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UPMC ‘ready’ for coronavirus

As of mid-Tuesday, there were no known cases of coronavirus in Pennsylvania, but — with cases expected — UPMC’s health system is prepared, according to officials in a webcast Tuesday from UPMC Montefiore in Pittsburgh.

“We’re ready for this,” said Donald Yealy, chair of UPMC’s Department of Emergency Medicine.

Screenings have not identified anyone who has fit the guidelines for testing at UPMC facilities, despite “proactive” efforts to find infected patients, Yealy said.

UPMC began preparing for the potential appearance of COVID-19 patients in January, with specific plans built on general ones already in place to care for patients with “emerging” infections, officials said.

The health system has been working on those plans with local, state and federal agencies, according to guidelines with the federal Centers for Disease Control and Prevention.

The preparation has involved “extensive communication” with UPMC employees, so they know what to do when they encounter an infected person, the officials said.

It has also involved working with suppliers to ensure sufficient access to equipment like masks, gloves and gowns, officials said.

“I think we’re well-positioned,” Yealy said.

Screening guidelines have been in place since early January at emergency departments, urgent care centers and primary physicians’ offices, officials said.

The screening criteria flags recent travel from countries with outbreaks of the disease and certain patient symptoms.

The most common coronavirus symptoms are fever, cough and shortness of breath, according to a UPMC webpage.

Precautions set

There are also guidelines that govern the actions of staffers when they encounter a patient who screens positive.

Those include taking the patient to a comfortable place away from other patients, beginning evaluation and starting procedures that have been around for a century for handling infectious diseases, Yealy said.

Those procedures include proper patient placement, masking and ongoing instructions to both patient and staff, such as hand hygiene, then calling an internal UPMC hotline to trigger additional necessary procedures, Yealy said.

If someone has a high fever and breathing difficulties and suspects they have coronavirus, they should go to an emergency department, officials said.

It’s best to call ahead if possible, so the workers can prepare, rather than to just show up, said Kristen Mertz, medical epidemiologist with the Allegheny County Health Department.

If someone suspects they have coronavirus, but they don’t have a high fever or breathing difficulties, they should call their primary care doctors or contact UPMC AnywhereCare for advice, Yealy said.

“We can guide you to the next steps,” he said.

Until this week, the CDC has been the exclusive provider of tests, but the Food and Drug Administration is now permitting qualified labs to conduct testing, using FDA test kits, and the state Department of Health has begun doing tests in Exton, said state Secretary of Health Rachel Levine on Tuesday.

Getting results from the CDC took two or three days, but the results from Exton should be available the same day or the day after.

UPMC expects to get kits soon.

The Exton lab’s capacity is about six tests per day, but that will increase soon, Levine said. The lab tests samples that health care providers obtain using nasal swabs.

For the last month, the department has been working with the CDC to test and then monitor individuals considered to be at risk, according to Levine, who didn’t give details about the monitoring, due to privacy concerns.

Hygiene critical

People can help protect themselves from getting coronavirus by practicing good hygiene, according to Graham Snyder, medical director of infection prevention and hospital epidemiology at UPMC.

They should cough or sneeze into the hollow of their elbows or into a tissues that they discard immediately, and they should stay home if they’re sick, Snyder said.

They should wash their hands frequently, avoid shaking hands and disinfect frequently touched surfaces often, Mertz said.

These are “common-sense” measures that have long been applicable to stop the spread of flu.

Getting infected with coronavirus in a store or on a train is unlikely, Snyder said.

Experts don’t recommend that healthy people wear masks. People who are unaccustomed to wearing masks are likely to touch their faces more often than they might otherwise, potentially infecting themselves by transferring the virus from a surface they touched, he said.

People should avoid nonessential travel to countries afflicted by the epidemic, including China, Iran, South Korea and Italy, and they should reconsider cruises to Asia, Mertz said.

It may be helpful to get a flu shot, to reduce the strain on medical resources that may be needed to combat the coronavirus, Mertz said.

They may also need to consider “social distancing,” she said.

“If there is community spread locally, there will be a coordinated effort with state and federal health agencies to implement procedures to help stop (it),” her department states on its website.

Such community mitigation measures can include urging people not to congregate, the closure of schools, cancellation of mass gatherings and encouraging teleworking, Mertz said.

Care centers vulnerable

The “most-concerning” possibility is an outbreak in a long-term care facility, because their residents are so vulnerable, Mertz said.

An outbreak like the one in Wuhan, China, where the epidemic began, is unlikely here, “because we’re more prepared,” Mertz said.

Moreover, anti-viral medications being developed through clinical trials in China may be available within the next month or so, to help mitigate the severity of the problem, Mertz said.

Emerging infections are “complicated things” and “transmission dynamics” are hard to predict, he said.

Media coverage is an important component in the effort to deal with the coronavirus, but it’s important to stick with “factual sources,” said Tami Minnier, chief quality officer for UPMC.

The CDC is the best source of information for people in the U.S., Snyder said.

The state Department of Health has spent about $200,000 so far on its coronavirus response, which includes adapting its flu plan for the new virus, monitoring travelers recently returned from China, opening an emergency operations center, paying employee overtime and communicating more with local, federal and other state agencies, according to Levine.

The department is also preparing to offer quarantine “resources” for people who contract the disease but can’t stay home, according to Levine, who declined to be more specific, because of privacy concerns.

The department receives federal preparedness funding and is looking for additional money to help with COVID-19, she said.

The fatality rate for COVID-19 is around 2 or 3 percent, according to a spokesman for the Department of Health.

Higher-risk groups include older people and those with underlying health problems.

The fatality rate for the flu is about 0.5 percent.

Mirror Staff Writer William Kibler is at 949-7038.

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