Health Risk to California Public Remains Low, Says California Department of Public Health

As of early this afternoon, Thursday, March 5, there are 215 confirmed cases of COVID-19 in the United States. [Screengrab from map depiction of Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE]

An outbreak of respiratory illness caused by a novel coronavirus (COVID-19) has been identified starting in Wuhan, China. Some patients have had mild illness, while others have been more severe and some have died.

The California Department of Public Health (the Public Health Department) understands there are concerns about novel coronavirus, and understandably so. Although coronaviruses are a group of viruses that aren’t new, this is a new type of coronavirus and we are still learning about it. However, the health risk to the general public in California remains low. While COVID-19 has a high transmission rate, it has a low mortality rate. From the international data we have, of those who have tested positive for COVID-19, approximately 80 percent do not exhibit symptoms that would require hospitalization. California is carefully assessing the situation as it evolves.

We are actively working with the Centers for Disease Control and Prevention (CDC), with local governments, and health care providers across the state to protect your health.

As of March 4, 2020, as of 10 a.m. Pacific Time, there are a total of 53 positive cases and one death in California: 24 are from repatriation flights. The other 29 confirmed cases include 12 that are travel related, seven due to person-to-person exposure from family contact, three due to person-to-person exposure in a health care facility, four community acquired and three from unknown sources.

• For more information about Coronavirus Disease 2019 (COVID-19) for travelers please visit the Centers for Disease Control and Prevention.

• For the latest information on repatriation and federal management, please see this statement from the CDC.

What is Novel Coronavirus (COVID-19)?

Coronaviruses are a large group of viruses that are common among animals and humans. In rare cases, animal coronaviruses can be transmitted from animals to humans. This novel coronavirus that causes COVID-19 is a newly discovered coronavirus that has not been previously detected in animals or humans. The source of this virus is not yet known.

What are the symptoms of COVID-19?

Typically, human coronaviruses cause mild-to-moderate respiratory illness. Symptoms are very similar to the flu, including:

• Fever
• Cough
• Shortness of breath

In some cases, COVID-19 can cause more severe respiratory illness.

What is the treatment for COVID-19?

Most people with illnesses due to common coronavirus infections recover on their own; there are no specific treatments for coronavirus infections. For patients who are more severely ill, hospitals can provide supportive care. We are continuing to learn more about this novel coronavirus and treatment may change over time.

How is it decided whether a person with a confirmed case of COVID-19 can self-isolate at home or must be confined to a hospital or elsewhere?

Local health departments are working in partnership with the California Department of Public Health and the CDC, and making determinations on whether a person ill with COVID-19 requires hospitalization or if home isolation is appropriate. That decision may be based on multiple factors including severity of illness, need for testing, and appropriateness of home for isolation purposes.

What can the public do to limit the spread of COVID-19?

The California Department of Public Health recommends the following steps to prevent the spread of all respiratory viruses:

• Washing hands with soap and water.
• Avoiding touching eyes, nose or mouth with unwashed hands.
• Avoiding a cough or sneeze.
• Avoiding close contact with people who are sick are all ways to reduce the risk of infection with a number of different viruses.
• Staying away from work, school or other people if you become sick with respiratory symptoms like fever and cough.

What is the difference between COVID-19 and other coronaviruses?

Coronaviruses are a large family of viruses. There are some coronaviruses that commonly circulate in humans. These viruses cause mild to moderate respiratory illness, although rarely they can cause severe disease. These normal human coronaviruses can be identified with widely available laboratory tests.  Those laboratory tests do not identify the novel coronavirus associated with COVID-19. It is closely related to two other animal coronaviruses that have caused outbreaks in people—the SARS coronavirus and the MERS (middle east respiratory syndrome) coronavirus.

Is California able to test for COVID-19?

The California Department of Public Health announced on February 28, 2020, that new CDC test kits used to detect Coronavirus Disease 2019 (COVID-19) now available in California can be used to do diagnostic testing in the community. California will immediately receive an additional shipment of kits to test up to 1,200 people. This means California public health officials will get test results sooner, so that any patients will get the best care.

California Public Health Laboratories with novel coronavirus (COVID-19) testing capabilities.

Currently, eleven California public health labs have already received CDC test kits and have begun testing. These labs include CDPH’s Laboratory in Richmond, and the Alameda, Contra Costa, Sacramento, San Francisco, Santa Clara, Tulare, Ventura, Los Angeles, Orange, and San Diego County labs. The CDPH Laboratory will provide diagnostic testing within a 48-hour turnaround time. More public health labs will soon be able to test, ramping up to a total of 20 public health labs in California in the coming weeks.  California Public Health Laboratories are working together as a network to provide novel coronavirus testing state-wide.  All requests for coronavirus testing for public health purposes must be submitted through a licensed health care provider and be approved by the Local Health Department prior to laboratory testing. COVID-19 California Map (PDF)

What is the state doing to protect our health?

The Public Health Department is working closely with the CDC to respond to the outbreak of COVID-19. Screening of incoming passengers at two California airports — Los Angeles International (LAX) and San Francisco International (SFO) — is ongoing. This is to identify people who have symptoms that could be due to COVID-19 so that they can receive appropriate assessment and care. The California Department of Public Health has been prepared and is continuing with the following actions as the situation surrounding COVID-19 evolves:

• Activating the State Operations Center to coordinate response efforts across the state.
• Continuing to prepare and respond in coordination with federal and local partners, hospitals and physicians.
• Providing information, guidance documents, and technical support to local health departments, health care facilities, providers, schools, universities, colleges, and childcare facilities across California.
• Coordinating with federal authorities and local health departments that have implemented screening, monitoring and, in some cases quarantine.
• Engaging with local health departments in managing suspect and confirmed cases of COVID-19 patients over the past several weeks.

Should public events be cancelled?

The California Department of Public Health is not recommending the cancellation of public events. There is no evidence of sustained person-to-person transmission of the virus in in the United States. The health risk from COVID-19 to the general public remains low at this time.

California state and local health officials are actively working to help protect the health of Californians. California has a limited number of confirmed cases of COVID-19 and we don’t have indication of it spreading widely in our communities at this time.

The U.S. government has taken unprecedented steps to protect against the spread of COVID-19. On January 31, entry into the United States was suspended for foreign nationals who have been in mainland China within the previous 14 days. U.S. citizens, residents, and their immediate family members who have been in Hubei province and other parts of mainland China are allowed to enter the United States, but they will be screened, and depending on their assessed risk level, will be subject to health monitoring and possible quarantine for up to 14 days. After the 14 day period with no symptoms, these travelers would no longer be considered a risk to others. These measures are expected to minimize the risk of exposure to COVID-19 associated with travelers who have been invited to attend conferences or public meetings in California.

Should people who have been exposed to COVID-19 be quarantined?

The federal government is responsible for quarantine procedures for travelers returning from China. The CDC recently announced a mandatory 14-day quarantine for travelers returning to the United States from Hubei Province, China. We are in communication with the CDC about their plans to quarantine passengers arriving at SFO and LAX.

What if I have symptoms?

Patient: If a person develops symptoms of COVID-19 including fever, cough or shortness of breath, and has reason to believe they may have been exposed, they should call their health care provider or local health department before seeking care. Contacting them in advance will make sure that people can get the care they need without putting others at risk. Please be sure to tell your health care provider about your travel history. You can also take the following precautionary measures: avoid contact with sick individuals, wash hands often with soap and warm water for at least 20 seconds, and get a flu shot.Health Care Provider: Patients who may have infection with this novel coronavirus should wear a surgical mask and be placed in an airborne infection isolation room. If an airborne infection isolation room is not available, the patient should be placed in a private room with the door closed. Health care providers should use standard, contact and airborne precautions and use eye protection. Please see “Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019-nCoV) in Wuhan, China” for more information about infection control. The Public Health Department will issue All Facility Letters to regulated healthcare facilities within California with updated information and guidance; these can be found on the AFL webpage.

Earlier Chapters:

• CDC Says California Now Has Confirmed Cases of Coronavirus
• One Case of Covid-19 (Previously Known as Novel Coronavirus) in Humboldt County
• Answering Questions About Covid-19 (AKA the Coronavirus) in Humboldt County
• Trinity Co. DHHS Asks Residents Who Have Traveled to Hubei Province, China, or Have Had Direct Contact With Someone Who Has to Contact Them
• Guidance for Business Owners on How to Prevent the Spread of Coronavirus (Covid-19)
• Humboldt County Department of Health and Human Services Says They Cannot Confirm a Second Case of COVID-19
• Washington Post Reports New Coronavirus Case in Northern California of ‘Unknown Origin’; DHHS Says Not Humboldt County
• State and Federal Response Lacks Places to Quarantine COVID-19 as Pandemic Evolves
• Of Cannabis and Covid-19
• Humboldt County Covid – 19 Patient released After No Longer Showing Symptoms
• UPDATE 10:40 a.m.: Breaking News, First US Death]Humboldt County Prepares as COVID-19 Cases Continue to Emerge Across the Nation
• Second US Resident Dead in Covid-19 Outbreak
• Six Now Dead in the US as Covid-19 Takes Further Toll in Seattle Area
• First California Death From Coronavirus; 11 Total Dead in the US
• Centers for Disease Control and Prevention Updated Guidance for Travelers Returning from Countries With High Rates of COVID-19 Transmission
• Mendocino County Declares ‘Public Health Emergency in Order to Prepare for Future Novel Coronavirus Activity’
• Governor Newsom Declares State of Emergency ‘to Help the State Prepare for Broader Spread of COVID-19’
• Hoopa Valley Tribe Chairman Declares Emergency Due to Coronavirus