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When it comes to the coronavirus, local hospitals are taking the position that it’s better to be safe than sorry.
Although there are no reported cases of the COVID-19 coronavirus disease in New Mexico at this time, Lovelace, Presbyterian and the University of New Mexico hospitals all have similar contingency plans in the event the illness suddenly appears.
World health officials fear the virus could become a pandemic. According to the Centers for Disease Control and Prevention, as of Thursday 50 countries have confirmed cases of COVID-19 – almost 79,000 of those cases in China and another 1,700 in South Korea.
The global count of those who contracted the virus stands at about 82,000, with 433 new cases reported Thursday in China, the epicenter of the outbreak. About 2,800 people have died, most of them in China.
“We are prepared and we have a basic plan that we’ve tailored to the coronavirus and we’ve run some drills,” said Dr. Vesta Sandoval, chief medical officer at Lovelace Health System.
The plan begins with intake, when a patient shows up at a clinic, urgent care center or hospital emergency room with respiratory or other symptoms that could indicate the presence of COVID-19. The patient is immediately given a surgical mask to cover the mouth and nose and is isolated from other patients to be further assessed by healthcare officials wearing personal protective equipment to prevent possible transmission, Sandoval said.
If the symptoms are mild, the mask-wearing patient may be discharged home with oversight from the New Mexico Department of Health, and instructed to remain in isolation for 14 days, as recommended by both the World Health Organization and the CDC.
“If we admit the patient to the hospital, we have special isolation rooms that have negative pressure,” so air from that room is not circulated throughout the hospital, thereby mitigating further transmission of the disease.
In the event of a mass surge of the illness, “we would probably create a central location where we have the ability to have tighter control of traffic as well as have multiple isolation rooms and be able to make certain that everyone has the correct protective equipment,” Sandoval said.
If a patient with severe symptoms of the illness has to be moved from one room in the hospital to another, or another location outside the hospital, an “isobag,” a kind of a protective bubble that fits over a stretcher, could be used to isolate that individual.
Dr. Jeff Salvon-Harman, chief patient safety officer and medical director of infection control at Presbyterian Hospital, said those conducting the initial intake assessment currently don’t have the ability to test for COVID-19. “But what we can do is rule out other causes,” he said.
“We could perform influenza testing, we could test for other coronaviruses, and we can test for RSV (respiratory syncytial virus). So there’s a number of conditions we can identify or rule out to give us a better sense of the possibility of this being COVID-19.”
Another factor, he said, is if the patient had traveled recently to countries where there was an outbreak of coronavirus.
In the event of a mass outbreak of the virus, Salvon-Harmon said, dedicated portions of hospitals, nursing units, or other appropriate buildings could be used to isolate patients, provide supportive care and monitor and restrict access.
Dr. Meghan Brett, UNM Hospital’s epidemiologist, said “the challenge is that the world is globally connected and this is why what happens in China matters, because it can still impact us here in New Mexico. Everything is just one flight away.”
The biggest risk from COVID-19 is to people age 60 and older and those with chronic health conditions, she said.
“The key thing is for people not to panic but to keep up with good practices that work for all respiratory viruses,” Brett said. “I would emphasize we’re not out of flu season yet, which is more likely at the moment than coronavirus, so washing your hands is always a good idea, minimize the amount of times you touch your face, and if people are sick and have fever they should stay home because they will recover faster and reduce the risk of transmitting the viral infection to coworkers or anybody they encounter.”
State epidemiologist Dr. Michael Landen reminded the public that there are currently no confirmed COVID-19 cases in New Mexico. Nevertheless, the state has planned for it.
“Right now we’re focused on containing the virus as much as possible by monitoring travelers from China and South Korea, assuring that hospitals and clinics are prepared to evaluate a potential case and that they know how to employ appropriate infection control measures,” he said.
As of next week, the state will have the capability to test for the virus at the Department of Health’s Scientific Laboratory Division in Albuquerque, which will reduce the process time to about two hours. That test is currently only done at the CDC.
Also, a triage phone line is being set up “but won’t be activated until there is evidence of community transmission in New Mexico,” Landen said.
“At this point it’s looking like at least 80% of people with novel coronavirus in other countries have mild illness; and if someone has mild illness and is not at risk for severe complications of the disease, they can call the triage line and be instructed about how to take care of their illness at home,” he said.
During influenza season, the Department of Health weekly checks on the status of how many hospital beds in the state are full and how many are available. Because of the potential for coronavirus, Landen said, “we are going to continue those weekly checks throughout the state.”
The DOH also weekly monitors the amount of personal protective equipment on hand at hospitals and tracks to some extent the amount at outpatient pharmacies.
“Some hospitals have not been able to get the same amount of personal protective equipment that they got in the past,” he said, and there are shortages of masks and gloves at outpatient pharmacies. “But our recommendation still stands that, in the context of coronavirus, masks are to be used to cover somebody’s cough if they are sick. We’re not recommending that the general population wear masks for coronavirus prevention if they’re not ill.”
An Albuquerque Public Schools spokeswoman said Thursday that the district is working closely with the state DOH, the city of Albuquerque and other agencies to anticipate and address concerns about coronavirus as they arise.
Local charter school New Mexico International School sent out a note to parents, dated Feb. 26, highlighting ways the school is taking precautions both against the flu and coronavirus.
The school will temporarily turn off drinking fountains to help curb the spread of germs. While there will be stations to fill up water bottles, communal drinking fountains will be shut off until further notice.
The school also emphasized commonsense habits like washing hands and covering coughs. Other precautions outlined include requiring hand sanitizer every time someone enters or exits a classroom and disinfecting highly public areas and items – things such as school supplies and doorknobs.
Nancy Messonnier, National Center for Immunization and Respiratory Diseases director, said at a news briefing that communities should start preparing – including schools. Measures she mentioned for the classroom included grouping students into smaller clusters to limit face-to-face contact and thinking about digital learning options if schools were to close.
On Friday, Mayor Tim Keller and the city of Albuquerque will convene a meeting with various city departments, including the Sunport and Environmental Health, as well as regional government agencies, to discuss COVID-19 preparedness.
Keller said it was important “to make sure that we have clear protocols in place.” He added that “coordinating efforts in advance is the best way to ensure an effective response if an emergency arises here at home.”
Meanwhile, the CDC has confirmed that 60 people in the U.S. are being treated for the COVID-19. Among them are 42 former passengers from the Diamond Princess cruise ship, the site of a recent outbreak and quarantine in Japan; three Americans recently repatriated from Wuhan, China, the center of the outbreak; and one patient at University of California Davis Medical Center who contracted the illness through unknown means. Most of the other patients either had recently been to China or are a spouse of someone who recently returned from China.
Journal staff writer Shelby Perea contributed to this report.
NM Department of Health hotline
The New Mexico Department of Health asks that people returning from travel to China or South Korea, even if they are not sick, call the DOH’s Epidemiology Hotline at 505-827-0006 for guidance on how to protect themselves and their communities. Health care providers who suspect the infection has made its way into patients in their communities are also asked to call the hotline.