One Spokane County resident is displaying symptoms of COVID-19 and has been tested for the respiratory disease, while five local people are under surveillance for the virus.
That’s according to the Spokane Regional Health District, which is asking local residents experiencing symptoms to call their health care provider before seeking care at the emergency department.
Test results for the local person under investigation were not available at press time, as they were submitted late on Saturday.
Concerns about the virus in the Spokane area come as state health officials confirmed more cases of COVID-19 in Washington late this week, including one man who died.
COVID-19 is a respiratory disease caused by the SARS-CoV-2 virus. It has symptoms similar to the common cold or flu, including fever, coughing and difficulty breathing. Globally, there are thousands of confirmed cases, including six confirmed cases in Washington state as of 6:30 p.m. Saturday.
Local health officials encourage those who are sick to stay home from work or school, to rest and to monitor their symptoms closely. Those who live with symptomatic individuals should keep their distance, Kelli Hawkins, public information officer at SRHD, said.
“Watch your symptoms closely for fever or increased shortness of breath in addition to coughing and sneezing and consider who you have been in contact with in recent weeks. Have they or someone they know been recently traveling?” Hawkins said.
People are also encouraged to practice good hygiene, including covering coughs and sneezes, washing hands, and sanitizing surfaces in the home. Health officials are not advising the use of masks at this time.
COVID-19 is thought to be spread through droplet transmission from coughing or sneezing, close personal contact or touching a surface that is infected and then touching one’s eyes, nose or mouth.
Hawkins said after taking all these precautions and monitoring symptoms closely, people who are still concerned should call their health provider first, before going into the emergency department or doctor’s office.
“Your doctor then will give you instructions and determine if you need testing,” Hawkins said.
Currently, health care providers must follow Centers for Disease Control and Prevention guidelines for testing for COVID-19, which state that a person must be not only showing symptoms but also have traveled to a country that has widespread transmission, such as China, Iran, Japan, South Korea and Italy, or have been in close contact with a person with a confirmed COVID-19 case.
Health care providers are also allowed to test already hospitalized patients with fever and acute respiratory illness, with no clear cause. Patients with symptoms and one of the additional factors are considered a person under investigation, or PUI, by the CDC. PUIs are either isolated to their homes or cared for at hospitals, depending on the severity of their symptoms while waiting for test results to come back.
“We still have to be selective on who we’re testing because we only have so many tests; we need to reserve those for patients showing severe symptoms,” Hawkins said.
Washington state has in-state testing at the Washington State Department of Health lab in Shoreline, which can turn around tests on the same day. Kathy Lofy, state health officer, said on Saturday the state lab is working to get its capacity up to 200 tests per day.
In addition to good hygiene, Washington residents are encouraged to plan for how they would deal with school or business closures, if health officials need to take more drastic measures.
Hospitals are reviewing their surge capacities if more patients need to be hospitalized for treatment due to the virus. The Spokane Regional Health District would coordinate regional emergency response east of the Cascades should it become necessary for hospitals to engage their surge capacity.
“I think the systems are in place to ensure that if surge capacity is necessary, people can feel confident and comfortable that patients and friends will be taken care of,” Bob Lutz, SRHD health officer, said.
Other local institutions respond
The near-certain spread of COVID-19 around the country could mean widespread disruption of schools, including partial closures and internet-based instruction.
Ally Barrera, a Spokane Public Schools spokesperson, said the district hasn’t received any new recommendations or protocols from public health officials since the infection of a Snohomish County high school student prompted a three-day deep clean of a high school and closure on Monday.
Additionally, Bothell High School closed Thursday and Friday after a staff member who returned to work from international travel reported a family member traveling with them became sick, according to a letter to families. The staffer was reportedly quarantined but public health officials have not released more information about that case.
The CDC has referred schools to previous guidance for flu pandemics published in 2017, which will be updated for COVID-19.
And last week Washington State Department of Health officials conducted a webinar for about 250 superintendents. They gave school officials a message to prepare, not panic, said Becky Doughty, health services director for Spokane Public Schools.
The 2017 CDC document notes “social distancing measures” for schools, workplaces and gatherings “can reduce virus transmission by decreasing the frequency and duration of social contact among persons of all ages.”
In schools, that could involve dividing classes into smaller groups or rearranging desks so students are spaced at least 3 feet from each other. Most school districts have access to broadband internet, but not necessarily the expertise in teaching classes online. Moreover, many families lack computers and high-speed internet.
The Spokane Regional Health District would lead the public health response if a COVID-19 case is transmitted locally.
“We’re continuing to be in constant contact with them,” Barrera said.
Meanwhile, Gonzaga University told more than 160 students studying abroad in Italy, where nearly 900 COVID-19 cases have been confirmed, to return to their homes in the U.S. The students were told not to return to campus in Spokane.
Sophomore Grace Camera, who was in Austria on spring break when Gonzaga announced it would close its campus in Florence, Italy, on March 6, said she returned home to Sammamish on Friday. Camera said she chose to fly directly home and have her belongings in Italy shipped to her rather than return to Florence. She said she hadn’t heard of anyone traveling from Italy to Asia, but some went as far as Morocco.
Gonzaga students were told to contact their doctors if they felt ill and inform the university of their new travel plans, according to Camera. She said she hadn’t heard of any concerns about illnesses among Gonzaga students abroad, though some students caught colds with “no red flags.”
Camera said she hadn’t heard of any Gonzaga students planning to return to Spokane, but some hope to visit campus later this semester. Study abroad students are supposed to find out about how they will finish their classes for the semester on March 6. Students were supposed to remain in Italy until mid-April.
During her trip home to Western Washington, Camera said customs agents focused on where travelers were coming from and that she heard some announcements about notifying airline staff if people had been through China.
“It was pretty easy to get through customs because I had just been in European nations,” said Camera.
She said she isn’t aware of any people who are being monitored for COVID-19 among friends and family in Sammamish.
Fairchild Air Force Base spokesperson Sgt. Travis Edwards said there is no possibility of mass numbers of COVID-19 patients being quarantined and cared for on base, as has been the case at Travis Air Force Base in California, with infected persons coming from Japan.
Two COVID-19 patients discharged from Sacred Heart
Currently, in the United States, the majority of confirmed cases of COVID-19 are from repatriated citizens who were on board a cruise ship in Asia that had hundreds of confirmed cases.
Four of those passengers were transferred from Travis Air Force Base, outside of Sacramento, to Spokane to receive treatment at Sacred Heart Medical Center, which has a special pathogens unit. The four patients remained in satisfactory condition for a week.
Late Friday night, DOH officials announced two COVID-19 patients at Sacred Heart were discharged to their homes. Health officials would not disclose where these patients were originally from.
In order to be discharged, Lutz said a COVID-19 patient must test negative for the virus twice, with more than 24 hours between tests. The patients will continue to be monitored by local officials once they are home.
The special pathogens unit at Sacred Heart is part of a national network initially established to treat patients in the wake of the Ebola crisis, and this is the first time it has been used. The two other patients with COVID-19 at Sacred Heart were in satisfactory condition on Friday.
A hospital does not have to have a special pathogens unit to treat patients with respiratory viruses, and hospitals can use airborne isolation infection rooms, with negative airflow.
EvergreenHealth Hospital in Kirkland, Wash., which is currently treating one patient with confirmed COVID-19 and treated the patient who died from the virus this weekend, converted part of its critical care unit into an isolation unit to treat those patients, Dr. Frank Riedo, medical director of infection control there, said on Saturday.
Sacred Heart Medical Center has many rooms beyond its 10-bed special pathogens unit with similar capabilities to treat patients with respiratory illnesses, a hospital spokesperson said.