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California undertakes massive effort to trace contacts of woman with coronavirus California undertakes extensive effort to trace contacts of woman with coronavirus
(about 3 hours later)
VACAVILLE, Calif. — California has launched a far-reaching effort to find anyone who might have come in contact with a new coronavirus patient, officials said Thursday, as federal officials moved to improve the faulty testing process that has hamstrung their ability to track how widely the disease has spread. VACAVILLE, Calif. — California has launched a far-reaching effort to find anyone who might have come in contact with a new coronavirus patient infected despite having no known link to others with the illness, as federal officials tried to fix the faulty testing process that has hamstrung their ability to track how widely the disease is spreading.
Gov. Gavin C. Newsom (D) and state health officials declined to reveal how many people may have crossed paths with the Solano County woman, who is the first person in the United States to develop the new covid-19 disease without traveling to a virus hotspot or having close contact with someone who did. U.S. officials raced to meet the daunting new challenge of a virus that could be spreading through a Northern California community, even as the covid-19 virus continued its relentless march around the globe. Stock markets continued to plunge, Japan initiated a weeks-long school closure and an Iranian lawmaker contracted the infection. From the Middle East to South Korea to parts of Europe, the number of deaths and infections continued to grow.
But they acknowledged the woman was living in the community and showing symptoms of the disease before she was admitted to a local hospital here Feb. 15. That is a worrisome prospect because the virus is highly transmissible, especially when someone with the disease has symptoms. They did not share any details about the woman’s family, work and social contacts, citing patient privacy. In Washington, Vice President Pence convened his first meeting as the new head of the task force battling the virus. On the other side of the country, California Gov. Gavin Newsom (D) and state health officials sought to reassure jittery residents that public health officials would be able to handle the first U.S. case of community transmission.
Solano County is home to Travis Air Force where hundreds of Americans repatriated from China and from the Diamond Princess cruise ship have been quarantined. Officials have said the woman had no known contacts with people quarantined on the base. Projecting an air of calm during a moment of rising anxiety over the outbreak, Newsom repeatedly told reporters that methods of tracing a Solano County woman’s contacts have been honed in response to other public health crises, from tuberculosis to the swine flu.
Newsom said the federal Centers for Disease Control and Prevention was sending 10 staffers to aid state and local personnel in tracing the woman’s contacts.
Mark Ghaly, secretary of the state’s Health and Human Services Agency, described a “robust and first-class reaching out to … many, many individuals in all walks of this person’s life.” That includes the people who cared for her at NorthBay VacaValley Hospital here, some of whom have been put on paid leave and are isolated at home monitoring themselves for symptoms, according to hospital official.
Projecting an air of calm during a moment of anxiety over the outbreak, Newsom repeatedly told reporters that the tracing methods employed in northern California have been honed in response to other public health crises, including outbreaks of tuberculosis and the H1N1 flu, also known as swine flu.
“This is not our first great challenge as it relates to public health,” Newsom said. “Quite the contrary. These protocols have been perfected.”“This is not our first great challenge as it relates to public health,” Newsom said. “Quite the contrary. These protocols have been perfected.”
At the same time, he called repeatedly for the CDC to expand guidelines that govern who should be tested and dramatically upgrade state and local capacity to test for the virus. Later Thursday, the CDC announced it had broadened the criteria to include people with symptoms of the disease but no known source. Federal officials have faced fierce criticism for overly narrow criteria about who should be tested and for shipping coronavirus test kits to public health labs that included a component that in most cases did not work correctly.
“It can’t happen soon enough,” Newsom said. “Testing protocols have a been frustration for many of us.” But on Thursday, the Centers for Disease Control and Prevention expanded the federal guidelines for testing to include people who have unexplained severe respiratory symptoms and people with symptoms who have recently traveled to Iran, Italy, Japan and South Korea as well as China.
The woman’s case is considered the first sign that coronavirus, which has killed more than 2,800 people around the world, may be spreading in a U.S. community. Federal health officials also are moving to try to correct the problems with the test kits. Scott Becker, executive director of the Association of Public Health Laboratories, said that although only eight public health labs are able to run the tests, federal officials have approved a procedural change that may allow about 40 more labs to come online very shortly.
The Solano County woman wasn’t tested for the disease for four days, despite an immediate request to the CDC, because she didn’t meet the strict criteria for the test, according UC Davis Medical Center, where she is currently being treated after spending four days at a community hospital in Vacaville. The CDC has not responded to that charge. But federal health officials have said clinicians always have discretion to order the test for people who do not meet the criteria. New tests are expected to be sent out to labs next week. That should result in all 100 public health labs across the country being able to run tests by the end of two weeks.
The patient who brought herself to NorthBay VacaValley Hospital, a 50-bed community hospital in Vacaville, Calif., with flulike symptoms on Feb. 15., Newsom and state health officials acknowledged the Solano County woman was in the community and showing symptoms of the disease before she was admitted to a hospital here Feb. 15. That is a worrisome prospect because the virus is highly transmissible, especially when someone with the disease has its flulike symptoms. Officials did not share any details about the woman’s family, work or social contacts, citing patient privacy, and declined to say how many people she came in contact with.
Staff at the hospital questioned the woman about travel and contacts under CDC guidelines, but she did not meet the criteria for someone who should be tested for the virus, because she had not recently traveled to China or had contact with someone who is a confirmed case, according to Aimee Brewer, president of NorthBay Healthcare, which owns the hospital. At the same time, experts reminded the public that, in other parts of the world at least, most cases of the virus are mild. To date, the coronavirus has killed 2,801 people and sickened more than 82,000, the vast majority of them in China. The United States has seen 60 cases, none fatal, and most of them among people who caught the virus while quarantined on a cruise ship off Japan.
The hospital is “meticulously tracing” anyone who may have come into contact with the woman there, and monitoring scores of dozens of staff members who may have been exposed, Brewer said in a statement. She added that any staff who had direct contact with the patient have been tested for the virus and are now on paid leave, tracking their health at home. So far, there have been no positive tests, she said. Nevertheless, the CDC warned Americans on Tuesday that community spread is almost certain and that they should prepare for the possibility of significant disruption in their daily lives.
Brewer said in an interview that the woman had a private room, and “we believe strongly that our patients are protected.” “This virus has adapted extremely well to the human species,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and a key member of the coronavirus task force. “This one has the capability of spreading readily from human to human.”
Solano County, where the new case emerged, is home to Travis Air Force Base, where hundreds of Americans repatriated from China and from the Diamond Princess cruise ship have been quarantined. Officials have said the woman had no known contacts with people quarantined on the base.
Newsom said the CDC was sending 10 staffers to aid state and local personnel in tracing the woman’s contacts.
Mark Ghaly, secretary of the California Health and Human Services Agency, described a “robust and first-class reaching out to … many, many individuals in all walks of this person’s life.” That includes the people who cared for her at NorthBay VacaValley Hospital here, some of whom have been put on paid leave and are isolated at home monitoring themselves for symptoms, according to Aimee Brewer, president of NorthBay Healthcare, which owns the hospital.
The Solano County woman wasn’t tested for the disease for four days, despite an immediate request to the CDC, because she did not meet the strict criteria for the test, according UC Davis Medical Center, where she is currently being treated after spending four days at the community hospital in Vacaville.
The CDC has not responded to that charge. But federal health officials have said clinicians always have discretion to order the test for people who do not meet the criteria.
The patient, who brought herself to NorthBay VacaValley Hospital, a 50-bed community hospital in Vacaville, Calif., with flulike symptoms on Feb. 15.
Staff at that hospital questioned the woman about travel and contacts under CDC guidelines, but she did not meet the criteria for someone who should be tested for the virus, because she had not recently traveled to China or had contact with someone who is a confirmed case, according to Brewer.
The hospital is “meticulously tracing” anyone who may have come into contact with the woman there, and monitoring scores of staff members who may have been exposed,” Brewer said in a statement. She added that staff who had direct contact with the patient have been tested for the virus and are on paid leave, tracking their health at home. So far, there have been no positive tests, she said.
Brewer said in an interview that the woman had a private room, and “we believe strongly that our patients are protected.”
The hospital was going through “records and security footage to make sure we know every person who has been in contact with the patient to determine if they are a low, medium or high risk,” she said. “We did that last night and are finishing it up today.”The hospital was going through “records and security footage to make sure we know every person who has been in contact with the patient to determine if they are a low, medium or high risk,” she said. “We did that last night and are finishing it up today.”
Staff at NorthBay inserted a tube in the woman’s lungs to help her breathe, a procedure experts say increases risk of exposure to the virus because it can aerosolize respiratory droplets, according to the person briefed on the case Staff at NorthBay inserted a tube in the woman’s lungs to help her breathe, a procedure experts say increases risk of exposure to the virus because it can aerosolize respiratory droplets, according to a person briefed on the case.
When the woman’s health continued to decline, Brewer said, she was transferred to UC Davis Medical Center in Sacramento, which has more capacity and expertise with pulmonary patient. UC Davis officials said she arrived there on Feb. 19. When the woman’s health continued to decline, Brewer said, she was transferred to UC Davis Medical Center in Sacramento, which has more capacity and expertise with pulmonary patients. UC Davis officials said she arrived there on Feb. 19.
“Contact tracing,” or finding anyone the woman has come in contact with “sounds simple,” but “is really a resource intensive effort, even with a single case” said Thomas Ingleby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health. “Contact tracing,” or finding people the woman has come in contact with “sounds simple,” but “is really a resource-intensive effort, even with a single case” said Thomas Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health.
“They are going to be working to identify everyone who spent substantial time in close contact — within six feet — during the time the person could have been incubating the virus. Family is fairly straightford, then close co-workers, but there may have been contacts” that are more difficult for public health workers to track down. “They are going to be working to identify everyone who spent substantial time in close contact — within six feet — during the time the person could have been incubating the virus. Family is fairly straightforward, then close co-workers, but there may have been contacts” that are more difficult for public health workers to track down.
“Standing in line quite briefly next to a person would probably be considered low risk, but sitting next to someone in church for a half-hour might be high risk,” he said.“Standing in line quite briefly next to a person would probably be considered low risk, but sitting next to someone in church for a half-hour might be high risk,” he said.
A pair of colleges in nearby Sacramento has sent home two students — one from each school — who came into contact with the infected woman. The students at American River College and Cosumnes River College were exposed during their work as health care providers. A pair of colleges in nearby Sacramento said they have sent home two students — one from each school — who came into contact with the infected woman. The students at American River College and Cosumnes River College were exposed during their work as health-care providers.
Like other health care workers who have had contact with the patient, the students have been asked by county health officials to isolate themselves for 14 days and monitor for symptoms. Like other health-care workers who have had contact with the patient, the students have been asked by county health officials to isolate themselves for 14 days and monitor for symptoms.
Neither school is asking other students to stay home and classes are continuing as scheduled. Neither school is asking other students to stay home, and classes are continuing as scheduled.
To date, the United States has 60 known cases of the infection, with 59 among people who traveled to Asia or were close contacts of people who went there. The vast majority, 42, picked up the virus while quarantined on the Diamond Princess cruise ship off Japan. On Thursday afternoon, UC Davis announced that three students who lived in its Kearney Hall dormitory were in insolation and being monitored for symptoms of coronavirus. One of the three was getting a covid-19 test from the CDC, while the other two had shown no symptoms and would not be tested, per current CDC guidelines. The dorm is located on the main UC Davis campus in Davis, Calif., about 19 miles west of the UC Davis Medical Center.
How the woman acquired the respiratory disease is unknown. The university did not say how or where the students were exposed to the virus or where they were staying while in isolation, because they were no longer in their campus housing. The university said it plans to increase daily sanitation procedures in Kearney Hall. No UC Davis classes are being canceled at this time.
Two UC Davis officials sent an email to employees Wednesday that said the patient arrived at the medical center Feb. 19 but was not tested until Sunday because they did not meet the criteria for testing. That includes recent travel to China or close contact with a confirmed case. UC Davis Medical Center officials sent an email to employees Wednesday that said the woman arrived at the medical center Feb. 19 but was not tested until Sunday because she did not meet the criteria.
The patient arrived from another hospital in Northern California, according to the email sent to UC Davis Medical Center employees from David Lubarsky, vice chancellor of human health sciences, and Brad Simmons, interim chief executive. “When the patient arrived, the patient had already been intubated, was on a ventilator, and given droplet protection orders because of an undiagnosed and suspected viral condition,” according to an email sent by David Lubarsky, vice chancellor of human health sciences, and Brad Simmons, interim chief executive of UC Davis Health. “Since the patient arrived with a suspected viral infection, our care teams have been taking the proper infection prevention (contact droplet) precautions during the patient’s stay.”
“When the patient arrived, the patient had already been intubated, was on a ventilator, and given droplet protection orders because of an undiagnosed and suspected viral condition,” they wrote. “Since the patient arrived with a suspected viral infection, our care teams have been taking the proper infection prevention (contact droplet) precautions during the patient’s stay.”
UC Davis asked the CDC to conduct a test for the virus because local and state labs were not doing so. “Since the patient did not fit the existing CDC criteria for covid-19, a test was not immediately administered. UC Davis Health does not control the testing process,” they wrote.UC Davis asked the CDC to conduct a test for the virus because local and state labs were not doing so. “Since the patient did not fit the existing CDC criteria for covid-19, a test was not immediately administered. UC Davis Health does not control the testing process,” they wrote.
The CDC ordered a test Sunday and additional precautions were taken, they wrote. The agency confirmed the positive test Wednesday. The CDC ordered a test Sunday and additional precautions were taken, they wrote. The agency confirmed the positive test Wednesday.
The virus, which originated in Wuhan, China, has killed 2,801 people and sickened more than 82,000 as it has spread around the globe, reaching every continent except Antarctica. The CDC on Tuesday warned Americans that community spread is almost certain to occur, and to prepare for significant disruption in their daily lives. Faiz Siddiqui, Heather Kelly, and Nitasha Tiku in San Francisco contributed to this report.
President Trump on Wednesday evening appointed Vice President Pence as the new head of the task force coordinating the battle against the virus.
Faiz Siddiqui, Heather Kelly and Nitasha Tiku in San Francisco also contributed to this report.
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