BY BRIAN JONES
brian.jones@packet-media.com
The Columbus City Council, the Lowndes County Board of Supervisors held a joint meeting with representatives from the Mississippi State Department of Health Monday afternoon at Emergency Management to be briefed on COVID-19. The police department, fire department, the city school district and Mississippi University for Women, among others, also sent representatives.
Dr. Robert Curry, regional health officer for the Central Public Health Region, gave a presentation about what is known about the virus right now.
“Let’s start with what COVID-19 is,” he said. “The virus started in a large seafood and animal market in Wuhan, which is in Hubei Province, China. The Chinese noticed a significant uptick in the number of people who were getting sick and it took them a little while to figure out what it was. They did not prevent the spread because they did not know what it was. If it popped up here, it would take anybody a while to figure out what it was. They had community spread very early on, had thousands of cases, started having a lot of deaths.
“In the coming days and weeks we’re going to get more cases, and obviously it is in the United States,” he said. “We have cases of it in Mississippi. There is continuing to be person-to-person spread. There are over 100 confirmed countries with it. The first case in the US was reported on Jan. 21. It was identified in a traveler who had come from Hubei Province in China to Washington State. Before they could get a handle on it the spread had occurred in that area. We can’t take a case and plot lines and show how everybody got it. It would be nice, but it doesn’t really work that way. There are way too many people involved.”
COVID-19 is a pandemic disease, he said.
“The current outbreak meets the criteria,” he said. “It is a new virus, and it is capable of person-to-person spread. It has shown sustained spread throughout the world. Basically almost the whole world has it at this point.”
Coronaviruses are very common, he said.
“The common cold includes multiple coronaviruses,” he said. “Ten to 15 percent of the common cold is caused by coronaviruses. Most of the time the coronaviruses in humans result in a mild respiratory illness. They are also common among animal species, including camels, cats and bats. The animal viruses rarely infect humans and then spread. Sometimes they lead to severe infection in humans. Back in 2002 we had SARS, and in 2012 we had MERS. They are all related.”
Person-to-person transmission is very similar to the flu, he said.
“It’s spread by droplets when a person coughs or sneezes,” he said. “Surface cleaning is very important, just like with the flu. The closer you are to someone, the more the infectivity increases. The closer you get within that six foot buffer the more likely you are to inhale the droplets.
“The symptoms are fever, cough and shortness of breath,” he said. “Maybe some sore throat. The fever, cough and shortness of breath occur later. It basically starts out feeling like a cold. A lot of people thought they had the flu, but it just wouldn’t go away. Some of them get seriously ill. Complications include pneumonia, and that’s what leads to death. The ones who truly get sick and really have a problem are the ones who go from a bad case of the flu to pneumonia to acute respiratory failure and end up on respirators.
“For most people who are infected the illness is mild,” he said. “If they don’t have a health problem, then they’re ok. There are some caveats to that. Some people have more serious problems, and there have been deaths. In Washington State a lot of the deaths were in a nursing home. Once it got into a nursing home it was very difficult to contain.
“Community transmission is increasing in the US,” he said. “There are several cases in Mississippi. Right now there are 12 cases. [This briefing took place at 1:30 p.m. Monday afternoon, so that number has certainly changed in the interim. – Ed.] The risk from infection requires exposure, either through direct travel to an area with ongoing transmission or direct contact from an infected person.
“How do you know a person’s infected?” he said. “That’s a problem. You can be exposed and have the virus and be contagious and not be sick. If you’re waiting on someone to get sick and have the fever and the shortness of breath, that doesn’t really work. You’re behind the curve.
“The highest risk is for older adults,” he said. “Anyone over 65. People who have serious, chronic medical conditions like hypertension, blood pressure problems, heart disease. We have a large population of people who are obese. COPD. You name it. Any chronic medical problem that messes with your immune system.
“Once again, it comes back to the fact that you can’t spot people who have it,” he said. “We have to be really diligent in how we handle crowds. The CDC recommends no group greater than 250. [That number has since been reduced to gatherings of 10 or more. – Ed.] For the most part, 10 people in a room real close together if one is infected…but they had to come up with something. If you are in a crowded environment, where people are close, it’s more dangerous. If you are at high risk because of COVID-19 because of your age or because of a long-term health problem, you need to take action to reduce your risk of exposure.
“We don’t want to cause a panic, but we want people to realize that it is real,” he said. “It’s not made up. We are working with health care providers to provide guidance. Most of the information we have is from the CDC and its web site. We are increasing surveillance of existing cases.
“Initially we did not have the testing capability,” he said. “It’s been released now for the past week or so and we’re testing. It is also available commercially. We don’t know how many tests have been done in the state simply because it has not been recorded. Positive tests are reported. All the numbers are there on our website, it’s public information. [The web site is msdh.ms.gov/coronavirus. – Ed.]
“We are looking at containment,” he said. “We are trying to delay the spread. The delay is important to provide more time to learn about the virus. There are still questions about its nature. There are no specific treatments. Antivirals we have tried have showed no real effect, and a vaccine is not presently in production. There is research going on right now. The real crux of the problem is that even if they develop a vaccine it would take time for it to become available, so we are not looking at that as a solution in the next two or three weeks. We have to deal with it as it is.
“There are a lot of event cancellations right now,” he said. “That’s for social distancing. Keeping six feet away is very important. We live in a society that wants to shake hands, hug folks, but for the sake of their and your safety just wave at them from across the room. That shows a lot more care to me. Individuals can practice everyday prevention management, and that’s what we want to do. Wash your hands, stay at home if you can. If you’re coughing or sneezing, if you’re running a fever, stay home. Cover your coughs and sneezes. Decisions about community mitigation will be based on geography, whether there are infections near you.
“We have done a total of 289 tests at our lab in Jackson,” he said. “We had 12 positives. This number is from this morning. When the testing became available it was restricted to cases where a doctor saw somebody and they wanted to test them. It was initially required they go through the state epidemiology office to get approval, but that didn’t last very long at all. This is not a test for people who are not having symptoms. For one thing, if they are not infectious then the test could be negative. The second part of is you can test and it’s negative and they think they’re fine and they can just quit doing this. You have to take that into consideration when you think about the testing. The testing has been confined to emergency rooms or doctor’s offices who are testing because the individual had something going on. A lot of them thought they had the flu, but it wasn’t going away. You can’t test a bunch of people with no symptoms and get results that mean anything. It just doesn’t work that way.”
The tests have about a 48-hour turnaround, he said.
Prevention and isolation is very important, he said.
“If you’re sick, stay at home,” he said. “Cover your coughs and your sneezes. Frequently wash your hands for 20 seconds with soap and water. Clean frequently touched surfaces. This is nothing new, this is what you do for the flu. You can use 60 percent alcohol hand sanitizer, that’s fine. Avoid touching your eyes, nose and mouth. Avoid contact with people who are sick.
“People who are at higher risk of being sick really need to take this to heart,” he said. “Stay at home as much as possible. Stay out of crowds. Be very careful about how they interact with folks. If you’re sick, stay home. Call your provider, let them triage you over the phone. If they think you’re bad enough, they will bring you in to test you.”
People should have medications on hand, he said.
“You need to keep them on hand if at all possible,” he said. “My feeling is you can get refills for lots of things without going in for an office visit. We don’t want vulnerable people sitting in a doctor’s office or in a waiting room where they can be exposed.”
A sudden spike in cases will overwhelm hospitals, he said.
“If (BMH-GT) has about 250 beds and 16 ICU beds, those can be filled up like that,” he said, snapping his fingers. [This number is an estimate. – Ed.] “That’s what happened in China and in Italy. It shut Italy down. They filled all their hospital beds and ICU beds. They weren’t prepared. We aren’t, either. The capacity simply is not there. And that’s not just here, it’s everywhere. If you don’t keep this stuff from spreading by whatever mechanism you have, you’re going to end up inundating your providers and your hospitals. There are people in the hospital who are already there and in those beds, and we can’t make them leave just because someone has COVID-19. Vulnerable people need to be careful, because they can overwhelm the hospitals real fast. Unfortunately this is not kind to people with chronic illness, even if they’re 40.”
Ward 1 Councilwoman Ethel Taylor Stewart suggested shutting down bars and restaurants, but Chris Bourland, BHM-GT’s director of ambulance service, disagreed.
“I feel like if you disrupt restaurants and bars it’s going to create more anxiety,” he said. “You need to let people make those decisions on their own. But do take precautions. If you’re sick, don’t go out to eat. If you’ve been around somebody with it, don’t go out. Once you get the fever, you’ve already been contagious.”
BMH-GT is limiting visitor access, he said. [See related story in this week’s Packet. – Ed.]
E911 is going to try to screen people over the phone for emergency calls, he said.
“If they have fever or flu-like symptoms we’re asking them to tell 911,” he said. “If they do we’re going to wear masks when we pick them up. We’re not going to wear them in public, because we feel like that will create chaos.”
Possible COVID-19 patients will be handled in a specific way once they get to the hospital, he said.
