New coronavirus spreads more rapidly than had been anticipated

The rapidly spreading novel coronavirus (Covid 19) is in some ways like the flu, but unfortunately it’s at least ten times more lethal to those who contract it. Influenza kills about one-tenth of one percent of people who get it. The death rate for cases of the novel coronavirus seems to be somewhere between one and two percent. We don’t know for sure because at the start of an outbreak the apparent mortality rate can be an overestimate if a lot of mild cases are being missed.

We’re only at the beginning stages of finding out how this dangerous pathogen behaves and what we can do to slow its transmission. There are no known or divulged cases of Covid 19 in Ulster County as of Tuesday, March 3 — four people who visited China and returned to Ulster voluntarily self-isolated for 14 days and were found to be free of the virus. But we note with apprehension the number of new cases nearer and nearer to where we live. This new threat is likely to exert an increasingly profound influence on human lives for some time.

Influenza as a menace to public health has been around a lot longer. The federal government and the states have accumulated sophisticated data-gathering systems to monitor its incidence. A very rough estimate is that this season 40 million Americans contracted a strain of it from the first beginnings of the flu season in October through late February. Of those afflicted with flu this year, the Centers for Disease Control (CDC) has estimated, about half have sought medical advice. A half-million people — roughly one in every 80 cases — have required hospitalization. And somewhere between 30,000 and 40,000 influenza-related deaths will be recorded nationally.

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State health departments keep track of the numbers by county. The New York State Flu Tracker updates its online data weekly. As of the week ending February 22, there were 131,604 positive influenza laboratory reports in New York State. In the same period, 392 flu cases had been reported in Ulster County.

There were only 28 Ulster County flu cases during the early weeks of the season through the end of 2019. The weekly count of new cases in the county since then increased from 17 the first week of 2020 to a peak of 78 new cases in the week ending February 8. Since then, the weekly numbers have begun to drop: 66 Ulster County new cases in the week ending February 15 and 51 in the week ending February 22.

If the usual pattern of seasonal incidence holds, there’ll be about 150 more Ulster County flu cases before the end of this year’s season. That total will be modestly higher than last year’s flu season, but significantly lower than each of the two seasons prior to that.

Some neighboring counties have been heavier hit by the flu than others. Despite having less than a third of Ulster’s population, Delaware County has had more confirmed flu cases than Ulster this year. The same for Sullivan County. The more urbanized parts of the New York metropolitan area have had more cases per thousand of population this year, with Bronx County the most afflicted.

 

New York State gears up

New York State and county health authorities have lots of experience handling emerging infectious diseases. The state’s hospitals say that they are prepared to handle any patient who presents with coronavirus. All facilities follow strict infectious disease protocols that begin with immediately isolating the patient so that staff and the public are kept safe. After an incomprehensible period of bureaucratic delay, not just the CDC but also the states now have access to Covid 19 test kits, which expedite diagnosis, and state labs can evaluate the results.

In a further development on Monday, governor Andrew Cuomo announced a partnership of the state’s central lab in Albany with private hospitals to expand testing capacity to 1000 tests per day statewide for the coronavirus. The state will supply hospitals with instructions on how to replicate the state’s test and help them purchase some of the equipment necessary to develop and validate the test.

Ulster County government has dedicated emergency funding to combat the further spread of the virus locally. (See “Ulster County health infrastructure readies for coronavirus cases.”) “Protecting the health and safety of our residents is my absolute top priority,” said county executive Pat Ryan on Monday. “The people of Ulster County should take comfort in knowing that we are prepared, and that have been preparing for weeks, to handle this situation. We will continue to provide the public with updates and we ask that all residents do their part to help prevent the spread of the virus by following preventive measures and reaching out to our health department with any concerns or questions.”

“Anti-viral drugs and supportive therapies are the best defenses we have to fight this virus,” says Suburban Hospital Alliance CEO Kevin Dahill. “Once one is diagnosed with the coronavirus, rest, fluids, and fever reducers are in order. This is the same treatment plan in place for the seasonal flu.”

Covid 19 has a higher chance of leading to serious respiratory symptoms than seasonal flu. Other at-risk groups like health workers are more vulnerable because they are likely to have higher exposure to the virus.

 

Lots of coordination

Today, in every hospital emergency department, patients are asked whether they returned from recent travel outside the United States whether or not there is a current pandemic in place. The state requires hospitals to hold surprise emergency preparedness drills on a regular basis.

Hospital staff have been in constant communication with the CDC, the state health department and county health departments about the most up-to-date information about the spread of the disease. Infectious disease control procedures and methods are in place. At the very local level in the Hudson Valley — MACE — Mutual Aid Coordinating Entity – works cooperatively to keep tabs on regional supplies and personnel resources.

Common signs of infection include fever, cough, shortness of breath and breathing difficulties.  In more severe cases, infection can cause pneumonia, kidney failure and death.

The best defense right now, Dahill says, is to frequently wash one’s hands, cough and sneeze into one’s elbow, stay home if any signs of viral infection emerge, and place a call to one’s physician for further instructions.

This is the same advice public-health officials give for combating the flu.