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By Anne Blythe

Even before news feeds were disseminating story after story on the coronavirus outbreak in China, North Carolina’s state epidemiologist and others dedicated to protecting the public’s health were in high gear.

Zack Moore, the state epidemiologist and a physician who has been with the North Carolina Division of Public Health since 2006, outlined some of the behind-the-scenes work that he and his colleagues have been doing during a meeting this week of the Joint Legislative Oversight Committee on Health and Human Services.

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Related: Flu season hits hard in North Carolina

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It’s important to note that North Carolina has no reported cases of the virus, Moore told the lawmakers gathered Tuesday. On that day, there only had been 13 cases reported in the United States, two of which were transmitted by person-to-person contact by people who knew each other.

By Thursday, another two cases had been reported in the U.S., the most recent being at Lackland Air Force Base in Texas, where the patient was under quarantine after being evacuated from China on a  Feb. 7 chartered flight.

“Globally and in the U.S. and North Carolina, this really is a very rapidly evolving situation,” Moore said Tuesday.

Because of that, it was difficult to provide concrete answers for lawmakers who wanted to know, flat out: Is the coronavirus coming to North Carolina, and if so, had bad could it be?

“There are a lot of uncertainties so we need to acknowledge that we could end up with widespread transmission in North Carolina and across the country,” Moore said in response to a question from Sen. Ralph Hise, a Republican from Spruce Pine. “We could end up with a situation more like SARS where we were able to contain it. … It’s certainly our plan to be prepared for a situation of widespread transmission so that we’re not caught off guard if that does happen.”

They are planning for the worst and hoping it’s all for naught.

WHO gives official name

Coronaviruses are a large family of viruses transmitted between animals and humans that can cause illnesses ranging in symptom severity from little more than a common cold to the more extreme problems associated with MERS, or the Middle East Respiratory Syndrome, and SARS, or the Severe Acute Respiratory Syndrome.

Only two people tested positive for MERS in the U.S., according to the CDC, and though there were more SARS cases, 115 from 29 states, that disease was quickly contained with no deaths being reported from either outbreak in this country.

The newest coronavirus was detected late last year in Wuhan City in China’s Hubei Province. The genome sequence shows it to be a betacoronavirus, which according to the Centers for Disease Control and Prevention, has its origins in bats, similar to MERS and SARS.

Zack Moore, state epidemiologist, briefs NC lawmakers on plans for potential coronavirus outbreak.Photo credit Anne Blythe

Early on, many of the patients in the outbreak area had some contact with a large animal and live seafood market, raising the possibility that it was being spread to people from an animal. But as the disease became more prevalent, virus trackers noted that more and more patients had no exposure to animal markets, leading them to believe it was moving from person to person.

Of the 15 cases detected in this country, the CDC has seen the virus spread among returned travelers, but not into the larger community.

California has the bulk of the cases confirmed in this country, with eight as of Thursday. Illinois has two and Arizona, Massachusetts, Texas, Washington and Wisconsin each have one.

Knitting together networks

The three new cases in this country came in the same week that Gov. Roy Cooper created a task force to “monitor, prepare for and respond” to the potential for an outbreak in this state.

“Though currently the risk to North Carolinians is low, we are taking a proactive approach and are prepared for potential scenarios,” Cooper said in a statement. “This task force will continue coordination between our agencies and federal partners so we can keep the public informed and safe.”

The announcement of the task force also came in the same week the World Health Organization gave the illness the official name of COVID-19, which Tedros Adhanom Ghebreyesus, the organization’s director-general, noted on Twitter could “not refer to a geographical location, an animal, an individual or group of people.” It also had to be easy to pronounce, according to his tweets.

Providing an official name not only creates a uniform reporting of the virus, but it also casts aside the potential for a stigmatizing name to develop against a certain region or specific animal.

Dr. Elizabeth Cuervo Tilson, the state health director and chief medical officer for the Department of Health and Human Services, is leading the task force with Mike Sprayberry, the state’s director of emergency management.

Tilson already has issued a temporary order that requires all physicians and labs to report suspected cases to the state. That way, the state can help isolate the patient while testing continues to determine whether it truly is a case.

Moore and others at the state level have been working with local health departments to coordinate information sharing, which is not uncommon.

They also are in regular contact with the CDC and other state epidemiologists to keep the lines of communication as open as possible.

Funneling travelers into U.S.

This can mean long days and short nights, particularly for epidemiologists and lab workers near any of the 11 U.S. airports chosen as the sites for any U.S. citizens returning from China. On Jan. 31, as TV screens and social media feeds ramped up fear about a virus with many unknowns, the Trump administration issued an order limiting any travel into this country from China to U.S. citizens and Chinese nationals who are immediate family to or spouses of U.S. citizens.

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TO AVOID CORONAVIRUS, FLU AND OTHER INFECTIOUS DISEASES

Wash your hands often. Use soap and water for 20 seconds. Alcohol-based hand sanitizers help, too.

Cover your mouth and nose with a tissue or your sleeve when coughing or sneezing. Hands are a no-no.

Avoid exposure to others who are sick.

Stay home when you are ill.

If you have questions or concerns related to COVID-19, call 866-462-3821 for more information. Press 1 for English or to ask for a language interpreter. Spanish speakers should press 2. To submit questions online, go to www.ncpoisoncontrol.org and select “Chat.”

The DHHS Division of Public Health website also has resources. www.ncdhhs.gov/coronavirus and on the CDC’s website at cdc.gov/coronavirus.Source: Gov. Roy Cooper. [/symple_box]

No North Carolina airports were chosen as funneling sites, Moore told the lawmakers. They are in Atlanta, Chicago, Dallas, Detroit, Honolulu, Los Angeles, Newark, New York, San Francisco, Seattle and just outside Washington, D.C.

At the airports, Moore explained, the travelers are screened for symptoms and if they show any they are isolated immediately. If not, they are self-monitoring at home, usually with public health workers checking in daily, or more, for 14 days.

If any of those travelers experience symptoms over the next 14 days, they’re asked to call public health officials before seeking treatment so the health care providers can ensure isolation and prepare against any person-to-person spread during examination and testing.

In an effort to keep perspective on the COVID-19, public health officials continue to point out that influenza is much more prevalent in this country and state. North Carolina has had 75 laboratory confirmed  flu deaths this season, with nine new deaths confirmed last week, according to DHHS data.

That comparison brought a question from Rep. Donny Lambeth, a Winston-Salem Republican at the Joint Legislative Oversight Committee earlier in the week.

“Is this similar to the flu in which it has a seasonal component?” the lawmaker asked, noting the lower number of cases in late spring, summer and early fall.

“That is definitely the case of most of the coronaviruses we see,” said Moore. “We expect this one might have a seasonality to it.”

But much remains unknown about the newest coronavirus.

Anne Blythe

Anne Blythe, a reporter in North Carolina for more than three decades, writes about oral health care, children's health and other topics for North Carolina Health News.

6 replies on “Coronavirus risk remains low in NC, but health officials plan for it just in case”

    1. According to the CDC’s latest update, “Similarly, the role of pre-symptomatic transmission (infection detection during the incubation period prior to illness onset) is unknown. Existing literature regarding 2019-nCoV and other coronaviruses (e.g. MERS-CoV, SARS-CoV) suggest that the incubation period may range from 2–14 days.”

      There’s some evidence that the incubation period could be longer, but the situation is quite fluid and this virus is quite new. New research is being done all the time and I’m sure we’ll learn plenty more about coronavirus over time.

      What we do know is that there have been no fatalities from coronavirus in the US, and there are only several dozen known cases in this country of more than 330 million. Meanwhile, this year’s influenza virus continues to circulate and we know that at least 75 North Carolinians have died from flu as a result, while tens of thousands in our state alone have become ill from the flu.

      The prevention messages for both coronavirus and flu remain the same: cover your mouth and nose when you cough, stay home if you feel sick and wash your hands, wash your hands, wash your hands.

  1. Parents with students at NCSU are now in a panic with the news that students studying aboard were being returned home starting this week.
    NCSU has has not issued a quarantine plan for these student returning back on campus.
    Furthermore, Spring break start next week. Again NCSU has no information for those student leaving on vacation.

    1. Thanks for the tip! We’ll definitely be checking out how schools respond to coronavirus.

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