Pace: What is the proper level of concern and preparation for novel coronavirus?

If you are watching the news, you recognize that the novel coronavirus situation is rapidly changing.

The World Health Organization now says that we are in a “pandemic,” the stock market is dropping quickly, colleges are closing around the state and some sports events are beginning to be cancelled. Yet there are still only about 1000 documented cases in the United States, and a handful of deaths at this moment. Are we overreacting?

In Lake County, we are still at low risk of getting coronavirus. We have not had any people testing positive yet, but we have only been able to do a limited number of tests.

There is no known community spread, but there may be some people with the virus in our county that we haven’t been aware of.

At Public Health, we have been monitoring some returned travelers, and following some sick people who have been tested, but so far there have been no positive cases here.

We did declare a “Local Health Emergency” and the Board of Supervisors ratified it on Tuesday, March 10. This was not done to cause more anxiety, but is meant to allow us to make changes quickly (if needed), to request supplies and staffing (if needed), and to access emergency State and Federal funds (if needed).

Also, the California Department of Public Health came out on March 12 with strong recommendations limiting group gatherings:

– Postponing or canceling non-essential gatherings including 250 people or more;
– Smaller gatherings should be held in venues that allow social distancing (keeping 6 feet distance between people);
– Canceling events of 10 or more people that are in vulnerable groups—senior citizens, immune-compromised.

This is a significant change, which reflects the intention to limit mixing of people, thus preventing the introduction and the spread of the virus.

As seen in Washington state and Italy, once the virus gets a firm foothold and starts spreading, the situation can get to be difficult to manage. It appears that strong attempts to slow or stop this spread by limiting group gatherings and social mixing can be effective.

County agencies, schools, and healthcare providers are in regular communication in order to prepare and adapt to the changing environment. We are also involved in regular communication with the public. Our website is becoming a good resource, and there are some documents translated into Spanish. We are also trying to provide weekly press releases and a social media forum hopefully starting next week.

With no cases currently identified in the county, but with the situation worsening in the larger Bay Area, we are recognizing that we are in a unique situation and that limiting large group gatherings may allow us to prevent the virus from getting a solid foothold here, or at least slow down the process, and thus minimizing impact on the healthcare system.

Our particular concern is our most vulnerable populations – the seniors and people with underlying medical conditions.

Overall, we want to continue to try to walk the line between adequate, reasonable preparation for what may come down the road, without causing unnecessary concern or panic.

We live in a resilient community with reasonable, practical leadership. If we are very lucky, this outbreak may pass by Lake County without significant impact, but we appreciate the diligent efforts by so many of our community agencies and partners to prepare for the possibility that we do begin seeing cases.

Gary Pace MD, MPH, is the Public Health officer for Lake County, California.