Are County Health officials right to release coronavirus patient home?

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by Doug Sain

Yesterday, the World Health Organization (WHO) said the fast-spreading coronavirus is a global health emergency — a rare designation that helps the international agency mobilize financial and political support to contain the outbreak.

There are now more than 12,100 suspected cases in China, on top of the 8,137 that have already been confirmed in the country, according to WHO and China state media data released Thursday. Although the coronavirus doesn’t appear to be as deadly as SARS, which had a mortality rate of about 10%, it is spreading significantly faster. The WHO data shows there are roughly 1,400 people in China who are severely ill.

Last Monday, January 27, 2020, San Diego County health officials let a man return home to his family after being tested for the novel coronavirus originating from Wuhan city in Hubei province in China. Test results were expected to be announced on Tuesday. Then, the results were delayed to Wednesday. Now the results have been delayed to possibly next week.

Did County officials — with the apparent support of County Supervisor Nathan Fletcher, the way he has injected himself in the conversation — make the correct decision to release the man, or should the County have quarantined him? To better understand that decision, consider the following news reports from domestic and international news agencies, the US State Department, and the US Center for Disease Control and Prevention (CDC).

Every day this week, more cases and deaths due to the novel Wuhan coronavirus have been announced.

Friday: 830 cases

Saturday: 41 deaths, 1,320 cases, 3.1% death rate

Sunday: 56 deaths, 1,975 cases, 2.8% death rate

Monday:  81 deaths, 2,744 cases, 2.9% death rate

Tuesday: 107 deaths, 4,515 cases confirmed, 2.3% death rate

Wednesday: 132 deaths, 5,974 cases, 2.2% death rate

Thursday: 170 deaths, 7,783 cases, 22 affected countries, 2.1% death rate

In another week, an expert predicts the coronavirus would spread to nearly 200,000 people due to the ability to be spread during the ten day incubation period. Some contend China is suppressing the actual numbers of infected and dead.

On Tuesday, the CDC expanded an earlier travel warning to Level 3 of 4 that advises Americans to avoid all nonessential travel to China, and Level 4 to not travel to Hubei province. The new Wuhan coronavirus, named “2019-nCoV,” originated in the river port city of Wuhan, and is from the same family of viruses as SARS, the viral respiratory illness that killed 774 people of 8,098 infections between 2002 and 2003.

Virus: % Death Rate

Wuhan Novel Coronavirus (2019-nCoV): 2%*

SARS: 10%

MERS: 34%

Swine Flu: 34%

Seasonal Flu: <0.01%

In China, 17 cities in Hubei have been locked down, and 28 provinces have raised their public health alert to level 1, the highest level emergency response ranking possible, which enables measures including quarantines. In China, travel has been restricted for 60 million people. Virtually no travel is being allowed into or out of Wuhan, and all inter-province travel has been suspended. All 72 train stations have been closed down. The entire province has announced a ban on group gatherings. Individuals are not allowed to organize gatherings, and restaurants are being prevented from hosting them.

The region has become totally locked down, and the lockdown has spread throughout China. Widespread neighborhood groups are building brick walls on city streets to block people from entering. All domestic and foreign tour group operations to China have been suspended. Shanghai’s Disneyland and all tourist sites in the popular Sanya city have been closed. Global airlines, such as United Airlines, have suspended or scaled back direct flights to China’s major cities. Countries including Australia, Canada, France, Germany, Indonesia, Italy, Japan, Singapore, South Korea and the United States are working to evacuate citizens from Wuhan or have already started.

China’s president warned of a “grave situation” and said the virus was “accelerating its speed.” Disturbing video shows dead bodies piling up in the hallways of a hospital in China, as the coronavirus outbreak continues to spiral out of control. China is rushing to build two 1,000-bed hospitals in just six days to treat patients at the epicenter, because infectious diseases should not be treated in general hospitals.

According to health experts and the CDC, the flu is still a far graver health threat in the US than the Wuhan coronavirus. At least 15 million Americans have caught the flu in the last four months; nearly a quarter million of them went to the hospital and 8,200 have died this season in the US <https://www.cdc.gov/flu/weekly/index.htm>. However, the death rate is much lower at 0.005%.

In 2018, which brought the worst flu season in about 40 years, 80,000 people in the US died of the illness. According to the World Health Organization, seasonal influenza epidemics cause between 3 million and 5 million severe cases worldwide every year and kill up to 650,000 people worldwide per year.

The New York Times reported, “the spread of the new coronavirus is starting to resemble that of seasonal flu, said Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.”

“I think we have to revisit which model we’re really using, and I think we really over the past week and a half have come closer to the influenza model,” Dr. Osterholm said. “Trying to stop influenza in a community without vaccine is like trying to stop the wind. I don’t know how we’re going to stop this.”

He added, “The only thing operating in our favor is at least it doesn’t appear to be as severe as SARS (10% death rate) or as MERS (35% death rate).” And, the New York Times reported, “if the new virus were to spread even more widely and a 2 percent mortality rate continued, the death toll could be considerable.”

A prior estimate had put the Wuhan coronavirus death rate at 3%. However, the fatality rate can change as a virus can mutate, according to epidemiologists. Once the province Hubei (where the epicenter Wuhan is situated) is removed from the calculation, the national (China) mortality rate drops to 0.3%. Within the Hubei province, the mortality rate is about 1% when excluding the city of Wuhan, where the death rate is 5.5%.

Unlike the typical flu, where the highest mortality is in infants and the elderly, the 1918 Spanish flu pandemic also struck down young, healthy adults. It was the deadliest outbreak of the influenza virus in history killing the most people in the shortest timeframe. Estimates were 20-50 million died from 500 million infections.

Another extreme situation was the Ebola virus which was a serious viral infection that originated in sub-Saharan Africa. Unlike the new coronavirus, Ebola is not an airborne disease, and as such it is impossible for a person to become infected by inhaling the same air as a patient. People could only become infected through direct contact with bodily fluids of someone with the Ebola virus. The 2014–2016 outbreak in West Africa was the largest Ebola outbreak since the virus was first discovered in 1976, and it ended with more than 28,600 cases and 11,325 deaths. The death rate was 39.6%.

Some predictions indicate the Wuhan coronavirus could turn into a major pandemic. China is allowing in international experts to help contain the outbreak. Germany and Japan say the virus has spread in their countries. Hong Kong put significant limits on travel from the mainland. At least five confirmed cases of the Wuhan coronavirus are in the US, a number the CDC predicts will continue to climb. “We need to be preparing as if this is a pandemic, but I continue to hope that it is not,” said Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases.

In Italy, 7,000 people are being confined to a cruise ship in a port near Rome because a couple is being tested for the virus. Six thousand people on board are passengers and around another thousand are crew members. A spokesperson for Costa Cruises told CNN that a 54-year-old woman aboard the cruise ship was suffering from a fever and that she and her husband were both being tested. “All the other passengers are, at the moment remaining on board,” the spokesperson said.

In Porter County Indiana, one person is being kept in isolation until test results are completed. Similarly, an airplane full of Americans who were in Wuhan, China, are being held at March Air Reserve Base in Moreno Valley, California. The U.S. government charted the flight to get the 201 Americans, including U.S. diplomats out of Wuhan. The passengers were screened for signs of illness before they left China, and again when the plane landed in Alaska to refuel. The passengers will remain at the base anywhere between three and fourteen days. If any one becomes ill, they will be transported to a nearby hospital.

Meanwhile, last Monday, San Diego County Health officials said they were investigating the first suspected case of Wuhan coronavirus in San Diego County. The patient traveled by train through Wuhan, where the virus originated, but did not get off in the city. Results of the patient’s test were to be completed Tuesday morning but the test results have been delayed twice. Now, according to local news reports, Supervisor Nathan Fletcher and other officials say the results of that test might not be confirmed until next week.

When the patient returned home from China to San Diego County, he started showing symptoms and was admitted to a general hospital. Late Monday, the patient was released, and is in isolation at home, according to the county.

Did County Health officials make the right decision to release the patient back home to be surrounded by family members who could then go out and spread the virus, or should the County have quarantined him like other government agencies are doing?

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Doug Sain is a documentary movie producer, policy analyst and political consultant.

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