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Global Pandemic: Prevention and treatment options available in Europe to curb the spread of COVID-19

Regarding prevention, it is an established fact that COVID-19 spread in hospitals.  ECDC (2021) suggests that this can be limited through proper hand washing, use of personal protective equipment as well as vaccination.  Hand washing with the proper technique is believed to be the single most important way to protect healthcare workers and patients (CDC, 2018). It can happen in any setting that has access to clean water and soap. In a situation where clean water and soap isn’t accessible, alternatives like alcohol-based hand sanitizer is advised.  With respect to PPE’s the goal is to protect, not just the provider of care, but the patient, from infections as well. The most commonly used pieces of personal protective equipments are gloves, triple layer medical mask, goggles or face shield and a gown (Neuwirth et.al, 2020). Another way to prevent the spread of COVID-19 amongst this population is through vaccination. EMA (2021) reports that vaccination remains one of the best protective measures against COVID-19. In fact, Italy, France, and Greece have made Covid-19 vaccination mandatory for healthcare workers (BMJ,2021). See table 1 below for other suggested preventive measures recommended.



Table 1 Infection prevention and control measuresrecommendation for COVID-19 in healthcare settings from WHO (2020) and ECDC (2020). (Park,S. 2020)

The European Centre for Disease Control and Prevention (ECDC) initially recommended airborne precautions for any situations involving contact with COVID-19 patients (see table 1); however, they have modified their recommendations to specify that surgical masks are acceptable alternatives if respirators are not available.  Despite this difference, airborne precautions are commonly recommended when Aerosol-Generating Procedures are performed’ (Park, 2020).

When it comes to treatment, it is usually administered according to the signs and symptoms on presentation (see figure 1). 


Figure 1: Symptoms of COVID-19 positive versus COVID-19 negative hospital workers. Loon et al. (2021)

 

Whether in the emergency department, clinic, or hospital, when we first see a new patient or a patient whose condition has worsened unexpectedly, it is important to assess the patient’s general appearance: level of consciousness using the AVPU system, also access the patency of airways using the ABCs and determine treatment options. It is worth mentioning that management of patients varies according to disease severity. Because it was difficult to find a Europe based study which showed treatment modalities in the region, search was broadened to include North America. Harvard medical school (2021) reports that ‘Merck released promising study results about an oral antiviral drug to treat COVID-19. Compared to placebo, the antiviral drug, called molnupiravir, significantly reduced the risk of hospitalization and death in people with mild or moderate COVID-19 who were at high risk for severe COVID’. In November 2020, the FDA granted emergency use authorization to two monoclonal antibody treatments (bamlanivimab, made by Eli Lilly; and a combination of casirivimab and imdevimab, made by Regeneron). Both treatments have been approved for patients with mild to moderate COVID-19 symptoms who are at risk for developing severe COVID-19 or being hospitalized for it. In scenarios whereby patients are hospitalized, steroids: dexamethasone among others has been approved.

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