The Middletown Press (Middletown, CT)
CT experts weigh in on virus
Coronavirus is here and viruses don’t stop at state borders. Those were the words of Gov. Ned Lamont and we knew it was coming.
So, as state residents think about how state and local governments, hospitals and other institutions work to minimize the impact COVID-19 makes on us, Hearst Connecticut Media is taking a look key players in this fight. We reached out to experts on the frontlines, in hospitals and at universities that house tens of thousands of students. We asked these experts about their roles, backgrounds and previous work, and thoughts on avoiding this virus and more. Some answered in writing, others in interviews.
These are just 10 of the experts working hard to protect others; they represent a broad swathe of jobs, institutions and goals.
William Hackett, state emergency management director, is helping prepare Connecticut in case the spread of the coronavirus becomes a state emer
gency.
Though the Department of Public Health heads the state coronavirus response, Hackett’s Division of Emergency Management and Homeland Security acts as coordinating agency, he said.
“This is a total team effort,” he said.
Hackett’s job is a busy one. “We have a rhythm of telephone calls, we have a rhythm of meetings,” Hackett said of state efforts to stay on top of the situation.
Hackett is working with the governor’s lawyers to prepare for the possibility of declaring a state of emergency or asking the federal government for help, he said.
Right now his biggest focus is information sharing between agencies and municipalities, and with the public, he said. New information comes in every hour, Hackett said.
It’s important for the general public to “keep informed,” Hackett said, adding that individuals can visit ct.gov for the latest updates.
The state conducted a “continuity exercise,” in November, which is a test to see that government can keep running in the case of an emergency, Hackett said.
It was a success, he said. Meanwhile, Connecticut’s first responders’ priorities are: life safety, incident stabilization and property preservation, the director said.
Hackett, who has been the Connecticut’s emergency management director for 16 years and is the governor’s deputy homeland security adviser, isn’t worried about himself.
“I feel pretty prepared,” he said, noting employees are ready to work long shifts if necessary.
“We have a very well-trained staff,” Hackett said, adding that the public should have high confidence in its ability to coordinate emergency response efforts.
Yale School of Medicine Professor Howard Forman, a practicing radiologist and expert in healthcare management, cautions against alarm, though the number of coronavirus cases in the United States expected to soar in coming days.
Forman is collaborating with colleagues across health care and public health communities to understand how the disease is spread and can be contained.
Forman, who has extensive background in public health, said the fact “no one’s an expert on the virus” has prompted an unprecedented spirit of teamwork across multiple disciplines, within and outside of the university, to “bring to bear an understanding of this in real time.”
Forman said “social media has been very helpful for those of us in the science community,” affording “a real-time peer review of our own ideas to see what’s right and what’s wrong, and what rises to the top” that, if not for the public health emergency posed by the virus, might have taken years.
“It will be easy to panic over the next few days and week,” he said. “While our public health infrastructure will be tested, we have extraordinary talent at every level working diligently to diagnose and contain the outbreak, and I’m confident that through adequate detection, we will contain or, more likely, at least mitigate this.”
“Now that the CDC has approved testing on a wider basis, within the next few days I hope, most states will reach the capacity to test,” he said. “The numbers may look gruesome, but these will be existing cases that are finally being diagnosed.”
The hope then, he said, “is that in the next week we uncover where the most severe cases are.”
In the short run, finding the worst cases might make mortality statistics look a lot worse, but once wide-scale testing is in effect, “a large number of us believes the mortality rate is likely to be still above flu, but considerably lower than what’s being reported, and I think that should be very reassuring to the public.”
Forman, an active clinician in the Yale New Haven Hospital Emergency Room, as do others, noted the importance of current CDC recommendations to check the spread of the virus: washing hands frequently, sneezing or coughing into a tissue, staying home when sick, and cleaning and disinfecting frequently touched objects and surfaces.
“These are tried and tested measures to effectively limit the spread of winter coughs, colds, and influenza, and they’re just as important in combating the coronavirus,” he said.
Then there is the practice of “social distancing,” which, Forman said, might well become a buzzword in the next week.
According to the CDC, it involves physically staying about six feet from other people, as well as avoiding public transportation, including ride shares.
- Lisa Reisman
Dr. Asha Shah of Stamford Hospital is an expert in infectious diseases who says the best way to respond to COVID 19, aka coronavirus, “is prevention, prevention, prevention.”
In her roles as an infectious diseases doctor and her as the associate hospital epidemiologist, Shah is on the frontlines of the hospital’s response to COVID-19 — with the latter including strategies and best practices to protect the hospital, its patients and staff against the spread of the disease, should it turn up there.
She has been treating infectious at Stamford Hospital for the past eight years. “From the hospital epidemiology part of my job, we’ve been planning for this for two months” and thinking about what to do is not at all a new thing, she said.
It’s serious stuff. But from the infectious diseases standpoint, it presents an opportunity to learn how to treat a new disease, Shah said.
“This is why we go into infectious diseases,” she said. Her basic assessment and advice, however, are not nearly as exotic as coronavirus might seem.
“It is a flu-like illness,” Sha said. “It’s a respiratory illness that does have symptoms similar to the flu, which we manage every year.
“It’s a virus,” she said.
“We also kind of felt that it was coming,” Shah said. “It was just a matter of time” and the disease was “just behaving the way respiratory illnesses behave. They’re contagious. It’s not surprising to me that we are starting to see cases...”
So what should we do? “I think that what we’re trying to stress is to practice respiratory etiquette,” Shah said. “The same procedures that we use for the flu, we should be practicing for Covid 19.
“Just a general rule of thumb is, stay home when you’re sick,” she said. “That’s not new.”
The other big thing is to wash your hands, Shah said.
“I think the prevention is the key here, and it’s sticking to the basics...” Shah said. “It’s not rocket science, and I think in the face of something like this, it’s a good reminder.”
— Mark Zaretsky
Xi Chen is an assistant professor of health policy and economics at the Yale School of Public Health and as a health policy researcher, his role in the coronavirus pandemic is to inform the public about risks and effective avoidance behavior. It also is to advise policy makers to improve preparedness and address bottlenecks of health systems in response to the pandemic, based on best available scientific evidence, he said.
Chen said he uses his background as a health economist “to always try to understand how to allocate limited resources to achieve maximum value, which may help guide improved actions at the individual, community, and societal levels.”
Chen’s research suggests that in history, pandemics and other disasters hit vulnerable groups hardest.
“Faced with the challenge posed by this virus outbreak, it is important to try best to make sure that the burden of protecting the population do not fall unfairly on people who are more vulnerable, such as those of lower economic or social status, disabled, in poor health, or less flexible in their jobs,” Chen said.
According to Chen, it is vital for health workers fighting against the virus on the frontline to mitigate their risks of infection.
“Only if when health workers are safer, all of us and our communities can be safer. To ensure the safety of health workers, we must make sure they have the priority to obtain all necessary medical supplies and receive adequate and standard trainings to diagnose and treatment patients,” said Chen.
Chen said cautious measures at the individual level should be taken, but not to panic. For example, he said, panic buying of medical grade masks will leave health professional who are saving lives in dangerous position.
Chen said he is not worried about infection from the coronavirus while conducting his research. He is, however, very concerned about having proper arrangements for vulnerable populations, “such as making sure those uninsured or underinsured incur no extra financial burden to get diagnosed and treated, those who are sick can have the option to stay at home with paid sick leave, and health facilities are immigration enforcement-free zones.”
Dr. Majid Sadigh, director of the global health program for Nuvance Health, which includes Danbury, Norwalk, (an employee at Danbury and Norwalk hospitals was diagnosed with coronavirus) Sharon and New Milford, has some experience with significant outbreaks of illness. In addition to his decades in the profession, he was on the front lines confronting Ebola, helping treat patients in Libya.
There, he learned something he believes holds true with the coronavirus. By taking the proper steps — in the case of Ebola, making sure his protective gear fit correctly — disease can be confronted. “I was in the hot zone. I put my hands on patients who were dying,” said Sadigh. “I knew I would not get the disease.”
A native of Iran, Sadigh worked for the Yale School of Medicine for 25 years before coming to Nuvance Health. He said he’s now involved in a wide-ranging task force working to address the coronavirus, with the hope of analyzing the latest research and data to better inform hospital employees.
Sadigh said he believes coronavirus can be contained with traditional public health measures, citing China as an example, which has reported decreasing numbers of patients in recent days.
He said would not be surprised if there are undiagnosed cases of coronavirus in Connecticut, given that testing has been limited to date, and called for more tests to be conduct to allow for a better understanding of the outbreak.
He said there is community spread of the disease — defined as appearances of the disease without obvious cause — but most cases can be traced to areas or points of contact, which suggests most people would have a sense they could have it.
And while the disease has killed people, children seem to be largely unaffected, and pregnant women do not seem to pass it on to their unborn children, as was the case with the Zika virus.
He also noted the lethality rate was likely lower than it seemed initially, as the medical system in Wuhan battled to confront a sudden onrush of cases. The lethality rate in South Korea has been approximately 0.6 percent, where a robust health response has prompted thousands of tests, he noted.
Sadigh said he believes the virus could be brought under control by the end of April.
- Ben Lambert
Dr. David R. Hill is a professor and the director of Quinnipiac’s Institute for Global Public Health in the Frank H. Netter MD School of Medicine, and an infectious disease expert. He is part of Quinnipiac’s task force to develop policy for the university response to COVID-19 and its goal to protect students, staff and faculty, while being mindful of any impact on the community, according to the university.
“I review the current clinical and epidemiologic information about the virus and interpret this for the task force, so that it can inform our decision-making,” Hill said. “As an infectious disease expert and with extensive experi