UPDATE 10:40 a.m.: According to Washington State officials, the first death from Covid-19 occurred in the United States. Little is being released about the patient at this point. Officials promised more information this afternoon.
While Humboldt County’s only patient diagnosed with the novel coronavirus, known as COVID-19 has recovered and with tests showing the person is free of the virus, and while there are currently no other cases in the county, the COVID-19 has the entire world on high alert as it spreads across the globe. Humboldt County officials, health care providers, and school districts are working to prevent as many people from contracting the illness as possible. As Eureka City Schools Superintendent Dr. Fred Van Vleck said with no current cases in the school system, “We are in a period of planning, not in a period of reaction” which benefits everyone.
The coronavirus emerged in Wuhan China in mid-December 2019. By January 23rd, there were 571 confirmed cases and 17 deaths reported, and it had begun to spread into other countries in the region. Due to the serious impacts of the illness and its rapid rate of transmission, China closed off its major manufacturing region of Hubei to all travel including the import and export of goods. This has impacted global supply chains and is at least partially responsible for an economic slow down in February and a stock market freefall this week.
Locally, the Humboldt County Public Health Branch continues to focus on emphasizing the CDC’s guidelines preventing the spread of every illness.
These include: wash your hands often throughout the day, especially when returning home from being in public places, before you eat and of course after using the bathroom. They also include routine sanitizing of door knobs, faucet handles, stair railings and other objects frequently handled by multiple people. Keep your hands away from your face, and do not touch your eyes, nose or mouth. If you sneeze or cough, do so into the corner of your elbow to keep your germs to yourself.
In a brief 10 minute interview with Humboldt County’s Health Officer, Dr. Teresa Frankovich during her busy day on Friday, she emphatically denied any validity to rumors that the patient in Humboldt County had returned to being ill after previously recovering from the virus. Dr Frankovich said, “That is not what happened with this patient.” She also denied that any other known case of COVID-19 has appeared in Humboldt County.
Nonetheless, COVID-19 remains a significant concern. Clinics, schools and the Public Health department are using this time to plan and prepare for the potential of future cases.
COVID-19 is clearly spreading internationally and within California. Dr. Frankovich suggested that isolation and quarantine are no longer a useful prevention strategy. She said, “Trying to contain the spread by isolating people returning from China made sense in the beginning, but now it is in lots of countries.” Frankovich continued, “Figuring out who has been exposed is almost impossible now.” Personal action is now the best defense. Frankovich re-emphasized the CDC prevention protocols saying, “They aren’t fancy but they are effective.”
If cases begin to appear, the protocol may evolve to include “social distancing” measures. Examples of social distancing include a ban on gatherings of more than a thousand people in Switzerland which has prevented an international auto show from bringing people from around the world into the country. On the other extreme, in China, people’s temperatures are checked in public places and people are expected to stay home rather than to mingle socially.
When asked what a future with COVID-19 endemic in the global population might look like, Frankovich made comparison to the H1N1 virus that caused the 1918 Spanish Flu epidemic that killed an estimated 50 million people around the world and at that time, the global population was under 2 billion people. H1N1 re-emerged in 2009, and a vaccine was developed which continues to be used as part of annual flu shots preventing H1N1 from spreading widely.
COVID-19 is now spreading throughout the western states. On February 14th, Governor Newsom said 8,400 people in California were being monitored for the potential of having the virus.
On Thursday, February 27th a person in Solano County was diagnosed with COVID-19 but she had already been in the hospital several days. The Solano County patient was the first to be diagnosed had been diagnosed by “community transfer” without knowing how they became ill.
In the morning on Friday, February 28th, a second case of “community transfer” was diagnosed after an older woman in Santa Clara County was hospitalized and then transferred to UC Davis with pnuemonia. She had been admitted to her local hospital last week but the CDC had not tested her for several days because she did not meet the CDC guidelines of who should be tested. Her point of contact to acquire the disease is not known.
By the end of Friday, California, Oregon and Washington had all reported diagnosed cases of COVID-19 acquired by unknown community contact.
The New York Times reporting on Thursday of a whistleblower complaint from the US Department of Health and Human Services may shed light on why cases of “community transfer” may be happening in the Bay Area,
Staff members from the Department of Health and Human Services’ Administration for Children and Families were sent to Travis Air Force Base and March Air Reserve Base in late January and early February and were ordered to enter quarantined areas, including a hangar where coronavirus evacuees were being received, the complaint said. They were not provided safety-protocol training until five days into their assignment, said the whistle-blower, who is described as a senior leader at the health agency.
Without proper training or equipment, some of the exposed staff members moved freely around and off the bases, with at least one person staying in a nearby hotel and leaving California on a commercial flight. Many were unaware of the need to test their temperatures three times a day.
Locally, Eureka City Schools Superintendent Dr. Fred Van Vleck, understands the central role schools can play in containing a contagious illness such as COVID-19. He says school custodial staff has already stepped up sterilization protocol cleaning points of common contact such as bus railings, door knobs, and faucets multiple times per day with a cleaner known to be effective against viruses. He said, “School staff are building on everyday practices already in place.” All class rooms have sinks and running water for hand washing in them. Van Vleck said teachers are re-emphasizing to students the importance of this prevention strategy. Teachers are also communicating with student families about reinforcing prevention strategies at home so they become habit. Van Vleck said they are adding dispensers of hand sanitizer with a minimum 60% alcohol content to all the classes and the office as well.
And the District is also keeping in close communication with families through facebook and robocalls so everyone has facts as they emerge.
Dr. Van Vleck realizes the “crucial role schools have to stop the spread of infection. We are the epicenter. We take this seriously. We are working closely with County, State and Federal agencies.” The school sites are monitoring student absences closely. If they notice any trend toward increasing absences, staff will work closely with Public Health to determine if COVID-19 is the reason and to stop its spread if that becomes the case.
Van Vleck had been in a teleconference Friday with CDC. He learned that about 80% of the people who get the virus do not get sick enough to realize they have this virus. He said “that cuts both ways.” It’s good that most people who get the virus won’t really even get sick, but it also means they won’t be staying home and the disease can spread more easily.
The public is extremely worried about this illness and have very little information about what it may bring.
When asked about the rate of spread of the virus and the statistic probability for patient mortality, Dr. Frankovich asserted that while the rate of death for people who get COVID-19 is clearly much higher than it is for the flu, and while researchers are learning about the disease quickly and efficiently, basic facts needed to develop statistical models have yet to be pinned down. Specifically, she said that epidemiologists do not yet know how many people are getting the illness overall.
Understanding COVID-19’s communicability and mortality continues to evolve. According to a report on the Center for Infectious Disease Research and Policy webpage at the University of Minnesota,published February 24th, COVID-19’s fatality rate may be 2.3%. Dr. Frankovich said that newer research has the estimation down to about 1%, which she said is still about 10 times greater than the 0.1% fatality rate of most flu strains.
The University of Minnisota report looked at both China’s Hubei Province and the Princess cruise ship that was quarantined in Japan. People in good health, and younger than 70, do not have nearly the risk that older and chronically ill people are showing. When China’s disease control department studied the cases in Hubei Province, they estimated that the overall mortality rate was about 2.3%. However, among patients between 70 and 80 years old, the mortality rate rose to 8% and to nearly 15% in those over 80. And if a patient becomes critically ill with the virus, the chance of death grows to nearly 50%.
In China, since closing the Wuhan region and implementing very strong social isolation policies, the rate of spread has been slowed to 0.7% according to a WHO report published last week.
The US Center for Disease Control says a vaccine is likely to be developed in the next year to 18 months. Until then, older people and those with chronic illness may need to reduce their contact with the general public through “self shielding measures” such as reducing the time they spend in public places, wearing face masks or avoiding face to face contacts by doing business by telephone, and reducing unnecessary travel by plane or mass transit to avoid this potentially lethal virus.
Currently, the nation is short on tests for Covid-19 because a reagent in the first one wasn’t working properly. Dr. Teresa Frankovich says she has been told the tests have been reformulated and are under production now. Humboldt County expects to receive their supply soon and major clinics in urban areas have already been supplied.
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- Analysis | The Health 202: Los Angeles is racing to discover the true coronavirus infection rate – The Washington Post
- Some Public Health Officials Not Releasing Coronavirus Hospitalizations : Shots – Health News – NPR
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- Lost Your Health Insurance During the COVID-19 Crisis? Here Are Your Options – The Motley Fool
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