Coronavirus a test of public health defenses

A new virus has emerged in the Chinese city of Wuhan that has put the world’s medical providers on high alert. A worldwide effort to contain the potentially deadly virus is in motion. “We need to be preparing as if this is a pandemic, but I continue to hope that it is not,” said Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases.
Alaska takes center stage as the 747 plane evacuating American consular personnel from Wuhan will stop at Ted Stevens International Airport for refueling and for a screening of the passengers for the virus. The airport reports six cargo flights from Wuhan have landed there since the first of the year.
What measures are being taken in Nome?
“What we’re doing is monitoring what is happening through the Center for Disease Control and the State of Alaska Department of Social Services,” said Tom Vaden, Chair of Nome’s Local Emergency Planning Commission. “There are teleconferences going on with the organizations and everybody is getting daily updates on what the status is.”
“We’re a port of entry so we can get smaller jets, business jets, coming in,” said Vaden. “So we’ve already dealt with Customs and Border Protection and come up with a plan of what we’re going to do. We’re expanding it a little bit. Any jet coming in from the Far East we want to screen the passengers. Not just from the Chinese provinces, just to try and stay a step ahead. This is unfolding and nobody knows just how it’s unfolding.”
Preliminary analysis of the virus finds it to be less severe than originally feared. The dead are older people, many of whom had pre-existing conditions. But those infected are contagious before the symptoms begin to show. A person who appears to be healthy can be spreading the virus.
The symptoms of the virus include respiratory problems, fever, cough, shortness of breath, and difficulty breathing. Severe cases can cause pneumonia, kidney failure, and death.
According to the World Health Organization coronaviruses are a large family of viruses, which cause illnesses ranging from the common cold to the more severe Middle East Respiratory Syndrome and Severe and Acure Respiratory Syndrome. Called MERS and SARS respectively, both of these raised the alarm when they appeared in the recent past.
The first group of patients hospitalized and sick with the virus were workers or customers at a Wuhan seafood wholesale market. In addition to seafood it sold processed meats and live animals for consumption including poultry, donkeys, sheep, pigs, camels, foxes, badgers, bamboo rats, hedgehogs and reptiles. First laboratory analysis suggested the virus had jumped to humans from a bat, with later reports naming snakes.
Megan Mackiernan is a physician’s assistant and does quality and risk management at Norton Sound Health Center. She reports that the hospital works in conjunction with the State of Alaska and the federal Center for Disease Control. They conduct training and drills on an ongoing basis and they screen those who’ve traveled or who have been in contact with an infected person. Some aspect of their training is always in progress. There are two negative pressure rooms at the hospital, one in primary care and one in acute care. A negative pressure room isolates the atmosphere surrounding the patient by ensuring airborne particles are not able to migrate out into the general environment. The hospital also coordinates with the local LEPC to make sure emergency services are up to speed on techniques and procedures for dealing with infected persons. Mackiernan observed that they are acting and even over-reacting to make sure they’re ready in case a truly serious epidemic appears.
What can people in Nome and the surrounding area do to protect themselves from the illness? “Same things we suggest all the time,” said Mackiernan.  “Wash your hands, cover your mouth when you sneeze. If you’re sick stay home.” She adds that if you’re sick don’t come visit the hospital or the nursing home. If you’re sick and enter the hospital wear a mask.  
The Chinese government has been working hard to contain the virus but gradually it has spread to other parts of China. As of Monday Jan. 27 there were 100 deaths reported and thousands were infected. In the USA five infected people who had just returned from Wuhan were hospitalized. At this point all of those with the disease had visited Wuhan. One man is hospitalized in Seattle, one in Chicago and in Arizona, and there two in Los Angeles. None of the American patients are in critical condition.
“We’ve been talking about bird flu and pandemics for a long time,” said Tom Vaden. “There are basically three pandemics a century. The average flu kills about 40,000 people a year in the USA. They are concerned with the coronavirus because it’s SARS related and not influenza related. SARS, no one wants to let that genie out of the bottle. It’s an ugly virus.”      
All cargo flights from Wuhan to Anchorage International Airport have been cancelled. None are scheduled. There are no scheduled passenger flights from Wuhan. Any flights suspected of carrying passengers with communicable diseases will be isolated. “All international flights and flights suspected of carrying passengers with a communicable disease are processed in the North Terminal where CDC staff and quarantine facilities are located,” said Jim Szczesniak, Airport Manager. “No flights suspected of carrying passengers with a communicable disease are processed in our main domestic terminal. The North Terminal is completely isolated from the domestic terminal and closed to the public.”