The key to dealing with a deadly new virus is to break the “chain of transmission,” a regional health director told a group of local health officials, emergency preparedness managers and school administrators at an informational meeting Thursday.
That could mean social distancing, avoiding crowds and large groups of people. It could mean cancelling events, perhaps even prom and holiday parades. And it definitely means staying home if you have a cough or fever.
Thursday’s meeting with 33 concerned local leaders proved just how difficult it will be to develop a response plan and reassure the masses as a new coronavirus spreads illness as well as anxiety. The group shared information and had many questions, but much work remains to determine how to best answer their concerns.
Local and state health and emergency management officials continue to urge calm, common sense and communication. However, there is still much to learn.
“Breaking the chain of transmission is very important,” Fred Rinne, readiness response coordinator with the SEK Healthcare Coalition, told the group. “Every day we slow it down puts us one day closer to treatment or vaccine. It still hasn’t hit Kansas that hard yet.”
At the same time, officials want to minimize panic and avoid overreaction.
“We’re already seeing some of the anxiety and the panic,” Josh Smith, regional coordinator with the Kansas Division of Emergency Management in Neosho County, said. “I thought it would take a little longer (for the anxiety) to get to a rural community. It’s here. It’s OK. We’re all professionals. We’re getting guidance. We can handle this.”
Four cases of COVID-19 have been confirmed in the Kansas City area, with the state’s first death reported Thursday, a man in his 70s who lived in Wyandotte County. Worldwide, infections were estimated at more than 125,000 with about 4,600 deaths.
Health care officials, including those at Allen County Regional Hospital and local senior care facilities, are screening visitors for illness and considering a restriction on non-essential visitors. The hospital asks anyone who comes to the hospital with flu-like symptoms to wait in their vehicle in the parking lot, call and wait for direction from health care professionals.
Shelves at local stores have been stripped of toilet paper, bleach, hand sanitizer and more, amid fears of long-term quarantines.
Major sporting events like the March Madness basketball tournament have been canceled.
Universities in Kansas and elsewhere will switch to online-only classes after spring break. Allen Community College officials are discussing whether they should take similar action.
The Kansas Department of Education so far has not ordered cancelation of classes, but has issued guidance to schools as to their options should they choose to do so. Schools can extend the year to June 30, offer online-only classes or ask the state for a waiver that would allow them to cancel classes entirely.
Local events already have been canceled, like community dinners, St. Patrick’s Day parades and Easter egg hunts.
School officials asked whether they should cancel things like prom and senior trips.
The answer: Maybe.
Now is the time to have those conversations and to be proactive, according to Rebecca Johnson, director of the SEK Multi-County Health Departments. The health department is the agency in charge of the response in Allen County, and receives its guidance from the Kansas Department of Health and Environment, and the Centers for Disease Control and Prevention (CDC).
Johnson has been communicating with various entities and talked about some of the discussions taking place across various counties and school districts. She shared examples of the actions they are considering such as cancelling events and moving schools to online-only. She urged the officials in attendance to take proactive steps, but did not make specific recommendations in the public meeting.
“Remind people if they’ve been to a place where they might have been exposed, don’t get out into the public,” Johnson suggested. “Also remind people how to prevent the spread of disease.”
“Getting the right information out to the public is the biggest challenge we have right now,” Rinne added.
Everyone wants answers, Angela Murphy, director of Allen County Critical Response Center, said. Local, state and federal officials are collaborating to educate each other, sort through information and determine how to implement the most effective plans on a local level, she said. Thursday’s meeting was one step toward a plan to help the community slow the spread of infection and prepare for what comes next.
The group included healthcare professionals with ACRH, as well as local senior care facilities, schools, law enforcement, EMS, emergency management and more. It included not only doctors and nurses but maintenance, cleaning and food preparation staff; and school nurses and administrators.
The goal was to facilitate communication between those entities, and to encourage cooperation with their counterparts at a regional level.
The next step is to break into smaller groups to develop more specific action plans, Murphy said.
“The community looks to us to be the calming force,” Smith reminded the group. “I don’t think anyone can determine how long we’re going to be dealing with this. The biggest thing right now is preparing to live with it.”
And despite the inevitable worries that come with the unknown, Rinne said he hopes people continue their daily activities as much as possible. It’s important to take necessary precautions to prevent the spread of illness, but it’s also essential to minimize disruptions.
“Take those moments and enjoy life,” he said. “We don’t want to lose sight of our sense of who we are as a community.”
ACRH AND local nursing facilities are taking extra precautions to screen and possibly restrict visitors. At this point, those restrictions are limited but that could change if COVID-19 cases are reported in the local area.
Because there is no treatment yet for COVID-19, those with the virus are asked to stay home and minimize contact with others. Most people will have only minor symptoms like fever, cough and shortness of breath. Those who are elderly or have compromised immune systems are most at risk
“On Monday, we will start to restrict visitors. If you have a cough and a fever, stay home,” Angela Slocum, ACRH risk management and emergency department director, said.
“Would you reach the point where you say no visitors at all?” Rinne asked.
“We would limit visitors unless you have a real reason to be there, like a loved one is dying,” Slocum responded.
Local nursing homes and senior care facilities are checking temperatures of everyone who comes into the building, staff said. So far, they aren’t limiting visitors but that could change.
At one point should someone ask for testing or contact the health department, Tera Pate, nursing supervisor at Windsor Place, an assisted living and nursing facility, asked.
The health department uses an algorithm to screen patients via phone to determine if testing might be warranted, Johnson said.
“Just give us a call,” she encouraged. “Pay attention to who’s around those people, who’s coming in and going out, and where they’ve been, including staff.”
If testing for coronavirus is deemed necessary, samples will be sent to the state. Tests will be conducted for influenza, respiratory illnesses and coronavirus if needed.
The state conducts an initial test, then sends samples to the CDC to verify. As of Thursday, KDHE had 41 negative tests and four positive.
Gov. Laura Kelly on Thursday issued an emergency declaration, which will allow better access to resources to address the problem.
“Right now, there is no community spread,” Dr. Lee Norman, KDHE Secretary, said. “The cases in Kansas are here because of transmission elsewhere. However, Kansans should remain vigilant. It’s important to live your lives, but it’s also important to take basic precautions like exercising good hygiene practices. It is up to each of us to do our part.”
On Friday, President Donald Trump declared a national emergency to aid coronavirus response.
On Wednesday, the World Health Organization declared COVID-19 a pandemic.
As of Friday, there were about 1,700 confirmed cases in the U.S. with 41 reported deaths. Projections indicate between 25% to 40% of Americans could contract the virus, with some reports that a Congressional doctor said he expects between 70 million to 150 million Americans to contract coronavirus.
That means up to 40% of healthcare workers also would become ill, Rinne pointed out.
“We have limited resources, and our biggest resource is people,” Rinne said.
“We don’t want people who are sick walking into the hospital and infecting everyone there.”
He suggested setting up an incident command center at the hospital, which would make it easier to document incidents and, down the road, potentially make it easier to recoup financial costs associated with the response. If the outbreak turns out to be less severe than anticipated, the hospital can use the experience as a disaster response exercise.
Some hospitals are restricting access to one entrance, Rinne said. Some doctors are using telecommunication options like Skype to screen patients. Some hospitals have suspended their auxiliary volunteers, who typically are senior citizens and most susceptible to the dangers of COVID-19.The hospital also could extend its credentials to additional health care personnel in the community.
As illnesses increase, hospitals and other healthcare facilities could face shortages of personnel and supplies.
It’s likely the most immediate shortage will be with personal protective equipment, things like gloves, gowns and masks, Rinne said. A majority of those supplies are made in China, where manufacturing has been shuttered for weeks as the coronavirus started there late last year.
“There’s going to be a lag time in supply,” Rinne said.
The region does have a cache of supplies that are slightly out of date, but the state could grant a waiver that would allow access to those supplies in an emergency situation, he said.
The state also could supply things like additional beds, as hospitals might need to set up additional care sites. But providing the necessary personnel and equipment to care for an outbreak of patients with serious respiratory illnesses may be more difficult, Rinne said.
Manufacturing likely will be ramped up in the U.S. and other countries where the illness has not yet had a significant impact, but it still will take time to increase those supplies.
That’s why it’s so important to slow the spread of the virus, Rinne said. The more time it takes for the illness to impact an area, the more time communities have to prepare.
LOCAL SCHOOL administrators and emergency personnel met separately Thursday, but also discussed coronavirus with the Kansas Department of Education and attended the larger group meeting the same day. They asked for guidance on whether to cancel classes and events.
“So far, it’s business as usual,” Doug Tressler, director of the ANW Cooperative, said. “But what about our medically fragile students? At what point do we need them to stay home?”
That may not yet be necessary, Johnson said, but it’s important to be proactive and create a plan.
Districts have been discussing their options, and sending notifications to parents.
So far, local districts have not announced any major changes to classes or events. They recommend parents pay attention to news articles and social media notifications.
Barbara Downey, also with ANW Coop, talked about the difficulty of keeping parents informed, without alarming them.
“That’s why we’re having these conversations now,” Rinne said.
IF YOU have symptoms such as fever, cough or shortness of breath and believe you may have had contact or have had contact with someone with a laboratory confirmed case of COVID-19, stay home and call your healthcare provider, according to KDHE.