Responding to Disease Outbreaks

A: Background 

A country's capacity to plan, prepare for, identify/detect, and respond fast to the outbreak of infectious diseases depends entirely on its competency levels. The latter helps mobilize a skilled workforce and its ability to provide and resupply its healthcare sector with all the necessary disease prevention and control supplies during public health crises. The health sector in most third world countries suffers from poor leadership, limited coordination, and fragmentation. Other issues that accelerate the spread of infectious diseases are low staff capacities, incompetent workforce, poor health policies, and weak information systems required in decision-making. Examples of infectious disease outbreaks are Ebola outbreaks in West Africa, Zika outbreaks in Latin America, and the most recent Coronavirus outbreak, which started in Wuhan, China, and spread to the rest of the world. The earlier the disease outbreak is detected, the better the response. When the outbreak is detected early, the outbreak's ultimate size can be reduced when healthcare personnel develop an appropriate and effective response plan. The healthcare workforce implements numerous approaches, and some techniques are used to measure the progress of the disease and its timeliness (Zhang et al., 2020) . Having prior knowledge of how the surveillance approaches work and fail to work elucidates the critical drivers of early detection of the disease. 

Coronavirus pandemic is an infectious and contagious disease. SARS-CoV-2 causes COVID-19. The first case of this disease was reported in December 2019 in Wuhan. The People’s Republic of China. As a nurse, I would do the first thing if a case is reported, I would run the patient's COVID test to determine whether the disease is COVID19. The known risk factors are death due to acute respiratory distress syndrome, respiratory failure, sepsis, and septic shock (Ali et al., 2020). Other risk failures include hospitalization, those that become seriously ill require oxygen, the critically ill, which is about 5%, need intensive care services. 

The most effective COVID-19 response plan checklist involves the following steps, having adequate planning and preparations in place, formulating realistic control measures, COVID-19 induction, dealing with the suspected case of the disease, thorough cleaning, and disinfection. The response plan comprises four steps: Read, sign and display the laid down policies, identify responsible people for performing critical tasks, fill out employer information, and use the above checklist to execute the response. 

B: Communicable Disease Overview 

Signs and symptoms 

Headache 

Loss of smell 

Nasal obstruction 

Cough 

Asthenia 

Myalgia 

Rhinorrhea 

Gustatory dysfunction 

Sore throat 

Fever 

Incubation period

At its incubation core, the period refers to when an individual is exposed to the virus and the onset of signs and symptoms (Shearer et al., 2020) . The COVID-19 incubation period is between five and six days. It can, however, go up to fourteen days. 

Mode of Transmission 

The coronavirus's primary transmission mode is through respiratory droplets passed during breathing, coughing, or sneezing from one person to another 

Lab Testing 

Presently, there are three necessary coronavirus tests to determine if a person has been infected with COVID-19. Namely: viral antigen detection, viral nucleic acid (RNA), and antibodies to coronavirus. The first two tests are used to detect acute infections, while the third test provides evidence of prior coronavirus infection. 

Treatment Recommendations 

Currently, there is no cure for coronavirus. If the symptoms are severe, doctors prescribe supportive treatments, and such therapies involve medications to reduce symptoms such as fever, fluids to minimize dehydration and supplemental oxygen when need be. 

C: Response Plan Necessity 

Having a good plan in place is necessary in case of a disease outbreak; it helps save time and act immediately to counter the spread and provide the right medication to those affected. A response plan requires entities to identify qualified staff and accumulate all the necessary commodities in preparation for an emergence. Response plan saves time and cost and helps to curb the spread of infections. 

Risks of a Local Outbreak 

Lockdown restrictions. 

Increased COVID-19 screening measures 

Closure of schools and other social facilities 

Potential Sources of Local Outbreaks 

People traveling from COVID-19 hotspots 

Community residents working in health facilities who may have come across infected patients. 

D: Plan Preparation 

Table 1: Logistics 

Physical Resource	Interdisciplinary Services
1. PPEs	1.Laboratory testing
2.Isolation rooms	2. Radiology rooms.
3.Hospital bed	3.Hospital ward
4.Gloves	4.Physical therapy
5.Breathing equipment(respirators)	5.Hospital wards

Table 2: Triage Protocols 

Protocol	Locations
PCR tests	Clinic
RNA test	Clinic
Antigen test	Hospital
Contact tracing	Within or out of the health facility
Quarantine (Ali et al., 2020).	Quarantine facilities
Hospitalization	Hospital wards

Table 3: Human Capital 

Nursing Department	Task details and management
Resource Management	isolation room.  An isolation room will be set apart to ensure that nurses have point of meeting where they can assemble to discuss and assess the progress.
Crisis communications	nurse reports to a supervisor.  The importance of communication is that the staff and executives alike remain informed about the crisis and are aware of the proactive measures to take.  The supervisor will then inform the rest of the employees through a particular communication channel. For example, they could send emails or write a memo.
Department continuity	add staff to relieve exposed staff  With the contagious nature of the disease, having additional staff os crucial as the exposed ones may contract the disease hence unable to render services.
Training	PPE annual training  On an annul basis, there will be training regarding PPE. The training will be done in a time frame of three days. The rationale stems from the need to keep up with the latest trends. Furthermore, innovations and technological advancements are constantly changing.

Table 4: Secondary Plan 

Secondary Plan Task	Task details
Hire new staff	Recruiting new staff-This will ensure that there is back up staff in case the existing ones are overwhelmed or contract the disease hence unable to effectively render their services.
Give them sick leave.	Ensure that the sick nurses do not come to work by granting them emergency leave. This will ensure that the disease is contained.  It is also crucial to communicate to the staff that in case they experience symptoms of the disease, they should stay at home. From there they can communicate with the supervisors on how to get a sick leave. This will help in containment of the disease as well as at home treatment that will avoid overwhelming the hospital capacity

E: Response Plan 

Table 5. Communication. 

Nursing Communication Protocol
Who do you notify?	Supervisor-Based on the communication protocols, the supervisor should be frequently informed of the progress of disease containment and treatment.
What do you communicate?	All the patient’s information. It is crucial to communicate patient information so that they can gauge the level of attendance. For example, if they need to be on oxygen or no.
When do you notify?	As soon as I have finished writing down all the patient’s information. Communication to the supervisor will be effective when there is handy information about the patient.
How do you notify?	Face to face or other communication channels such as telephone and email. Furthermore, in the modern era, there are diverse means of instant and effective communication (Zhang et al., 2020)

Table 6: Infection Control Measures 

Primary Department: Nursing	Ancillary Department
Nursing gloves  Preventing contact with body fluids to avoid high risk of infections.	Laboratory testing  Offering diagnosis test  Collecting blood samples.  Testing blood samples
PPEs:  Decreasing staff hazard exposure if the administrative controls area ineffective.  To reduce the hazard risk when the engineering controls are not viable.	Physical therapy services  Aids the patients to recover from injuries.  Maintain and promote health of individuals.
Sanitizer  Prevents spread of communicable diseases.  It kills germs.	Laboratory testing-after taking the samples  Testing for antibodies.  Analyzing and determining the blood samples.
N-95 masks  Prevents individuals from airborne elements.  Safeguards people from contaminated liquid.	Radiology services  Diagnosing and treating patients through internal body structures to know if there exists foreign bodies and diseases or damages or not.

F: Reflection of Nurses Ability 

Residents of my local community are aware of the current coronavirus pandemic. Most of them adhere to the guidelines like wearing face masks, washing their hands regularly, and observing social distancing rules. As a result, the possibility of an outbreak is minimal. The current known ways for containing the disease are: wearing masks, observing social distance, washing hands/sanitizing, and traveling when necessary to avoid the risk of exposure. The nurses/ other medical practitioners should observe the laid down COVID-19 rules because they are highly exposed to the virus compared to other people. 

References 

Ali, S. A., Baloch, M., Ahmed, N., Ali, A. A., & Iqbal, A. (2020). The outbreak of Coronavirus Disease 2019 (COVID-19)—an emerging global health threat.  Journal of infection and public health . https://doi.org/10.1016/j.jiph.2020.02.033 

Shearer, F. M., Moss, R., McVernon, J., Ross, J. V., & McCaw, J. M. (2020). Infectious disease pandemic planning and response: Incorporating decision analysis.  PLoS medicine ,  17 (1), e1003018. https://doi.org/10.1371/journal.pmed.1003018 

Zhang, J., Lu, X., Jin, Y., & Zheng, Z. J. (2020). Hospital's responsibility in response to the threat of infectious disease outbreak in the context of COVID-19: implications for low-and middle-income countries.  Global Health Journal . https://doi.org/10.1016/j.glohj.2020.11.005