Other COVID-19 Information

| General Information |

Updated information for South Africa can be found at:

National Institute for Communicable Diseases Department of Health

International information/guidance can be found at:

World Health Organisation
Centers for Disease Control

| Local & Global Interactive Maps |

COVID-19 Visualizer
COVID-19 Awareness SA

The COVID-19 resources below are presented in the form of questions, in a user-friendly FAQ format. Please note the following about these resources:

  • ECSSA has not generated any of the resources itself. The resources listed here are those that have been generated by other reputable organisations and have been reviewed by us. We are simply trying to collate resources that we consider valid (considering the rapidly evolving nature of this pandemic) and make them available in one place for ease of reference.
  • In doing the above, ECSSA has worked together with ER24, Netcare 911 and the African Federation for Emergency Medicine to obtain, review and share information that we all feel is useful and applicable to safe and effective pre-hospital emergency care.

How can a possible COVID-19 case be identified?

The National Institute for Communicable Diseases (NICD) is the authority designated by the South African Department of Health. Working together with several experts in the field they guide the South African Health workforce on what the correct case definition is to follow when screening patients for COVID-19. The case definition is a set of questions that can be asked in person or by a trained contact centre operator. These definitions can be found on the NICD website.

We suggest that telephonic screening is done when the caller calls into a contact centre, as well as at the start of assessment of the patient.

What personal protective equipment (PPE) should I wear to protect myself and my patient?

There is a global shortage of personal protective equipment, this includes hand sanitizer, masks (specifically N95/FFP2), face shields, gloves and gowns. Due to this shortage, it is of the utmost importance that we use PPE sparingly and for the correct patients. Once you have completed your screening questions that should be done from a safe distance, you can decide on whether you need to use PPE. We suggest that you only use PPE in patients that screen positive according to the case definition. Remember that if you DO NOT require PPE if you can maintain a distance of 2 meters from patients (this includes the driver of the vehicle)

Once the patient has screened positive according to the case definition you will need to do a risk assessment to understand if the patient is high or low risk. Patients where aerosol-generating procedures might take place are considered high risk, whereas patients that only require transportation to hospital and monitoring are low risk (find list of aerosol-generating procedures below). We suggest that WHO recommendations around PPE are followed once this risk assessment is completed.

For low-risk patients, use the following PPE:

  • Surgical mask
  • Goggles/Eye Protection
  • Gown/Apron
  • Gloves

For high-risk, aerosol-generating procedures, use the following PPE:

  • N95/FFP2 Mask
  • Goggles/Eye Protection
  • Gown/Apron
  • Double Gloves

Aerosol-generating procedures:

  • Tracheal Intubation & Related Procedures (see these recommendations for intubating severely ill COVID-19 patients)
  • High-Frequency Oscillation Ventilation
  • Non-invasive Ventilation, including CPAP
  • Bag-valve-mask Ventilation
  • Cardiopulmonary Resuscitation
  • Suctioning of the Oropharynx/Nasopharynx
  • Nebulisation
  • Manipulation of an Oxygen Mask
  • Administration of Pressurized Humidified Oxygen
  • Obtaining Diagnostic Nose & Throat Swabs

How should these patients be prioritised?

Once you have completed the screening, establishing that the patient is suspected of having COVID-19 and you have donned your PPE you will need to determine the severity of your patient. We suggest following the recommendations made by the African Federation for Emergency Medicine (AFEM). A severity scoring tool can be used to help with the decision making about where you should be transporting your patient.

How do I clean after the case?

Currently, the WHO recommends that one of two disinfectants are used:

  • 70% ethyl alcohol
  • Sodium hypochlorite at 0.5% (note that sources differ on this, 0.5% seems to be the highest and is recommended by the WHO).

70% alcohol solutions are in short supply and used by health care workers (and others) as hand sanitizer. For this reason, we recommend that you use sodium hypochlorite at 0.5% to clean your ambulance after contamination. Directions to how to mix this solution using standard house-hold bleach can be found here.

Should I be worried after treating a patient that possibly has COVID-19?

If you have used the appropriate PPE in the correct way you should be well protected. We do suggest that you do self-screening and quarantine* for 14 days after you have been exposed to a positive patient. The South African Department of Labour has declared that COVID-19 can be occupationally-acquired and you will be able to claim for it through the compensation fund. It is important that you can provide details of when you were exposed to a suspected case and when you develop symptoms. It is recommended that organisations assist employees with the function of tracking exposure to suspected cases. In addition, after testing if you have been found to be positive, the WHO recommends that you should self-isolate for 14 days unless the symptoms are mild to severe requiring supervision.

*Quarantine is for people that have been exposed to spread of a contagious disease who do not have symptoms but were exposed to the others who are known to have the disease. Self-isolation serves the same purpose as quarantine, but is reserved for people who are found to be positive after exposure.

What should I do if I start feeling sick with symptoms that may be COVID-19?

It is important to act on this quickly, as you may have become infected and will potentially infect others around you. We suggest the following:

  • Inform your employer immediately and follow any protocols that they have in place for this situation.
  • Follow the current recommendations regarding quarantine and self-isolation. Ensure that you don’t further put people at risk. More information can be found on the NICD website.
  • Consider consulting telephonically with a knowledgeable medical doctor if you are unsure of anything.

What should I do if I feel that I can't cope with the situation?

The current situation with COVID-19 can result in stress and anxiety, especially amongst health workers. This is partly because of the associated increased workload and working conditions (e.g. shortages of PPE) and also the anxiety associated with the risk of becoming infected. It is important to recognise the signs of burnout and seek help as early as possible. While you will need to contact your employer about access to professional help if this is required, it is also important to recognise that we all have a duty to be on the lookout for these signs amongst our colleagues and to support each other as much as possible. The resources below offer some perspectives on dealing with stress in general, and specifically in relation to the situation that all health workers now find themselves in.

https://www.stemlynsblog.org/understanding-fear-and-anxiety-around-covid-19-a-st-emlyns-podcast/ https://badem.co.za/head-vs-heart-opening-box/

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