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- Page navigation anchor for RE: Transmission of Corona Virus by Nebulizer- a serious, underappreciated risk!RE: Transmission of Corona Virus by Nebulizer- a serious, underappreciated risk!
The current pandemic of COVID-19 cases demands greater infection control precautions. Nebulizers generate aerosol particles in the size of 1-5 µm that can carry bacteria and viruses into the deep lung. The risk of infection transmission via droplet nuclei and aerosols may increase during nebulizer treatments because of the potential to generate a high volume of respiratory aerosols that may be propelled over a longer distance than that involved in natural dispersion pattern (1). Furthermore, the larger particles may stimulate both patients' and bystanders' cough and thus increase the risk of spreading the disease (2). Nebulizer therapy in patients with pandemic COVID-19 infection has the potential to transmit potentially viable COVID-19 to susceptible bystander hosts.
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In recent years there has been a welcome shift, in some centers, from the use of nebulizers to metered dose inhalers (pMDI) with Valved-Holding Chambers (VHCs). In Alberta Canada for example, any order for nebulizer is now restricted and nebulizer is only to be used in the following situations:
1. Severe, life-threatening respiratory disease (e.g., those with severe or impending respiratory arrest, those with hypoventilation or ventilation compromise, continuous nebulization, end-stage COPD, cystic fibrosis); OR
2. Patients who are uncooperative or are unable to follow the directions required for a metered-dose inhaler (MDI) with spacer use; OR
3. Patients with a history of...Competing Interests: M. T. Newhouse is employed by InspiRx Pharmaceuticals Inc as the Chief Medical Officer and has patents through InspiRx Pharmaceuticals Inc (6,470.882; 8,119,016; D 689,602; D 685,085; and D 686725; Pending: US 2012/0318261 and 2012/0318265). - Page navigation anchor for Lack of COVID-19 Transmission on an International FlightLack of COVID-19 Transmission on an International Flight
In response to Wendy Glauser’s article, Communication, transparency key as Canada faces new coronavirus threat, we would like to share the public health response to the first Canadian cases of COVID-19. Case details have been published.(1) The patients traveled from Wuhan to Guangzhou, then Guangzhou to Toronto, Canada, arriving on January 22, 2020. The index patient was symptomatic with dry cough during the flight. His wife developed cough on January 23rd. Both sets of throat and nasopharyngeal swabs collected were positive for COVID-19.
There were approximately 350 passengers on board the airplane. The public was notified through the media that the index case was symptomatic during the 15-hour flight. Close contacts included 25 individuals sitting within two meters of the index case during the flight, flight crew members, and one close contact on arrival in Toronto. Close contacts received active daily contact monitoring by local public health officials for 14 days from the flight. Passengers and crew members who were not from Ontario were referred to their home jurisdiction for follow-up. On January 29th, one close contact developed symptoms of cough; however, nasopharyngeal and throat swabs were negative for COVID-19. Non-close contact passengers were advised to self-monitor and contact public health if symptomatic; five non-close contact symptomatic passengers were tested and found negative by nasopharyngeal and throat swabs for COVID-19.
The United St...
Show MoreCompeting Interests: None declared.