Officials plan for Milwaukee outbreak
Importance of public cooperation emphasized
Health officials are preparing for the novel coronavirus’ arrival in Milwaukee by making changes to the 911 dispatch system, holding meetings to hash out roles and responsibilities, and determining how to best protect both workers and residents from the virus.
When the virus might come to Milwaukee is unknown, but experts speaking at public meetings Thursday said there is little doubt it will come.
Officials from the city’s Health Department told members of a Common Council committee Thursday that they’re preparing on a number of fronts. They’re focusing on containing the virus while also planning for its spread in the community.
They called on residents to do their part by thoroughly washing their hands, avoiding touching their faces, staying home when sick, following travel advisories and taking other precautions that are normally recommended to stop an illness’ spread.
“Public cooperation is going to be so, so important to stop the spread or to mitigate the spread of the disease,” said Julie Katrichis, director of clinic operations for the Health Department.
There is currently no vaccine for the virus that has made its way across the globe.
Of the four people in Milwaukee who city officials said last week were under voluntary quarantine after having returned from China, the epicenter of the outbreak, only one is still in quarantine, Health Commissioner Jeanette Kowalik said. The measure was precautionary.
There are no known cases of coronavirus in Milwaukee, she said.
Dane County public health officials said last week that the lone person in Wisconsin to be diagnosed with coronavirus was determined to be healthy.
The Milwaukee Health Department’s lab is one of two in the state currently able to test for the virus, but there have been no requests for tests since the lab got that capability, said Sanjib Bhattacharyya, laboratory director and special health commissioner with the city’s Health Department.
The second lab is the Wisconsin State Laboratory of Hygiene in Madison.
Milwaukee’s lab can handle between 25 and 30 tests per day but may double or triple that number, depending on the circumstances.
On Thursday afternoon, there had been 11 deaths from coronavirus in the U.S., 10 of which were in Washington state and one in California.
California and Los Angeles have both declared states of emergency.
On Thursday afternoon, the number of confirmed cases across the world was approaching 100,000, with at least 3,347 deaths, USA Today reported.
Symptoms are mild for about 80% of people who contract the virus, and older people and people with compromised health are at greater risk, city health officials said.
Symptoms can appear between two and 14 days after exposure and include fever, cough and shortness of breath.
Preparations underway
In the city and the country there was significant energy put into planning and testing plans for the H1N1 pandemic flu, Kowalik said, and plugging coronavirus into that existing plan is “pretty seamless.”
Staff from the Health Department’s Communicable Disease Program are notified of travelers coming from mainland China so they can be monitored, Katrichis said. They’re also notified of people who are under investigation and confirmed cases of coronavirus.
“Identifying cases early is critical to mitigating spread,” she said.
If there is a positive case in the city, the department would go about “contact tracing” — identifying other people who may have come in close contact with an infected person and may need follow up and testing.
They can also use measures including isolation and home quarantine to stop the virus’ spread, Katrichis said.
Ald. Michael Murphy asked how to target resources to older people who are at higher risk, whether city officials are working with hospitals to see whether enough beds would be available and what happens if additional bed space is needed.
Katrichis said in long-term care facilities, there are practices in place to separate sick and healthy people and to limit visitors.
She also said there are ongoing conversations about mask and sanitizer supplies and whether masks can be used once or multiple times.
Nick Tomaro, preparedness coordinator for the city’s Health Department, said hospital systems have “robust plans in place” and that surge capacity is a constant topic of discussion.
Asked how many isolation beds were available in the region, Tomaro told Murphy, “Honestly, it won’t be the number that you want to hear.” But, he said, it’s not expected that with a widespread illness there would be enough isolation units within a hospital system. That means regular rooms will be used to treat people, a reality around the country, he said.
911 callers to be asked if they may have symptoms
On Wednesday, Milwaukee County EMS Medical Director Ben Weston directed all fire chiefs to have 911 dispatchers countywide begin asking callers if they are suffering from flu-like symptoms that may be the coronavirus.
West Allis went live with the new direction Wednesday night. Others have until March 11 to begin.
If a patient reports flu symptoms, they will be told to self-isolate to avoid spreading the illness. If they do need to be transported, that paramedic crew will be notified so they can take precautions such as wearing masks, gloves and gowns and decontaminating their ambulances after transporting a patient with those symptoms, officials said at Thursday’s meeting of the Milwaukee County Council on Emergency Medical Services.
Weston, an emergency medicine doctor at Froedtert Hospital, said it is “quite likely,” the virus will come in a “major way” to Milwaukee County and Wisconsin.
Every Friday morning, a 60-person conference call is taking place with officials discussing best techniques to combat the virus, said Christine Westrich, director of the county’s emergency government office. Those on that call include the Milwaukee County Jail, House of Correction, the county Behavior Health Division facility, the airport, the zoo and those working with the homeless.
Officials are considering what do to with the expected overwhelming number of patients that want medical evaluation. Like with the flu, the advice will be to stay home, rest and stay hydrated. But officials expect patients will be scared and want to see their own doctor.
“When there is a pandemic like this, people really want to see their health care provider, even if they have a fever but otherwise feel ok,” Weston said.
In such a scenario, hospitals would be overwhelmed as well as doctors’ offices, urgent care facilities and clinics at pharmacies.
Quarantines, isolation could be ordered
Kowalik told the committee Thursday that as health commissioner she is empowered to order quarantines and isolation.
Isolation refers to someone who has the illness whereas quarantine is a precaution for someone who may have been exposed, she said.
She said after the meeting that she would consider factors including the number of cases and the virus’ spread in the community in order to make decisions on issuing any isolation or “stop movement” orders — cancellations of large gatherings, including at churches, sporting events and schools.
“Our goal is to make sure it doesn’t become a community spread situation where we have to shut things down and really impact the quality of life to protect the public’s health,” she said.
In the next week or two, a large exercise with 100 officials from across many areas in the county is expected to be held to discuss pandemic authority and contingency plans, Westrich, director of the county’s emergency government office, said at Thursday’s county meeting.
There is no county health director, but Kowalik would assume that role if an emergency is declared and with it the authority to close schools, cancel social gatherings and other actions.
“There is a lot of authority that department will have,” Westrich said.
Regarding preparations for this summer’s Democratic National Convention, Kowalik said there’s no way for health officials to know now what the situation will be in July when 50,000 people are expected to descend on Milwaukee for the convention.
That means they have to continue to evaluate the situation and make sure staff are engaged with their counterparts on the federal and state levels, she said. Any cancellation of the DNC would be a coordinated decision between the city’s Health Department and state and federal officials.