COVID-19 Questions/Answers with Douglas Public Health

Q: If someone has a cough and a fever where can they go to be tested for COVID19? A: Douglas Public Health Network Thank you for your question! At this time our testing capabilities for COVID-19 are limited, but we hope that this will expand soon. As of today, 3/3/2020, we are only arranging tests for three groups of people: 1. Persons sick with fever or cough / shortness of breath, who have had close contact with a laboratory-confirmed COVID-19 patient 2. Persons sick with fever and cough / shortness of breath, with history of travel from China, Japan, Iran, Italy or South Korea within 14 days of symptom onset 3. Persons hospitalized with severe acute lower respiratory illness like pneumonia or ARDS, with no other explanatory diagnosis Q: What is the R nought (R0)-number of secondary cases for COVID19? A: Douglas Public Health Network This is a great question. Epidemiologists are still researching this, but most have calculated the R0 of COVID19 to be between 2 and 3.5. For others wondering, the R0 or “basic reproduction number” is a way that epidemiologists estimate the number of people who can catch a pathogen from a single person. To compare, the regular seasonal flu has a R0 of 1.3 and measles has a R0 of 12-18. The R0 may vary considerably for the same disease in different populations, for example in a nursing home, college dorm or cruise ship. Q: How does it spread? A: Douglas Public Health Network COVID-19 is spread when people touch or breathe in droplets made when ill people cough, sneeze or talk. This can happen when someone is close to a sick person, within six feet. Rarely, people might catch COVID-19 by touching a surface that a person with the infection coughed or sneezed on, and then touching their own mouth, nose or eyes. Coronaviruses can’t survive for long on surfaces, though, so this isn’t common. Q: Should households in Douglas County be preparing? If so, what does DPHN recommend? A: Douglas Public Health Network The anniversary of last year’s winter storm was a good reminder to always have 2 weeks of non-perishable food and basic emergency supplies on hand. FEMA.gov and Ready.gov are great resources for emergency supply lists. Basic steps every household should take to prepare for any unexpected event: 1. Learn about your employer’s sick leave and telecommuting policies. 2. Establish a childcare plan in the event your kids need to stay home from school. 3. Make sure you have the kinds of foods, drinks, medications, and pet supplies you would want if you needed to stay home and limit your contact with other people for a couple weeks. 4. Get to know your neighbors, especially those who might need extra help like seniors or people living alone. Write down their email or phone numbers so you can check in on them without human contact. If it becomes necessary, you could offer to run errands like grocery shopping for them. Q: What styles of beards can wear N95 masks? A: Douglas Public Health Network If you know any nurses or health care workers with facial hair that need to be fit-tested for n95s (or those who need a trim!) you can share with them this infographic for guidance: https://www.cdc.gov/.../pdfs/FacialHairWmask11282017-508.pdf Q: Other than hand washing and surface sanitizing, are there other recommended precautions I can take to help prevent my family from contracting COVID-19? Are n95 masks helpful in limiting exposure to COVID-19? A: Douglas Public Health Network To protect yourself and your family we recommend: 1. Wash your hands often with warm water and soap for at least 20 seconds. 2. Cover your mouth with a tissue, sleeve, or elbow (not hands) when you cough or sneeze. 3. Stay home if you are sick. 4. Keep your immune system strong by eating a healthy diet, staying current on your vaccinations including the flu vaccine, getting enough sleep and regular exercise, and by taking care of underlying health conditions. The CDC does not recommend that people who are well to wear a facemask to protect themselves from respiratory illnesses. You should only wear a mask if a healthcare professional recommends it. A facemask should be used by people who have COVID-19 and are showing symptoms. This is to protect others from the risk of getting infected. Health care workers who are appropriately fit-tested for facemasks will wear them to care for people infected with COVID-19. There is little evidence that masks limit exposure or decrease risk of illness when used in the public setting. They might lead to a false sense of security and make people less likely to take other, more effective measures to decrease risk of infection. Q: What is my risk of getting COVID-19? A: Douglas Public Health Network Your risk of becoming ill from COVID-19 depends on your exposure to the virus. Most people in Douglas County have not travelled to locations where the virus is active, nor have they had close contact with someone who has COVID-19. As the outbreak develops, we recommend taking the steps listed below to decrease your risk of infection. Q: When will covid 19 tests be available in roseburg? A: We are sorry to hear about your ill child at home, and hope they feel better soon. We share your concerns regarding testing. For right now, the COVID-19 test is only available in OR at the Oregon State Public Health Laboratory and only for persons in 3 categories (see answer to Bailey). Patients will not be charged for COVID-19 tests sent to the Oregon State Public Health lab, but they may have other medical costs like the ones you described depending on their insurance, where they go, and what medical care they receive. We don’t know when exactly COVID-19 testing will be available in Roseburg, but we hope commercial labs will gain the capacity to do testing soon. Q: What are Douglas Counties plans for handling Covid-19? A: Douglas Public Health Network Thanks for your question. Douglas Public Health Network has been busy working with our healthcare coalition to coordinate and prepare for COVID-19. Our partnerships include EMS, Fire, Mercy Medical Center and Lower Umpqua Hospital, the Cow Creek Tribe, Douglas County commissioners, and local city governments. We are also having weekly calls with smaller clinics and urgent cares, the school districts, home hospice, senior services and others. We are following guidance from the Oregon Health Authority and Centers for Disease Control. Q: What is the mortality rate for young children with COVID-19? A: Douglas Public Health Network We understand that the parents of small children may be especially concerned about COVID-19. At this time we have limited data regarding their clinical outcomes. Children seem to have more mild illness, if they show any signs at all. Severe complications have been reported, but they appear to be uncommon. Those under the age of 10 have made up less then 1% of the total number of confirmed COVID-19 cases in China. Mortality rates depend on a lot of factors including the person’s age, chronic conditions, smoking status and overall health status as well as the level of medical care they receive. The overall case fatality rate for COVID-19 looks to be about 2%, but for individuals age 80 and older that rises to 15%. Q: We have seen the list of symptoms for the virus but, Is there a list in what order they show up first? A: Thank you for your question. The disease progression of COVID-19 ranges from person to person. Symptoms of COVID-19 are non-specific and the disease presentation can range from no symptoms (asymptomatic) to severe pneumonia and death. People with COVID-19 generally develop signs and symptoms on an average of 5-6 days after infection (mean incubation period 5-6 days, range 1-14 days). According to the World Health Organization, “As of 20 February 2020 and based on 55924 laboratory confirmed cases, typical signs and symptoms include: fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%), shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgia or arthralgia (14.8%), chills (11.4%), nausea or vomiting (5.0%), nasal congestion (4.8%), diarrhea (3.7%), and hemoptysis (0.9%), and conjunctival congestion (0.8%).” Q: Should people who can stay home and work from home do so at this time? Should immune compromised people avoid going out in public? A: Thank you for your question as I am sure many others in our community may be wondering the same. At this time, we are not yet recommending social distancing precautions as you described. However, we may in the future as the situation develops and we would recommend preparing for that possibility. Q: Do mosquitoes or other pests carry COVID-19? A: Thank you for your question. Mosquitoes and other insect vectors do transmit some viruses like Zika or West Nile, but there is no evidence yet that suggests they can carry COVID-19. Q: In the event of the Coronavirus surfacing here in D.C., Will there be a preferred public information platform? A: thank you for your question. In the event of a positive COVID-19 test in Douglas County, DPHN will send out a FlashAlert with information and advice to all media partners. There will be a press briefing with our Public Information Officer, Dr. Robert Dannenhoffer, who as our county Health Officer will be available to answer questions from the media. The initial briefing is announced in advance. The public will be alerted through local media sources: the radio, TV, Facebook, and newspapers. We may communicate through Douglas County, operate a Joint Information Center or be in tandem with Oregon Health Authority’s JIC.