We aren’t prepared for coronavirus battle, many on the front line say

Broward County, by many indications, is not ready for what comes next in the coronavirus outbreak.

Public officials, health care providers, emergency responders and community leaders say they are worried about a lack of staff, a dearth of supplies like hand sanitizer and face masks, and a frustratingly slow drip of information and guidance.

Three of Broward’s four cases are related to the thriving cruise industry, which unloads thousands of passengers a day at Port Everglades. This month, thousands more spring breakers from across the country will bask on the county’s famous beaches.

Broward, the county in Florida with the largest number of confirmed cases, on Tuesday declared a state of emergency, giving authorities the power to act more quickly. But down the line, as the virus spreads, the situation could lead to more dramatic steps like containment zones, locked schools, and secured nursing homes.

If hurricane season is challenging, dealing with the coronavirus during that

time could be even worse.

Many of those who’ll be on the front lines express doubt about the county’s ability to handle the situation if it were to spiral into a large outbreak.

Inadequate testing

Although Broward has only four confirmed cases of the coronavirus, many health officials at a community meeting Tuesday said they believe that number is higher.

One way to be sure, they said, is to expand testing.

“We know the doubling time, but we don’t have widespread testing and no one feels confident with our numbers that it accurately portrays who has COVID,” said Alison Schwartz, chief medical officer for student health administration at Florida Atlantic University, referring to the coronavirus disease.

Patients wanted to be tested for the virus, but most doctors still don’t have a way to do that without going through state labs, said Shahnaz Fatteh, president of the Broward County Medical Association.

“We have the ability to test for influenza but not for COVID-19,” she said.

The Department of Health issued new guidance Tuesday for health officials, saying that people should be tested if they have had close contact with a confirmed coronavirus case, if they are part of a suspected outbreak, if they have been hospitalized with unexplained cough or shortness of breath, or if they have recently traveled to or from an area with widespread transmission of the virus.

A person also should be tested if they attended a gathering or stayed on a cruise ship where there have been confirmed cases, or if they are 65 and older and have chronic medical conditions or have symptoms of cough or shortness of breath.

The guidance said a person’s physician can take samples for testing at a commercial lab run by LabCorp or Quest Diagnostics, which both recently announced they would start testing for the new coronavirus.

However, state officials in Florida have said there is still a lack of tests available in the state. So far, all testing has been handled by three state labs.

Health care shortages

The lack of testing is compounded by a potential for a lack of healthcare staff as the virus spreads, according to Natasha Strokin, director of emergency preparedness at Memorial Healthcare System.

“If there is exposure we would have to quarantine staff. There are only a couple of physicians in each specialty who have been fit tested for masks and are knowledgeable enough for specific needs,” she said.

Ella Furman, an administrator at an assisted living facility in Plantation, said staff at long-term-care facilities also are at risk. “We already have people out with the flu, which causes other people to work overtime,” she said. “What happens when this becomes an issue?

Doctors, caregivers and emergency responders on Tuesday also expressed a lack of guidance about how they should approach people who have contracted the virus and isolate them.

“We are following the recommendations about self-isolation, but what happens after the 14 days?” said Tashika President, director of emergency management for Broward College. “What do we do? There are a lot of questions and we don’t have answers.”

Schwartz, the medical officer with FAU, said the guidance from the health department that sick patients call a hospital before showing up isn’t effective.

“That sounds lovely, but you try calling for a patient and you might be routed to a billion different people,” she said. “How do we know that person we spoke to is going to put precautions in place for when the patient shows up?”

Emergency responders have similar concerns.

Frank Galgano, a division chief at the city of Pompano Beach, said response procedures still need to be worked out. “We are walking into a room thinking it could be one thing, and we walk in and it’s something else,” he said. “We’re worried about exposure.”

Galgano said that if his staff were to discover days later they were exposed to an infected person they likely will be told to selfquarantine for 14 days, which could also present staffing challenges. “It could wipe out our command center,” he said.

“We need guidance on this big time,” Galgano said.

Many who worry about Broward County’s approach to the coronavirus share the same concern: The plan seems shortsighted, focusing on the cases as they come, instead of looking forward and planning for the potential for cases to multiply quickly as they have in other large population centers.

“We can’t wait until the caseload is here,” said Peter Antevy, an EMS physician and medical director who oversees emergency response for Davie, Coral Springs, Parkland and Palm Beach County. “I think it is already more widespread in the county than people think.”

Antevy said the numbers of new coronavirus patients doubles every six days, based on reports from around the world. He added that it’s critical for Broward to step into the next phase to stop community spread, including canceling public gatherings and getting test kits quickly to hospitals and doctors.

The state of emergency issued Tuesday allows Bertha Henry, the county administrator, to request supplies from the state and avoid the constraints of regular day-to-day purchasing.

Henry said the state of emergency allows her to limit and cancel big events. “We would consider doing that,” she said. “Not now, but we’re looking at it.”

Jared Moskowitz, the director of Florida’s Division of Emergency Management, said a number of contingency plans statewide will help combat the spread of the virus.

Those plans could look a lot like what New York City and Washington State are currently doing, including creating containment zones and closing schools and universities, according to Moskowitz. They also would look to protect the vulnerable elderly population in nursing homes by screening visitors or halting visitation altogether.

Moskowitz said his team also is considering that the virus’ spread could coincide with hurricane season in Florida.

Some plans would account for how to separate healthy and infected people in shelters and how to evacuate hospitals that are housing coronavirus patients.

Moskowitz defended the actions of local county leaders thus far, saying that conferences and events have already been canceled as preventative measures.

He stressed that more drastic decisions would ultimately have to coincide with guidance from the health department and the evidence of virus’ spread that they see on the ground — rather than read about in the headlines.

Ultimately, he said, it is important to plan for the worst, but not get ahead of ourselves in terms of putting those plans into motion like other cities that have more infected people.

“As of today and this moment, the spread of the virus is not as bad,” he said.