PASSENGERS ARRIVE at Heathrow Airport in London after the last British Airways flight from China touched down in the United Kingdom following an announcement that the airline was suspending all flights to and from mainland China amid the escalating coronavirus crisis Wednesday. Local, state and global health leaders are monitoring the virus but implore people to avoid panic. Instead, they suggest all citizens get their flu shot. (Photo by the Associated Press)

By SARA ARTHURS

Staff Writer

Area public health leaders, like their counterparts around the globe, are keeping an eye on the new coronavirus and reviewing plans to prevent infectious disease in general. Want to help? Don’t panic — and get your flu shot.

The 2019 novel coronavirus (2019-nCoV) is causing an outbreak of respiratory illness first detected in Wuhan, China. As of Friday, seven cases had been confirmed in the United States. The Centers for Disease Control and Prevention website reports that 240 patients were under investigation, but 114 had tested negative. Results are pending on the rest.

As of Friday afternoon, the Ohio Department of Health reported no confirmed cases in the state. Two Miami University students are considered suspected cases, and testing is pending.

And while the sixth U.S. confirmed case of the virus is known to have visited Cleveland, the Ohio Department of Health tweeted Thursday night that it, along with the CDC and the Cuyahoga County Board of Health, had determined the individual “was not infectious during his day trip to Cleveland. It is important to remember the U.S. is still low risk for nCoV.”

Many of the first patients in China “reportedly had some link to a large seafood and animal market,” which suggests the virus spread from an animal to a person, but later cases have indicated it can also spread from one person to another. At this point, it’s not clear how easily, the CDC reports.

Monitoring the situation

There are four common human coronaviruses, and others have been responsible for previous outbreaks of Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), said Steven Martin, dean of the college of pharmacy at Ohio Northern University, who did postdoctoral study in infectious disease and critical illness. The viruses can infect anyone, but are most dangerous to young children, very old people and people who have weakened immune systems. They are transmitted by close personal contact, coughing and sneezing, like the flu.

Martin answered The Courier’s questions via email while on vacation. He pointed out, “I’ve had to travel through airports and on airplanes, and those seem to be areas where there is high risk for infection. That didn’t stop me from heading out.”

Hancock Public Health has been on conference calls with the CDC and state health officials and has reached out to local health care providers and the University of Findlay, said Chad Masters, epidemiologist and emergency response planner. (After the suspected cases of novel coronavirus at Miami University, the Ohio Department of Health asked local health departments to reach out to universities.)

ODH Director Dr. Amy Acton has declared the virus a class A reportable disease in Ohio, meaning doctors must report confirmed or possible cases immediately to a local health district.

“Everyone’s antennae are raised up” and they’re paying attention, but that doesn’t mean you need to be “alarmed,” Masters said.

Tara Smith, Ph.D., said she hoped the Miami University cases would not generate fear. The Hancock County native is a professor of epidemiology in the College of Public Health at Kent State University. (Epidemiology is the science of how disease develops and, in infectious disease, how it spreads from person to person.)

She said keeping the students in isolation “should be standard protocol.” She explained other things public health officials would do to limit the spread of illness. Even before knowing if the suspected cases will become confirmed, they would likely already be doing “contact tracing,” or investigating who the students had come into contact with and then monitoring those individuals for symptoms.

“I believe the CDC and the state health department are doing the right things” to prevent further spread of the virus, Martin wrote. “Public understanding is the greatest preventative measure.”

Dr. Nathaniel Ratnasamy, director for infection control at Blanchard Valley Health System and medical director at Hancock Public Health, said the hospital will be asking patients about their travel history. There’s an established process in place for how to identify and isolate a sick person, which grew under the guidance of the CDC and ODH, he said.

Locally, ever since outbreaks of other viruses around the world in years past, like Ebola and the H1N1 flu, “There’s been a plan in place,” he said.

So, Masters said, Hancock Public Health, Blanchard Valley Hospital and others are all on the same page and “continue to build our preparedness and planning efforts.”

The general public plays a role, too. Masters encouraged people to stay home when sick and keep sick kids at home, cough into your elbow rather than your hands, and wash your hands frequently. Ratnasamy added you should avoid touching your eyes, nose or mouth with unwashed hands.

Martin gave similar advice to his daughter, a student at Miami University. While noting that the possibility of cases at that school “brings this global problem to our back door,” he said other than common-sense precautions like staying away from sick people, “I advise people to go about their daily business. Stay home if you feel sick so you don’t risk infecting others.”

Masks are not perfect, and must be used correctly, but if you’re actively coughing and you need to leave your home (say, to go to a doctor), wearing a mask can help contain the spread of illness, Smith said.

Smith said a lot of what’s scary about the novel coronavirus is the unknown. “We don’t know how it’s going to play out.”

And the ODH, on its website, said, “Health experts are concerned because little is known about this new virus.”

Ratnasamy said “it’s very early” to determine how worried people need to be about the new coronavirus. But, he said, “It’s phenomenal that the virus has been identified and its RNA sequence has been released” so scientists can work on treatments and vaccines.

The likelihood of it coming into our area is “not zero” but locally, right now, “the imminent threat is low,” Ratnasamy said.

Flu and you

“What’s common here is influenza,” Ratnasamy said.

He said Blanchard Valley Hospital hasn’t had a lot of patients hospitalized with the flu, but there have been “a lot of outpatient cases.”

Since this year’s flu season started last fall, about 8,200 Americans have died and about 140,000 have been hospitalized with flu.

“Imagine if that was with a new virus,” Smith said. “People would be freaking out.”

But for the flu, that is just a normal year. And Martin pointed out that Ohio is still approaching the peak of its flu season, which is usually in February.

Smith said those who are vaccinated are about half as likely to get the flu as those who are not. But, if you do get sick, being vaccinated can help prevent a more lengthy illness or serious complications.

If you are vomiting and nauseated, although we call it stomach “flu,” that is probably actually another virus, like norovirus. Influenza involves a quick onset of headache, fever and muscle aches. Basically you feel “like you’ve been hit by a truck,” Smith said. If you’re feeling like that, “please, please don’t go out in public,” she said.

Some people are sick for just a couple of days, others for a week. An antiviral drug, Tamiflu, can help shorten the symptoms. The most serious complication is usually pneumonia. If you’re having trouble breathing or feel “like someone is sitting on your chest,” go to the doctor, because that can be dangerous.

Smith noted that the CDC recommends a flu shot for everyone 6 months and older. By getting the shot you not only minimize the risk you’ll get infected, but also the risk that you’ll transmit it to others. “You’re not only protecting yourself,” but elderly people you may encounter (as the shot doesn’t work as well in that population) or babies too young to get the flu shot. If you are immunized, the virus cannot replicate in you.

“The more people we can get protected, the less virus that’s going to be circulating around,” Ratnasamy said.

As for the people who say they got a flu shot and it gave them the flu? “It’s scientifically impossible,” as the flu shot is a killed virus, Smith said.

She said individuals might get a mild fever after getting the shot, because their immune system is responding to the vaccine. Also, it takes about two weeks for the vaccine to work. So if you’re exposed to the flu during that period, you can still get sick.

The flu usually circulates through April, so it’s not too late to get a shot.

“Get it now,” Smith said. (Masters said the health department has vaccine available. Call 419-424-7105.)

When Martin was interviewed by The Courier in 2018 for a story on the 100th anniversary of the 1918 Spanish flu pandemic, he said those who get a flu shot every year have “a lot of immunity built up.” Your body will in essence “remember” each strain it has been immunized against, so if you get the vaccine every year, you’re building a collection of many different strains. Then, if you’re re-exposed, it can influence your immune system to rapidly develop more of those antibodies. Even if this year’s strain is a virus you haven’t previously been immunized against, if it is similar, you may have partial immunity, he said.

Smith said throughout human history we’ve experienced extreme pandemics, like the Black Death and the Spanish flu. We have a “collective memory” of those things as a species. And, in fiction, there are movies about pandemics that lead to apocalyptic situations. But she doesn’t anticipate that happening now on that scale, although she noted that “people have died” and that is terrible for those affected.

Ratnasamy said anytime something new like this occurs it tends to cause “a lot of anxiety. … Anxiety’s normal. But until we get more information” we don’t know that it’s warranted.

He said we do need to watch the new coronavirus “with caution.” But he also pointed out that roughly four Americans die in a traffic accident every hour, “and we don’t stop driving.”

Martin wrote that today, compared to 1918, “I think health systems are in a much better position to deal with mass infections and severe illness. We also have a much better global communication system so that public awareness can be maximized.

“Nonetheless, people are dying from the latest coronavirus outbreak … and that means the virus can be dangerous,” he wrote. “We should be vigilant here in the U.S. and in Ohio, and smart.”

Arthurs: 419-427-8494 Send an E-mail to Sara Arthurs

Twitter: @swarthurs

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