Airborne Diseases and Risks for HCP

00:00 Hi. Welcome to our video series on caring for COVID-19 Patients.

00:05 We're going to focus on safety for healthcare personnel.

00:08 Now, airborne diseases are these infections and they spread when someone coughs, sneezes, or talks.

00:18 This is the kind of stuff I hate looking at those pictures when you see what could likely be flying out of people's mouths when you're talking to them.

00:26 But viruses or bacteria can also be present in the air.

00:31 They can kind of just hang out.

00:33 Now, they can land on other people or on surfaces, and sometimes they can live for a lot longer than we're comfortable with outside of the body.

00:42 Just for fun, let's see if you can answer this question.

00:45 How long can an M. tuberculosis bacteria exist in the air? Okay, give us your best guess.

00:53 How long do you think the bacteria that causes TB, how long can it exist just hanging out in the air? Ready? Yes, six hours. To me, that is unbelievable.

01:10 They can hang out in the air for that long.

01:12 Let's look at these types of viral airborne diseases.

01:15 We're gonna look at these are caused by a virus, that's why they're called viral airborne diseases.

01:20 Now, the first one, not real surprising, it's the common cold and it's usually caused by a virus called rhinovirus.

01:27 The varicella-zoster virus causes chickenpox.

01:30 You had that as a kid, would not recommend it.

01:34 Now, the next one and the next one are also childhood diseases and their name of their virus is also the name of the disease, mumps and measles.

01:43 So, there are four viral airborne diseases.

01:48 Let's look at bacterial airborne diseases.

01:51 Whooping cough, which is Bordetella pertussis, tuberculosis, we talked about M. tuberculosis, and the third one is diptheria.

02:01 Now, that is a mouthful and I am not even going to attempt it but you see the name there under bacteria, next to diptheria.

02:10 Now, you may be asking yourself, hey, what about COVID-19 or SARS-CoV-2? Remember, SARS-CoV-2 is the virus that caused COVID-19.

02:22 What about the flu? I mean, that goes around every year.

02:25 That's caused by this virus that changes and moves around the world.

02:28 Well, this has been a topic of discussion in the scientific community.

02:33 Is COVID-19 or SARS-CoV-2 airborne? Now, in our graphic there, you see that single RNA green strand in the middle, you see the spiky proteins where it has five of those proteins in SARS-CoV-2.

02:48 Is this particular nasty beast airborne? Well, airborne transmission may be possible.

02:56 Okay, WHO and CDC agree on this that procedures or treatments that generate aerosols, you want to protect yourself based on airborne transmission.

03:07 So, if you're gonna do something, some type of treatment or procedure that will cause these viruses to be aerosolized, they wanna make sure that you take extra precautions.

03:17 So, if a patient is gonna have a bronchoscopy, that's a procedure where they put a scope down and look at the lungs.

03:23 That may aerosolize virus. If the patient is gonna be intubated, that means they put an endotracheal tube down into the patient's lungs.

03:32 That might cause aerosolization of the virus.

03:36 If they're gonna have open suctioning, meaning if I put a suction catheter down and I try to suction the patient.

03:41 Close suctioning is one that is done within the ventilator tubing, but if I'm doing open suctioning, it's particularly risky to aerosolize the virus.

03:49 So, here's an example of some of the procedures that can cause an aerosolized virus.

03:54 Now, there was this study that came out in the Journal of the American Medical Association.

03:58 Now, they used this fancy lab equipment, 3-jet Collison nebulizer and Goldberg drum.

04:04 Now, in their study, they started to question whether SARS-CoV-2 could be an airborne virus.

04:12 How long could it actually hang out? Now, I encourage you to go and read the study but what they found out was that yes, it could kind of hang up in the air but they used up 3-jet Collison nebulizer and Goldberg drum.

04:27 The World Health Organization, on March 29th, 2020, identified this is not normal human cough conditions.

04:35 So, this is what the World Health Organization recommends based on the available evidence, including the recent publication we just talked about, WHO continues to recommend droplet and contact precautions for those people caring for COVID-19 patients.

04:50 WHO continues to recommend airborne precautions for circumstances and settings in which aerosol generating procedures and support treatment are performed, according to risk assessment.

05:01 So, back to those, if you're gonna have a patient that's undergoing one of those procedures or treatments, the WHO, the World Health Organization, clearly recommends that you protect yourself with airborne PPE, personal protective equipment.

05:15 Now, the Center for Disease Control and the European Center for Disease Prevention and Control, they recommend that airborne precautions for any situation involving the care of COVID-19 patients.

05:27 They consider the use of medical mask as an acceptable option in case of shortages of respirators N95, FFP2, or FFP3.