Public health officials want to slow down coronavirus

Infections could increase by spring, Locke says

PORT TOWNSEND — The Jefferson County Health Officer anticipates global outbreaks of the coronavirus that originated in China, possibly as soon as this spring, but as of last week, no cases have been detected on the North Olympic Peninsula.

Dr. Tom Locke said that three people in Jefferson County have been monitored for the COVID-19 virus. All three have completed a 14-day observation period, and none of them contracted the coronavirus, he said.

Clallam County health officials are monitoring one person who had traveled to China in the last 14 days, said Dr. Allison Unthank, Clallam County public health officer.

“We don’t get a lot of travel to and from China in Clallam County,” Unthank said.

“We have a lot of infrastructure built to monitor things like this, and we are doing that right now.”

Locke emphasized the public health process on Thursday during a county Board of Health meeting at the Cotton Building in Port Townsend.

“There will be outbreaks globally, and there will be outbreaks in the United States gradually,” Locke said.

“It’s very important from a public health process to slow this process down. You don’t want everyone to be sick all at the same time.

“Even if we can’t contain something, by slowing it down and limiting the outbreaks, spreading it out over time has a definite advantage.”

Locke said there continues to be many unknowns about the coronavirus, including whether or not it has “pandemic potential.”

“Is this something that has the capability of spreading worldwide?” he asked.

“In order for that to happen, it would have to be highly communicable, efficiently transmitted from one person to another, and it can’t be too lethal or you would get snuffed out.”

Locke said an ideal environment for a virus would be one in which it infects a lot of people who are only mildly ill or present no symptoms at all.

“So far, the coronavirus is exhibiting all of these features,” he said.

Locke pointed to the Diamond Princess cruise ship, which had been quarantined in Japan, and suggested infections there could have come from germs left on inanimate objects, a phenomenon called “fomite transmission,” he said.

More than 300 passengers were flown back to the United States last weekend and are now quarantined for two weeks at military bases on hospitals, according to The Associated Press.

At least 18 Americans were infected, bringing the number of cases in this country to 35, the Centers for Disease Control and Prevention (CDC) said Friday.

Locke said most who contract the infection are not seriously ill.

“It’s very mild, often just a few days of illness,” he said. “Children especially seem to be having very mild symptoms.”

He also expressed caution about those results, saying some people could be silent carriers — those who don’t experience any symptoms.

“The milder it is, the more difficult it is to contain because you can’t identify people who have the infection,” Locke said. “You can’t isolate and you can’t quarantine.”

The U.S. is taking “Ebola-grade precautions” with potential victims, using full gowns and gloves in addition to pressurized breathing apparatus, Locke said.

“Hopefully in the future, that level of personal protective equipment will not be necessary if we can determine it’s not that infectious and isn’t able to spread,” he said.

Locke called it a good news, bad news scenario because traditional high-risk populations — “the very old, the very young and the pregnant,” he said — may have an increased risk of infection.

“The risk starts to go up at [age] 50 and into the mid-60s,” he said. “Of course, in Jefferson County, we have a lot of high-risk population, so we’re going to be doing whatever we can to avoid that.”

The best-case scenario is a track similar to the 2009 flu pandemic, Locke said.

“We’ll have sporadic outbreaks during the spring, then into early summer, and then it dies down over the summer,” he said. “The highest risk for widespread outbreaks will be the fall, when influenza returns.”

Locke said there are about four coronaviruses circulating in the population at any given time, and the key will be identifying Covid-19 from the others.

The CDC was still working late this week to develop a rapid test that could be manufactured and reproduced nationwide, he said.

One test was developed and sent to a manufacturer, “but one of the three primers didn’t work and they had to send it all back,” Locke said.

“We have one of the top five labs in the nation to do this kind of thing,” he said. “The CDC has plans to start doing some population screening, and Seattle is one of them. As of Wednesday, they did not have the test up and running yet.”

If and when an outbreak does occur in local jurisdictions, Locke said he has the authority to call for quarantines. Other options could be to close schools and cancel public events, he said.

Only one case has been reported in Washington state, and the man has been treated and released from a hospital in Everett.

Locke said there are almost 800 people who are currently being monitored by local health departments.

“We call them up and get them to check their temperature twice a day,” he said of public health officials. “If we run into any [symptoms], they don’t run into a clinic, they call us.

“Right now, we would be doing all of that testing at the [Jefferson Healthcare] hospital.”

Of the confirmed cases worldwide — the vast majority of which are in China — the reported fatality rate has been at 2.3 percent.

“If that statistic held stable, it would be a replay of the 1918 flu pandemic,” he said.

But Locke added the true case fatality rate is likely up to 1 percent.

“Of the 800 cases outside of China, only three people have died,” he said. “That’s very reassuring, but it’s still very early in this.”

________

Jefferson County Managing Editor Brian McLean can be reached at 360-385-2335, ext. 6, or at [email protected].

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