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Plumas prepares for coronavirus

As the coronavirus marches across the globe, health officials at all levels are preparing. And now that cases of confirmed community spread have been identified in Solano and Santa Clara counties, it’s getting closer.

“It’s not so much of a question of if this will happen in this country anymore but a question of when this will happen,” the Centers for Disease Control and Prevention’s Dr. Nancy Messonnier said last week, of COVID-19, often referred to as simply the coronavirus.

Just a day later she was proven correct when a woman tested positive at U.C. Davis Medical Center with no known risk factor for the virus.

Messonnier warned that schools could be closed, mass public gatherings suspended and businesses forced to have employees work remotely.

It’s a situation that has occurred in China, South Korea, Italy, and a growing number of countries where the virus has gained a foothold.

Local response

Health officials in Plumas County are listening and putting plans in place should an outbreak happen locally.

Plumas County Public Health Director Andrew Woodruff is heading up the effort and addressed the issue during an interview last week.

“This country bought itself a lot of time,” Woodruff said of the government’s initial response to the virus by issuing a travel ban to China.

But as the virus spreads to more countries, a travel ban isn’t so easy to implement.

As of this writing there are 70 confirmed cases in the United States, and more than 87,000 globally. Also, as of this writing there have been two fatalities in the United States from the virus, and more than 2,900 worldwide.

When comparing the coronavirus to previous outbreaks such as SARS, Public Health’s Director of Nursing, Tina Venable said, “The spread seems much bigger. We prepared for SARS, but it really didn’t happen here.”

Venable, Woodruff and Dr. Mark Satterfield, the county’s chief health officer, are meeting regularly on the topic.

Venable is coordinating communication with the three local healthcare districts: Eastern Plumas Health Care, Seneca and Plumas.

Donna Vaughan is a nurse at Plumas District Hospital in Quincy and the district’s infectious disease specialist. She, like her counterparts in Chester and Portola, are following the guidelines established by the Centers for Disease Control (CDC).

She and Venable stressed that individuals who suspect that they may have the coronavirus should call before they go to an emergency room or a clinic. Staff is trained to prescreen and will inquire about symptoms, as well as any known contact with an infected person and travel history.

Until Feb. 26, the CDC limited travel history to China, but now the CDC has expanded its criteria for testing. In addition to symptoms such as cough, fever and breathing difficulty, it includes inquiring about travel not only from China, but from Iran, Italy, Japan and South Korea, as well as the all encompassing “no source of exposure has been identified.”

If a health care provider suspects that a patient could have the coronavirus, he or she must contact the county’s public health agency where either Woodruff, Venable or Satterfield are available 24 hours per day to give instruction.

Depending on the severity of the symptoms, a patient could self-isolate at home with daily check-in from a health care provider, or be hospitalized. Each of Plumas County’s three hospitals has one isolation room.

Until it’s been determined whether or not a patient has the coronavirus, the individual is considered a “person under investigation” or PUI.

The local public health department must alert the state immediately if a coronavirus case is suspected, and in turn the state will contact the CDC. The reverse is true as well. The state will alert the county if a PUI enters Plumas County.

“At this time we don’t have any PUIs or cases or coronavirus,” Woodruff said March 2.

In an effort to assuage public angst, Woodruff emphasized that for 80 to 85 percent of the people who contract coronavirus, the symptoms are mild.

According to the CDC: No vaccine or specific treatment for COVID-19 is available; care is supportive.

Woodruff also announced that his agency has opened an operational center to deal with the coronavirus as it evolves and enable officials to quickly share information.

“We need to prepare for how fast this can change,” he said.

In the community, schools

In addition to working with the healthcare providers, Public Health is working with local law enforcement, other agencies and the schools, including preschools and Feather River College, as well as local daycares.

Plumas Unified School District’s Kevin Bean, who is director of student services, said the district has an emergency action plan that covers pandemics.

“We work hand in hand with Public Health,” he said of the county office.

The district has already been utilizing standard protocol for flu season, which includes sanitizing the classrooms and common areas every night.

When asked about the possibility of schools closing as they have in other countries, Bean said that such a decision would come from Public Health.

Other countries have also closed public places and canceled events to prevent large groups of people from being in close contact.

“It becomes a fine line between public health and personal freedom,” said Woodruff, and ultimately his department, in conjunction with the state and CDC, would make that call.

He is also working with Gabrielle Hydrick, the county’s administrative officer. During an interview last week, Hydrick said he has been communicating with the supervisors, the sheriff, public health and other officials to coordinate any response to coronavirus should it become necessary.

Woodruff recommends that the public access information from the county’s own website, the CDC website or the California Department of Public Health site, due to the misinformation that can circulate via social media.

Another area of concern has been churches, where greetings and communion are often part of the services.

Pastor Matt Warren, of Christ the King Episcopal Church in Quincy, said that they are following their usual protocol and asking people who aren’t feeling well to refrain from shaking hands or hugging during the service. As for communion, where congregants drink wine from the same cup, no changes have been made, but the same precautions should be taken if one isn’t well.

Close to home

A female patient being treated at UC Davis Medical Center, is considered by the CDC to be the first instance of “community spread” of the virus, where no known potential cause exists.

“That suggests that the virus is out there in the community, and that means pretty much that everybody’s at risk,” Dr. Dean Blumberg, an infectious disease specialist at the CDC, told Sacramento television station KCRA. “We don’t know who might be carrying it. We don’t know who we can get it from.”

Testing for the woman was delayed because she did not meet the CDC guidelines established at that time, despite requests from U.C. Davis Medical Center.

“Upon admission, our team asked public health officials if this case could be COVID-19,” the hospital said in a written statement. “Since the patient did not fit the existing CDC criteria for COVID-19, a test was not immediately administered. UC Davis Health does not control the testing process.”

Health and Human Services Secretary Alex Azar has since said that the CDC is streamlining the process it uses to test for the coronavirus across the country and that tests should be available in all states by the end of this week.

Global reach

There are now more than 87,000 cases globally, with nearly 3,000 deaths. The bulk of the cases are still attributable to mainland China, though it now has a presence in at least 58 countries and is on every continent except Antarctica.

How COVID-19 Spreads

The following information is from the Centers for Disease Control:

Current understanding about how the virus that causes coronavirus disease 2019 (COVID-19) spreads is largely based on what is known about similar coronaviruses. COVID-19 is a new disease and there is more to learn about how it spreads, the severity of illness it causes, and to what extent it may spread in the United States.

Person-to-person spread

The virus is thought to spread mainly from person-to-person: Between people who are in close contact with one another (within about 6 feet).

Through respiratory droplets produced when an infected person coughs or sneezes.

These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

Spread from contact with infected surfaces or objects

It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

Can someone spread the virus without being sick?

People are thought to be most contagious when they are most symptomatic (the sickest).

Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.

How easily does the virus spread?

The virus that causes COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in some affected geographic areas. Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected.

Q: Why is the disease causing the outbreak now being called coronavirus disease 2019, COVID-19?

A: On Feb. 11, 2020 the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak, first identified in Wuhan China. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease.

Symptoms

Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases.

Symptoms may appear 2 to14 days after exposure:

Fever

Cough

Shortness of breath

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