While the risk from the new deadly coronavirus that has closed cities in China remains low in New York, Long Island hospitals, including Stony Brook, are working with the New York Department of Health to prepare in case it makes its way to the New York area.
The respiratory virus, which originated at a seafood market in Wuhan Province in China during contact between humans and an animal that reportedly could have been a snake, has claimed the lives of 132 people as of Jan. 29. The virus has spread to three states, with single cases in Seattle, Washington, and Chicago, Illinois, and two cases in California.
The reported deaths from the virus are all in China, although people have also tested positive for coronavirus in countries including Australia, Canada, France, Japan and Vietnam, among others.
As of earlier this week, New York State had sent samples for nine people to the Centers for Disease Control and Prevention for testing. Four samples tested negative, while the state is awaiting results for the other five.
A Q&A with Susan Donelan, Medical Director of Health Care Epidemiology, Stony Brook University Hospital, About the New Coronavirus
1. Is the outbreak plan for this new coronavirus any different than the plan for SARS or MERS at Stony Brook?
The 2019 novel coronavirus (2019-nCoV), a new virus that causes respiratory illness in people and can spread from person to person, shares a lot of similarities to other coronaviruses we have seen such as SARS and MERS-CoV. At Stony Brook Medicine, our teams are incorporating best practices from the Pandemic Influenza Plan. These practices are especially important during the flu season.
2. Is everyone in the emergency room taking a history on admission, particularly for people presenting with respiratory infections and a fever, that includes questions about travel to China?
As a matter of standard practice for many years, the hospital has asked all patients with any influenza-like illness [ILI] about recent travel history and is well versed in obtaining this information. Additionally, regardless of the presence or absence of travel, any patient presenting with an ILI immediately will be given a surgical mask to place over the nose and mouth, in order to limit the spread of any respiratory pathogen they may be harboring.
3. How much space could Stony Brook make available if the hospital needed to isolate people who might have this virus?
Stony Brook Medicine has already performed a walk-through of our facility to identify where patients could be cohorted if there were suspicions for this illness, and should they need hospitalization. As per the [CDC], people confirmed to have the 2019-nCoV infection, who do not need to be hospitalized, can receive care at home.
4. What is the current recommended treatment plan if someone either has or is suspected to have this virus?
Currently, there is no vaccine available to protect against 2019-nCoV and no specific antiviral treatment is recommended for the infection. People infected with 2019-nCoV should receive supportive care to help relieve symptoms.
“These five individuals remain in isolation as their samples are tested at CDC,” Gov. Andrew Cuomo (D) said in a statement. “While the risk for New Yorkers is currently low, we are still working to keep everyone informed, prepared and safe.”
China has been working to contain the virus by enforcing lockdowns in cities like Wuhan. Indeed, an unnamed Stony Brook scientist, who was visiting his family, has been unable to leave China to return to Long Island. Through a spokeswoman, Stony Brook said it is grateful for the help of Sen. Chuck Schumer (D-NY), the State Department and the university community in trying to bring him home.
When he returns to the United States, the professor will remain in quarantine until he could no longer be a carrier for the virus.
Area hospitals, meanwhile, are watching carefully for any signs of coronavirus.
“There are procedure plans in place in every hospital,” said Dr. Bettina Fries, chief of the Division of Infectious Diseases in the Department of Medicine at Stony Brook University’s Renaissance School of Medicine. “There is always a concern when these outbreaks are announced.”
At this point, however, the World Health Organization has not declared the outbreak an emergency. The CDC has classified the new coronavirus threat level as “low.”
The coronavirus, called 2019-nCoV, is in the same family as sudden acute respiratory syndrome and the Middle East respiratory syndrome. The initial mortality rate from the current coronavirus is lower than the 10 percent rate for SARS, which spread in 2002, or the 30 to 35 percent rate from MERS, which started in Saudi Arabia in 2012.
The timing of the virus is challenging because the symptoms are similar to those for the flu, which has become more prevalent in New York and around the country this winter. Coronavirus symptoms, according to the CDC, include coughing, fever and shortness of breath.
While airports like John F. Kennedy Airport in Queens are screening people who arrive from Wuhan, efforts to determine whether they may be carrying the virus could be limited, in part because the incubation period could be as long as two weeks, during which time an infected person could be contagious.
Infectious disease experts suggested practicing the kind of hygiene that would reduce the likelihood of contracting the flu. This includes: washing hands for at least 20 seconds, using hand sanitizer and maintaining a distance of about 3 feet from anyone who has the sniffles or appears to be battling a cold. Infectious disease experts also suggest cutting back on handshakes, especially with people who appear to be battling a cold.
“If you have immunocompromised people, they should be extra careful,” Fries said, adding that the CDC, which has been regularly updating its web page, www.cdc.gov, has been working tirelessly with national and state health officials to coordinate a response to this virus, wherever it hits.
“The New York State Department of Health and the CDC need to be praised for all the work” they are doing, she said. “They have a task force that doesn’t do anything else but prepare for patients coming from outbreak areas.”
Scientists around the world have also been working to develop a vaccine for this new virus. According to a recent report in The Washington Post, researchers anticipate developing such a vaccine in as little as three months, which is considerably shorter than the 20 months it took to develop a vaccine for the SARS virus. The Post, however, suggested that the development of a vaccine would require testing before it received approval.
Fries said the concern about the coronavirus comes less with the current death toll than it does with the effect as it continues to spread.
“It’s important to see how far it spreads and what the real mortality is,” which is tough to track because the outbreak is still at the beginning and scientists and public health officials are still processing new information, she added.