Manajemen PPI untuk COVID-19

KOMITE PPI RSSW

 Subyek
• Epidemiologi Covid-19
• Sekilas Covid-19
• Strategi dan Manajemen PPI
• Kesimpulan
Situasi Pandemic Dunia
Peta Pandemic Dunia
Data Asia Tenggara
Peta Covid-19 Indonesia
Data Covid-19
Data tiap Propinsi: Konfirmed dan Death
Covid-19 di Jawa Timur
Protokol Covid-19
Pertempuran Belum Selesai
 Mengenal Pandemi Covid-19
• Desember 2019, Wuhan – infeksi pneumonia
misterius, penyebab disebut 2019-ncov
• Di sebabkan oleh Virus yg didapatkan di pasar Wuhan,
yang disebut SARS-Cov-2
• Penyakitnya di sebut Covid-19 (Coronavirus Infectious
Diseases)
• Menyebar ke seluruh daratan cina
• Menyebar ke luar cina, ke seluruh Dunia
• Awal April WHO mengumumkan- Dunia mengalami
Pandemi Covid-19, lebih dari 200 Negara terjangkit
The Huanan Seafood and Wildlife
Market in Wuhan, China
Wuhan Wet Market
Wild Animal Market
 Indonesia: Transmisi Komunitas
• Community transmission: experiencing larger
outbreaks of local transmission defined
through an assessment of factors including, but
not limited to:
• Jumlah besar kasus tidak berhubungan dengan
rantai penularan;
• Jumlah besar kasus di dapat dari surveilans lab
sentinel;
• Dan/atau Kluster multiple yang tidak saling
berhubungan dalam area Negara/ territorial/
area
 Struktur
Morfologi
SARS-Cov2

Parks and Smith, NEJM

2020
Coronavirus Origins

Dhama et al, Clin Mibrobiol Rev, October 2020

 Perilaku virus COVID-19: Stabilitas
• Aerosol di udara: 3 jam
• Permukaan Tembaga: 8 jam
• Permukaan Kardus: 24 jam (satu
hari)
• Permukaan Stainless Steel: 48 jam
(2 hari)
• Permukaan Plastik: 72 jam (3 hari)
• Dapat bertahan pada kondisi
kering
dan basah serta Asam
V
Efektivitas Disinfeksi terhadap
Coronavirus

ECDC,2020
 The Six Componen Chain
of SARS-Cov-2 Infection
Infectious agent

Susceptible host
SARSCoV-2 Reservoir
Extreme Ages People
Diabetics Equipment
Immunosuppressed Animal: Bat
Cardiovascular
disease

Portals of Entry
Mucous Portals of Exit
membrane Secretions
Modes of
Respiratory, Eye Droplets
Transmission
/ Direct Excretions (?)
Gastrointestinal Contact/fomite
Tract (?)
Droplet
Airborne/aerosols
 Penularan SARS-Cov-2
• Penularan SARS-Cov-2 dapat melalui:
• Kontak langsung (Kontak erat, jabat tangan)
• Kontak tidak langsung (benda, alat)
• Melalui Droplet (percikan Ludah)
• Melalui Airborne- melalui aerosol (Batuk/
Bersin, Tindakan menghasilkan Aerosol)
• Faecal-Oral (Kotoran manusia)
• Zoonosis (Domestic Cat, Bat, Ferret)
 Penularan Covid-19
Batuk Bersin
 Covid-19 dan Penularan ke Hewan
Ferret

Kucing
Harimau
Gejala Klinis Covid-19
Komorbiditas (Pemberat) Covid-19
• Lanjut Usia
• Hipertensi
• Diabetes Mellitus
• Penyakit Jantung
• Penyakit Pembuluh Darah
• Penyakit Ginjal
• Penyakit Kanker
• Perokok
• Obesitas
Perjalanan Penyakit Covid-19
Perjalanan Penyakit Covid-19 Berat
 Jenazah Covid-19: Source of Transmission

Nature and Science Magazine: Jenazah pertama kasus Covid di Amerika Serikat
 Manajemen Post Covid-19
• Penderita yang sembuh dari Covid-19:
• Sehat Seperti Sedia Kala
• Mengalami Penurunan Fungsi Tubuh
• Mengalami Kecacatan Organ misalnya Fibrosis
Paru dengan Gejala sesak
• Dapat mengalami Re-Infeksi (terinfeksi
Kembali)
 Manajemen Post Covid-19 Pribadi
• Gunakan Masker, dan cuci tangan
• Etika batuk serta bersin
• Makan makanan Bergizi
• Istirahat yang cukup
• Olah raga teratur
• Menjaga Hewan peliharaan tetap sehat
• Hindari orang yg sakit
Pencegahan Post Covid-19 di Masyarakat
• Lakukan Social distancing atau physical distancing
• Hindari kerumunan orang banyak
• Gunakan masker Kain, bila hendak bepergian ke
area public
• Pembersihan permukaan yg banyak kontak orang
dengan disinfektan
• Tetap tinggal di rumah bila tidak ada keperluan
• Perilaku hidup bersih sehat (PHBS)
Immunology during Pandemic Covid-19
• Istirahat (Tidur)
• Olah raga (Menjaga
Kebugaran)
• Nutrisi • Meningkatkan
• Hindari Stress Sistim Imun Tubuh
• Hygiene sanitasi
pribadi
• Masker dan Hand
Hygiene
• Vaccine (?)
The Six Componen Chain of Infection
Infectious agent

Susceptible host SARSCoV-2 Reservoir

Extreme Ages People
Diabetics Equipment
Immunosuppressed Animal: Bat
Cardiovascular
disease

Portals of Entry
Mucous Portals of Exit
membrane Secretions
Modes of
Respiratory, Eye Transmission Droplets
/Gastrointestinal Direct Excretions (?)
Tract (?) Contact/fomite
Droplet
Airborne/aerosols
 Kewaspadaan Standard dan Transmisi
(CDC, 2020)
• Hand hygiene
• Personal protective equipment
• Respiratory hygiene and cough etiquette
• Cleaning and disinfection of devices and
environmental surfaces
• Safe injection practices
• Medication storage and handling
 Kewaspadaan Isolasi
• Kewaspadaan Isolasi
• Kewaspadaan isolasi terdiri atas 2 komponen:
–Kewaspadaan Standar
–Kewaspadaan berdasar Transmisi
 COVID-19: IPC Priorities
• Rapid identification of suspect cases
– Screening/Triage at initial healthcare facility encounter and rapid
implementation of source control
– Limiting the entry of healthcare workers and/or visitors with
suspected or confirmed COVID-19
• Immediate isolation and referral for testing
– Group patients with suspected or confirmed COVID-19
separately
– Test all suspected patients for COVID-19
• Safe clinical management
– Immediate identification of inpatients and healthcare workers with
suspected COVID-19
• Adherence to IPC practices
– Appropriate use of Personal protective equipment (PPE)
 COVID-19: APD (CDC, 2020)
• Use a medical mask (i.e., at least a
surgical/medical mask)
• Wear eye protection (goggles) or facial
protection (face shield)
• Wear a clean, non-sterile, long-sleeve
gown
• Use gloves
Alur Petugas
 COVID-19: Everyday Preventive
Actions (CDC, 2020)
• Avoid touching your eyes, nose and mouth
• Avoid close contact with people who are sick
– Remember that some people without symptoms can still spread the
virus
• Stay at home when you are sick
• Cover your cough or sneeze with a tissue, then dispose of it
properly
• Use a face covering when physical distancing is difficult or when
going into closed spaces
– Physical distancing should be at least 1 meter (3 ft)
• Clean and disinfect frequently touched objects and surfaces
• Perform hand hygiene with soap and water or use alcohol-based
hand rub
– Hand Rub should contain at least 60% alcohol
– Hand washing should be done for at least 40-60 seconds based on
WHO’s recommendations
 Tindakan yg menghasilkan Aerosol
(CDC, 2020)
• Endotracheal intubation
• Bronchoscopy
• Non-invasive ventilation
• Tracheotomy
• Manual ventilation
before intubation
• Cardiopulmonary
resuscitation
• Sputum
induction
• Autopsy
procedures
CSSD
 Kesimpulan
• Pandemi Covid-19 adalah
Masalah Global
• Penularan Covid-19
melalui Kontak, Droplet
serta Airborne yang
berasal dari Aerosol
• Kewaspadaan Isolasi
yang harus diterapkan
pada Pandemi Covid-19
• Meliputi Kewaspadaan
Standard dan Transmisi
References