Coronavirus. The very word elicits a variety of emotions, ranging from curiosity to anxiety to terror. The operative word here, however, is emotions. When news of a pandemic overtakes the airwaves, panic can replace rationality, causing people to react out of fear rather than reason.
Not that there isn’t a problem. President Franklin Roosevelt’s immortal observation, “We have nothing to fear but fear itself,” made during his presidential campaign at the height of the Great Depression, may have served as a healing balm to the nation in 1932, giving people hope that they would make it through hard times. When it comes to coronavirus, however, we have something to fear besides fear. COVID-19, as it’s known, is a growing concern, with cases escalating literally by the hour, around the country and the globe. Two days ago there were 226 known cases of the virus in the U.S., with 22 deaths reported. An hour ago, that number had risen to 545. And three hours later, as this article is being written, the update is 606 cases, with the number of deaths unchanged. By the time this paper comes out, that number will undoubtedly have increased exponentially.
At the same time, fear can’t be allowed to dominate our response to what has been declared a national emergency. Originally, people testing positive for the virus were limited to those who had contracted it abroad. Containment was the response. Now, however, it has been classified as a “community transmitted” pathogen, meaning it has entered the general population without travel history as a determining factor. The CDC response has moved from containment to “mitigation.” In the words of Surgeon General Jerome Adams, “Now we’re shifting into a mitigation phase, which means that we’re helping communities understand, ‘You’re going to see more cases. Unfortunately, you’re going to see more deaths.’ But that doesn’t mean that we should panic.”
So what are the facts about coronavirus? And what are the chances of coronavirus coming to Oceana County?
First of all, what, exactly is coronavirus? According to the CDC, it’s a “respiratory disease caused by a novel (new) coronavirus that was first detected in China and which has now been detected in almost 90 locations internationally, including in the United States. The virus has been named ‘SARS-CoV-2’ and the disease it causes has been named ‘coronavirus disease 2019’ (abbreviated ‘COVID-19’). Coronaviruses are a large family of viruses that are common in people and many different species of animals, including camels, cattle, cats and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with Mers-CoV, SARS-CoV, and now with this new virus (named SARS-CoV-2).”
The virus was initially spread in China, where it was linked to a large seafood and live animal market, indicating animal-to-person spread. Later it moved to person-to-person spread in China, and is now a global threat. As a community spread virus, it is not known how infected persons became exposed.
What do we in Oceana need to know about coronavirus? How likely is it that the virus will get here? How can we prepare for an outbreak, and protect ourselves from getting sick? What are the symptoms? When should we go to the doctor? The ER? Will our schools, our churches, our community centers close? Above all, how well prepared is our district health department, DHD #10, to deal with the possibility of COVID-19 in our community?
Dr. Jennifer Morse, DHD #10 medical firector, is confident that Oceana County is well-prepared to deal with a coming outbreak of COVID-19 should it reach our doorstep.
Q: Do you think coronavirus will come here?
A: At present there are no cases in Michigan. So our risk right now is very low. But things are changing very rapidly. There’s no way of knowing at the moment, but it’s most likely a question of time before it gets to Michigan. Odds are that it will become a pandemic, but when that will happen and where is very hard to say. We do monitoring of routine travelers throughout the state, but so far no cases have been reported.
Q: Are you seeing anxiety in the community?
A: It’s a front and center issue for our department. It’s occupying the majority of our time. We’re getting many questions from the community. Everyone is really nervous. And the more worried people are, the more likely they are to panic. The fact is that older people, and those with chronic or underlying medical conditions, are most at risk. It likely will affect most people as a mild cold. It’s important to educate people who are not very ill to stay home. If everyone goes into the ER or the hospital, we won’t have enough resources.
Q: What are your recommendations for preparedness?
A: First of all, people need to be well-informed. One of the biggest struggles right now is misinformation. How do we find the right information? The CDC is doing a fantastic job of updating their website daily. It’s an amazing effort. For the most up-to-date information, people should go to www.michigan.gov/coronavirus. Our health department also has numerous links on our website, www.dhd10.org/coronavirus. We’ve pulled together numerous resources for different groups—education, businesses and the like.
Q: How are the various health departments in Michigan pooling information and resources? Isn’t this particularly important, given that Oceana only has one hospital, Mercy Health Lakeshore in Shelby?
A: We have a regional healthcare coalition covering the different regions in the state and our jurisdiction. We’re in Healthcare Region 6. We have regional meetings and a number of counties work together to collaborate for emergencies and share resources. If beds are a shortage, for instance, they’re able to move people around. We meet at least once a month. We just had a call yesterday to discuss this.
We’ve had essential experience with epidemic preparedness. With the H1N1 pandemic in 2009, we really had a response. Emergency measures were put into place. So we know how to deal with something like this. This situation is similar, but it’s also something different. There are four human coronaviruses that circulate and are the second most common cause of colds. This virus, COVID-19, crossed over from animals. It’s similar to the flu in how it behaves. But unlike H1N1, it doesn’t seem to be affecting young people and children as much. H1N1 has a predilection for young people.
Q: The Spanish flu pandemic of 1918 decimated entire communities. How have we evolved since then, particularly since we don’t yet have a vaccine for COVID-19?
A: Today we can provide ventilators and respirators and dialysis for kidney failure. We can provide supportive care for various organs to help the victim get through. None of that was available in 1918.
Q: Are masks effective?
A: Masks are needed for healthcare workers, who have a special filtration mask, the N95, which filters out at least 95 percent of microscopic particles that you’re breathing in. They must be specifically fitted to the face so that when you breathe in, it creates a seal. Public masks, on the other hand, are not effective protection. They’re like the masks a surgeon wears. They keep droplets from your breath from getting out, but they don’t protect you against droplets getting in. They block big particles, but they’re loose fitting and people tend to touch them a lot so you’re touching your face, which you definitely don’t want to do. If you are sick and wear a mask it helps keep your germs from getting out to others. But for the average healthy person it won’t do much good.
Panic causes people to feel the need to have masks and gloves, but unfortunately these are not the best way to prevent illness.
Q: Is COVID-19 an airborne virus?
A: COVID19 is spread by droplets, such as when you sneeze or cough. It is not airborne. Airborne is when the virus can stay in the air for several hours. Measles is an airborne virus. The example of this is that a person with COVID19 is likely to infect two to three others, while a single person with measles could infect 12-15 people. So coronavirus is definitely not the most infectious disease we have.
It’s a good time to prepare and think about what you would do in the event of an outbreak here. But don’t panic. With this virus, there has been very little illness and no deaths in children. If you’re not feeling well, drink plenty of fluids, get plenty of rest, and take OTC meds that are safe for you. If you get weak or dizzy, or have a high fever, you should call your doctor or go to the ER.
Q: What’s the situation on testing kits?
A: The state did just get additional test kits, but we still don’t have a lot. We only have 300 in the entire state.
Q: How is testing done?
A: The way you would be tested is your provider would collect a specimen, and it would be shipped to a state lab. Anyone who tests positive would then have to have the test confirmed by the CDC.
Robin Walicki, clinical supervisor at DHD10, directly supervises the communicable disease and immunization coordinators at the department. She has been actively involved with the coronavirus issue.
Q: It seems that coronavirus has been a dominant issue for you.
A: We have a huge team working on this. It really takes a village.
Q: What’s the mood of the community?
A: People are cautiously asking questions. We’re hearing a lot from businesses and healthcare, especially long-term care. Early on we heard from hospital infection control with questions. We get numerous community calls, particularly questions about whether it’s safe to go to places where people congregate, like church.
There’s a lot of proactive communications going on. For instance, the Michigan Department of Education has sent out school info. All the state and national groups are getting info to their specialties.
The hardest thing with this is that information changes several times a day. So what we generate can be outdated very quickly.
Q: Are the symptoms of coronavirus any different from those of the flu?
A: Symptoms of coronavirus are just like flu symptoms. Fever, cough, possibly diarrhea. Several weeks ago there was someone with those symptoms. They went thru the proper channels with Dr. Morse, state and CDC, and it was determined that they didn’t have the criteria for testing. The state health department is doing a great job making sure we have what we need and communicating regularly with us. We have a 2 p.m. and 3 p.m. call today with them.
Q: What’s your opinion regarding coronavirus and the flu vaccine?
A: The flu vaccine is recommended. It will prevent or lessen the severity of regular flu. It’s just an extra line of defense.
Q: Is the state restricting travel in any way?
A: There are no recommendations not to travel at this time. In our jurisdiction, we’ve had two travelers we’ve had to monitor. They went through airports and are considered medium risk. They have to take their temperatures every day. We’ve been monitoring travelers for around six weeks now. They’re not in Oceana but in our jurisdiction, which covers 10 counties. Region 6 covers Masion, Oceana, Muskegon, Ottawa and then over to central Michigan.
Q: Do you feel we’re ready should coronavirus get to our area?
A: Yes. The different healthcare regions have connections to each other. We have an epidemiologist covering region 6. She’s been great getting information to us.
What people may not realize is that we do have those underlying structures like Michigan Health Regions Coordination and the state health department for resources and support. Dr. Morse is a fantastic medical director, and we have an emergency preparedness coordinator and representatives from all our divisions on a team. Two years ago we did this with Hepatitis A. So we’ve had some practice.
I feel confident that we have the best team we could have.
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