*UPDATE* Since the initial printing of this article, Nevada has discovered two of the latest cases of COVID-19, one being reported in Las Vegas and one testing positive in Reno.  As of 10:00 am March 6th, over 100,000 cases and over 3,400 deaths have been reported globally, with 12 deaths and 233 active infection cases in the United States, with patients being treated in as many as 19 states, now including Colorado, Nevada, and New Jersey.

This virus is affecting older populations and individuals with pre-existing respiratory issues.  It is important to stay informed and vigilant in maintaining personal hygiene practices.  The World Health Organization, the Centers for Disease Control and Prevention and William Bee Ririe Hospital are recommending everyone wash their hands regularly with soap and water; and self-isolating if presenting any flu-like symptoms.  If you have a cough, it is recommended to wear a mask if going into public spaces.  Call your primary care physician if experiencing flu like symptoms.

 

Article that follows was printed in The Ely Times, March 6, 2020.

International health organizations and Centers for Disease Control and Prevention are actively responding to a massive outbreak of a novel (new) coronavirus and the respiratory disease it causes, COVID-19.  First detected in China and reported to the World Health Organization on December 31, 2019, the coronavirus has since spread rapidly across the globe. So far, 2020 has seen the number of new infections quickly accumulating, currently reaching over 95,000 infection cases worldwide, resulting in an estimated 3,200 deaths across 80 countries and territories; including 11 fatalities in the United States. 

Documenting a US time line, The New England Journal of Medicine provides that, on January 19, 2020, a 35-year-old man presented to an urgent care clinic in Snohomish County, Washington, with a 4-day history of cough and fever. This was the first confirmed US case of COVID-19. By January 30, the patient remained hospitalized in isolation; and on that day, the International Health Regulations Emergency Committee of the World Health Organization declared the outbreak a “public health emergency of international concern.”  The next day, US Health and Human Services Secretary Alex M. Azar II declared a public health emergency for the United States to aid the nation’s healthcare community in responding to COVID- 19.

 On February 8th an American citizen died of the virus in Wuhan, China. The first confirmed deaths in the United States linked to the coronavirus and the respiratory disease, COVID-19, came last Wednesday, February 26th, from a nursing home in Kirkland, Washington, where the two deaths signaled the start of the nation’s worst outbreak of the virus. 

Across the country over the past week, approximately 153 people have tested positive for the infection, with cases detected in fifteen states, including Washington, Oregon, California, New York, Texas, Florida, New Hampshire, North Carolina, Georgia, Illinois Massachusetts, Utah, Arizona, Rhode Island, Wisconsin, and Nebraska. 

On Tuesday, March 2nd , the head of the World Health Organization announced the disease was far more lethal overall than previously suspected. At a Geneva press conference, the World Health Organization Director General Dr. Tedros Adhanom Gheberyesus laid out what they know, “While many people globally have built up immunity to seasonal flu strains, COVID-19 is a new virus to which no one has immunity. Globally 3.4% of reported COVID-19 cases have died.  By comparison seasonal flu generally kills fewer than 1% of those infected.”

Here in the Silver State, Nevada’s Chief Medical Officer, Dr. Ihsan Azzam is reported as saying on Monday, “It is no longer an outbreak. It is more appropriate to use the words ‘global pandemic. We are going to do our best to ensure the safety of our community, and we wish that everybody would be safer. It’s not a question of if, it’s when.”  Reported by the Nevada Independent, Azzam was addressing the Patient Protection Commission, detailing the substantial lengths state health agencies have taken to prepare in the event of an epidemic, “We are ready to be able to early identify every single case, to immediately isolate cases.”  

In urban areas like Las Vegas, results from a coronavirus test can be determined within hours, for rural areas like White Pine County, a result could take days. However, at William Bee Ririe Hospital, the most remote hospital in the continental United States, the nurses and doctors on staff are reportedly prepared and ready, in the unlikely event a patient here tests positive for COVID-19.  Matt Walker, CEO of WBRH confirms, “We have a pandemic emergency plan in place, and our medical providers are no more worried about this than dealing with the regular flu.”

Walker and Dr. David Byun, White Pine County Health Officer and the State Point of Contact for COVID-19  response, will be attending a meeting on Thursday March 5th, with state health agencies to discuss testing and precautionary measures specifically addressing coronavirus and the respiratory infection COVID-19. The Ely Times will provide an update next week with additional information from that gathering. 

In the meantime, Walker says, “Doctors are following Centers for Disease Control and Prevention algorithms when it comes to patient care, should a patient be presenting flu like symptoms.”  Doctors may ask if you’ve traveled to any of the areas affected by the coronavirus or if you have come into direct contact with someone who has; a test will be administered, and patients will be kept in precautionary isolation until cleared. 

Coronavirus is an easily spread, highly contagious, and easily sustained community style virus, believed to spread mainly from person-to-person, usually between people who are in close contact with one another. According to the CDC, it may be 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.

Transmission of respiratory infections commonly occurs when an infected person coughs or sneezes near people who then inhale those contagions into their lungs.  

Public health officials have, over the last few weeks, openly discussed the likely impact coronavirus and COVID-19 will have on the world’s populations,  “Ultimately we expect we will see community spread in the United States,” says, Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the CDC. “It’s not a question of if this will happen, but when this will happen, and how many people in this country will have severe illnesses. We are asking the American public to prepare for the expectation that this might be bad.”

Echoing that sentiment is Harvard Epidemiology Professor Marc Lipsitch, who last week described a nightmare scenario shared as a consensus among leading epidemiologists, “I think the likely outcome is that it will ultimately not be containable.” Lipsitch told The Atlantic that he predicts within the coming year, some 40 to 70 percent of people around the world will be infected with the virus that causes COVID-19. But, clarifies, “It’s likely that many will have mild disease, or may be asymptomatic,” he said.  As with the common flu, which can be life-threatening to people with chronic health conditions, most cases will resolve without little or no medical intervention. 

For now, most of the American public, and White Pine County residents, are unlikely to be initially exposed to this virus, and the immediate health risk from COVID-19 is considered very low. If you have traveled to any region of the United States affected or visited a country currently experiencing an outbreak, your risk of contracting the illness is increased. 

There are simple things you can do to help keep yourself and others healthy. 

Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food. 

Avoid touching your eyes, nose, and mouth with unwashed hands.  

Stay home when you are sick. It is suggested you stay home for 24 hours after your symptoms or fever have subsided.  Isolation will prevent the spread of illness. 

Cover your cough or sneeze with a tissue, then throw the tissue in the trash, and wash your hands after each use.

Wear a mask if you have flu-like symptoms to limit the spread of airborne contagions.  

Know the signs of the flu, and COVID-19:  Both cause fever, cough, body aches, fatigue; sometimes vomiting and diarrhea, and can result in pneumonia. Both can be spread from person to person through droplets in the air from an infected person coughing, sneezing or talking. Both can be spread by an infected person for several days before their symptoms appear, as symptoms may not appear for 2-21 days from infection. 

Neither virus is treatable with antibiotics, which only work on bacterial infections. Both may be treated by addressing symptoms, such as reducing fever. Severe cases may require hospitalization and support such as mechanical ventilation. Both may be prevented by frequent, thorough hand washing, coughing into the crook of your elbow, staying home when sick and limiting contact with people who are infected.

It is important to note an estimated 1 billion cases of the flu are recorded worldwide with anywhere from 9.3 million to 45 million cases in the U.S. per year.  While  COVID-19 has accumulated approximately 3,200 deaths reported worldwide and 11 deaths in the U.S., as of Mar. 4, 2020, the flu averages 291,000 to 646,000 deaths worldwide, with an average of 12,000 to 61,000 deaths in the U.S. per year.  Even though there is no vaccine to prevent COVID-19, it is recommended you get a flu shot as a means of prevention and safe practice against seasonal flu.