2019-nCoV: The Identify-Isolate-Inform (3I) Tool Applied to a Novel Emerging Coronavirus

Abstract

2019 Novel Coronavirus (2019-nCoV) is an emerging infectious disease closely related to MERS-CoV and SARS-CoV that was first reported in Wuhan City, Hubei Province, China in December 2019. As of January 2020, cases of 2019-nCoV are continuing to be reported in other Eastern Asian countries as well as in the United States, Europe, Australia, and numerous other countries. An unusually high volume of domestic and international travel corresponding to the beginning of the 2020 Chinese New Year complicated initial identification and containment of infected persons. Due to the rapidly rising number of cases and reported deaths, all countries should be considered at risk of imported 2019-nCoV. Therefore, it is essential for prehospital, clinic, and emergency department personnel to be able to rapidly assess 2019-nCoV risk and take immediate actions if indicated. The Identify-Isolate-Inform (3I) Tool, originally conceived for the initial detection and management of Ebola virus and later adjusted for other infectious agents, can be adapted for any emerging infectious disease. This paper reports a modification of the 3I Tool for use in the initial detection and management of patients under investigation for 2019-nCoV. After initial assessment for symptoms and epidemiological risk factors, including travel to affected areas and exposure to confirmed 2019-nCoV patients within 14 days, patients are classified in a risk-stratified system. Upon confirmation of a suspected 2019-nCoV case, affected persons must immediately be placed in airborne infection isolation and the appropriate public health agencies notified. This modified 3I Tool will assist emergency and primary care clinicians, as well as out-of-hospital providers, in effectively managing persons with suspected or confirmed 2019-nCoV.

Mutated COVID-19 may foretell a great risk for mankind in the future

“…From WHO records, the period from symptom onset to death ranges from 6 to 41 days with a median of 14 days. This period depends on the age and immune status of the individual and is shorter in those <70 years old [11].…”

Simulating the infected population and spread trend of 2019-nCov under different policy by EIR model

“…The novel coronavirus (2019-nCoV) is fast spreading, now to over 20 countries. In Jan.25, 2020, human-to-human transmission is confirmed [1][2][3].…”

Scabies: Application of the Novel Identify-Isolate-Inform Tool for Detection and Management

“…The 3I Tool was originally developed for Ebola virus disease and subsequently modified for use in measles, Middle East Respiratory Syndrome (MERS), mumps, Zika, hepatitis A, pertussis, and 2019 nCoV (COVID-19). [13][14][15][16][17][18][19][20]…”

“…The Identify-Isolate-Inform (3I) Tool was conceived during the 2014 Ebola virus disease outbreak and later modified for application to the ED evaluation and management of patients with other communicable diseases. [14][15][16][17][18][19][20] The novel modification of this tool presented here can be applied for ED evaluation and management of a patient under investigation for scabies. The Scabies 3I Tool is an algorithm that begins with identifying suspected cases based on symptoms, exposure history, and testing as needed.…”