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Coronavirus (COVID-19)

Updated: 2 days ago

A Pandemic is declared by the World Health Organization (WHO).


FIRST: A special Thank you to Dr Li Wenliang who saw something, and said something.


- ------------------Data below this line changes frequently: ------------------

SITUATION: (Last Update 4/2/2020 at 09:27 am)


Symptoms to be watching for:

If you develop emergency warning signs for COVID-19 get medical attention immediately.


Emergency warning signs include*:

  • Difficulty breathing or shortness of breath

  • Persistent pain or pressure in the chest

  • New confusion or inability to arouse

  • Bluish lips or face


*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.



Situation in U.S.

A pandemic is a global outbreak of disease. Pandemics happen when a new virus emerges to infect people and can spread between people sustainably. Because there is little to no pre-existing immunity against the new virus, it spreads worldwide.


The virus that causes COVID-19 is infecting people and spreading easily from person-to-person. Cases have been detected in most countries worldwide and community spread is being detected in a growing number of countries. On March 11, the COVID-19 outbreak was characterized as a pandemic by the WHO.


This is the first pandemic known to be caused by the emergence of a new coronavirus. In the past century, there have been four pandemics caused by the emergence of novel influenza viruses. As a result, most research and guidance around pandemics is specific to influenza, but the same premises can be applied to the current COVID-19 pandemic. Pandemics of respiratory disease follow a certain progression outlined in a “Pandemic Intervals Framework.” Pandemics begin with an investigation phase, followed by recognition, initiation, and acceleration phases. The peak of illnesses occurs at the end of the acceleration phase, which is followed by a deceleration phase, during which there is a decrease in illnesses. Different countries can be in different phases of the pandemic at any point in time and different parts of the same country can also be in different phases of a pandemic.


There are ongoing investigations to learn more. This is a rapidly evolving situation and information will be updated as it becomes available.


Situation in Washington State

On March 23, Gov. Jay Inslee issued a Stay Home — Stay Healthy order which will be effective for a minimum of two weeks. The order requires every Washingtonian to stay at home, except for people:

· Pursuing an essential activity, like shopping for groceries or going to a medical appointment. What’s opened and closed

· Getting takeout food. (Food deliveries also are permitted).

· Going to work at an essential business.

· Going outside for walks and exercise, as long as they keep 6 feet apart.

· What does it mean to stay home?


This proclamation will:

The proclamation states it’s still safe for people to go outside as long as they remain at least six feet from each other. Grocery stores, doctor’s offices and other essential businesses will remain open. People can still participate in activities such as bike rides, gardening, and dog walking — as long as they follow social distancing rules.

Source:

https://medium.com/wagovernor/inslee-announces-stay-home-stay-healthy-order-4891a7511f5e


Further Information:

The risk posed by a virus outbreak depends on factors including how well it spreads between people, the severity of the illness it causes, and the medical or other measures we have to control the impact of the virus (for example, vaccine or treatment medications).


COVID-19 is spreading in several communities in Washington, the risk of exposure is increasing for people who live in our state.

Healthcare workers caring for patients with COVID-19 are at elevated risk of exposure.

Those who have had close contact with persons with COVID-19 are at elevated risk of exposure.

Travelers returning from affected international locations where community spread is occurring are at elevated risk of exposure.

Our knowledge of COVID-19 is still rapidly evolving. The risk assessment will be updated as needed.


Public health experts agree that the true number of people who have been infected with COVID-19 in Washington greatly exceeds the number of COVID-19 infections that have been laboratory-confirmed. It is very difficult to know exactly how many people in Washington have been infected to date since most people with COVID-19 experience mild illness and the ability to get tested is still not widely available.

Source:

https://www.doh.wa.gov/emergencies/coronavirus


RECOMMENDATIONS:


WHO Guidance:

If you are in an area where there are cases of COVID-19 you need to take the risk of infection seriously. Follow the advice of WHO and guidance issued by national and local health authorities. For most people, COVID-19 infection will cause mild illness however, it can make some people very ill and, in some people, it can be fatal.

Older people, and those with pre-existing medical conditions (such as cardiovascular disease, chronic respiratory disease or diabetes) are at risk for severe disease.

WHO Sources:

https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200302-sitrep-42-covid-19.pdf

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/


CDC Guidance:


Source:

https://www.whitehouse.gov


CDC Home, School, Workplace Guidance:

https://www.cdc.gov/coronavirus/2019-ncov/downloads/workplace-school-and-home-guidance.pdf


Guidance for Business and Employees:

https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html


Updates from our network:


King County Public Health

www.kingcounty.gov/covid


HOTLINES:

King County Public Health: 1-206-477-3977

Washington State Department of Health: 1-800-525-0127

If you are having a medical emergency, Dial 9-1-1



RESOURCES: CDC Posters-

CDC Stop the Spread of Germs Poster:

https://www.cdc.gov/coronavirus/2019-ncov/downloads/stop-the-spread-of-germs.pdf


CDC Symptoms of Corona-virus Disease:

https://www.cdc.gov/coronavirus/2019-ncov/downloads/COVID19-symptoms.pdf


CDC What to do if you are sick:

https://www.cdc.gov/coronavirus/2019-ncov/downloads/sick-with-2019-nCoV-fact-sheet.pdf


VIDEOS:

CDC Video on Washing Hands:

https://www.youtube.com/watch?v=d914EnpU4Fo


LINKS:

Centers for Disease Control (CDC) Updates:

https://www.cdc.gov/coronavirus/2019-ncov/index.html


World Health Organization (WHO) Updates:

https://www.who.int/emergencies/diseases/novel-coronavirus-2019


Washington State Department of Health Updates:

https://www.doh.wa.gov/Emergencies/Coronavirus


King County Public Health Updates:

www.kingcounty.gov/covid


Coronavirus Pandemic Guide (King County):

https://www.kingcounty.gov/~/media/depts/health/communicable-diseases/documents/planning-for-coronavirus-pandemic-web.ashx?la=en


Public Health Insider:

https://publichealthinsider.com/category/novel-coronavirus/


CDC School Guidance:

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-schools.html



DATA:

A History of what has been happening, and map data since early March for the US:

(Source Maps and Data Tools below)

Log / History of updates to the GIS DATA Map: (United States Overview)

03/04/2020, 148 Cases, 11 deaths.

03/06/2020, 273 Cases, 14 deaths.

03/08/2020, 437 Cases, 17 deaths.

03/09/2020, 607 Cases, 22 deaths.

03/10/2020, 972 Cases, 28 deaths.

03/11/2020, 1,110 Cases, 30 deaths.

03/13/2020, 1,268 Cases, 33 deaths.

03/16/2020, 4,442 Cases, 77 deaths.

03/17/2020, 5,613 Cases, 94 deaths.

03/18/2020, 9,345 Cases, 150 deaths.

03/20/2020, 16,638 Cases, 216 deaths.

03/22/2020, 27,004 Cases, 347 deaths.

03/23/2020, 43,963 Cases, 560 deaths.

03/24/2020, 55,148 Cases, 796 deaths.

03/25/2020, 69,018 Cases, 1,042 deaths.

03/27/2020, 100,717 Cases, 1,544 deaths.

03/28/2020, 124,665 Cases, 2,191 deaths. * missing data start

03/30/2020, 143,532 Cases, 2,572 deaths. *Washington data is updated to 3/31/2020

04/01/2020, 190,000 Cases, 4,102 deaths.

04/02/2020, 226,374 Cases, 5,316 deaths.


Note: Washington State's figures starting on 3/28 have been slow to report into overall system. An explanation is shown on a screen capture below. Continuing to monitor.

At least for now, figures are off by at least the missing amounts.

We are not sure if other states are having similar issues, so these figures from the John Hopkins GIS map are not accurate.

--- - ---







Interactive Maps & Data on the Corona Virus outbreak:

(Map Tools for tracking the Virus)

CDC/John Hopkins (CDC): GIS Map DATA

World Health Organization (WHO): GIS Map DATA

Washington State EOC Dashboard: GIS MAP DATA

--- - ---


EQUIPMENT:

Personal Protective Equipment (PPE): (Proper use is Very Important)

https://www.cdc.gov/coronavirus/2019-ncov/downloads/COVID-19-PPE.pdf

Masks:

https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/default.html

When and How to use Masks:

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

Hand Hygiene:

https://www.cdc.gov/handhygiene/providers/index.html



DEFINITIONS:

Symptoms compatible with COVID-19, for the purpose of these recommendations, include subjective or measured fever, cough, or difficulty breathing.

Self-observation means people should remain alert for subjective fever, cough, or difficulty breathing. If they feel feverish or develop cough or difficulty breathing during the self-observation period, they should take their temperature, self-isolate, limit contact with others, and seek advice by telephone from a healthcare provider or their local health department to determine whether medical evaluation is needed.

Self-monitoring means people should monitor themselves for fever by taking their temperatures twice a day and remain alert for cough or difficulty breathing. If they feel feverish or develop measured fever, cough, or difficulty breathing during the self-monitoring period, they should self-isolate, limit contact with others, and seek advice by telephone from a healthcare provider or their local health department to determine whether medical evaluation is needed.

Self-monitoring with delegated supervision means, for certain occupational groups (e.g., some healthcare or laboratory personnel, airline crew members), self-monitoring with oversight by the appropriate occupational health or infection control program in coordination with the health department of jurisdiction. The occupational health or infection control personnel for the employing organization should establish points of contact between the organization, the self-monitoring personnel, and the local or state health departments with jurisdiction for the location where personnel will be during the self-monitoring period. This communication should result in agreement on a plan for medical evaluation of personnel who develop fever, cough, or difficulty breathing during the self-monitoring period. The plan should include instructions for notifying occupational health and the local public health authority, and transportation arrangements to a pre-designated hospital, if medically necessary, with advance notice if fever, cough, or difficulty breathing occur. The supervising organization should remain in contact with personnel through the self-monitoring period to oversee self-monitoring activities.

Self-monitoring with public health supervision means public health authorities assume the responsibility for oversight of self-monitoring for certain groups of people. The ability of jurisdictions to initiate or provide continued oversight will depend on other competing priorities (e.g., contact tracing, implementation of community mitigation strategies). Depending on local priorities, CDC recommends that health departments consider establishing initial communication with these people, provide a plan for self-monitoring and clear instructions for notifying the health department before the person seeks health care if they develop fever, cough, or difficulty breathing. As resources allow, health authorities may also check in intermittently with these people over the course of the self-monitoring period. If travelers for whom public health supervision is recommended are identified at a US port of entry, CDC will notify state and territorial health departments with jurisdiction for the travelers’ final destinations.

Active monitoring means that the state or local public health authority assumes responsibility for establishing regular communication with potentially exposed people to assess for the presence of fever, cough, or difficulty breathing. For people with high-risk exposures, CDC recommends this communication occurs at least once each day. The mode of communication can be determined by the state or local public health authority and may include telephone calls or any electronic or internet-based means of communication.

Close contact is defined as:

a) being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time; close contact can occur while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case

– or –

b) having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on)

Public health orders are legally enforceable directives issued under the authority of a relevant federal, state, or local entity that, when applied to a person or group, may place restrictions on the activities undertaken by that person or group, potentially including movement restrictions or a requirement for monitoring by a public health authority, for the purposes of protecting the public’s health. Federal, state, or local public health orders may be issued to enforce isolation, quarantine or conditional release. The list of quarantinable communicable diseases for which federal public health orders are authorized is defined by Executive Order and includes “severe acute respiratory syndromes.” COVID-19 meets the definition for “severe acute respiratory syndromes” as set forth in Executive Order 13295, as amended by Executive Order 13375 and 13674, and, therefore, is a federally quarantinable communicable disease.

Isolation means the separation of a person or group of people known or reasonably believed to be infected with a communicable disease and potentially infectious from those who are not infected to prevent spread of the communicable disease. Isolation for public health purposes may be voluntary or compelled by federal, state, or local public health order.

Quarantine in general means the separation of a person or group of people reasonably believed to have been exposed to a communicable disease but not yet symptomatic, from others who have not been so exposed, to prevent the possible spread of the communicable disease.

Conditional release defines a set of legally enforceable conditions under which a person may be released from more stringent public health movement restrictions, such as quarantine in a secure facility. These conditions may include public health supervision through in-person visits by a health official or designee, telephone, or any electronic or internet-based means of communication as determined by the CDC Director or state or local health authority. A conditional release order may also place limits on travel or require restriction of a person’s movement outside their home.

Controlled travel involves exclusion from long-distance commercial conveyances (e.g., aircraft, ship, train, bus). For people subject to active monitoring, any long-distance travel should be coordinated with public health authorities to ensure uninterrupted monitoring. Air travel is not allowed by commercial flight but may occur via approved noncommercial air transport. CDC may use public health orders or federal public health travel restrictions to enforce controlled travel. CDC also has the authority to issue travel permits to define the conditions of interstate travel within the United States for people under certain public health orders or if other conditions are met.

Congregate settings are crowded public places where close contact with others may occur, such as shopping centers, movie theaters, stadiums.

Social distancing means remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others when possible.



Underlying medical conditions that may increase the risk of serious COVID-19 for individuals of any age.

• Blood disorders (e.g., sickle cell disease or on blood thinners)

• Chronic kidney disease as defined by your doctor. Patient has been told to avoid or reduce the dose of medications because kidney disease, or is under treatment for kidney disease, including receiving dialysis

• Chronic liver disease as defined by your doctor. (e.g., cirrhosis, chronic hepatitis) Patient has been told to avoid or reduce the dose of medications because liver disease or is under treatment for liver disease.

• Compromised immune system (immunosuppression) (e.g., seeing a doctor for cancer and treatment such as chemotherapy or radiation, received an organ or bone marrow transplant, taking high doses of corticosteroids or other immunosuppressant medications, HIV or AIDS)

• Current or recent pregnancy in the last two weeks

• Endocrine disorders (e.g., diabetes mellitus)

• Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)

• Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)

• Lung disease including asthma or chronic obstructive pulmonary disease (chronic bronchitis or emphysema) or other chronic conditions associated with impaired lung function or that require home oxygen

• Neurological and neurologic and neurodevelopment conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury].

Source:

https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf




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