None of the HPA Health Group hospitals or units is a “COVID-19 unit”.
However, we have defined referral protocols on decisions to be followed related to referrals in suspected cases or positive patients:
Why can pathogenic droplets depending on room temperature and humidity, reach distances of 7-8 meters?
When we sneeze, we emit two types of droplets: large and small. The large ones fall to the ground faster than they evaporate, while the smaller ones are airborne and evaporate faster than they fall, forming a cloud in the environment. Currently, it is known that small droplets, when transited from respiratory system’s hot and humid conditions, to a cooler and drier environment, evaporate and form aerosols.
Recent investigation has shown that coughing and sneezing produce multiphase clouds of turbulent gas that enters the environment and carries clusters of droplets. The inside of the cloud remains hotter longer, allowing the droplets to escape evaporation for a longer period, increasing its life span and contagion.
Due to the advanced momentum of the cloud, the pathogenic droplets are propelled much further, and are able to travel 7-8 meters, depending on air temperature and humidity.
How long so the SARS-CoV 2 aerosols remain in the air?
On average they remain viable for 30 min.
Can objects (via fomites) effectively be a source of transmission?
A fomite is any inanimate object or substance capable of absorbing, retaining and transporting infectious organisms from one individual to another, after contact with aerosols or droplets.
Smooth (non-porous) surfaces transmit bacteria and viruses better than porous materials, as they absorb and trap the contagious agent, making it more difficult to contract through touch.
Examples of fomites: contaminated shoes, laryngoscopes, computer keyboard, mobile phone, cutlery, door handles, floor and walls.
What are the transmission routes of SARS-CoV 2?
Respiratory secretions, feces and cases of sexual transmission (semen) have also been reported.
Is the viral load the same throughout the respiratory system?
The highest buildup of COVID-19 is found in the sputum and secretions of the upper airway.
Every year, on the 5th of May - World Hand Hygiene Day - is celebrated by the GCL-PPCIRA of the HPA Health Group. We began with minimum local initiatives to raise awareness among professionals on the importance of hand hygiene, where we would welcome and reward the department that adhered most to this practice and, more recently, with further initiatives aimed at the community.
However, this year will be different. The world is different. Our units are different. We are all different. But the importance of hand hygiene in the prevention of infection has not changed. Perhaps what has changed is the way we all view its effectiveness. Now, we look at hand hygiene as a powerful and truly effective way in the prevention of cross-transmission. Now and always we realize the importance of continued hand hygiene.
We know and feel how much anguish and uncertainty this pandemic has caused to us all. However, we also recognize that it has brought us something that for years the World Health Organization, the National Health Department, the Regional Coordinating Groups of PPCIRA, the Local Coordinating Groups of PPCIRA, tried, but never succeeded: real awareness of the importance of hand hygiene. Today we are all aware that WASHING HANDS SAVES LIVES!
Some patients with SARS-CoV-2 (COVID-19) have since the beginning of this pandemic, passed through our hospitals, fortunately not many. We believe that all the measures adopted by our professionals, of which we highlight hand hygiene, were essential in avoiding what could have been a catastrophe in our units: transmission of the virus to professionals or to other patients. Our SARS-CoV-2 cross infection rate is zero at the moment, and we are sure that good practices such as hand hygiene have contributed immensely towards this result.
Masks vary depending on their protective barrier both for the wearer and also for others.
Surgical masks cover the mouth and nose and act as a barrier minimizing the direct transmission of infectious agents between the wearer and others. The main purpose is to protect the health of others, while at the same time safeguarding the user.
Respirators or respiratory masks (Filtering Face Piece, FFP) are personal protective equipment for health professionals. They are commonly classified as P1, P2 and P3 (FFP1, FFP2 and FFP3) according to their filtration capacity.
Social masks have become common use in this context of the current pandemic, as they have become mandatory use in a community context. They are made from a textile material and must ensure at least 70% filtration. Manufacturers of this type of mask must provide detailed information on their reuse (washing, drying, conservation and maintenance), as well as the number of possible uses.
Some foods contribute to improving our immunity, such as yogurts, which have a probiotic action due to the presence of bacteria that help regulate intestinal flora, onions and garlic act as anti-inflammatory agents, ginger and mushrooms, more specifically the shitake mushroom, for their beneficial properties.
During confinement it is inevitably that we use less energy than usual and, naturally, combating a sedentary lifestyle and weight gain become a difficult task. It is recommended, in addition to a healthy diet, to maintain physical exercise, with daily exercise classes at home and /or hiking or running outdoors.
Do not forget that drinking water regularly is essential for the for the correct functioning of our bodily functions. At least 1 ½ liters of liquids per day is recommended, can be plain water, flavored water, tea or herbal infusions without sugar.
From a planning point of view, when buying food, especially vegetables, preference should be given to frozen products that have greater durability, but at the same time, fresh products and fruit, such as orange, lemon, kiwi, pineapple and red fruits are a must.
One should take advantage of these moments which mean spending more time at home with the children. Invite them to participate in the elaboration some healthy recipes, such as natural yogurt ice cream or natural fruit jelly. Likewise instilling in them the habit of eating more vegetables by using your imagination in the ways presentation, by grating, slicing, cutting into cubes or making “spaghetti” vegetables.
On a final note, it is important to stress that this is not the time for very restrictive diets, a balanced diet and maintaining a good body weight, is already great!
The test most commonly used for the diagnosis of COVID-19 infection is performed using nasopharyngeal swabs, for the detection of the virus's RNA (genome) by RT-PCR.
This test has a high specificity, that is, the results do not cause false positives. However, for sensitivity it appears that it can reach 30% false negatives. To eliminate this possibility, it is advisable to carry out more than one sample test on different days.
The analysis of RT-PCR requires differentiated and expensive technology, which is why rapid tests for the detection of COVID-19 antigens, similar to pregnancy tests, are being developed. It is expected that the percentage of false negatives from these tests may be even higher. However, it will also make it possible to treat individuals with a positive result early.
Parallel to the RT-PCR and antigen tests, tests that detect IgM and IgG antibodies against COVID-19 have now begun to appear, using the English ELISA technique (Enzyme Linked ImmunonoSorbent Assay, based on antigen-antibodies reactions detectable by enzymes), are cheaper and more accessible compared to RT-PCR.
There is, however, a drawback to antibody testing; in the early stages of infection results are negative. Physiologically the explanation lies in the fact that in the first few days of the individual being infected, it is his innate system that is asked to act, and it is only days later that the adaptive system is activated, including B cells, responsible for producing specific antibodies against COVID-19.
IgG and IgM tests are especially suitable when PCR tests are negative, but the patient presents the initial symptoms of pneumonia or persisting symptoms for over 10 days.
(Source: (DGS, 2020)
According to DGS (Direção Geral de Saude), waste such as handkerchiefs, food scraps or other household waste, from an individual who is in quarantine or isolation, should be treated with special care, including the waste produced by other cohabitants:
Therefore, we must all follow two recommendations: ensure that food balance requirements are met and be responsible with your purchases, that is, buy the necessary quantities without exaggeration, so as not to cause stock outages in supermarkets.
1. CEREALS AND DERIVATIVES, TUBERCULES
1.1 Breakfast and snacks
|FOOD||QUANTITY PER PERSON FOR 14 DAYS*|
Breakfast cereals (Cornflakes, muesli or oats type cereals) (cereals only)
|Breakfast cereals (Cornflakes, muesli or oats) + Marie biscuits /crackers + Toste||500g + 300g + 200g|
|Bread + breakfast cereals (Cornflakes, muesli or oats)||700g + 500g|
1.2 Main meals
|Rice, pasta or potatoes||3Kg|
|Vegetables (vegetables, greens...)||2,5Kg|
4. DAIRY PRODUCTS
|FOOD||QUANTITY PER PERSON FOR 14 DAYS*|
Milk + Cheese (eg.: plain sliced cheese)
|5L + 600g|
|Milk + Cheese (eg.: plain sliced cheese) + Yogurt||3L + 600g + 14 Yogurt|
5. MEAT, FISH AND EGGS
|Meat, fish and eggs||3kg (1/2 dozen eggs) + 700g (or 6 cans of tinned fish + 2kg meat or fish (frozen/fresh)|
|Legumes (beans, chick peas, green peas, lentils)||1kg (tinned legumes) ou 350g (dry legumes)|
|Olive Oil||350 ml|
8. OTHER FOODS
|Coffee, tomatões, nuts, jams||Not applicable|
* Estimated average daily nutritional needs for the Portuguese population: 2000 kcal, 20% protein, 50% carbohydrates and 30% lipids. Adjust the quantities according to your household..
Remember that if you have any of the following respiratory symptoms – cough, high temperature, or difficulty breathing – should (National Health Service)
SNS24 PORTUGAL MAINLAND: 808 24 24 24 or SRS24 MADEIRA ISLAND: 808 24 24 20.
Do not go to your doctor or hospital.
If you have recently travelled within the last 14 days or had contact with anyone who was possibly infected, you must protect yourself and remain in quarantine.
Comply with the following preventative measures:
Quarantine and isolation are both ways of social distancing to protect individuals and the population in general from an epidemic.
Those who are believed to be healthy are placed in quarantine but that might have come into contact with a patient who has been confirmed to be infected. If you are placed in quarantine be aware of possible symptoms, by measuring your temperature twice daily.
The preventative measures must continue to be observed: In addition to social distancing, maintain respiratory etiquette and wash hands frequently
Isolation is the measure adopted for people that are ill, to avoid others from becoming infected.
See how a patient in isolation at home should behave, as well as the other members of the family residing in the same home.
Whether in quarantine or in isolation, the individual must comply scrupulously with the period indicated, even when no symptoms are present.
Human health, animal health and the ecosystems are intimately connected.
We now know that 70-80% of emerging infectious diseases including the reemerging ones are of zoonotic origin. That is, they can be transmitted between humans and animals.
Population growth, climatic changes, urban growth, travel facilities, and successive international migration, increase the risk pathogenic respiratory dissemination agents.
The Ccoronavirus causes diseases of varying severity: the manifestation of a simple flu, to more serious conditions, such as Middle East Respiratory Syndrome (MERS), which occurred in 2012, or a Severe Acute Respiratory Syndrome (SARS) in 2002.