Name : Dayinta Witaradya

NIM : P1337420318100
Class : 2 Regular B
UAS
BAHASA INGGRIS

A. What is COVID-19 ?
COVID-19 is the infectious disease caused by the most recently discovered coronavirus.
This new virus and disease were unknown before the outbreak began in Wuhan, China, in
December 2019.
Coronaviruses are a large family of viruses which may cause illness in animals or
humans. In humans, several coronaviruses are known to cause respiratory infections
ranging from the common cold to more severe diseases such as Middle East Respiratory
Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently
discovered coronavirus causes coronavirus disease COVID-19.

B. History of COVID-19
Coronavirus was discovered in the 1960s. The earliest viruses discovered were infectious
bronchitis viruses in chickens and two viruses from the human nasal cavity with the
common cold which were later named human coronavirus 229E and human coronavirus
OC43. Since then, other coronavirus members have been identified, including SARS-
CoV in 2003, HCoV NL63 in 2004, HKU1 in 2005, MERS-CoV (formerly known as
2012-nCoV) in 2012, and SARS-CoV-2 (formerly known as 2019-nCoV) in 2019; most
of these viruses are associated with serious respiratory infections.
On 31 December 2019, the WHO China Country Office was informed of a pneumonia of
unknown cause, detected in the city of Wuhan in Hubei province, China. According to
the authorities, some patients were operating dealers or vendors in the Huanan Seafood
market. The outbreak was declared a Public Health Emergency of International Concern
on 30 January 2020.

C. Characteristic of COVID-19
The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some
patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea.
These symptoms are usually mild and begin gradually. Some people become infected but
don’t develop any symptoms and don't feel unwell. Most people (about 80%) recover
from the disease without needing special treatment. Around 1 out of every 6 people who
gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people,
and those with underlying medical problems like high blood pressure, heart problems or
diabetes, are more likely to develop serious illness. People with fever, cough and
difficulty breathing should seek medical attention.
D. How Can The Virus Infected ?
People can catch COVID-19 from others who have the virus. The disease can spread
from person to person through small droplets from the nose or mouth which are spread
when a person with COVID-19 coughs or exhales. These droplets land on objects and
surfaces around the person. Other people then catch COVID-19 by touching these objects
or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if
they breathe in droplets from a person with COVID-19 who coughs out or exhales
droplets. This is why it is important to stay more than 1 meter (3 feet) away from a
person who is sick.
Studies suggest that coronaviruses (including preliminary information on the COVID-19
virus) may persist on surfaces for a few hours or up to several days. This may vary under
different conditions (e.g. type of surface, temperature or humidity of the environment).
The “incubation period” means the time between catching the virus and beginning to
have symptoms of the disease. Most estimates of the incubation period for COVID-19
range from 1-14 days, most commonly around five days. These estimates will be updated
as more data become available.
While we are still learning about how COVID-2019 affects people, older persons and
persons with pre-existing medical conditions (such as high blood pressure, heart disease,
lung disease, cancer or diabetes)  appear to develop serious illness more often than
others. 

E. What can we do for prevent ?

Some simple precautions:
1. Regularly and thoroughly clean your hands with an alcohol-based hand rub or
wash them with soap and water. Because hand rub kills viruses that may be on
your hands. The most effective ways to protect yourself and others against
COVID-19 are to frequently clean your hands, cover your cough with the bend of
elbow or tissue and maintain a distance of at least 1 meter (3 feet) from people
who are coughing or sneezing.
2. Maintain at least 1 metre (3 feet) distance between yourself and anyone who is
coughing or sneezing.
3. Avoid touching eyes, nose and mouth.
4. Make sure you, and the people around you, follow good respiratory hygiene. This
means covering your mouth and nose with your bent elbow or tissue when you
cough or sneeze. Then dispose of the used tissue immediately.
5. Stay home if you feel unwell. If you have a fever, cough and difficulty breathing,
seek medical attention and call in advance. Follow the directions of your local
health authority.

Protection measures for persons who are in or have recently visited (past 14 days) areas
where COVID-19 is spreading
 1. Follow the guidance outlined above (Protection measures for everyone)
2. Self-isolate by staying at home if you begin to feel unwell, even with mild
symptoms such as headache, low grade fever (37.3 C or above) and slight runny
nose, until you recover.
3. If you develop fever, cough and difficulty breathing, seek medical advice
promptly as this may be due to a respiratory infection or other serious condition.
Call in advance and tell your provider of any recent travel or contact with
travelers.

F. Planning management for nursing

WHO emphasizes the prioritization of those with highest probability of poor outcomes:
patients with severe and critical illness and those with mild disease and risk for poor
outcome (age >60 years, cases with underlying co-morbidities, e.g., chronic
cardiovascular disease, chronic respiratory disease, diabetes, cancer).
a. Management of mild COVID-19: symptomatic treatment and monitoring
 Patients with mild disease do not require hospital interventions; but
isolation is necessary to contain virus transmission and will depend on
national strategy and resources.
 Provide patient with mild COVID-19 with symptomatic treatment such as
antipyretics for fever.
 Counsel patients with mild COVID-19 about signs and symptoms of
complicated disease. If they develop any of these symptoms, they should
seek urgent care through national referral systems.
b. Management of severe COVID-19: oxygen therapy and monitoring
 Give supplemental oxygen therapy immediately to patients with SARI and
respiratory distress, hypoxaemia or shock and target > 94%.
Remarks for adults: Adults with emergency signs (obstructed or absent
breathing, severe respiratory distress, central cyanosis, shock, coma or
convulsions) should receive airway management and oxygen therapy
during resuscitation to target SpO2 ≥ 94%.
Remarks for children: Children with emergency signs (obstructed or
absent breathing, severe respiratory distress, central cyanosis, shock, coma
or convulsions) should receive airway management and oxygen therapy
during resuscitation to target SpO2 ≥ 94%; otherwise, the target SpO2 is ≥
90% (25). Use of nasal prongs or nasal cannula is preferred in young
children, as it may be better tolerated.
 Closely monitor patients with COVID-19 for signs of clinical
deterioration, such as rapidly progressive respiratory failure and sepsis and
respond immediately with supportive care interventions.
Remark 1: Patients hospitalized with COVID-19, require regular
monitoring of vital signs and, where possible, utilization of medical early
 warning scores (e.g. NEWS2) that facilitate early recognition and
escalation of the deteriorating patient (26).
Remark 2: Haematology and biochemistry laboratory testing, and ECG
should be performed at admission and as clinically indicated to monitor
for complications, such as acute liver injury, acute kidney injury, acute
cardiac injury or shock. Application of timely, effective and safe
supportive therapies is the cornerstone of therapy for patients that develop
severe manifestations of COVID-19.
 Understand the patient’s co-morbid condition(s) to tailor the management
of critical illness.
Remark 1: Determine which chronic therapies should be continued and
which therapies should be stopped temporarily. Monitor for drug-drug
interactions. Use conservative fluid management in patients with SARI
when there is no evidence of shock.
c. Management of severe COVID-19: treatment of co-infections
 Give empiric antimicrobials to treat all likely pathogens causing SARI and
sepsis as soon as possible, within 1 hour of initial patient assessment for
patients with sepsis.
 Empiric therapy should be de-escalated on the basis of microbiology
results and clinical judgment.
d. Management of critical COVID-19: acute respiratory distress syndrome (ARDS)
 Recognize severe hypoxemic respiratory failure when a patient with
respiratory distress is failing standard oxygen therapy and prepare to
provide advanced oxygen/ventilatory support.
 Implement mechanical ventilation using lower tidal volumes (4–8 mL/kg
predicted body weight, PBW) and lower inspiratory pressures (plateau
pressure < 30 cmH2O).
 In adult patients with severe ARDS, prone ventilation for 12–16 hours per
day is recommended.
 Use a conservative fluid management strategy for ARDS patients without
tissue hypoperfusion.
e. Management of critical illness and COVID-19: septic shock
 Recognize septic shock in adults when infection is suspected or confirmed
AND vasopressors are needed to maintain mean arterial pressure (MAP) ≥
65 mmHg AND lactate is ≥ 2 mmol/L, in absence of hypovolemia.
 Recognize septic shock in children with any hypotension (systolic blood
pressure [SBP] < 5th centile or > 2 SD below normal for age) or two or
more of the following: altered mental state; tachycardia or bradycardia
(HR < 90 bpm or > 160 bpm in infants and HR < 70 bpm or > 150 bpm in
children); prolonged capillary refill (> 2 sec) or feeble pulses; tachypnea;
 mottled or cold skin or petechial or purpuric rash; increased lactate;
oliguria; hyperthermia or hypothermia.
 In resuscitation for septic shock in adults, give at 250–500 mL crystalloid
fluid as rapid bolus in first 15–30 minutes and reassess for signs of fluid
overload after each bolus.
 In resuscitation from septic shock in children, give 10–20 mL/kg
crystalloid fluid as a bolus in the first 30–60 minutes and reassess for signs
of fluid overload after each bolus.
f. Management of critical illness and COVID-19: prevention of complications
 Reduce days of invasive mechanical ventilation
 Reduce incidence of ventilatorassociated pneumonia
 Reduce incidence of venous thromboembolism
 Reduce incidence of catheterrelated bloodstream infection.
 Reduce incidence of pressure ulcers.
 Reduce incidence of stress ulcers and gastrointestinal bleeding.
 Reduce incidence of ICU-related weakness.