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Coronavirus community spread in the US will test health systems – Business Insider – Business Insider

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  • A confirmed coronavirus patient in California had no travel history in China and no known exposure to anyone infected.
  • It’s the first potential case of „community spread“ in the US.
  • One health official said this requires a transition „from trying to contain the disease to more of a mitigation approach.“
  • Visit Business Insider’s homepage for more stories.

A patient in Solano County, California, has gotten the COVID-19 coronavirus without traveling to China or having any known contact with someone sick, the Centers for Disease Control and Prevention confirmed on Wednesday.

„This person appears to be a community-acquired case of coronavirus, which would be the first here in the United States,“ Bela Matyas, the Solano County health officer, said in a press conference on Thursday. He added, however, that he doesn’t think this is the only such case.

„There are probably cases of coronavirus from community acquisition in multiple parts of the country right now,“ Matyas said.

That means the virus is likely spreading undetected in the US, according to Amesh Adalja, an infectious-disease expert at the Johns Hopkins Center for Health Security.

Adalja offered a simple definition of community spread:

„‚Community spread‘ reflects the fact that the virus is out there in the community spreading from person to person, meaning that it’s not just spreading from people who had contact with someone from China or a travel history, but that it’s something established in the community,“ he said.

That reality, Matyas said, means health officials have to transition „from trying to contain the disease to more of a mitigation approach.“

A delay in detection

The California patient is now in serious condition, according to CNN.

She initially went to the NorthBay VacaValley Hospital on February 15. The 50-bed hospital is in Solano County, which is also home to the Travis Air Force Base, where some Americans evacuated from China and from the quarantined Diamond Princess cruise ship have been quarantined.

A surgeon at the base, who requested that he be kept anonymous, told Business Insider that it’s likely the new case has some connection to the the base, given the proximity.

But Matyas said no such link has been found and added that workers on the base were „scary meticulous“ about safety.

„This individual has no connection whatsoever to that federal mission and to any of the personnel that have been involved in that evacuation process,“ he said.

Foto: Ambulances outside the Travis Air Force Base in California. Source: Hector Amezcua/AP Photo

The patient was not tested for COVID-19 at VacaValley during her four days there. After her symptoms worsened, she was transferred to the University of California, Davis Medical Center in Sacramento on February 19. But she wasn’t tested there either until four days later.

„Since the patient did not fit the existing CDC criteria for COVID-19, a test was not immediately administered. UC Davis Health does not control the testing process,“ the center said in a statement.

Until now, the CDC has made decisions about whether to test people for the coronavirus based on whether they have recently traveled to places with outbreaks.

But this case, Adalja said, shows that „when we have protocols set up to really identify patients only based on travel history, those are going to fall short of identifying all cases.“

Matyas said testing criteria are indeed changing now, and the CDC praised the doctors who diagnosed the woman in a statement on Thursday.

„This case was detected through the US public health system – picked up by astute clinicians,“ the CDC said.

Dozens of healthcare workers were exposed

coronavirus california

Foto: Tien Nguyen wears a mask as she shops at the 168 Market in Alhambra, California, on January 31, 2020. Source: AP Photo/Damian Dovarganes

Health officials are working to trace and isolate anyone the patient had contact with – her family has been quarantined, and hospital staff are being evaluated and tested.

Aimee Brewer, president of NorthBay Healthcare, said any medical workers who had direct contact with the patient at VacaValley have been tested for the virus and are now on paid leave at home. So far, there have been no more positive tests, she said.

„As far as the headcount is concerned, at this time I can say it’s a moving target,“ Steve Huddleston, vice president of public affairs at NorthBay Healthcare, said in a press conference Thursday. „We have identified dozens of employees on our health team, but it still remains less than 100.“

According to CNN, a University of California, Davis student is also under investigation, and the student’s two roommates are being isolated at their home off campus as well.

The CDC said in a statement on Thursday that „unprecedented, aggressive efforts have been taken to contain the spread and mitigate the impact of this virus.“

A question of when, not if

A day before this case of community spread was reported, CDC officials suggested it was imminent.

„It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen and how many people in this country will have severe illness,“ Dr. Nancy Messonnier, the head of the National Center for Immunization and Respiratory Diseases at the CDC, said during a media briefing.

But thus far, the US lags behind other countries in testing – as of Wednesday, only 445 Americans had been tested for the virus.

The ultrastructural morphology exhibited by the 2019 Novel Coronavirus (2019-nCoV), which was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China, is seen in an illustration released by the Centers for Disease Control and Prevention (CDC) in Atlanta, January 29, 2020. Alissa Eckert, MS; Dan Higgins, MAM/CDC/Handout via REUTERS

Foto: An illustration, created by the CDC depicts the novel coronavirus Source: Reuters

„At first, CDC was the only place where testing could be performed,“ Richard Martinello, an associate professor of infectious disease at the Yale School of Medicine, previously told Business Insider. „For a country of our size, when you only have a single site doing that, it limits the resources available for testing.“

The CDC sent test kits nationwide earlier this month, but those were also found to be flawed, so only about a dozen labs can currently run the tests, according to The Washington Post.

‚The cat’s out of the bag in terms of it having spread‘

Solano County and the nearby San Francisco and Santa Clara counties have all declared emergencies.

Matyas said the declaration frees up resources to „allow us to investigate this incident more effectively and more efficiently.“

But he added that containment is „only possible when you’re dealing with a disease condition where you know everyone who’s sick, and they get sick before they spread, and you can contain them – and that’s a rare reality.“

Coronavirus face mask

Foto: Source: Manuel Silvestri/Reuters

Now, he said, efforts must focus on mitigation because „we know the cat’s out of the bag in terms of it having spread, and what we’re trying to do is slow the spread as much as possible.“

California Gov. Gavin Newsom announced Thursday that 33 people in the state have tested positive for the virus – including citizens repatriated to military bases – and 8,400 people are being monitored. He stressed that the risk to the public is still low, but added that the state needs access to more resources.

„We have just a few hundred testing kit,s and that’s surveillance testing as well as diagnostic testing. That’s simply inadequate to do justice to the kind of testing that is required to address this issue head on,“ Newsom said.

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Ontario nursing home sees 7 coronavirus deaths, 24 staff infected – 680 News

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An Ontario health unit says one nursing home has seen seven COVID-19 deaths and at least 24 staff members infected.

The Haliburton, Kawartha, Pine Ridge District Health Unit has said the outbreak at Pinecrest Nursing Home in Bobcaygeon is believed to be the largest in the province.

The health unit says 10 other staff members are awaiting test results, and another person in the community has died in a case linked to the nursing home.

Ontario reported 351 new COVID-19 cases Monday, the largest single-day increase by far, which health officials attribute at least in part to clearing a backlog of pending test results.

Ontario’s chief medical officer of health is recommending that everyone in the province _ especially people over 70 and with compromised immune systems _ stay home except for essential reasons.

Premier Doug Ford says medical supply lines will be “seriously challenged” if there is a massive surge of people into hospitals in the next two weeks, and all options — including further shut downs — are on the table.

The new total of cases in the province is 1,706 — including 431 resolved cases and 23 deaths.

The number of resolved cases had been stuck at eight for many days, but health officials had said to expect a large jump once the data caught up to a new definition for resolved.

The increase in the number of resolved cases also means there are actually fewer active COVID-19 cases in Ontario — 1,252 — than the 1,324 that Sunday’s data had indicated.

A new reporting format from the province also shows that more than 61 per cent of all cases are in the Greater Toronto Area.

Information on how people became infected is still pending for nearly half of all cases in Ontario. About 16 per cent are attributed to community spread, 26 per cent to recent travel, and nearly 10 per cent to close contact with another confirmed case.

About 10 per cent of people in the province who have tested positive for COVID-19 have been hospitalized.

The median age of people infected is 50, with cases ranging in age from under one year old to 100 years old.

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'Nobody went out and intentionally spread this': No order broken in Caul's cluster – CBC.ca

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The first person who had COVID-19 at a St. John’s funeral home— also known as the index case — did not spread the virus knowingly and did not violate any government orders by being there, says the province’s chief medical officer of health.

As of Monday, 111 people infected with coronavirus in Newfoundland and Labrador contracted it either directly or indirectly from Caul’s Funeral Home in St. John’s, between March 15 and 17. One man, 78, died Sunday as a result of the virus, linked to the funeral home.

Social media has been awash with vitriol, shaming and misinformation on the incident, with some calls for the individual to be charged, but Dr. Janice Fitzgerald called for calm.

“Nobody went out and intentionally spread this,” Fitzgerald said Sunday. “This happened at a time when we didn’t have the same measures in place that we do now.

“Taking our experience from now and trying to apply that to something that happened nearly two weeks ago is fraught with problems because where we are now is very different.”

Dr. Janice Fitzgerald, N.L.’s chief medical officer of health, says the person who spread coronavirus at Caul’s was not violating any government rules in place at the time when they attended a wake. (Malone Mullin/CBC)

Fitzgerald, who is Newfoundland and Labrador’s chief medical officer of health, said it does not appear anyone violated government rules at the time, and shaming individuals is not conducive in the fight against the ever-spreading virus.

Caul’s Funeral Home disclosed March 22 that people who had attended its LeMarchant Road business for visitation for two people between March 15 and March 17 were being contacted by public health, as a suspected infected person had visited the building. 

The provincial government had only ordered public sector employees who returned from travel outside the country to self-isolate on March 16. Also on that date, the federal government advised all Canadians returning from outside the country to voluntarily self-isolate for 14 days. 

It is unclear if the individual was showing symptoms at the time, and where they were prior to the funeral service.

“That is our balance we always have to achieve,” Fitzgerald said Sunday. “We want people to come forward, we want people to feel safe to come forward.”

The self-isolation period for anyone who did attend the funeral home and has not yet been sick ends Wednesday.

Read more from CBC Newfoundland and Labrador

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‘It’s a war zone’: Coronavirus deaths at Bobcaygeon, Ont., nursing home climb to 9 – Global News

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Nine residents of a long-term care home in Bobcaygeon, Ont., have died of COVID-19 complications since March 25, according to the facility’s medical director.

Dr. Michelle Snarr has called the Pinecrest Nursing Home a “war zone” since an outbreak of the novel coronavirus disease was declared on March 18. The nine deaths are presumed cases of COVID-19, she said, noting that seven of the deaths occurred over the weekend.

“It’s a war zone — more than one nurse has said that,” Snarr said Monday morning. “I feel like a field commander in a war.”


READ MORE:
2 long-term care home residents in Bobcaygeon, Ont. die after COVID-19 outbreak

“We started off with 65. We’ve had nine die so far,” said Snarr.

“There are patients dying right now; more are going to die.”

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Snarr said she emailed families on March 21, warning them they may have to decide on sending a loved one to the hospital or placing them on a ventilator — the latter of which Snarr said would likely cause a patient to “suffer a great deal,” adding that they “may not survive.”

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“I cannot begin to imagine what the abysmal quality of life would be for a person in a nursing home — that frail — and if they survived a ventilator, the quality of life would just be abysmal,” she said.

Snarr thanked the public for the outpouring of support and said a “plea for compassion is needed” for the situation, which she describes as “beyond horrifying … heart-wrenching, gut-wrenching.”

“I can’t put it into words. It’s just devastatingly horrible. So, so, so sad,” she said.

The health unit has called the outbreak the largest in the province.

Global News has reached out to Health Minister Christine Elliott’s office numerous times for comment on this story, however the minister’s office has declined to comment, saying it would have more details Monday afternoon.

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On Monday afternoon, the Haliburton, Kawartha, Pine Ridge District Health Unit confirmed the seven COVID-19-related deaths. As of Monday, 24 staff at the nursing home have been confirmed positive for COVID. Test results are pending for 10 other staff, the health unit stated

There have also been two additional deaths at the home since March 18 that were not related to COVID-19, the health unit issued in a release.

Mary Carr, Pinecrest administrator, says residents have been isolated in the home and staff with symptoms have been sent home for self-isolation to help limit the spread of the virus.

“Our team members are dedicated professionals, trained in infection, prevention and control strategies and they will continue to focus on keeping our residents, families and team members safe,” said Carr in an email to Global News. “We actively monitor and screen our residents to determine if they are showing any of the related symptoms and take necessary precautions if they do. We also actively screen all our team members every time they enter our building, and they are encouraged to self-monitor at home and are not permitted to come to work if they are feeling unwell.”

Carr said limited visitation is only for essential visitors.

“Our residents and staff have shown incredible resilience during this difficult time and we truly appreciate the support we have received from the community,” she said.

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2:05
COVID-19: Positive case confirmed at Peterborough long-term care facility


COVID-19: Positive case confirmed at Peterborough long-term care facility

© 2020 Global News, a division of Corus Entertainment Inc.

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