After a long seaside trip aboard the Westerdam cruise ship, which was denied entry to ports across Asia due to concerns about the Coronavirus, Holly Rowen finally returned to Florida on Wednesday evening. Moments later, she found out that she had joined a group of thousands of people who are closely tracked by local health officials across the United States.
While Ms. Rawin’s plane landed outside, one of the messages was already waiting on her phone from a nurse in her local public health department in her Florida county. If she has a fever or cough within the next 14 days, she should report it immediately, the nurse explained when Mrs. Rowen called back to reply.
“I was very moved,” said Ms. Rawin, a retired public health nurse from the same health department in Lee County. “We are really really into unknown waters.”
Experts said preventing the spread of infectious diseases is the core of public health work, but the scale of efforts by government and local health departments across the country to contain the virus known as COVID-19 is rarely seen. Since early February, thousands of people returning to the United States from mainland China, the epicenter of the disease, have been asked to isolate themselves in their homes for 14 days.
Local health officials check in daily with email, phone, or text. They arrange tests for people with symptoms and, in some cases, grocery stores and isolated housing. There is no central account in the U.S. for people who are monitored or required to remain in isolation, and they are scattered throughout the nearly 3,000 state health states.
People arriving from mainland China are added daily, while people who complete “quarantine” periods are released for 14 days of censorship. In California alone, the Department of Public Health monitors more than 6,700 returning travelers from China, while Washington state health officials track about 800, and Illinois officials more than 200.
Health officials say the nationwide mobilization is causing financial losses. The cost of local health departments is unknown, but some experts say it has reached tens of millions. Even as the first of Thirty-four confirmed patients with the confirmed Coronavirus virus in the United States in recent days, and health officials say they are preparing for what some may fear spreading. Worldwide, the virus, known to be highly infectious, has infected 75,000 people and killed more than 2,000 people.
“All manpower on this matter is being withdrawn,” said Dr. Marcus Plesia, chief medical officer of the Association of Governmental and Regional Health Officials, a non-profit organization representing public health agencies across the country. “If it really explodes, at some point, it can overwhelm government and local health departments.”
So far, officials say, the containment efforts in this country have been largely organized. The only known virus transmission in the United States has involved people in the same household. “No matter how effective health workers can monitor their fees, there will always be some leakage,” said Dr. John Weizman, the Secretary of Health in Washington State.
In Washington, where The first coronavirus patient in the United States was confirmed on January 21, and health officials tracked and monitored 69 people the man called, including co-workers, health workers and other patients at a clinic he visited when he first visited he felt unwell. Still, there were problems. One person the man was in contact with and who had symptoms of the disease flew on a plane to Wisconsin during the 14 days that he was supposed to be isolated at home.
“There is nothing so large, that you can make it impenetrable,” said Dr. Weizmann, who started phone calls twice a week with senior health officials in every state and territory to exchange advice and strive. Advice on how to manage changing challenges to respond to the Coronavirus. While full compliance with removal orders may not be possible, Dr. Weissman said: “We have to try 80 to 85 percent, and we hope it will work.”
Federal authorities are responsible for developing risk management guidelines, such as determining the amount of risk posed by the returning traveler and who should be tested for the Coronavirus. But the daily work that puts these policies into practice and tracks thousands of people lies with the vast and decentralized network of local health departments across the country. Passenger data, which was extracted from federal customs officials, is transmitted to government health agencies, which compile lists of people returning from China to local health departments.
In the Chicago area, public health officials use an electronic monitoring system that was originally developed to track measles to monitor more than 200 passengers. Every day, they receive a link asking about its temperature and symptoms.
The costs associated with containing the virus have reached more than $ 150,000 a week for the Chicago Department of Public Health alone, according to its commissioner, Dr. Alison Arwadi. Among the costs: $ 17,000 for a quarantine facility in an unknown location for people who cannot isolate themselves at home. She said that less than five people have used it so far.
She said: “If you are putting them in quarantine under a legal order, you should consider food, their medication, their communication needs, and their mental health.”
Some jurisdictions have negotiated with hotels to host people who might harbor the virus. Washington State has an RV.
Ruth Jones, commissioner for public health in Quincy, Massachusetts, a town of about 100,000 people south of Boston, says her department receives lists of three to 10 people every day returning from China and asking them to remain isolated from other people. Quincy public health nurses and interpreters work long hours to contact them and ensure they understand how to monitor and report any symptoms.
“It’s extra time for our nurses,” said Ms. Jones. “It was very busy.”
Local officials in places where they were found to have been exposed to special pressure. In Madison and Dane County, Wisconsin, a 160-member local health team has had to rearrange its operation to focus on monitoring anyone who might have been exposed to a resident who has tested positive for HIV after contracting the disease and remains isolated from himself. .
“We are in this new normal, but this is not normal,” said Janel Heinrich, the district’s director of public health.
Besides monitoring individuals seen as at risk of contracting the virus, state and local government health officials are seeking to prepare for worst-case scenarios in the coming months. Government officials in Washington said they will hold an online seminar next week to inform school principals of best practices for cleaning and planning for home education if schools need to be closed.
“People are planning contingencies,” said Julie Sullivan-Springgeti, a spokeswoman for the Department of Health in Multnomah County, Oregon, who is allocating resources to prepare a local hospital for a possible condition. “Just as we plan for the Cascadia earthquake, which may or may not happen in our lives.”
As for the passengers returning from the Westerdam cruise ship, the passengers initially thought they had no reason to worry about the Coronavirus because no person on the ship had traveled over mainland China during the outbreak. But after the passengers started leaving the ship returning to their home, an 83-year-old woman was said to have proven positive in a temporary pause in Malaysia, causing chaos and mayhem.
Irene Carney, 70, a retired and midwife nurse from Mendocino County, California, has gone on the same trip as the woman who is said to have proven positive, although questions have been raised about this finding and C.D.C. He has since said that other passengers do not need to isolate themselves.
Looking at the initial reports of the positive test, Mrs. Carney contacted hospitals to find out what she and her partner should do.
“The person we spoke to read CD said Mrs. Carney said:“ We thought everything looked good and we don’t have to quarantine. ”They said: If you have symptoms, consult your doctor.
But then, a nurse from the Mendocino County Department of Health and Human Services invited Mrs. Carney. She recommended that they isolate themselves at home, and offered them to provide groceries.
“We talked a lot about doing this anyway,” said Ms. Carney. “They have been summoned every day since.”
Nicholas Bogel Burroughs contributed to the reporting.