30 Days to Slow the Spread

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Published on Friday, 03 April 2020 00:19

THE PRESIDENT'S CORONAVIRUS GUIDELINES FOR AMERICA

30 DAYS TO SLOW THE SPREAD

Listen to and follow the directions of your STATE AND LOCAL AUTHORITIES.

IF YOU FEEL SICK, stay home. Do not go to work. Contact your medical provider.

IF YOUR CHILDREN ARE SICK, keep them at home Do not send them to school. Contact your medical provider.

IF SOMEONE IN YOUR HOUSEHOLD HAS TESTED POSITIVE for coronavirus, keep the entire household at home. Do not go to work. Do not go to school. Contact your medical provider.

IF YOUR ARE AN OLDER PERSON, stay home and away from other people.

IF YOU ARE A PERSON WITH A SERIOUS UNDERLYING HEALTH CONDITION that can put you at increased risk (for example, a condition that impairs your lung or heart function or weakens your immune system), stay home and away from other people.

DO YOUR PART TO SLOW THE SPREAD OF THE CORONAVIRUS

Evin if you are young or otherwise healthy, you are at risk and your activities can increase the risk for others. It is critical that you do your part to slow the spread of the coronavirus.

Work or engage in schooling FROM HOME whenever possible.

IF YOU WORK IN A CRITICAL INFRASTRUCTURE INDUSTRY, as defined by the Department of Homeland Security, such as healthcare services and pharmaceutical and food supply, you have a special responsibility to maintain your normal work schedule. You and your employers should follow CC guidance to protect your health at work.

AVOID SOCIAL GATHERING in groups of more than 10 people.

Avoid eating or drinking at bars, restaurants, and food courts - USE DRIVE-THRU, PICKUP, OR DELIVERY OPTIONS.

AVOID DISCRETIONARY TRAVEL, shopping, and social visits.

DO NOT VISIT nursing homes or retirement or long-term care facilities unless to provide critical assistance.

PRACTICE GOOD HYGIENE:

• Wash your hands, especially after touching any frequently used item or surface.
• Avoid touching your face.
• Sneeze or cough into a tissue, or the inside of your elbow.
• Disinfect frequently used items and surfaces as much as possible.

School operations can accelerate the spread of the coronavirus. Governors of states with evidence of community transmission should close schools in affected and surrounding areas. Governors should close schools in communities that are near areas of community transmission, even if those areas are in neighboring states. In addition, state and local officials should close schools where coronavirus has been identified in the population associated with the school. States and localities that close schools need to address childcare needs of crtical responders, as well as nutritional needs of children.

Older people are particularly at risk from the coronavirus. All states should follow Federal guidance and halt social visits to nursing homes and retirement and long-term care facilities.

In states with evidence of community transmission, bars, restaurants, food courts, gyms, and other indoor and outdoor venues where groups of people congregate should be closed.

National Child Abuse Prevention Month

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Published on Wednesday, 01 April 2020 10:29

April is National Child Abuse Prevention Month

The Andrew County Health Department would like to remind you anyone can and should report suspected child abuse ore neglect. Reporting child abuse and neglect is everyone's responsibility. If you think a child is being mistreated, take immediate action.

Call the Missouri Child Abuse and Neglect Hotline at 1-800-392-3738 or 573-751-3448.

You also can call the National Child Abuse Hotline at 1-800-4-A-Child (1-800-422-4453).

Error on the side of over-reporting. If you have the thought, "Maybe I should call . . . " - DO! Not all calls to the hotline are determined to be abuse/neglect. However, the Children's Division can often provide services and assistance that can help families prevent abuse.

The trauma of child abuse or neglect has been associated with increased risk of depression and suicide attempts, substance abuse, developmental disabilities and learning problems, social problems with other children and with adults, teen pregnancy, lack of success in school, and chronic illnesses, including heart disease, cancer and lung disease, among others.

When you call to make a report, you will be asked for specific information, such as: 

• The child's name and location
• The name and relationship (if known) of the person you believe is abusing the child.
• What you have seen or heard regarding the abuse or neglect
• The names of any other people who might know about the abuse
• Your name and phone number (voluntary)

For your baby

Breastfeeding promotes mother and baby bonding.  During the skin-to-skin that happens while nursing, mothers release a powerful cocktail of calming hormones, including oxytocin – often referred to as the ‘love hormone’ or ‘cuddle chemical’.  Released whenever they are close to their newborn, or even when a mother simply smells or thinks about her baby, this clever hormone helps moms adjust to motherhood in a number of ways.  It enhances her ‘mothering behaviors’ – things like caressing, making eye contact, and using affectionate language with her child.  It also has anti-anxiety and anti-depressive properties, and may help protect against postnatal depression.

Steps to help prevent the spread of COVID-19

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Published on Thursday, 26 March 2020 17:28

Steps to help prevent the spread of COVID-19 if you are sick

Stay home except to get medical care

• Stay home: Most people with COVID-19 have mild illness and are able to recover at home without medical care. Do not leave your home, except to get medical care. Do not visit public areas.
• Stay in touch with your doctor. Call before you get medical care. Be sure to get care if you have trouble breathing, or have any other emergency warning signs, or if you think it is an emergency.
• Avoid public transportation: Avoid using public transportation, ride-sharing, or taxis.

Separate yourself from other people in your home, this is known as home isolation

• Stay away from others: As much as possible, you stay away from others. You should stay in a specific “sick room” if possible, and away from other people in your home. Use a separate bathroom, if available.
  • See COVID-19 and Animals is you have questions about pets.

Call ahead before visiting your doctor

• Call ahead: Many medical visits for routine care are being postponed or done by phone or telemedicine.
• If you have a medical appointment that cannot be postponed, call your doctor’s office, and tell them you have or may have COVID-19. This will help the office protect themselves and other patients.

If you are sick wear a facemask in the following situations, if available.

• If you are sick: You should wear a facemask, if available, when you are around other people (including before you enter a healthcare provider’s office).
• If you are caring for others: If the person who is sick is not able to wear a facemask (for example, because it causes trouble breathing), then as their caregiver, you should wear a facemask when in the same room with them. Visitors, other than caregivers, are not recommended.

Note: During a public health emergency, facemasks may be reserved for healthcare workers. You may need to improvise a facemask using a scarf or bandana.

Cover your coughs and sneezes

• Cover: Cover your mouth and nose with a tissue when you cough or sneeze.
• Dispose: Throw used tissues in a lined trash can.
• Wash hands: Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol.

Clean your hands often

• Wash hands: Wash your hands often with soap and water for at least 20 seconds. This is especially important after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
• Hand sanitizer: If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.
• Soap and water: Soap and water are the best option, especially if hands are visibly dirty.
• Avoid touching: Avoid touching your eyes, nose, and mouth with unwashed hands.

Avoid sharing personal household items

• Do not share: Do not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people in your home.
• Wash thoroughly after use: After using these items, wash them thoroughly with soap and water or put in the dishwasher.

Clean all “high-touch” surfaces everyday

Clean high-touch surfaces in your isolation area (“sick room” and bathroom) every day; let a caregiver clean and disinfect high-touch surfaces in other areas of the home.

• Clean and disinfect: Routinely clean high-touch surfaces in your “sick room” and bathroom. Let someone else clean and disinfect surfaces in common areas, but not your bedroom and bathroom.

• • If a caregiver or other person needs to clean and disinfect a sick person’s bedroom or bathroom, they should do so on an as-needed basis. The caregiver/other person should wear a mask and wait as long as possible after the sick person has used the bathroom.

High-touch surfaces include phones, remote controls, counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets, and bedside tables.

• Clean and disinfect areas that may have blood, stool, or body fluids on them.

• Household cleaners and disinfectants: Clean the area or item with soap and water or another detergent if it is dirty. Then, use a household disinfectant.

• • Be sure to follow the instructions on the label to ensure safe and effective use of the product. Many products recommend keeping the surface wet for several minutes to ensure germs are killed. Many also recommend precautions such as wearing gloves and making sure you have good ventilation during use of the product.
  • Most EPA-registered household disinfectants should be effective. A full list of disinfectants can be found hereexternal icon.

Monitor your symptoms

• Common symptoms of COVID-19 include fever and cough. Trouble breathing is a more serious symptom that means you should get medical attention.
• If you are having trouble breathing, seek medical attention, but call first.
  • Call your doctor or emergency room before going in and tell them your symptoms. They will tell you what to do.
• Wear a facemask: If available, put on a facemask before you enter the building. If you can’t put on a facemask, cover your coughs and sneezes. Try to stay at least 6 feet away from other people. This will help protect the people in the office or waiting room.
• Follow care instructions from your healthcare provider and local health department: Your local health authorities may give instructions on checking your symptoms and reporting information.

When to Seek Medical Attention

If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion or inability to arouse
• Bluish lips or face

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

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Call 911 if you have a medical emergency: If you have a medical emergency and need to call 911, notify the operator that you have or think you might have, COVID-19. If possible, put on a facemask before medical help arrives.

How to discontinue home isolation

• People with COVID-19 who have stayed home (home isolated) can stop home isolation under the following conditions:
  • If you will not have a test to determine if you are still contagious, you can leave home after these three things have happened:

• • • You have had no fever for at least 72 hours (that is three full days of no fever without the use medicine that reduces fevers)
      AND
    • other symptoms have improved (for example, when your cough or shortness of breath have improved)
      AND
    • at least 7 days have passed since your symptoms first appeared
  • If you will be tested to determine if you are still contagious, you can leave home after these three things have happened:
    • You no longer have a fever (without the use medicine that reduces fevers)
      AND
    • other symptoms have improved (for example, when your cough or shortness of breath have improved)
      AND
      you received two negative tests in a row, 24 hours apart. Your doctor will follow CDC guidelines.

In all cases, follow the guidance of your healthcare provider and local health department. The decision to stop home isolation should be made in consultation with your healthcare provider and state and local health departments. Local decisions depend on local circumstances.

More information is available here.

Additional information for healthcare providers: Interim Healthcare Infection Prevention and Control Recommendations for Persons Under Investigation for 2019 Novel Coronavirus.

COVID-19 Breastfeeding Advice

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Published on Wednesday, 25 March 2020 17:02

Can mothers who are exposed to or who have contracted covid-19 breastfeed their babies?

Yes. Please see up to date information from the Centers for Disease Control concerning known facts for pregnant and breastfeeding women here.

Breastfeeding and the risk of respiratory tract infections after infancy

Infectious diseases, including respiratory tract infections, are a leading cause of morbidity and hospitalization in infants and children.[1, 2] There is much epidemiological evidence for the benefits of breastfeeding against a wide range of infections and illnesses.[3, 4] Breast milk contains various antimicrobial substances, anti-inflammatory components and factors that promote immune development.[4, 5] It enhances the immature immune system of the infant and strengthens defense mechanisms against infectious and other agents during the breastfeeding period.[4–7] Exclusive breastfeeding for the first 6 months of life with breastfeeding along with complementary feeding thereafter is recommended by the World Health Organization (WHO).

Transmission of COVID-19 through breast milk

Much is unknown about how COVID-19 is spread. Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza (flu) and other respiratory pathogens spread. In limited studies on women with COVID-19 and another coronavirus infection, Severe Acute Respiratory Syndrome (SARS-CoV), the virus has not been detected in breast milk.

Preventing the Spread of COVID-19 in Homes and Residential Communities

Household members, intimate partners, and caregivers in a nonhealthcare setting may have close contact2 with a person with symptomatic, laboratory-confirmed COVID-19 or a person under investigation. Close contacts should monitor their health; they should call their healthcare provider right away if they develop symptoms suggestive of COVID-19 (e.g., fever, cough, shortness of breath) (see Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposure in Travel-associated or Community Settings.)

Close contacts should also follow these recommendations:

• Make sure that you understand and can help the patient follow their healthcare provider’s instructions for medication(s) and care. You should help the patient with basic needs in the home and provide support for getting groceries, prescriptions, and other personal needs.
• Monitor the patient’s symptoms. If the patient is getting sicker, call his or her healthcare provider and tell them that the patient has laboratory-confirmed COVID-19. This will help the healthcare provider’s office take steps to keep other people in the office or waiting room from getting infected. Ask the healthcare provider to call the local or state health department for additional guidance. If the patient has a medical emergency and you need to call 911, notify the dispatch personnel that the patient has, or is being evaluated for COVID-19.
• Household members should stay in another room or be separated from the patient as much as possible. Household members should use a separate bedroom and bathroom, if available.
• Prohibit visitors who do not have an essential need to be in the home.
• Household members should care for any pets in the home. Do not handle pets or other animals while sick.  For more information, see COVID-19 and Animals.
• Make sure that shared spaces in the home have good air flow, such as by an air conditioner or an opened window, weather permitting.
• Perform hand hygiene frequently. Wash your hands often with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• The patient should wear a facemask when you are around other people. If the patient is not able to wear a facemask (for example, because it causes trouble breathing), you, as the caregiver, should wear a mask when you are in the same room as the patient.
• Wear a disposable facemask and gloves when you touch or have contact with the patient’s blood, stool, or body fluids, such as saliva, sputum, nasal mucus, vomit, urine.
• Throw out disposable facemasks and gloves after using them. Do not reuse.
• When removing personal protective equipment, first remove and dispose of gloves. Then, immediately clean your hands with soap and water or alcohol-based hand sanitizer. Next, remove and dispose of facemask, and immediately clean your hands again with soap and water or alcohol-based hand sanitizer.
• Avoid sharing household items with the patient. You should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items. After the patient uses these items, you should wash them thoroughly (see below “Wash laundry thoroughly”).
• Clean all “high-touch” surfaces, such as counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables, every day. Also, clean any surfaces that may have blood, stool, or body fluids on them.
• Use a household cleaning spray or wipe, according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.
• Wash laundry thoroughly.
• Immediately remove and wash clothes or bedding that have blood, stool, or body fluids on them.
• Wear disposable gloves while handling soiled items and keep soiled items away from your body. Clean your hands (with soap and water or an alcohol-based hand sanitizer) immediately after removing your gloves.
• Read and follow directions on labels of laundry or clothing items and detergent. In general, using a normal laundry detergent according to washing machine instructions and dry thoroughly using the warmest temperatures recommended on the clothing label.
• Place all used disposable gloves, facemasks, and other contaminated items in a lined container before disposing of them with other household waste. Clean your hands (with soap and water or an alcohol-based hand sanitizer) immediately after handling these items. Soap and water should be used preferentially if hands are visibly dirty.
• Discuss any additional questions with your state or local health department or healthcare provider. Check available hours when contacting your local health department.

Guidance on breastfeeding for mothers with confirmed COVID-19 or under investigation for COVID-19

Breast milk is the best source of nutrition for most infants. However, much is unknown about COVID-19. Whether and how to start or continue breastfeeding should be determined by the mother in coordination with her family and healthcare providers.  A mother with confirmed COVID-19 or who is a symptomatic PUI should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while feeding at the breast.  If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use. If possible, consider having someone who is well feed the expressed breast milk to the infant.