7 March 2020 Blog Post: COVID-19 Update

Worldwide cases of the novel coronavirus passed 100,000 yesterday and as of this morning stand at 102,471 with 3,491 deaths. In the US, there are now 340 confirmed cases with 14 deaths and 8 recoveries.

The largest new cluster of cases is on the Grand Princess cruise ship which has 21 cases. The ship has moved to a location 20 miles off the San Francisco coast for easier delivery of supplies. A total of 46 individuals were tested. While there are no details on why certain people were tested one would reasonably imagine that testing was based on suggestive symptoms. Test kits, which are in scarce supply, were delivered to the ship via California National Guard’s 129th Rescue Wing helicopter. One cannot help but find the testing process on the Grand Princess symbolic of our health system somehow -one that utilizes helicopters to airdrop tests in one location while there remain 5 states (Maine, Idaho, Oklahoma, Ohio and West Virginia) cannot even test at this time.

At a most confusing press conference CDC yesterday, President Trump wondered if these cases ‘count’ towards the US total and stated “Frankly, if it were up to me, I would be inclined to say leave everybody on the ship for a period of time and use the ship as your base.”

In short, the cases do ‘count’ as our public health system is responsible for managing known cases and limiting spread. More confusing is the concept that passengers (particularly the 25 individuals that tested negative) should remain on the ship. In general, a viral infection accelerates in the close quarters and shared facilities of a cruise ship. Norovirus spread through a ship is notoriously swift for instance.

More germane, however, is that we have already had experience with #COVID-19 and a cruise ship quarantine – and it didn’t work out particularly well. On February 3, 2020, 10 people aboard the Diamond Princess cruise ship tested positive for the new coronavirus, each developed the resulting illness. By February 4, the people with COVID-19 had been isolated from the rest of the passengers and when the ship reached Yokohama, Japan, local authorities placed it under quarantine. Those who tested positive for COVID-19 were isolated in a hospital. The remaining crew members and passengers were not able to disembark until February 19. By the time the authorities lifted the quarantine, 17% of the 3,500 people aboard the ship had contracted the SARS-CoV-2 virus.

Summed up succinctly by Dr. Anthony Fauci

“The quarantine process failed,” Fauci said. “I’d like to sugarcoat it and try to be diplomatic about it, but it failed. People were getting infected on that ship. Something went awry in the process of the quarantining on that ship. I don’t know what it was, but a lot of people got infected on that ship.”

At Santa Monica Primary Care we continue to monitor patients with fever, cough and upper respiratory symptoms by telemedicine and video conferencing modalities. We have had initial return of general viral test kits in patients with persistent or more worrisome symptoms. Thus far, we have isolated another viruses as the likely causes of symptoms and have yet to have any cases that needed hospital evaluation. We remain unable to access #COVID-19 test kits directly.

As always, if you have concerning symptoms or questions, please do contact us at (310) 828-4411

link: https://www.ksbw.com/article/coast-guard-helicopter-drops-off-covid-19-test-kits-to-cruise-ship-off-california-coast/31253201

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