Pneumonia-Like Coronavirus: State, Healthcare Leaders Prepare for Local Outbreaks

Updated March 11: National and local health officials are preparing for community outbreaks of the pneumonia-like respiratory illness caused by the Coronavirus Virus 2019 (COVID-19), which originated in China in December and has infected more than 120,000 people worldwide, the vast majority in China. There are nearly 40,000 cases confirmed in more than 70 nations outside of China.

More than 4,300 deaths have been reported worldwide, the majority in China. In the U.S., there are more than 900 people who have been diagnosed with COVID-19, with the largest clusters around Seattle, New York City and in California. At least 31 people have died, including two deaths in Florida (in Santa Rosa and Lee counties). Most of the U.S. deaths have been reported in the Seattle area., according to state health officials and the U.S. Centers for Disease Control and Prevention (CDC). Of the total U.S. cases, 49 are Americans repatriated from Asia, where they had been quarantined.

State health officials report that four patients in Broward County have tested positive for COVID-19. Overall, state health officials confirm 28 cases in Florida. Additionally, the number of people under “public health monitoring” in Florida is at 319, mostly travelers who had visited outbreak areas in Asia.

“Despite these cases, the overall, immediate threat to the public remains low,” stated Gov. Ron DeSantis last week at news conferences. “With that said, we do anticipate that more will test positive and we have taken additional actions to help contain the virus’ spread.”

One of the actions taken, the governor said, is to issue a “public health emergency” to better equip Florida “with the resources needed to handle this threat.” The public health emergency “ensures that healthcare providers, hospitals and labs immediately report all suspected cases to the Florida Department of Health,” he added.

The declaration also advises individuals who may have been exposed to the coronavirus “to contact their local county health department prior to traveling to any physician’s office, emergency department, hospital or urgent care center.”

Most cases of COVID-19 involve mild symptoms, including fever, tiredness and a dry cough, that can be home-treated without medical intervention. Following guidance from the CDC, Baptist Health South Florida is encouraging people who may be experiencing symptoms similar to those of COVID-19 to stay home and see a doctor from their smartphone, tablet or computer via the Baptist Health Care On Demand app

This week, at least two private companies — LabCorp and Quest Diagnostics — will be processing coronavirus tests under the supervision of state and federal health officials. This should speed up COVID-19 testing throughout the country in coming weeks, said the Florida governor.

Who is Most at Risk

“Most individuals with COVID-19 will have a mild case — 80 percent of individuals will be home-treated,” explained Florida Surgeon General Scott Rivkees, M.D., who also spoke at Monday’s news conferences. “Up to 15 percent of individuals may have a more severe case requiring hospitalization. For up to 5 percent of individuals, (COVID-19) may be especially severe.”

Worldwide, adults older than 60 with underlying health issues have been affected the hardest by the virus.

“The elderly and individuals with underlying medical conditions, like high blood pressure, obesity, heart problems and diabetes, may be more prone to develop serious complications should they contract COVID-19,” said Dr. Rivkees.

Miami International Airport (MIA) is screening travelers for potential cases of the Wuhan coronavirus, under the direction of the CDC. The quarantine station at MIA is one of at least 20 operated by federal health officials at major airports across the country.

Expanded Testing

The U.S. Food and Drug Administration has announced that testing for COVID-19 will be expanded significantly across the U.S. by authorizing private laboratories and hospitals to conduct tests — instead of the current method of having the CDC analyze specimens, which can take as long as five days to complete.

The FDA’s decision should speed up detection of COVID-19 infections and make it possible for health officials to identify outbreak locations. Dozens of labs — run by states, universities and private companies — have applied for emergency approval for on-site testing. Once these labs have submitted evidence that they are fully capable of testing for COVID-19, they will be able to use them immediately, bypassing the normal and lengthier review process at the FDA.

“This action today reflects our public health commitment to addressing critical public health needs and rapidly responding and adapting to this dynamic and evolving situation,” the F.D.A.’s commissioner, Stephen M. Hahn, said in a statement.

Symptoms of COVID-19

The most common symptoms associated with this virus have included fever, tiredness and cough. Some patients have aches and pains, nasal congestion, runny noses, sore throat and diarrhea. The majority of cases involve mild symptoms. The most severe cases present conditions similar to pneumonia, which is an infection that inflames the air sacs in one or both lungs. The more serious cases involve trouble breathing. The incubation period — or the time elapsed between exposure and when symptoms first become apparent — for COVID-19 is between 2 to 14 days.

South Florida healthcare professionals are preparing for any possible outbreak.

Baptist Health South Florida is screening patients at entry points, including ERs and urgent care facilities, for pneumonia-like symptoms, similar to those reported in COVID-19 patients, said Anexis Lopez, R.N, manager of Infection Control at Doctors Hospital, part of Baptist Health South Florida. Baptist Health will work closely with local and national public health officials if there is an outbreak.

“We’re vigilant and already screening anybody who has traveled to the affected area within the past 14 days for fever, cough or any trouble breathing. We want to make sure we identify and isolate any potential patients of the virus.”

Ms. Lopez offers the same infection protection tips for the public that apply to avoiding the flu or other viruses. Washing your hands frequently with soap and water is a priority. So is keeping your distance from anyone who is sneezing or coughing.

The CDC says that it is “unclear how easily this virus is spreading between people.” Pubic health officials say that people carrying the virus, but not showing symptoms, may still be able to infect others.

“If you’re traveling, you need to protect yourself,” says Ms. Lopez. “And if you’re next to somebody who’s coughing or sneezing, you should stay away from that person as much as possible.”

Person-to-Person Spread

The CDC says 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)
• Via 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.

It’s also 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. However, this surface-originating method is not thought to be the main way the virus spreads, the CDC says.

For more information on COVID-19, visit the CDC website. Florida residents and visitors can visit the Florida Department of Health website.

Tags: emergency care, infectious disease