Now that the CDC has identified the first cases of non-travel-related COVID-19 coronavirus in the US, federal and state agencies have begun to step up their response plans to handle what are likely more cases to come. Here in South Carolina, state agencies are also being diligent in their preparations. But, in the meantime, what measures should we be taking on an individual level for both prevention and the possibility of a self-quarantine? I checked in with Dr. Melissa Nolan, an assistant professor of epidemiology with the University of South Carolina’s Department of Epidemiology and Biostatistics at the Arnold School of Public Health, to ask how South Carolinians should be preparing in their own homes.
“The fact that CDC is coming out now and saying we need to be prepared as a community is a good indicator the risk is elevated slightly. I still believe the risk, overall, is low, but something that South Carolinians need to be aware of, and start thinking and making their own plans for what would happen if their schools were closed, or if they’re coming in contact with someone who might be sick or ill…how they would care for other people in their families, or for themselves.” As a member of the USC community, Dr. Nolan gave assurances that the University is also prepared, working in conjunction with South Carolina DHEC, and adapting plans that had already been drafted in case of an influenza pandemic. The plan allows agencies to quickly react and make sure that the virus does not spread to others.
Which leads to the next question: since initial symptoms of the flu and COVID-19 are so similar (fever, cough, shortness of breath), how can an individual tell which of the two respiratory viruses they have? Dr. Nolan responded, “Unfortunately, it is flu season. And we’re still very active in that. So, it’s hard to say right now if someone has the flu, if it’s this COVID-19 virus, it could also be a lot of others. There’s tuberculosis that we commonly see, there’s RSV in children, so, lots of different respiratory infections circulating at the time. Traditionally, with respiratory infections, you see transmission and shedding of the virus at the same time as symptoms. That has to do with fever as an indication that you’re having these high levels of shedding. Unfortunately, we’re starting to learn now that with this particular infection (COVID-19), asymptomatic people, those without any indications of infection can, in fact, transmit this virus, which is concerning. If you’re a clinician and you have a patient that’s coming in, there’s key indicators. We would look at your leukocytes, for example, your CT scan, there’s ways for us to identify what those clinical signatures might be so that we could quickly triage patients so that we’re not overwhelmed at the hospital.”
But whether it’s the flu or COVID-19, in either case, Dr. Nolan emphasizes the importance of good hygienic practices, such as keeping hands washed, and limiting contact if you yourself are sick, or if you’re around other people who are infected. As for home prep beyond hygiene, Dr. Nolan also recommends asking yourself a few questions if you needed to stay home and self-quarantine, “What would you do if you had to be in your home for 14 days. Come up with a plan. Do you have people that could bring food to you, or what would you do if you had pets? What would you do if you do need extra medicines? Do you have a stockpile of those in the home?”
As for investing in facemasks, over the weekend, US Surgeon General Jerome Adams took to Twitter to make his position on the matter very clear: “Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”
Many concerned Americans have ordered a variety of facemasks, from the simple disposable kind to the more advanced N95 FFR respirator masks, the latter of which are vital to healthcare workers who are in direct contact with patients exhibiting symptoms or who have been confirmed to be infected with COVID-19. But with manufacturers struggling to keep up with mass demand, the risk of those healthcare workers having access to those essential tools further puts more people at risk. The official word from the CDC states they do not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19. Facemasks are only recommended for those who are sick, but are not necessary if they are quarantined within the home.
If one is diagnosed with COVID-19, Dr. Nolan has some hopeful news, “We’re seeing that younger, healthier people are not at great risk of more severe (symptoms) or from dying from this infection. If you’re an elderly person, or maybe have an immune-compromised condition, you might want to practice more restrictive hygienic protocols.” Dr. Nolan does point to an important statistic about South Carolina, and that is the very large and vulnerable group of people in our state who have confirmed cases of HIV and AIDS. According to the South Carolina Department of Health and Environmental Control, South Carolina ranks 11th among states with the highest number of cases of HIV and AIDS. For them, contracting COVID-19 would be exceptionally difficult to contend with.
Regarding any available vaccines for COVID-19, Dr. Nolan said, “Anthony Fauci, who’s the director of the National Institutes of Allergy and Infectious Diseases with the National Institute of Health, made a statement saying that the NIH (National Institutes of Health) is in fact developing a vaccine and working on that, but the earliest that would come out would be a year to a year and a half from now. There are four different steps to ensure not only the safety of a vaccine, but the efficacy of a vaccine. So, unfortunately, I don’t think that will be available for this particular outbreak and epidemic. But, if this becomes an endemic virus that we see circulating year after year, hopefully it could help then.”