Dear Doctor,

• On Friday, Feb. 6, Nova Scotia, along with all provinces, territories and the federal government, announced that national screening guidelines are being enhanced to respond to the evolving novel coronavirus situation.
• Travellers arriving in Canada who have travelled to Hubei province, China in the last 14 days will be asked to self-isolate at home for 14 days from their last day in Hubei province. They will receive supporting health information from Nova Scotia Health Authority public health services.
• People who have travelled from any other part of China in the last 14 days will be asked to closely monitor their health for 14 days from their last day in China and call the province’s 811 line if they develop fever, cough or difficulty breathing.
• Unknown people in either category who have returned to Nova Scotia within the 14-day time period will be asked through public messaging to take the appropriate measures for the remainder of the 14 days.

Update – Dr. Rob Strang, Chief Medical Officer (Feb. 6, 2020):
The attached bulletin from Dr. Robert Strang has more information for screening in health-care settings. If a patient presents with fever (over 38°Celsius) AND/OR new onset (or exacerbation of chronic) cough and in the 14 days prior to symptom onset has travelled to or through China or been in close contact with a probable or confirmed case of 2019-nCoV, the screening tool recommends:

• referring the patient to the closest emergency department (ED) for testing 
• providing the patient with a surgical/procedure mask (N95 not required) to wear to the ED to limit exposure to others
• contacting the ED in advance to inform them that a person under investigation (PUI) for 2019-nCoV will be arriving
• reporting the PUI to Public Health. Immediate notification by phone to the local Medical Officer of Health (MOH) is required. During business hours, the local MOH can be contacted through the appropriate regional hospital switchboard (in Central Zone this is QEII locating); after hours phone 902-473-2222 and ask for the MOH on-call.

Note: asymptomatic individuals returning from China or close contacts of a case who develop symptoms will be directed by public information and/or local Public Health to call 811 for further direction. 

Read the bulletin here

NSHA information and resources:
The Nova Scotia Health Authority’s Infection Prevention and Control provides advice for managing 2019-nCoV in community settings along with posters to help raise awareness of protocols.

Posters:

• Dos and Don’ts for glove use
• Dos and Don’ts for gown use 
• Dos and Don’ts for masks and face protection
• Putting on PPE droplet and contact
• Removing PPE droplet and contract 

Read the full notice here

Quick facts:

• There are five confirmed cases in Canada—three in Ontario and two in British Columbia.
• There are no reported cases in Nova Scotia; the risk to Nova Scotians remains low.
• There is evidence the virus spreads from person-to-person, however it is not clear how easily it spreads.
• Most cases in China and internationally continue to have direct links to or through Hubei province.
• The Government of Canada recommends avoiding all non-essential travel to China and all travel to Hubei province, China, including Wuhan city.

Additional resources:

• Government of Canada
• Public Health Agency of Canada, guidance for infection control in acute care
• Department of Health and Wellness
• Canadian Medical Association