If China virus hits Bay Area, hospitals ready
The deadly respiratory virus that has infected nearly 1,300 people worldwide — including at least two people in the United States — has not reached the Bay Area, but public health and infectious disease experts are bracing for potential cases and ramping up outreach to those most at risk of falling ill.
In California, 18 people ranging from 3 to 58 years old had been tested as of Friday, and no cases of infection had been confirmed, according to the state Department of Public Health. Nationwide, 63 patients have come under investigation in 22 states; two were confirmed positive and 11 tested negative, according to the U.S. Centers for Disease Control and Prevention.
The positive cases — a man in Washington state and a woman in Chicago — are individuals who had recently traveled to Wuhan, China, the epicenter of the outbreak. Both patients are in stable condition but remain hospitalized for infection control.
“This is a rapidly changing situation both abroad and domestically. This virus was only identified in the past month and there is much we don’t know yet,” said Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the CDC, in a news conference Friday. “While there are many unknowns, CDC believes the immediate risk to the American public continues to be low at this time.”
Fortyone people have died from the new illness. The vast majority of cases have been reported in Wuhan or other areas of China. Though there are signs that the virus is spreading from human to human, it’s unclear how easily transmissible it is.
The outbreak was first reported in Wuhan at the end of December, with about 40 cases of pneumonia not caused by a previously identified virus or bacterium. About a week later, scientists found that the illnesses were all caused by a new coronavirus.
Members of the Bay Area’s Asian American communities are closely watching the contagion, said Cynthia Choi, coexecutive director of Chinese for Affirmative Action.
“There is a tremendous amount of concern because we have a lot of community members who have family there,” Choi said. “There is just widespread panic and concern.”
Coronaviruses most often cause mild cold symptoms. But they can also cause severe illness. A coronavirus caused SARS (severe acute respiratory syndrome), which infected 8,000 people and killed nearly 800 worldwide in 2002 and 2003. Like the new coronavirus, SARS originated in China before exploding worldwide. A second coronavirus causes MERS (Middle East respiratory syndrome), which has infected 2,500 people and killed nearly 900.
SARS eventually petered out, partly due to aggressive public health efforts to stop transmission. But before then it wreaked havoc worldwide, leading to quarantines of entire hospitals and tens of thousands of people in some parts of the world.
Fewer than a dozen people ended up testing positive for SARS in the United States. In the Bay Area, at least one resident was confined to isolation after falling ill with suspected SARS symptoms and refusing to comply with selfquarantine orders.
Officials with Bay Area hospitals and public health agencies said they are far better prepared now than they were 18 years ago to handle an outbreak of a neverbeforeseen disease.
“We’re way advanced compared to SARS,” said Dr. Jeffrey Silvers, medical director of infectious disease at Sutter Health in the Bay Area. For starters, the cause of illness was identified much more quickly this time, resulting in an early diagnostic test.
Also, the original outbreak was identified very early by Chinese authorities. Less than a month after the first reports, travel out of Wuhan and other parts of China has been restricted and the government has shut down large gathering areas, including Shanghai Disneyland.
The United States started screening passengers flying from Wuhan to three U.S. airports — including San Francisco International — last weekend. As of Thursday, about 2,000 people had been screened, CDC officials said. But now that travel out of Wuhan has been stopped, U.S. officials are reconsidering how best to screen for potential incoming cases.
“We are reevaluating our approach,” said Dr. Marty Cetron, director of CDC’s division of global migration and quarantine. He added that recent public health efforts have focused on getting word out to people who recently traveled to China to be on alert for symptoms of the new illness and to contact their doctor or local public health department if they think they may be sick.
The spread of the virus comes as many travel within and out of China to other countries to celebrate the Lunar New Year, stoking fears amid what is considered one of the biggest traveling periods.
“People have heightened awareness of the risk,” said former San Francisco Supervisor and Assessor Mabel Teng. “Lunar New Year is the most significant holiday.”
Both U.S. patients who have tested positive reported themselves to health care providers.
The new disease primarily involves lower respiratory symptoms, including cough and shortness of breath, plus fever. At this time, patients are only suspected cases if they have symptoms and have recently traveled to Wuhan or have had close contact with someone who tested positive for the disease.
Dr. David Witt, regional health care epidemiologist for Kaiser Permanente Northern California, said the health system’s call centers have been fielding questions and concerns from patients who think they could be sick, or at risk of falling ill, with the new virus. But so far no cases have emerged.
“At this point, there’s way more worry than actual cases,” he said. Witt added that Kaiser has disaster plans in place for these kinds of outbreaks, and that from what he knows of the new virus so far, the health system should be able to safely care for any patients that test positive.
“We have had no major suspect cases in Northern California yet. But we will get some,” he said. “When that happens, we have directions on what kind of protection our staff needs to use. We will work with the health department to get the testing done. It will involve pretty strict isolation, but that’s within the range of what we do routinely.”
Dr. Susan Philip, director of disease prevention and control at the San Francisco Department of Public Health, advised people to take the normal precautions they would take during cold and flu season — washing hands, covering a cough, getting a flu shot, staying home when sick — to stave off common respiratory ailments that cause “unnecessary worry.”
She assured that local hospitals already have the infrastructure to handle any cases of coronavirus that may arise.
“The equipment, the techniques, the procedures ... are already in place at the hospitals, and this is what we use every flu and cold season,” Philip said. “There are no special isolation (rooms), special techniques or special equipment required other than what is already good hospital practice.” Staff writers Alejandro Serrano and Rachel Swan contributed
to this report.