With cases now in 50 countries, the World Health Organization has declared the spread of COVID-19, or coronavirus, a “public health emergency of international concern.” Around 83,000 cases have been confirmed internationally, 78,000 in China according to the Centers for Disease Control. About 2,800 people have died due to the virus.
Soccer games are being played in empty stadiums in Italy, and travel plans are being canceled all over the world. CNN reports that there are only 62 cases in the United States so far, but the reduced travel and tourism have caused the stock market to have the worst week since 2011, and the hotel, airline, cruise, and tourism industries that depend on hundreds of millions of travelers is in peril. For context, 16,000 people have died and 280,000 people have been hospitalized during this year’s flu season.
According to officials, Dallas isn’t sleeping on the possibility of coronavirus spreading to the region. “Dallas County Health and Human Services (DCHHS) is taking the risk of an outbreak in the US very seriously and is preparing for any level of response that may be needed,” said DCHHS Director Dr. Philip Huang in an email. “DCHHS continues to work with healthcare providers, schools, businesses, local governments and others to prepare for the possible spread of the coronavirus.”
The county is busy spreading the word about guidance from the CDC, alerting local providers and monitoring patients who are under investigation for the virus. They are developing additional laboratory capacity and public education strategies around what the public can do to keep themselves safe, and are updating and adapting the county’s Pandemic Management plan.
“The immediate risk of this new virus to the Dallas residents is believed to be low at this time, everyone can do their part to help prepare for the possible spread of the coronavirus,” Huang says. Thorough hand washing, using hand sanitizer, wiping down surfaces with bleach, and avoiding others if you feel sick will help keep the virus under control, should it arrive in Dallas. Mayor Eric Johnson said basically the same thing in an interview with the Texas Tribune on Friday morning.
The Dallas County Medical Society (DCMS) is also working to prepare providers and the public. DCMS President and Baylor Scott and White Internal Medicine physician Dr. Mark Casanova also happens to be a longtime member of the DCMS’ pandemic preparedness committee. He says the original pandemic plan was developed 15 years ago, and was made in collaboration with hospitals and the county. But plans developed 15 years ago need to be adapted to today’s viruses and treatment methods.
“What we are seeing with COVID-19 is a fluid and rapidly changing situation,” Casanova says. “The plan needs to be limber. It close to impossible to say today if it will strike in 3 weeks, but having a framework of preparedness in mind is what is key.”
He notes that the public should do their best to have a plan in place in case someone becomes ill. Sequestering the infected individual, finding childcare, and dividing other responsibilities will be key to stopping its spread. It is important to have ample supplies of food and medication, because if sequestration becomes necessary, it is good to have enough to have what you need at home so you don’t have to venture out into a crowded store with the infection. Having quality “sick foods” like soup and fluids at the ready is also important.
The research is mixed about face masks, according to NPR. The type of mask can impact its effectiveness, and authorities say it can provide a false sense of security. Most agree that if you are sick, a mask can help keep your virus from spreading to others, no matter what kind of infection you have.
Casanova says the hospitals are as prepared as they can be for something that is unknown, and the DCMS is trying to get the word out to community physicians so that they can be ready to care for patients who may show up to their office. He recommends doing as much triage over the phone as possible to avoid spreading the disease, using telemedicine when possible or just calling the office rather than going in.
For patients heading to their physician, tests for the virus have to be sent to the CDC, and a patient isn’t going to have an answer right away like they might with strep throat or another illness. He says if someone has an upper respiratory infection and haven’t been traveling or interacting with those who have been abroad, they probably don’t have the virus and shouldn’t request a coronavirus test.
What is more worrying is that there are those who can carry the disease but don’t display any symptoms, meaning they aren’t aware of the virus they may be spreading, Casanova says.
For providers and health systems, Huang recommends that they be proactive in identifying potential cases, asking about travel history and doing their best to educate patients how to stop the spread of disease.
Parkland Hospital, for its part, says the people should be more worried about this year’s flu. “Parkland has included additional screening of patients at all points of entry to the health system for travel history and symptoms using screening tools that were already in place. The greater concern in Dallas is for seasonal influenza,” said Carolee Estelle, the interim chief of infection prevention at Parkland, via statement. “We are continuing to orient all patients and staff to follow standard precautions including hand washing, covering your cough, etc. to prevent the spread of flu and other respiratory illness. Parkland follows CDC guidelines and partners with our local public health agencies to coordinate efforts in a concerted way.”
Authorities say we are still at least a year away from any vaccine for the virus, and with unreliable international reporting, there are still many unknowns about the true lethality and infection rate. Casanova says the virus has been lethal in about 2 percent of those who have shown symptoms. Those who have died have usually had some complicating medical conditions, and Casanova says children have been less affected than adults. “Unfortunately there are not a whole lot of answers,” he says.
Casanova agrees with Huang that in a situation with a lot of unknowns, Dallas is as prepared as it could be. “This is the bread and butter of county and state health department,” Casanova says. “The reason we do these exercises is for what is going on now. We have developed, tweaked, and readjusted the plan, and are changing it in real time.”