State and local public health officials gathered Monday with providers and staff at the community nonprofit Asian Health and Service Center to discuss community concerns over the outbreak of Wuhan Coronavirus and what public health agencies are doing to protect Oregonians.
Oregon has no cases of the new virus and the risk to people in the Portland metro area is low, Dr. Richard Leman, chief medical officer in the Oregon Health Authority’s Public Health Division, assured the group.
The United States reported its first case Jan. 21, and the Centers for Disease Control and Prevention reported Monday that the number of cases is now at 11. Of the more-than-17,000 people infected with the virus worldwide, only about 150 live outside China. Still, agencies across the state began last month to prepare in the event an Oregonian does test positive.
“We don’t have anyone with this coronavirus in Oregon. It could happen and that’s why we’re taking these steps to protect the community,” Leman said. “But we do have a lot of cases of influenza... nobody gets excited for some reason about the flu, but that’s causing lots of illness right now.”
Health officials are still learning about this new virus, but it appears to spread the same way as influenza — through droplets when some coughs or sneezes. And while there is no vaccine for the new coronavirus, people can prevent it in some of the same ways — washing one's hands, covering a cough or sneeze, and staying home when sick.
About Wuhan Coronavirus
Leman, joined by Multnomah County nurse epidemiologist Sara McCall, answered questions about the virus itself, symptoms to watch for, and risks to the general public.
“This is a new virus we hadn’t seen before,” Leman explained, “but it’s related to this family of germs we have seen before. That helps us learn from what we already know and it has helped guide us in figuring out how to respond.”
No one is completely sure where the virus originated, but the family of viruses appears to transmit from animals — often bats — into humans, and then spreads between humans. Its name comes from the way the virus looks under a microscope: spikes on the outside made of a mixture of sugars and proteins that look like a crown. The spikes seem to have a role helping the virus stick onto the cells of a bat or a person.
There have been two prior coronavirus outbreaks for which there was no vaccine or cure, including SARS in 2003 and MERS in 2012. The spread of both outbreaks was slowed and eventually stopped without vaccines through standard public health practices that included isolating sick people.
Many of the risks and the precautions for Wuhan Coronavirus are the same as with the outbreak of influenza that Oregon sees each year, which lands thousands of people in the hospital.
Based on what authorities know about other coronaviruses, this particular virus may be able to live on surfaces for a few days, McCall explained. However, even if a virus remains on a surface, it’s unclear for how long it could make people sick because conditions such as sunlight and temperature can weaken or kill a virus.
Symptoms and illness
When someone has been exposed to this coronavirus, symptoms take anywhere from two days to two weeks to appear, Leman explained. Those usually include cough, shortness of breath and a fever. Sometimes people get body aches, as they do with influenza.
If a person has symptoms after traveling to Hubei Province (China) or having contact with someone known to have the virus, they should call a health care provider before going into a clinic, Leman said. That way the doctor can help plan how to see the patient without exposing others to the germs.
Leman shared that while there may be some risk of people without symptoms spreading the virus to others, "we think that risk is much less likely than if a person has symptoms. If someone is coughing, it’s more likely they will spread this infection. If you’re not coughing or sneezing you’re not exposing people in the same way."
Currently, only the CDC performs coronavirus tests, Leman confirmed. If a local health care provider thinks someone is sick with coronavirus, they work with a local public health agency, like Multnomah County, to collect a nasal swab and a blood sample. The local health authorities work with the state to send those samples to the CDC in Atlanta, Ga., where the test is performed.
According to McCall, there is no medicine or specific treatment for coronavirus other than helping people to fight the infection until their immune system kicks in.
Oregon health officials encourage people to take simple precautions against germs and viruses like the flu and the common cold. According to Leman, the same precautions work for the coronaviruses too, including:
Washing your hands with warm water and soap
Covering your cough or sneeze.
Staying home if you’re feeling sick.
While wearing masks is not an official recommendation, Leman emphasized that there are different types of masks. Certain masks can be effective in health care settings when people are trained in how to use a mask consistently and in the right way. Any protection afforded by the mask goes away when someone scratches her nose or lifts the mask away from her face.
Yuling Chen, a mental health provider with the Asian Health and Service Center, works with many elderly Chinese American clients. She said she understands her clients' reliance on masks, despite the absence of an official recommendation for this strategy.
“Our concern is that we work with seniors who may have illnesses to begin with. If one person gets sick everyone gets sick. ”
Leman said that other measures are much more effective.
“There are ways we can protect ourselves from infections,” he said. “Washing your hands and staying away from people who are actively coughing. And if you are sick, stay away from other people so you don’t share that infection. It may sound simple but we say it because it works.”
What if we meet someone who just traveled from China, a provider asked Leman.
“Say hello,” he said, and the staff laughed. “Just because someone has traveled from China doesn’t mean someone has this infection. It really looks like most illness happens when someone is sick and coughing. If you just meet someone who has come from China and they feel fine, I would just say ‘hi.’”