Officials from the state Department of Health are hoping to get test results back tomorrow on the state’s first suspected case of the new coronavirus first identified in Wuhan, China.
The case remains under investigation; if the test results are positive and the case is confirmed, the department will implement a protocol approved by the federal Centers for Disease Control and Prevention to minimize the potential spread of the virus.
The patient became sick after returning from a trip to China, the department has confirmed.
Dr. Gary Wheeler, senior medical consultant for the Department of Health, said state officials don’t know exactly when they will get results back but are hopeful that the CDC would turn its test results around in 24 hours. The respiratory and serum samples from the patient were due to arrive at 10:30 ET this morning to CDC headquarters in Atlanta. “We’re hopeful that we’ll get that result by tomorrow,” Wheeler said. “That’s our expectation, but there’s no guarantee.”
If the test is negative, the patient would continue to receive whatever care was appropriate from providers but would no longer be under the state protocol for the public health investigation.
If the test is positive, the Department of Health would continue to keep the patient isolated until it was determined that the patient was no longer infectious. Wheeler said there was not a precise timeframe for how long a patient should remain in isolation. That decision would be made in consultation with the CDC, he said, based on the patient’s condition and potentially some additional testing. (There is currently no specific treatment recommended; a patient would simply receive care for the symptoms until they subside.)
If a case of the new coronavirus was confirmed, Wheeler said, the next phase would be identifying the people the patient had contact with in the U.S. while infectious.
The department has already communicated with the patient’s immediate contacts, such as family members, and cautioned them about minimizing their social interactions and taking steps to avoid spreading the disease in the event that they were infected. It has also acquired information about the flights that the patient travelled back from China on. But full precautionary measures won’t be activated until confirmation of a case of coronavirus.
“That requires boots-on-the-ground kind of work,” Wheeler said. “It’s the work that we do all the time with all the other infections that we manage. We have a lot of personnel that can be deployed. It starts by interviewing the patient and family to see what sorts of social contacts and close contacts they’ve had. We would alert all those people that they were potential contacts and provide instructions. We would identify people who were symptomatic and do testing on them if necessary.”
“It’s the same principles of management of infectious disease that we employ on everything else,” Wheeler said. “The attempt is to create a cordon of surveillance around the index patient to manage and minimize any spread beyond that patient.”
Even if the patient is confirmed to have the new coronavirus, people who have had contact with the patient would likely only be tested if they show symptoms, following the CDC’s guidelines. Symptoms include fever, coughing, and difficulty breathing.
Wheeler stressed that there were three different categories of patients — people who are at risk, patients who are under investigation, and confirmed cases. Someone who has been in contact with a confirmed case “would simply be at risk,” he said. “They would be educated about the disease and if they went on to develop symptoms, they would be directed to medical care and evaluation.” That person could potentially then be under investigation and, in consultation with the CDC, testing could be ordered. Depending on their symptoms, these patients might be directed to an inpatient facility to be observed in isolation or might be observed at home.
Like many respiratory viruses, such as the flu or the common cold, the new coronavirus is transmittable from secretions or direct contact with droplets from coughing or sneezing. It is not considered an airborne virus, such as measles or chickenpox, which can be contracted from germs that remain in the air, simply from being in the same room with a person. The coronavirus would typically only be contracted from being in very close proximity with someone who was coughing or sneezing, drinking after someone, or hand to hand contact. (Therefore, unlike during the Ebola outbreak when medical providers wore full protective suits, providers treating a suspected case of the coronavirus would wear the standard gown, gloves, goggles, and a mask that they would be typical when treating any infectious virus.)
“I really want to emphasize, hand to hand contact is probably the way most of these things get transmitted,” Wheeler said. “It’s really important for people to pay attention to hand hygiene this time of year.” While very few people in Arkansas are likely to come into contact with someone with the new coronavirus, there have been more than 2,000 confirmed cases of the flu.
Wheeler said that state officials have been active in trying to spread the word to keep an eye out for any potential cases of the new coronavirus.
“We have spent a lot of time in the last few days sending out information to doctors around the state, to hospitals, to nursing homes, to universities,” he said. “We’ve talked to businesses who have travelers. We’ve spent a lot of time trying to quickly educate at-risk people about what the signs and symptoms are. We’re also trying to make sure that all physicians are including a screening question — when anybody walks in the door — have you travelled in the last 30 days?”
The red flag, Wheeler said, would be if a person has recently travelled to China and shows symptoms of coronavirus. If people have recently travelled to an at-risk area and show such symptoms, they are advised to contact the Department of Health or their medical provider. The department has set up a call center for such cases; the number is 1-800-803-7847.