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Coronavirus update: Shawnee physician explains prep effort against COVID-19

Vicky O. Misa
On Friday afternoon, about 40 area business owners and organization leaders attended an impromptu informational meeting hosted by SSM Health St. Anthony Shawnee and Shawnee Forward where they heard from Dr. Scott Stewart about COVID-19. Stewart talks to SSM Health St. Anthony Shawnee President Angi Mohr just before the meeting.

VICKY O. MISA STAFF PHOTOS

In an impromptu meeting Friday afternoon, SSM Health St. Anthony Shawnee and Shawnee Forward assembled an informational forum to keep locals up-to-date on the country's rapidly-developing circumstances regarding COVID-19 — a new strain of coronavirus.

The last-minute meeting was spurred by the volume of calls to the hospital.

Addressing about 40 area business owners and organization leaders heard from Dr. Scott Stewart explained issues around the strain, presented the latest news from the Centers for Disease Control and Prevention (CDC), discussed best practices for avoiding spread of the virus, and also fielded questions.

SSM Health St. Anthony Shawnee President Angi Mohr said the purpose of the gathering was to offer local organizations tools and tips on how to handle COVID-19.

She said she has been receiving calls about what organizations can do protect employees, especially as many come back from Spring Break next week.

“To answer your questions, yes, the hospital is prepared for COVID-19,” she said. “We have been doing disaster drills for several years around respiratory illness and disease — for H1N1, Ebola, that type of thing, so disaster drill with respiratory is not anything we have not been prepared for.”

She said she feels her staff is prepared for an influx of patients regarding respiratory disease.

Regarding common terms associated with this type of outbreak Mohr clarified the difference between isolation and quarantine.

“Our health-care providers are very used to working in isolation situations,” she explained. “We have patients in our building all year-round that are at different levels of isolation.”

She said her staff is very comfortable working in situations where they have to put on protective equipment — hats, gloves, masks, gowns — to take care of patients with a variety of diseases, including things like pneumonia and flu.

“We're constantly monitoring the CDC website,” she said. “Those are the guidelines that you can pull up; you will know exactly what we're using; that's where we're going for our resources.”

Mohr said those guidelines are changing frequently, so routine monitoring of the site is encouraged.

She also said constant inventories are being kept of supplies at the hospital to ensure what's needed is there if an influx should occur.

Many of the questions from resident calls can be answered at the CDC website, she said, but for additional questions like when should someone be tested, the Oklahoma State Department of Health is a good resource for that information.

Mohr said the decision on who should be tested is not done locally.

“That comes from a State Health Department level, and so we are looking to them for guidance,” she said. “They go through and screen our patients that we may or may not need to test.”

She said the hospital is in discussions on whether to restrict visitors.

“We do know that nursing homes within our own community have restricted visitors; we are not to that point yet, but we are discussing it,” she said. “These things are changing frequently throughout the day, so today I might say we aren't restricting visitors, but that could change within an hour or day as we figure out what we should and shouldn't do.”

Dr. Scott Stewart first offered a brief background on the virus.

“Coronavirus has been around a long, long time,” he said. “We've known about coronaviruses for a long time; when they talk about COVID being a new virus what we don't mean is that this is a new strain of virus.”

He said it's just a different sub-type of a virus that's been known for a long time. It infects animals; it infects humans, he said.

“The two notable coronavirus outbreaks that we've had in the recent past have been SARS and MERS,” he said. “Those were coronaviruses just like COVID-19.”

He said it's a family of viruses, sometimes it causes very mild disease in other strains.

“We are aware of it and we test for other forms of coronavirus relatively routinely,” he said. “You may know people whose child goes to Children's Hospital and they think they have RSV and get told the child has coronavirus; before this coronavirus came out that was very obvious that they had another milder form of a respiratory virus and nobody got alarmed about it.”

Now, he said when people look back at those reports and see coronavirus, it sometimes creates alarm.

“But it's not all COVID-19,” he explained. “We weren't testing for COVID-19 several months ago; now we know about it and testing is starting to become more available.”

He said it's important to know this virus has been out there and has been causing disease for a long, long, long time — it's this particular strain that we've not seen in human population until recently.

The level at which COVID-19 is important to note.

“We were hearing on the news, globally, that we were seeing a lot of community transmission — people passing the coronavirus from person to person,” he said. “That's why travel was shut down and hearing about countries where outbreaks were community-spread.”

Stewart said as of noon Friday, he was not aware of any community spread of coronavirus in the state of Oklahoma.

“The cases that Oklahomans had are from direct contact or travel from outside the U.S. — not that we're having people spread it from person to person; that is an important distinction.”

He said that doesn't mean that won't happen at some point; it is happening in other places in the world.

“It may happen here,” he said. “That's why we're being so vigilant and pushing so hard to make sure we have good hand-hygiene, try to separate people, encourage people to stay home and not travel, because what we don't want is to get a strong person-to-person transference going.”

The virus is very successful, just like the flu and other respiratory pathogens this time of year, he said.

“Viruses are very good at infecting people,” Stewart said. “That's how they keep going.”

COVID-19 is spread by droplets that land on things and surfaces, but the main way these viruses affect people is by coughing micro-bits of liquid into the air that is inhaled or gets on someone's eye or mucous membrane, he said.

“We think a six-feet rule is a safe range for communication for this virus; we know it can live on surfaces, but when you start talking about a virus on a surface and someone touching it, that's a much lower risk of getting enough viral contact for infection,” he said.

“What we know is based on the coronavirus family, like SARS and MERS; we've been studying those for years,” he said. “The more we see it, the more we will learn about the new strain.”

He said there aren't any positive cases in Pottawatomie County.

“Right now our community prevalence is zero,” he said.

That could change; it's also possible mild cases could be around that are unknown right now, Stewart said.

“We aren't going to know how prevalent it is until we test thousands of people,” he said. “When influenza starts every year, we start testing and seeing patients with consistent flu-like symptoms.”

He said once a physician gets a feeling for the symptoms they may stop testing because the likelihood is high enough that the symptoms are almost always going to come back as the flu and testing is no longer necessary.

“We don't have a feeling for that yet (for COVID-19),” he said. “Right now, our community prevalence is low; that's why testing is important.”

He said test kits are starting to come, but are limited because it is being tested all over the country.

“All of our testing comes through the state health department,” he said. “As early as next week we think we're going to have some private lab that will start offering testing.”

But just like any other medical test, he said residents will have to go to their physicians or clinics for screening.

Also, there can be other reasons for symptoms, he said.

“We're still getting lots of Influenza A and B cases,” he said. “There are a lot of explanations for respiratory diseases.”

Stewart said if someone has a cough and a fever, they likely have something other than COVID-19.

“At the moment, our community exposure is low,” he said. “If you want to know what to do in certain situations, go to cdc.gov; it's a great resource of information.”

If an employee is sick, he encourages business owners to send them home.

“In an outbreak and with something we don't understand, it's important to keep people at home,” he said. “It's true for flu virus, it's true for any other respiratory illness; they don't need to be at work, and its better for customers and other employees, etc.”

He said he thinks what most are worried about is not the disease itself, but the strain on manpower and supplies.

He said if the virus does come, he would rather see cases trickle in than a big surge, becoming a huge resource consumer.

“When we're talking about isolation and not going to large events, canceling activities, a lot of that is just about not letting this virus get a foothold in a large population of patients so we can manage patients who get sick without overloading our healthcare system or resources,” he said.

Stewart said information is changing — sometimes multiple times a day — so monitoring the site is encouraged.

For more information about COVID-19 and updates on the situation, residents also can visit coronavirus.health.ok.gov or call (877) 215-8336.

Read more next week about the meeting and watch for updates.

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Tips for business owners and organizations:

• Send sick employees home; make them stay home until they are fever-free for 24 hours

• Suspend HR policy requiring a doctor's note to return to work; health care facilities have to assess a person before issuing a note, and can get overwhelmed with patients when illness is rampant

• Promote respiratory illness etiquette and hygiene — wash hands often with warm water and soap; limit handshakes, hugs, kisses; keep your distance

• Keep tissues available

• No lids on trash bins — they require touching to use

• Keep hand sanitizer available — must be 60 percent to 95 percent alcohol-based to be productive

• Routinely clean surface areas in home and office; do often

• Talk about travel as residents come back to work after Spring Break; know where they've been and who they have been exposed to — be cautious of areas of outbreak or overseas

• If you are sick, don't go anywhere

• Those over 60 years old and/or having chronic health issues — especially respiratory-related ones — should avoid risky situations

• Learn specific guidance/instructions; visit cdc.gov

Tips from Dr. Scott Stewart, SSM Health St. Anthony Shawnee