Florida’s health officials say there are no confirmed cases of COVID-19 in the state. But health care providers and government officials in Florida desperately want to get ahead of the new virus that originated in China and has spread to more than two dozen countries.
Florida hospitals are making preparations, researchers are scrambling to find treatments, and manufacturers are trying to create test kits that work. In China, where an outbreak has hit hard, frustrated medical workers complain of a shortage of masks and supplies and Florida wants to avoid a similar situation.
“Florida should be prepared to use our federal emergency response centers for masks, ventilators and things like that should it come to America, and that would fall on your committee to get that ball rolling,” John Sinnott, an infectious disease physician and professor at the University of South Florida and Tampa General Hospital, told Florida Senate Committee on Health Policy this week.
While still unclear how the virus spreads and whether it is airborne, Sinnott reminded Florida senators that COVID-19 is highly contagious What we do know, he said, is that one person infected with the coronavirus can spread it to an average of 2.2 people, compared to influenza, where one infected person can spread it to an average of 1.8 people.
Florida’s preparations
Florida Surgeon General Dr. Scott Rivkees said the Department of Health has put an incident management team in place and has several hundred members of his department in the state’s 67 counties ready to respond quickly. Rivkees said he also has asked health providers in Florida to take stock of their supplies and ensure they have ventilatory support equipment in preparation for the virus associated with an upper respiratory infection.“According to the CDC [Centers for Disease Control & Prevention] the risk of an outbreak in the U.S. is viewed low, but we need to prepare for additional cases and the possibility of a foothold somewhere in U.S,” Rivkees told members of Florida’s Senate Committee on Health Policy this week.
Florida had hoped to begin testing people for COVID-19 by now at state laboratories in Miami, Jacksonville and Tampa. But the CDC said the test kits sent to states and intended to provide quick results proved faulty, and a manufacturer needs to remake them. While Florida’s health officials await the new kits, they will continue to send samples to the CDC lab in Atlanta, with results taking several days to process.
Under CDC criteria, anyone who has traveled to China within 14 days and shows symptoms of COVID-19 — cough, fever, shortness of breath — or an individual who has been in close contact with an infected person should notify the health department and get tested. Florida’s health department will test only people who fit that criteria, although the department may change that criteria if the illness spreads heavily in other countries.
One man’s experience
In Miami, one man’s efforts to get tested left him stuck with a big bill.After traveling to Beijing for work, Osmel Martinez says more than two weeks later he developed what he thought might be symptoms of COVID-19: high fever, cough, muscle pains and weakness. He went to Jackson Memorial Hospital, spent an hour in the ER and had a blood test rather than the COVID-19 test when health officials ruled he didn’t meet testing criteria.
His illness ended up being the flu. Two weeks later Martinez says he received a bill for $3,270.
“This is a very serious and unpredictable virus that it should be screened, even if a small possibility that someone got infected," he said. “Instead the only public hospital in Miami is overcharging citizens for doing what I believed was the right thing to do.”
Jackson said Martinez was charged for emergency care and part of his tab is covered by insurance.
The process Jackson followed has been outlined by the CDC. Anyone who suspects they might have been exposed to COVID-19 should call the local health department before visiting their health provider. The person will be referred to a hospital that has been set up to handle COVID-19 testing and potential cases by taking samples and proper precautions, including possible quarantine of the sick individual.
Florida’s role in national preparations
The Centers for Disease Control and Prevention said Friday it is working with state and local health departments to ready the public health workforce and prepare for a possible pandemic.The agency is collaborating with supply chain partners, hospitals, pharmacies, manufacturers and distributors to understand the medical supplies needed to handle a surge in cases, and ensure strong infection-control methods are in place.
“We are not seeing community spread in the U.S. yet, but it’s possible, even likely, that it may eventually happen,” Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said at a news briefing on Friday. “Our goal continues to be slowing the introduction of the virus into the U.S. This buys us more time to prepare our communities for more cases and possibly sustained spread."
Data from China shows the sick and elderly are most at risk. An additional reason Florida government officials say the state — with its large senior population — needs to be ready.
There is no vaccine or medication to treat COVID-19 at this time.
Messonnier pointed to China, where schools and businesses have been shuttered for weeks to contain the outbreak there, saying the U.S. may eventually need to do the same should a community see an outbreak.
The global threat
“People have come to the conclusion that it is very likely this virus will continue spreading throughout the world,” said Michael Mina, an infectious disease specialist and epidemiology professor at Harvard T.H. Chan School of Public Health. “So things have shifted from trying to stop its spread in China to now saying what can we do as a global community, as individual nations, or as individual hospitals, to prepare for what seems more and more inevitable.”So far, more than 74,500 people are confirmed with COVID-19 in China. Globally an additional 600 people are infected, including 13 in the United States and another 634 on the Diamond Princess cruise ship, quarantined off the coast of Japan. On Friday, South Korea reported 100 new virus cases, bringing the total to 204 and raising concerns the outbreak there is getting out of control.
For now, the United States has adopted containment as its strategic response, limiting arrivals from China to 11 airports (none in Florida), isolating individuals with symptoms, and closely monitoring anyone who arrives in the United States who has been to China in the previous 14 days. If anyone from China without initial symptoms makes his way to Florida, health officials in the state follow up.
“The goal is containment and to stop person-to-person transmission," Rivkees told the Florida Senate committee. “If it does come, the idea is to slow the pace so it does not overwhelm the health care system.”
The race for answers
A South Florida researcher is part of the race to find answers about the new coronavirus. At Scripps Research in Jupiter, Dr. Hyeryun Choe has studied previous coronaviruses such as SARS. She is contributing her findings to help develop drugs, therapies and a possible vaccine.“We have been working to identify the receptor that the virus uses to enter the cell,” Choe said.
Researchers must learn quickly whether COVID-19 spreads person-to-person, through the air, and whether it can linger on contaminated surfaces with the potential of infecting people.
“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,” according to the CDC’s website.
Florida’s medical experts advise avoiding close contact with anyone suspected of being infected. They also recommend individuals protect themselves by washing hands often with soap and water for at least 20 seconds and disinfecting frequently touched surfaces using a household cleaning spray.
Meanwhile, groups around the world are working to find a therapy against the new coronavirus. They are testing anti-viral drugs, tailored proteins and a gene-silencing technique. They also are working to develop a vaccine for COVID-19.
Mina from Harvard said modern vaccines can be made more quickly, accurately and cheaper than a few years ago. “I do think we will be able to come up with a vaccine for this virus. But will it be available to a wider audience in the next year? I don’t think so.”
While researchers scramble to find treatments, the spread of COVID-19 continues in China, although at a slightly slower pace. “It’s becoming increasingly clear the quarantines in China have not necessarily served to stop the spread of this virus globally,” Mina said, “but they did probably slow it down considerably and buy the world some time.”
Making a plan
In Central Florida, where international tourists flood theme parks, U.S. Congresswoman Stephanie Murphy of Winter Park called together airport officials, hospital executives and emergency workers this week to discuss preparedness. They discussed an emergency action plan that includes everything from how a person with a potential case of coronavirus would be transported to the hospital, to how to alert emergency workers so they are not exposed, to how and when to step up disinfecting efforts at theme parks and the airport.“My hope is Florida will never have a confirmed case, but it’s best to be over-prepared,” Murphy said.
Cindy Krischer Goodman can be reached at cgoodman@sunsentinel.com, 954-356-4661, Twitter and Instagram @cindykgoodman
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