Commentary: Identifying the risk of coronavirus in Delaware

By Dr. Karyl Rattay

With recent cases of 2019 novel coronavirus (2019-nCoV) reported in several countries including the U.S., health officials across the nation, and here in Delaware, are increasing monitoring efforts to identify potential cases. The Division of Public Health (DPH) has posted information on its website and we are sharing information about 2019-nCoV and our activities related to the outbreak.

While currently the risk to the general public is considered low, we consider any new infectious disease a serious concern and are working with health care providers to promptly identify and evaluate any suspected cases. It is important to recognize that the current investigation and response are dynamic, and frequently changing, and new information about the disease may impact the response. DPH will keep the public updated as the situation evolves.

Dr. Karyl Rattay

At this time, there are only a handful of confirmed cases in the U.S., and none in Delaware, though we recognize that could change at any time. DPH is investigating one potential case of 2019 Novel Coronavirus (2019-nCoV) in a Kent County resident. Test results are pending from the CDC and are expected in the coming days. The individual is currently hospitalized in isolation out of an abundance of caution. There is no widespread risk to hospital staff, patients or visitors, as all appropriate protective precautions are being taken at all hospitals statewide.

Risk for contracting coronavirus is based on exposure. At this time, only those individuals with recent travel to China, or close contact with someone who has had recent travel and is ill, have an increased risk for becoming ill themselves. DPH is not currently recommending exclusion from work or school of asymptomatic persons arriving from China but employers should review their own procedures and staff responsibilities to determine the need for exclusion.

For persons without an associated travel risk, it should be assumed that most respiratory illnesses are not the 2019 novel coronavirus. As you know, we are in the heart of flu and respiratory disease season, and with more than 2,000 cases statewide, Delawareans have a greater risk of contracting seasonal influenza than coronavirus.

Symptoms of coronavirus are most similar to lower respiratory infections with patients having fever, cough, and shortness of breath. There is no specific antiviral treatment recommended for 2019-nCoV infection. While in some cases, illnesses can be severe and require hospitalization, many individuals infected with 2019-nCoV recover by resting, drinking plenty of liquids and taking pain and fever-reducing medications.

Based on what has been learned from past outbreaks – including outbreaks of related coronaviruses – we know that finding cases quickly and responding to them effectively is key. That rapid response helps ensure that the ill person receives the care they need, and it lessens the chance of other people getting sick. Fortunately, Delaware has a strong disease surveillance system in place that includes partnerships with hospital and clinic systems as well as local health care providers.

We have asked Delaware health care providers to alert us if a person with recent travel to China, becomes sick with respiratory symptoms. When cases are reported, laboratory samples are collected and submitted to the Centers for Disease Control and Prevention (CDC) for confirmatory testing. This testing can take several days.

We have had a handful of calls from providers and have followed up. If at any point testing confirms a case of novel Coronavirus in a Delaware resident, the available details and protective recommendations would be shared with both the affected parties and the public as quickly as possible.

Additionally, we have issued guidance to Emergency Medical Services responders regarding what to do if they are called to transport someone suspected to be infected with 2019-nCoV. DPH is holding frequent internal calls to ensure a constant flow of communication, and we are developing materials such as flyers to help the public understand what this virus is, and what they can do to protect themselves.

When a new disease is circulating, it’s natural for people to ask what they can do to protect themselves and their families. The best guidance at this point is to take the same precautions recommended for avoiding colds and flu: People should stay home when they are sick, cover their cough and practice good hand washing.

The CDC recommended that Americans avoid all nonessential travel to China. If you have recently returned from a trip to China and are feeling sick, call ahead to your health care provider and let them know of your travel and symptoms.

I urge Delawareans to be vigilant and to stay informed. The Division of Public Health will share updates with you that will help to keep you and family healthy and safe. Together, we can prevent the spread of germs and make Delaware a healthier state overall.

Dr. Karyl Rattay is the director of the Division of Public Health in the Delaware Department of Health and Social Services.