Minnesota hospitals and public health agencies are ramping up preparations for the novel coronavirus that has almost reached global pandemic levels since emerging in China this winter and spreading to at least 37 countries.
While the U.S. government continues efforts such as travel restrictions and quarantines to limit the introduction of the virus into the country, state and federal officials said Tuesday that the disease’s entry into the country is inevitable and that the virus will eventually spread from person to person. So far, the infections identified within the United States have only involved people who traveled to China or their spouses.
“We are preparing … for not if, but when, we end up with a case in Minnesota,” Gov. Tim Walz said.
A key first step is increasing protections for health care workers, who will be urgently needed to treat cases of Covid-19, which so far has no vaccine or specific medications to combat it. The severity of this coronavirus remains unclear, but reports from China showed that it spread quickly among health care providers treating infected patients.
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State hospital and health care leaders have been holding weekly teleconferences about their preparedness and supplies of masks, gowns, visors and other disposable items to protect workers.
Some stockpiles created after the 9/11-related bioterrorism scares weren’t maintained, and some supplies stored up after the 2009 H1N1 swine flu pandemic have reached their expiration dates, said Kris Ehresmann, who directs infectious disease programs for the Minnesota Department of Health.
While hospitals are stocking up on supplies, Ehresmann said the U.S. Centers for Disease Control and Prevention (CDC) also is examining whether some expiration dates were too conservative and whether older protective equipment remains usable.
Individuals can prepare as well, Ehresmann said, by washing hands and practicing other forms of hygiene, and by making sure they have basic supplies at home if they ever need to be confined there.
“We’re not talking about stocking up for Armageddon,” she said, “but just, if you and your family are sick for a while, and can’t get to the store, do you have enough soup or other nonperishable items that you would need?”
The risk to the American public might still be low, but the CDC’s Dr. Nancy Messonnier said it is better to overprepare for a new virus that isn’t fully understood.
The latest estimates suggest that 80% of infected people suffer mild symptoms, but as many as 2% of infected people die. That would be a higher fatality rate than those seen in recent flu pandemics, said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy.
The risks appear greatest for people who are older or have underlying health problems.
The virus also appears more infectious than many seasonal forms of influenza, as health officials estimate that every one infected person will spread the new coronavirus to 2.2 others. Other viruses are far worse, though. One measles patient typically passes that virus to 18 others, for example.
Trying to prevent the spread of such a virus is “like trying basically to stop the wind,” Osterholm said. “We need to really get away from the idea of containment, which can’t happen, and focus more on mitigation.”
Minnesota was not among the first states to receive kits from the CDC to test on its own for coronavirus, because it had neither a federal quarantine site for travelers at risk for infection nor one of the specially designated airports to receive returnees from high-risk areas of China.
Minnesota and other states have since received test kits, but they were found in quality checks to be unusable, Ehresmann said. So for now, the state continues to send samples to the CDC for confirmation.
The state sent three samples to the CDC in January after people who had recently traveled to China became ill, but those tests were negative.
Ehresmann said a fourth sample was just sent Monday, after someone in the state became ill following recent travel to Southeast Asia (although not to China). That person has agreed to remain in voluntary isolation until the test results come back.
Hospitals have learned lessons from 2014 preparations for the potential global spread of Ebola, said Dr. Rahul Koranne, president of the Minnesota Hospital Association. He said suppliers must help by increasing the availability of masks and other disposables, and federal authorities must provide more timely funding.
Local testing also will be crucial to produce more rapid information about a suspect case, he said. “If we don’t hear about the test in a timely fashion, this individual will be in isolation and we will all be worried about who else [he or she has] been exposed to.”
Ehresmann said businesses can help by creating policies that allow sick people to work from home so they don’t spread the virus.
The CDC also is asking individuals and businesses to support other actions that can limit the spread of the virus. Those range from more frequent cleaning of high-contact surfaces, to the creation of online classes so students can learn at home when their schools have infection risks, to the cancellation of elective surgeries or large public events.
The virus could have only a modest impact in the U.S., or it could end up having a seasonal cycle and wane by summer, but the nation needs to be prepared, Messonnier said.