This morning, there were nearly 10,000 confirmed cases of the new coronavirus worldwide—a number that surely will have increased by the time you read this.
Is Rochester ready?
At least one local university immediately started screening students who had recently visited China, where the virus originated. Hospitals implemented screening processes recommended by the Centers for Disease Control and Prevention and the New York State Department of Health.
The Rochester health care community in years past has mobilized responses to pandemic threats from Ebola to severe acute respiratory syndrome (SARS). Applying lessons learned, we grow faster each time. But each situation also is unique and calls for an effectively targeted response.
2019 Novel Coronavirus
The 2019 Novel Coronavirus, or 2019-nCoV, was first detected in December in Wuhan City, China. Coronaviruses are a large family of viruses that circulate commonly among animals including camels, cats and bats. In humans, coronaviruses cause illnesses such as the common cold and gastrointestinal infections. Some strains cause more-severe diseases, such as SARS and Middle Eastern respiratory syndrome (MERS).
The concern about 2019-nCoV is that it’s in the same larger classification of viruses as prior bad actors like MERS and SARS. While some patients experience only mild symptoms, others have contracted pneumonia, fevers, and lung infections. The death toll by Jan. 31 had reached 213.
What we don’t know
In Rochester, what concerned us most is what we don’t yet know about 2019-nCoV. We don’t know important details about how it’s transmitted from person to person. Is it airborne? Through droplets? Can you get it from touching a surface like a doorknob? All of the above? When is a person most infectious?
Because we don’t know, we adopted measures of utmost caution. At Rochester Regional Health, where I work, we ask specifically if a patient has traveled to China or has been in contact with anyone under evaluation for 2019-nCoV. If they say yes and are experiencing fever or respiratory symptoms such as coughs and shortness of breath, we have them wear surgical masks, move them to airborne isolation or private rooms, and conduct further testing. Staff wear additional protective gear to stay safe.
All of this went into effect when there were only five confirmed cases in the United States, and none in Rochester.
The new normal
The bad news is that this type of pandemic risk is on the rise. Ecological disruption is setting loose viruses that previously lived quietly in forests or bat caves. Human populations are more mobile, including people displaced by conflict and natural disasters. Climate change increases the spread of infectious diseases through insects and contaminated water. Federal funding cuts threaten research dollars. Staffing shortages can make it hard to devote sufficient resources, and some U.S. hospitals might even run low on protective equipment such as masks—something not currently happening in our health system.
Learning faster response
The good news is that we’re getting better and faster at responding. As reported in the Washington Post, the appearance of 2019-nCoV sparked an unprecedented global collaboration among scientists, who started sharing data almost in real time to understand and respond to the pathogen.
In Rochester, our day-to-day collaboration focuses mainly on direct patient care and infection prevention. When 2019-nCoV came on the horizon, we sprang into action with infection-control meetings, hospital leadership meetings, and departmental planning of response protocols. We held internet conferences, and jumped onto webinars run by the CDC, and local and state health departments. These are very helpful, and I personally have participated in six of these over the past three weeks.
The Greater Rochester infectious-disease health care provider community routinely meets monthly to discuss cases and important issues. Beyond that, infection-control teams maintain constant contact regarding emerging community needs.
Patients in the Rochester area frequently move among hospitals and health care systems. Knowing this, we as providers call our counterparts in these places with needed updates. In addition, hospitals across systems coordinate initiation of visitor restrictions.
Flu remains prevalent
To keep the new coronavirus in perspective, as of this writing there were no confirmed cases in New York. In contrast, as of Jan. 18, the state health department reported 13,843 cases of the flu. If you want to avoid respiratory illness, get a flu shot. Wash your hands, cover your cough. Don’t go to school or work or visit patients in the hospital if you are sick.
In Rochester, it’s far likelier today that a cough, fever, shortness of breath and muscle aches are signs of flu. But if you’re experiencing these and have recently been in China or around someone who has, put on a mask and call your health care provider.
To learn more about 2019-nCoV, see the CDC website.
Emil Patrick Lesho, DO, FACP, FIDSA, FSHEA, is a specialist in infectious disease and the health care epidemiologist at Rochester Regional Health.
The 2019 Novel Coronavirus originated in the “wet markets” in Wuhan, China. These are extremely crowded places where dead, live, and exotic animals are bought and sold for food, status, or presumed medicinal properties. Under these circumstances, the virus was able to jump from animals to humans. Scientists speculate that 2019-nCoV likely started in bats, jumped to other animals, and then to humans.
Thank you for the update. What is the origin of this virus, or the best speculation?