With the 12th case of coronavirus in U.S. confirmed today, here are some things I learned in my embed @SnoHD, a few blocks from where the first confirmed case was sequestered in a hospital isolation unit. What I saw was both inspiring and daunting. nytimes.com/2020/02/05/us/…
1) At least 69 people were potentially exposed to the coronavirus in the 5 days between when the man, 35, returned from China & when he was admitted to Providence Regional Medical Center. That includes fellow-passengers on plane, co-workers, people at clinic, healthcare workers.
How do they know this? Hollianne Bruce, one of 3 epidemiologists at the @SnoHD -- a public health dept. that runs on county and municipal funding -- interviewed the patient multiple times, with input from her counterpart at @KCPubHealth and @WADeptHealth.
One of my favorite moments in the events of that first hospital day came when Bruce decided to not to wait for the @CDCgov experts, who were requesting input on the patient interview. From my notes: "I could see waiting for guidance from CDC, because it's so new.'' MORE
"...They were literally flying in from the east coast, there were emails and calls, coordinating with the state. I remember getting anxious. I’m like, 'I've really got to talk to this guy, I‘ve got to interview him. By 4PM, I'm not waiting anymore."... MORE
"We didn’t know who else he may have been around, where else he went. Was he going to feel up to an interview? It was getting later in the day. What about the contacts that are out there that have been exposed to him? We didn’t know who that was or how many people that could be."
..."That's our job, to stop that transmission from happening.'' (CDC had nothing but praise for Bruce's work). OK so these "close contacts" were spread across 5 counties, with the vast majority split between Snohomish, where the man lived, and Seattle-King, where he worked.
2) Of the 69 people health workers monitored, at least nine, by my calculation, developed symptoms that warranted testing under CDC guidelines. But, you may wonder, if a contact of the case comes down with symptoms, wouldn’t it be a bad idea to go to a clinic for testing?
3) Yes. So in the King County, the public health office, @KCPubHealth, worked with local hospital to set up house calls for people needing testing. When I was there, @Snomo was finishing a standalone facility dedicated to testing to manage this too.
4) While people with symptoms are awaiting test results, they are ordered to "isolate at home.'' Health workers coordinate getting food and supplies to them if necessary. They also call every day. If not obvious, this is all a lot of work. On top of the usual TB, HIV, Hep A, flu.
5) But a big thing I learned is, this is what public health workers DO. Last spring Bruce & colleagues tracked hundreds exposed to a HS student with measles. Preventing the spread of communicable disease routinely takes Herculean efforts. Most are just not on the public radar.
6) What heightens the stress for the workers I talked to now is the uncertainty. With measles, they know the contagious period (4 days before & after rash) & that it's transmitted thru droplets. Even w/Ebola, they know what they’re up against. It’s still unclear with #2019nCoV.
7) All but three of the tests have been returned and were negative. The state DOH updates total “persons under investigation’’ here (includes others beyond contacts of the confirmed case). Those 3 tests have been out for several days. doh.wa.gov/Emergencies/Co…
8) Also, did I mention that, during all this, one of the people under the investigation, awaiting her test results back, supposedly in isolation-at-home, got on an airplane and traveled to Wisconsin?
9) Lastly - I learned that February is #AmericanHeartMonth. To raise awareness, @SnoHD
is challenging the Medical Examiner's office to see who can get the most people to wear red. The morning I was there, they were posing for this picture.
is challenging the Medical Examiner's office to see who can get the most people to wear red. The morning I was there, they were posing for this picture.
More details in the story. Would love to hear from other public health workers dealing with the other 11 cases. DMs open or email amy@nytimes.com. nytimes.com/2020/02/05/us/…
