2.85

Chlorine bleach (1%, 2%), 70% ethanol and 0.05% chlorhexidine are effective against live virus in lab tests.

  • 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. Always wash hands with soap and water if hands are visibly dirty.
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. 
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
  • Practice social distancing: stand six feet apart from others.
  • Obey Monterey’s Shelter-in-Place and the Governor’s Stay-at-Home directives.

Social Distancing- 1 Fathom (graphic)

Q5: Are there treatments available for COVID-19?

A5: Prevention is the best practice: https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html while antiviral medications are currently being tested and development of a vaccine is underway. Antibiotics are ineffective, since they treat bacterial infections. Approaches include rest and reducing fever; hospitalization and mechanical ventilation may be required in severe cases. People presenting with respiratory illness, a fever greater than 100.4, cough, shortness of breath, and symptoms of influenza, may be screened using CDC criteria. 

Q6: How serious is COVID-19?

A6: Because cases worldwide are on the increase, the World Health Organization declared the outbreak of COVID-19 a public health emergency of international concern. If a community outbreak occurs, CDC guidelines are at: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html. Community guides from the Monterey County Health Department are at: https://www.co.monterey.ca.us/government/departments-a-h/health/diseases/2019-novel-coronavirus-2019-ncov. 

Q7: How is the coronavirus transmitted through the air?    

A7:

  • If an individual coughs, sings, shouts, speaks, sneezes or otherwise forcibly directs breath out of their mouth, then droplets form, which dependent on local environmental conditions can “hang” for seconds to hours over an average distance of 3-6ft. 
  • 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. According to current evidence, COVID-19 virus is primarily transmitted between people through respiratory droplets and contact routes. In an analysis of 75,465 COVID-19 cases in China, airborne transmission was not reported. https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations
  • The bigger droplets can fall within seconds to minutes.  The smaller the droplet the longer the “hang time”, with the right environmental conditions could be hours.  (SARS-CoV-2 has an aerosol half-life of 2.7 hours particles <5 μm, tested at 21-23 C and 65% RH). (2)
  • It is not known, the number or viral particles inside a droplet needed to cause the disease. How susceptible an individual is will depend on the status of that individual’s immune system.  People with weakened immune systems have a greater likelihood of developing symptoms and severe illness. https://www.cdc.gov/coronavirus/2019-ncov/travelers/map-and-travel-notices.html Healthy individuals without a weakened immune system potentially need more viral particles to get sick. 
  • The 6 ft distancing rule is primarily for healthy non-symptomatic personnel (For the average person not working in a hospital). https://www.npr.org/2020/03/28/823292062/who-reviews-available-evidence-on-coronavirus-transmission-through-air  
  • If the person has symptoms, they should wear a surgical mask or cover their face with a cloth or other item, to protect those around them.  
  • People are thought to be most contagious when they are most symptomatic (i.e., experiencing fever, cough, and/or shortness of breath).  Therefore, the sicker the individual the more viral particles within the droplets, the higher the likelihood of a infection producing droplet, and the more it is important to control. 
    • Modeling suggests asymptomatically infected persons were half as contagious as persons with observable symptoms. Which reinforces the value of testing and social distancing as prevention measures. 

Q8: Who is most likely to die from the coronavirus if infected? 

A8: Most deaths are caused by respiratory failure or respiratory failure combined with (heart) damage. The case fatality rate (CFR) depends on comorbidities (concurrent presence of two or more chronic diseases or conditions in a patient); cardiovascular disease, hypertension, diabetes, and respiratory conditions all increase the CFR. 

Current modeling suggests the overall case fatality rate (CFR) of COVID-19 is approximately 2.4%.

  • The CFR increases with age; individuals >60 are at higher risk of death

Q9: How am I most exposed to the coronavirus? 

A9: By the virus coming in contact with mucous membranes.  Examples: mouth, tongue, nose and eyes.  

Hand to mouth/face movement.  Touching a surface that has been contaminated by someone who is sick and then scratching your eyes or touching your mouth.

Inhalation. By breathing in infected droplets.  

Droplets coming in contact with your mucous membranes. 

Exposure Route: The virus coming in contact with mucous membranes.  Examples: mouth, tongue, nose and eyes.  

  • How can I be exposed: 
    • Hand to mouth/face movement.  Touching a surface that has been contaminated by someone who is sick and then scratching your eyes or touching your mouth.
    • Inhalation. By breathing in infected droplets.  
    • Droplets coming in contact with your mucous membranes. 

Q10: Do Masks Work?

A10: The CDC is additionally advising the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.  Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html

  • the face coverings/masks prevent spread from individuals without symptoms, they don't protect you.  These coverings do not seal around your face and provide very limited protection.  Respirators such as N95's have to be fit-tested, that means they have to seal against your face and this provides the protection against particles along with the N95 material construction, which filters our 95% of particles >0.3um. 
  • People are thought to be most contagious when they are most symptomatic (3) (i.e., experiencing fever, cough, and/or shortness of breath).  Therefore, the sicker the individual the more viral particles within the droplets, the higher the likelihood of a infection producing droplet, and the more it is important to control. 
  • Modeling suggests asymptomatically infected persons were half as contagious as persons with observable symptoms. Which reinforces the value of testing and social distancing as prevention measures. (4)
  • Severe cases are more likely to transmit disease; most new infections are within households of infected patients, currently making household contacts the main transmission mode. From DHS SCIENCE AND TECHNOLOGY Master Question Lis.t
  • Children of all ages are susceptible to COVID-19, though generally show milder or no symptoms; up to 28% of children may be asymptomatic. 
  • To learn how to properly wear and dispose of a mask, go to: https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html
  • Masks (cotton masks, surgical masks, etc.) that are not NIOSH approved respirators (i.e N95), provide very limited protection, since no seal can be made. 
  • Masks will protect OTHERS from you.  Because they will provide a physical barrier at the source (your mouth and nose) to larger particles exiting you.  
  • Facemasks should be used by people showing symptoms to reduce the risk of others getting infected. The use of facemasks is crucial for health workers and people in close contact with infected patients (at home or in a health care facility). https://www.cdc.gov/coronavirus/2019-ncov/faq.html.
  • The most effective protection measures are (listed from most effective to least effective): engineering controls (ventilation systems, solid barriers, ect), Immunizations (none available), administrative controls (social distancing, hand washing, ect), safe work practices (a type of administrative control), and PPE (like respirators and masks). https://www.osha.gov/Publications/OSHA3990.pdf

Q11: Are costs related to COVID-19 testing reimbursable?

A11: Check with your insurance provider to determine your copays, associated costs, and potentially waived fees for COVID-19 testing.

Q12: How can I stay informed about COVID-19?

A12: The Center for Disease Control and Prevention (CDC) provides updates at: https://www.cdc.gov/coronavirus/2019-ncov/index.html.
Campus updates are at the NPS Health and Safety site: https://nps.edu/web/safety/coronavirus
The COVID-19 web page at: https://nps.edu/group/mynps/covid-19-updates-for-nps-faculty-students-and-staff

Monterey County Health Department guidance is at: https://www.co.monterey.ca.us/government/departments-a-h/health/diseases/2019-novel-coronavirus-2019-ncov

Q13: Will I be notified if someone at NSAM/NPS tests positive for COVID-19?

A13: In the event that NSAM has a positive case, communication will follow higher headquarters protocol and HIPPA compliance, which includes a public announcement of the case by higher headquarters. To stay informed check the latest campus updates:

Q14: What should I do if I feel feverish, have a cough, and shortness of breath?

A14:   If you are sick with shortness of breath/cough + fever/chills and/or traveled from at risk area or close contact with someone who has had the virus: Do not go to ER; contact your physician so they can rule out influenza; and inform your supervisor. 

For Veterans: go to https://www.publichealth.va.gov/n-coronavirus/ also Veterans can sign into My HealtheVet (https://www.myhealth.va.gov/mhv-portal-web/web/myhealthevet/secure-messaging-spotlight ) to send a secure message to VA or use telehealth options (https://telehealth.va.gov/type/home) to explain your condition and receive a prompt diagnosis.
 For Tricare Beneficiary:  Call the Military Health System Nurse Advice     Line (MHS NAL) at 1-800-874-2273, Option 1 or online at https://mhsnurseadviceline.com/ 
 For Others: Contact you Primary Care provider, or E-Consult; CHOMP, Montage Medical Group 831-622 8001 or at:  https://www.montagehealth.org/montage-health/services/evisit/#.XnFb8ahKjIU.

IF YOU HAVE SCREENED POSITIVE FOR COVID-19, OR ARE QUARANTINED AWAITING RESULTS 

o    Call the Presidio of Monterey Department of Public Health at 831-242-4826 or 

o    Monterey County Health Department (MCHD) at 831-755-4521, 

o    Outside business hours, please call MAJ Jodi Brown at 831-234-9510 or

o    MCHD afterhours line at 831-755-5100 for further instructions. 

*Supervisors: Notify Chain of command, Deans and Directors send e-mail (ajcolon@nps.edu) with information (sans names) of sick personnel.

A link to the “Active Duty Service Member Wakes up and Feels Sick” chart is at: 

https://nps.edu/documents/111291366/116210200/Preventive+COVID19+Procedures+and+Resources.pdf/50816b03-2668-dcc9-7b1b-0ff7d1ff8b03?t=1584249967929

Q15: Who should I contact if I have questions or concerns?

A15: Utilize your chain of command and organizational leadership to raise questions and concerns. Information and campus updates can be found at:

Q16: Where can I find out about safety and health procedures and resources? 

A16: For procedures, please see the following links: https://nps.edu/web/safety/coronavirus   https://mysymptoms.mil/ also in the text: 

For free Virtual Care related to COVID-19 call: 831-622-8001
https://www.montagehealth.org/montage-health/services/evisit
https://www.mhsnurseadviceline.com/home
https://nps.edu/web/safety/coronavirus

For Veterans: go to https://www.publichealth.va.gov/n-coronavirus/  also Veterans can sign into My HealtheVet (https://www.myhealth.va.gov/mhv-portalweb/web/myhealthevet/secure-messaging-spotlight) to send a secure message to VA or use telehealth options (https://telehealth.va.gov/type/home) to explain their condition and receive a prompt diagnosis. Or 1-800-455-0057 (select #4) 

• For Tricare Beneficiary: - Call the Military Health System Nurse Advice Line (MHS NAL) at 1-800-874- 2273, Option 1 or - Web or video chat with a nurse: https://www.mhsnurseadviceline.com/home  - VA/DOD GOURLEY CLINIC contact 866-957-2256 

• For Others: Contact your Primary Care provider, or E-Consult; CHOMP, Montage Medical Group 831-622-8001 Montage Health free coronavirus E-Visit (virtual) available 24 hrs online https://www.montagehealth.org/montage-health/services/evisit

Q17: What are the current rules regarding face coverings/masks? 

A17: The base commander CAPT Wiley is following DOD Guidance and CNO’s Guidance and CDC guidelines for face coverings. You must wear a face covering coming on the base, when transiting to/from buildings, and when you cannot maintain the required minimum six feet of social distancing. 

  • Face coverings shall meet the following criteria and CDC guidelines: (1) conservative in appearance; (2) not offensive; (3) fit snugly but comfortably against the side of the face; (4) be from nose to chin; (5) be secured; be multiple layers of fabric (if cloth); and (6) shall NOT be a full face covering like ski masks.
  • For uniform personnel, until official face coverings are produced and implemented, individuals are authorized to wear medical or construction type masks, or other cloth covering, such as bandanas, scarfs, etc., but should follow the above criteria and CDC guidelines in the first bullet.  (COS comment:  If you find yourself wondering if the mask is appropriate, it likely isn’t.)
  • For non-uniformed personnel, follow the above criteria and CDC guidelines.
  • When entering the installation, all individuals in a vehicle shall lower the face covering to the chin as directed by Navy Security Forces to verify identification and crosscheck the photograph on the identification.
  • Consider the wear of face coverings while transiting into/across NSA Monterey property and NPS buildings mandatory.
  • If you are in your own office with adequate room to maintain six feet of distance from your colleagues, wearing a face covering is not required.
  • At the Child Development Center, children ages 0–5 will not wear face coverings.
  • Neither NPS nor NSAM will provide face masks/coverings.  

In addition, when entering the installation, the Navy Security Force will ask you an updated series of questions:

  • Are you currently experiencing cough, shortness of breath, fevers, and have you experienced or been sick in the last three days?
  • Have you had a known exposure to a COVID-19 patient in the past 14 days?
  • Have you been tested for COVID-19? … If Yes, have you been cleared by your medical provider to return to work?
  • [If not wearing a face covering] Do you have a mask in your possession or readily available on campus/base?
  • Additional information can be found on our NPS COVID-19 website  including official guidance  and NSAM’s website, which is updated daily. 

Q18. What are the current updates from the DOD in regards to travel?

A18.  SECDEF Memo of April 20, 2020 states that COVID-19 continues to present significant risk to our forces; therefore, international and domestic travel for all DOD Service members and their dependents, and DOD civilian personnel and their dependents on government-funded travel, including leave, permanent duty, Change of Station (PCS) and Authorized and Ordered Departures related travel issued by the Department of State will stop movement through June 30, 2020. For DOD Service members, personal leave outside the local area and non-official travel outside the local area is prohibited. DOD components may onboard civilian employees within the local commuting area only, and civilian employees whose travel to the local commuting area is not funded by the government.  This policy will be reviewed every 15 days from its date of issue to determine if travel can resume earlier than June 30, 2020.  

Q19: Are there key things to keep in mind to stay safe? 

A19: Here are some important reminders:

  • Know the closest emergency exit to your office/classroom.
  • Know the fire evacuation route for your building.
  • Know the numbers to call in an emergency:
    • Emergency: For Medical/Fire/Police Emergencies: 9-911
    • Non-Emergency: NSAM Police (Non-Emergency): x-2556
    • NPS Quarterdeck: x-2442
    • Police - Monterey: 831-646-3914
    • Police - POM Annex: 831-242-7851
    • Fire Station - POM Annex: 831-242-7701/2
    • NSAM Security Manager/ATO - Mr. Andy Archuletta: x-7555
    • NPS ATO - CWO2 Jamal Thompson: x-3031
    • NPS Special Security Officer/Security Manager - Mr. Andy Andersen: x-2450
    • Know your role in an Active Shooter Situation.
    • Earthquakes are our biggest natural disaster threat. Know what you should do if we have one.
    • Get Prepared California has instructions for every type of building you might be in during an earthquake and information on how to make sure you are prepared before an earthquake hits.
    • Be aware of your surroundings at all times—if you see something, say something.
    • If you have suggestions, please use the NSAM Suggestion Box.

CAL MED COVID-19 Protocol Chart

Q20 : How much agent will make a healthy individual ill?

A20: 

Q21:How does it spread from one host to another? How easily is it spread?

A21:

  • SARS-CoV-2 is passed easily between humans, likely through close contact with relatively large droplets and possibly through smaller aerosolized particles. SARS-CoV-2 Spike (S) receptor-binding domain binds the human cell receptor (ACE2) stronger than SARS-CoV-1,389 potentially explaining its high transmissibility. https://www.biorxiv.org/content/biorxiv/early/2020/02/15/2020.02.11.944462.full.pdf
  • Individuals can transmit SARS-CoV-2 to others before they have symptoms. https://doi.org/10.1001/jamainternmed.2020.2020 
  • Individuals who have recovered clinically, but test positive, appear unable to transmit COVID-19.
  • Epidemiological investigations by the Korean CDC suggest that individuals who have clinically recovered from COVID-19, but later show PCR positive tests, are not infectious. KCDC, Findings from investigation and analysis of re-positive cases. Korean Centers for Disease Control and Prevention: 2020. https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030 
  • SARS-CoV-2 RNA (viral particles) has been detected in upper and lower respiratory tract specimens, and SARS-CoV-2 virus has been isolated from upper respiratory tract specimens and bronchoalveolar lavage fluid. This Fluid forms respiratory droplets when an infected person sings, coughs, sneezes or talks. These droplets come into contact with mouths, noses or eyes of people who are nearby or possibly be inhaled into the lungs and cause an infection. Studies that attempt to reconstruct transmission chains among confirmed cases have also found that prolonged close contact is the source of most new infections. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30528-6/fulltext

Q22: How long after infection do symptoms appear? Are people infectious during this time?

A22:  Most individuals develop symptoms within 14 days of exposure. For most people, it takes at least 2 days to develop symptoms, and on average symptoms develop 5 days after exposure. Incubating individuals can transmit disease for several days before symptom onset. Some individuals never develop symptoms but can still transmit disease.

Q23: What are the signs and symptoms of an infected person?

A23: Many COVID-19 cases are asymptomatic. Most symptomatic cases are mild, but severe disease can be found in any age group. https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_w#suggestedcitation  Older individuals and those with underlying medical conditions are at higher risk of serious illness and death.

Q24: After being sick how long does the immune response provide protection from reinfection?

A24: Unknown

Q25: Are there effective treatments?

A25: No.  

Q26: How long does the agent live in the environment?

A26: SARS-CoV-2 can persist on surfaces for at least 3 days and on the surface of a surgical mask for up to 7 days depending on conditions. If aerosolized intentionally, SARS-CoV-2 is stable for at least several hours. SARS-CoV-2 on surfaces is inactivated rapidly with sunlight. https://doi.org/10.1093/infdis/jiaa274 

  • SARS-CoV-2 has an aerosol half-life (required for the activity of a substance taken into the body to lose one half its initial effectiveness) of 2.7 hours (particles <5 μm, tested at 21-23oC and 65% RH). https://doi.org/10.1056/NEJMc2004973 

Q27:What are the best ways to decontaminate? 

A27: Soap and water, as well as common alcohol and chlorine-based cleaners, hand sanitizers, and disinfectants are effective at inactivating SARS-CoV-2 on hands and surfaces. https://www.dhs.gov/news/2020/05/25/weekly-update-dhs-response-covid-19 

Q28: What PPE is effective?

A28: The effectiveness of PPE for SARS-CoV-2 is currently unknown, and data from other related coronaviruses are used for guidance. Healthcare workers are at high risk of acquiring COVID-19, even with recommended PPE.

The filtering efficiency of homemade mask materials is variable. Some non-standard materials (e.g., cotton, cotton hybrids) may be able to filter out >90% of simulant particles >0.3μm, https://www.ncbi.nlm.nih.gov/pubmed/32329337 while other materials (e.g., T-shirt, vacuum cleaner bag, towels) appear to have lower filtration efficacy.

Q29: Is COVID-19 natural or developed for intentional use?

A29: Genomic analysis suggests that SARS-CoV-2 is a natural variant and is unlikely to be human-derived or otherwise created by “recombination” with other circulating strains of coronavirus. Evidence does not support the idea that SARS-CoV-2 is a laboratory construct. https://doi.org/10.1038/s41591-020-0820-9 

Q30: How does the disease agent compare to previous strains?

A30: Structural modeling suggests that observed changes in the genetic sequence of the SARS-CoV-2 Spike protein may enhance binding of the virus to human ACE2 receptors. This could potentially explain the rapid viral spread of SARS-CoV-2 in humans. https://pubmed.ncbi.nlm.nih.gov/32210742 

  • A key difference between SARS-CoV-2 and other beta-coronaviruses is the presence of a polybasic furin cleavage site in the Spike protein (insertion of a PRRA amino acid sequence between S1 and S2). Coutard et.al. Antiviral research 2020, 176, 104742 
COVID19 FAQ Links public v2