How New Orleans, Louisiana And Their Hospitals Prepare For A Coronavirus Outbreak

WWNO - New Orleans Public Radio | By Ashley Dean

Published February 28, 2020 at 3:01 PM CST

This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses.

Update: Dr. Jennifer Avegno, New Orleans Health Department director, brief the New Orleans City Council on Thursday. There are still no known cases of the novel coronavirus in the city.

“We’ve been on top of this for weeks, since very early January when it became obvious that it was going to spread,” Avegno said.

She reiterated advice from the CDC that healthy people do not need masks but do need to wash their hands thoroughly.

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As the coronavirus continues to spread across the globe and the number of people sickened nears 84,000, the Centers for Disease Control and Prevention (CDC) has said a U.S. outbreak is almost inevitable, while Louisiana officials say the risk here remains low.

There are no known cases of coronavirus — or COVID-19 — in Louisiana right now, according to the Louisiana Department of Health. There are 60 diagnosed cases in the U.S. as of Feb. 28, most of which are in people who were aboard the Diamond Princess Cruise Ship. The epidemic — which originated in China — has spread to at least 56 countries, and the World Health Organization has raised the global threat level to “very high.” The New York Times reports some health officials are saying a global pandemic may be inevitable.

In New Orleans and Louisiana, preparations are underway.

“While the CDC now do expect community spread in some parts of the United States, the immediate threat to the U.S. and to Louisiana remains low,” said Alyson Neel, director of communications at the Louisiana Department of Health. “We're not seeing the same level of spread as other countries are seeing. And that said, all of that said, we know it's important to be prepared and we do take it seriously, and that's why we've been preparing and we've been monitoring the situation and reviewing our plans since the outbreak in mainland China earlier this year.”

The bigger threat, she added, is still the flu.

And in fact preparations for a COVID-19 outbreak look much like they do for the flu.

“The CDC has told us that as part of this new guidance that a state should be looking to their pandemic influenza planning,” Neel said. “And that's because in many ways this COVID-19 does behave like the influenza.”

With limited information on how this particular coronavirus works, preparedness looks somewhat general. Stephen Murphy, an assistant professor in the Department of Environmental Health Sciences at Tulane University’s School of Public Health and Tropical Medicine, has been working in public health and emergency preparedness since just after Hurricane Katrina and has worked on preparedness efforts for H1N1 and Ebola. He said local hospitals have “without a doubt” begun preparedness efforts.

That means they’re having conversations about supply chains, walking through protocols for protecting themselves, testing facial respirators and looking at how they can work with partners in the community.

“That’s preparedness 101,” he said.

COVID-19 is not airborne, which essentially means it’s not floating around in the air long after someone who’s carrying it leaves a room. It’s spread by droplets (think coughing) and can live for a little while on hard, nonporous surfaces — but no one knows yet for how long. Research into other coronaviruses indicates it could be anywhere from five to nine days.

So that’s what hospitals are preparing for, Murphy said. They practice how to put on and take off their protective gear and go through training on how to best utilize personal protective equipment like respirator masks. They’re also checking their supply chains for that kind of gear.

“Maybe they look at their supply in-house and start to document, ‘When we reach certain levels of supply cache, at typical usage rates, 30 percent left over, we might re-order. Now we’re going to reorder at 60 percent.’” Murphy said.

They’d also look into their capacity to handle a surge in patients, in terms of space and staffing.

Right now, there’s no vaccine or even an approved medication treatment. But at the Louisiana State University School of Veterinary Medicine, they’re performing “significant research” in an effort to develop a vaccine, the university announced in a press release.

Yes, the veterinary school. COVID-19 is part of a large family of coronaviruses found in animals as well as people.

The research effort is part of the LSU-Tulane Center for Experimental Infectious Disease Research, and the goal is to begin testing vaccines “in a matter of months,” the press release says. That testing would be done in collaboration with the Tulane National Primate Research Center in Covington.

The Louisiana Department of Health is in contact and sharing information with the CDC and local and national partners, and has sent recommendations for screening, testing and protection to EMS and health care providers across the state.

Officials with the city of New Orleans didn’t respond to questions about preparedness at the time of publishing.

Joseph Kanter, assistant state health officer and administrator and medical director for Region 1 (greater New Orleans area) at the Louisiana Office of Public Health, said there isn’t much screening being done at Louis Armstrong International Airport right now, but that could change. As for the seaport:

“The duration of travel from China here by boat is about longer than two weeks, which is the typical incubation period. So that's actually protective for us in this case, as opposed to Ebola where it was under the incubation period. And also, there's a great system in place when anyone on the ship becomes ill. They coordinate with the Coast Guard and with the CDC quarantine station, and we get word about that. And that's been going on. That's normal practice.”

Murphy said private industries should have performed a business impact analyses to figure out how to let employees work from home, or even to stagger their arrival and departure times from an office to avoid large groups in elevators, for example.

At the community level, it comes down to personal responsibility.

“I think No. 1 from the individual perspective is really looking at your hygiene,” Murphy said. “I know it sounds trivial and elementary school level but literally washing your hands, that’s so important. It’s really amazing how many times an individual touches their face.”

And, of course, it helps to have all the information. Here’s a quick guide:

What are the symptoms of COVID-19 infection?

The main symptoms are:

Fever
Cough
Shortness of breath/difficulty breathing
Confirmed cases have ranged in severity. While some are getting very sick and dying, others have little to no symptoms at all.

The CDC believes symptoms may appear two to 14 days after a person is exposed to COVID-19.

How can I protect myself and others?

As of now, there is no COVID-19 vaccine or any medication approved to treat it. The CDC recommends nonpharmaceutical interventions as “the most important response strategy.”

That’s much more straightforward than it sounds. Here are some basic steps:

Get a flu vaccine
Cover your cough
Wash your hands often
Stay home if you’re sick

You should also stock up on food and medications — that way if you do get sick, you don’t need to go out into the world.

What would a U.S. outbreak look like?

Again, the CDC has said an outbreak here is nearly inevitable and “that would translate to large numbers of people needing medical care at the same time.” That could be overwhelming for public health and health care systems, and law enforcement and emergency medical services would also be under stress.

As more people get sick, you’ll find less people at work, at school, on public transportation and in other places where you usually find a lot of people.

How can I stay up to date on this?

The New York Times is on it.

The paper’s live blog includes global and national tracking maps and frequently updated reporting.

You can also check in with the CDC and the Louisiana Department of Health.

More reporting on COVID-19 from New Orleans Public Radio and NPR:

When Coronavirus Struck Seattle, This Lab Was Ready To Start Testing

U.S. Added 273,000 Jobs Last Month, But Economists Brace For Coronavirus Impact

Maryland Confirms 3 Coronavirus Cases, As COVID-19 Spreads In Other States

Trump Visit To CDC Up In Air After Suspect Coronovirus Case Cleared

6 Ways Universities Are Responding To Coronavirus

Coronavirus Test Kits Are In Shortly Supply, Vice President Pence Says

Coronavirus: Your Questions Answered