One of the first things that Medina County Doctor Richard Neel pointed out to us is that local doctors do not have access to testing kits for Corona Virus, should they want to test anyone. Medina County Health Director Patricia Mechler confirmed that she has reached out to ask about testing kits, but did not get an answer on when those would be available to local doctors.
“Sometimes I have a patient with fever, sneezing, cough–upper respiratory symptoms– and they are negative for the flu, strep, RSV, and pneumonia, it kind of leaves us hanging. I can’t say it’s the Corona Virus, but I have no way of ruling that out…I asked the county health department for kits this morning, but we do not have any and do not know when they will be available. I was just trying to be a little proactive. That was before I heard about the patient at North Star Mall (where one of my sons works). Supposedly there are only 75,000 kits in the country as of Saturday. There are supposed to be a bunch more today (Monday).”
We asked Dr. Neel for his thoughts on the virus. Dr. Neel, who many will know from the Little Alsace Urgent Care Clinic in Castroville, has a Master’s Degree in Public Health from Harvard University. Neel also served as a subject matter expert in the US Pentagon for military defense of chemical and biological weapons from 1998-2003.
Quarantine issues
We also discussed some of the quarantine measures which he feels are inadequate. The first group of people quarantined in San Antonio over the coronavirus were still released 14 days after quarantine began, even though one of the subjects tested positive halfway through the quarantine.
“When that happens, quarantine should start over for another 2 weeks for the rest of that group with that exposure,” Dr. Neel said. “Some things require common sense.”
Currently, when a quarantine patient tests positive for the virus, only those who are staying in the same room with them are held for additional time, not everyone who traveled with them to the US.
Mortality rate much higher
Many people are writing off cautions, by comparing the virus to the flu, but Dr. Neel points out there are important differences.
“The flu has a .1% mortality rate, whereas the mortality rate of the Corona Virus might be 1-2% and looks like it might be as high as 4.4% for elderly people. That’s a huge difference,” Dr. Neel said. “For a lot of people, it might not be any worse than the flu, but for a lot of other people, especially people over 70, it’s going to be deadly. You can see that just from the deaths in Washington State. And if it’s your grandparents or parents who are getting exposed to this virus because people think it’s just the flu–or not any worse than the flu–you might feel differently.”
“Another problem with this virus is that many people who survive it are still having to remain on a ventilator for a week or two. That’s what was initially one of the most disturbing things to me….seeing that the huge wards of people on ventilators in China,” Dr. Neel said.
“When this virus gets into a nursing home, a big office building, a church, a school, that’s when it’s going to be the biggest problem. I was encouraged that they did the right thing by shutting down North Star Mall right away after the Corona Virus patient went into the mall. They attacked the situation right away by shutting the mall down and de-contaminating all surfaces, and that’s what it’s going to take,” Dr. Neel said.
Dr. Neel will join the CDC’s conference call on Thursday and hopes to learn more about the virus. A flyer about the conference for the medical community states it will instruct clinicians on how to “prepare for the COVID-19 including identifying persons under investigation, apply infection prevention and control measures, assessing risks for exposures, optimizing the use of personal protective equipment, and managing and caring for patients (inpatient and at home).”
1918 Flu Pandemic before vaccines
Interestingly, according to the CDC, it is estimated that about 500 million people or one-third of the world’s population became infected with this the flu during the Flu Pandemic of 1918. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States. The 1918 influenza pandemic was the most severe pandemic in recent history. With no vaccine to protect against influenza infection and no antibiotics to treat secondary bacterial infections that can be associated with influenza infections, control efforts worldwide were limited to non-pharmaceutical interventions such as isolation, quarantine, good personal hygiene, use of disinfectants, and limitations of public gatherings, which were applied unevenly (Centers for Disease Control).
“Flu in 1918 killed more people than the war,” Dr. Neel adds.
Devine ISD sends out message to parents
Devine ISD sent out a notice to parents regarding actions they are taking to keep students safe. A meeting of San Antonio area school Superintendents will take place this Wednesday to further discuss the concerns with health officials, along with plan for the continuation of educational services for our students should schools be affected in any way. TEA as well as SA Metro Health officials will be there to brief educators.
A letter from Superintendent Todd Grandjean stated, “We want to make sure you have accurate information regarding how DISD is handling concerns about the coronavirus and recent media coverage surrounding the respiratory illness. I want to assure you that DISD is keeping track of the situation through proven and trustworthy sources: Medina Health Care Unit, San Antonio Metropolitan Health District, the Texas Department of State Health Services DSHS), and the Centers for Disease Control and Prevention (CDC). We are following their guidance regarding appropriate screening and infection control. These health officials believe the risk to the San Antonio area and our school community is low at this time.”
“Based on the current information, health officials are recommending local communities and schools should take the same steps to protect against coronavirus as we take to prevent the spread of everyday illnesses like the common cold or the flu: Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer. Avoid touching your eyes, nose, and mouth with unwashed hands. Avoid close contact with people who are sick. Stay home when you are sick. Cover your mouth and nose with the inside of your elbow when you cough or sneeze. Clean and disinfect frequently touched objects and surfaces.”
Testing
According to the CDC, State and local health departments who have identified a person under investigation (PUI) should immediately notify CDC’s Emergency Operations Center (EOC) to report the PUI and determine whether testing for COVID-19 at CDC is indicated. The EOC will assist local/state health departments to collect, store, and ship specimens appropriately to CDC, including during afterhours or on weekends/holidays.
As of Tuesday afternoon, there had been 9 deaths and 115 cases of Corona Virus reported n the US.