Marin’s Health and Human Services department on Tuesday declared a local health emergency in anticipation of the spread of coronavirus, a move the Board of Supervisors can ratify on March 10. As of yesterday afternoon, there were no cases of COVID-19 reported among Marin residents.
The emergency declaration will make the county eligible for federal and state financial assistance, and will enhance the authority of county health officials to coordinate a local response. Numerous other Bay Area counties have taken the same action.
Governor Gavin Newsom has activated the state emergency operations center in Mather, Calif., and requested the legislature make up to $20 million available for emergency response. Per his request, California last weekend received additional test kits from the Centers for Disease Control and Prevention, which has come under criticism for delaying and restricting the availability of testing.
On Jan. 30, the World Health Organization declared the outbreak a public health emergency of international concern, and the United States followed the next day by declaring a federal public health emergency. The number of cases identified in the country continues to grow, with the majority on the West Coast.
About a third of the confirmed cases in the United States as of Wednesday morning were passengers on the Diamond Princess cruise ship; one passenger who tested positive was transferred from the Travis Air Force Base in Solano County to Kaiser Permanente Medical Center in San Rafael last week. That person was asymptomatic, showing no signs of the virus.
On Feb. 26, the C.D.C. confirmed the community transmission of COVID-19 in the Bay Area, meaning an afflicted patient had no signs of associating with anyone diagnosed with the virus. The first death in California occurred yesterday, in Placer County.
Coronavirus is thought to spread mainly between people who are in close contact—within six feet of each other—through respiratory droplets produced when an infected person coughs or sneezes. The droplets present risks if they land in one’s mouth or nose, or are inhaled. “It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose or possibly their eyes, but this is not thought to be the main way the virus spreads,” the C.D.C. states.
Like the flu, the virus can cause fever, cough, body aches, fatigue and sometimes vomiting and diarrhea. It can be mild or severe, resulting in pneumonia and death. The director general of the WHO, Dr. Tedros Adhanom Ghebreyesus, on Tuesday estimated that 3.4 percent of the reported cases have resulted in death, but the organization continues to underscore that that rough estimate is subject to change. By contrast, about 0.1 to 0.2 percent of people who catch seasonal flus die from the illness.
There are four known types of coronaviruses that cause very mild infections every year. Another coronavirus that moved through China in 2003 caused severe acute respiratory syndrome, or SARS, that was contained after it killed 774 and sickened more than 8,000. Middle East respiratory syndrome, or MERS, first reported in 2012, is also caused by a coronavirus. The new virus has been named SARS-CoV-2, and the disease it causes is called COVID-19. It has killed more than 3,200 worldwide.
The virus is not treatable, but symptoms can be addressed, such as reducing fever. Severe cases may require hospitalization and support such as mechanical ventilation. “The best way to prevent illness is to avoid being exposed to the virus,” the C.D.C. states.
These are the recommendations from the C.D.C.: wash your hands often with soap and water for at least 20 seconds, especially before eating (if soap and water are unavailable, use an alcohol-based hand sanitizer with at least 60 percent alcohol); avoid close contact with people who are sick; avoid touching your eyes, nose and mouth; stay home when you are sick; cover your cough or sneeze with a tissue, then throw the tissue in the trash; clean and disinfect frequently-touched objects and surfaces using regular household cleaning spray or wipes. The C.D.C. does not recommend that people who are well wear a facemask.
Dr. Lisa Santora, the deputy public health officer, underscored that flu shots are also recommended, to help health professionals identify the risk that symptoms are related to coronavirus.
“Our top messaging is focusing on reassuring the community,” Dr. Santora told the Light on Monday. “It’s challenging to respond when we are learning so much new and so much is changing every day. We are lucky to have the tools that our community needs to be prepared and to protect themselves.” She added, “One of those tools is to aggressively promote hand hygiene and respiratory education, like the need to cough into your sleeve. A lot of people cough into their hands, and then shake other people’s hands.”
Frances Grau Brull, the clinical operations manager at the Coastal Health Alliance, said the organization is closely following guidelines from the C.D.C. for staff and for patients, and is communicating with the county and other nearby health centers. The alliance has held several staff trainings over the past week on infectious disease protocol, and has ramped up the cleaning of its facilities.
“We’re ready to serve the community,” Ms. Brull said. “We are ready to give them the information they need, to follow whatever guidance we receive. We are ready for an infectious disease. We train on this continuously, though we are aware that this is not a drill.”
The Marin County Office of Education is working with the county health department to update its infectious disease emergency response plan, which was developed in 2009 in response to the H1N1 virus. In the event that a case of coronavirus occurs at a school site, the school’s crisis response team will work with public health officials to determine next steps, which may include closing a school for up to 14 days.
“We don’t want to spread any panic, but we want to let folks know that there are concrete steps to take,” Bob Raines, the superintendent of Shoreline Unified School District, told the Light. As far as morale within the district, Mr. Raines said, “People are concerned, and teachers are here for their students. The big thing is to stay home if you’re sick for at least 24 hours without a fever or medication. We know that’s a hardship for families, for parents missing work.”
Brittany Hartwell, the director of the Palace Market, said over last weekend, store employees started to notice people stocking up on dry goods, and it has been a challenge to keep hand sanitizer and wipes in stock. The business has increased its hygiene, both at the registers and for staff.
“In the last few days especially, people are realizing that it’s coming and it’s best to be prepared,” she said. “The whole industry is thinking ahead, of this affecting events and everything like that. The power shut-off last year was a good fire drill for us—that’s a terrible [analogy]—to get a good idea of what the community needs while they are stuck at home with minimal resources.”
A forum on the coronavirus takes place from 6 to 7:30 p.m. on March 9 at the Marin County Office of Education (1111 Las Gallinas Avenue), in San Rafael.