Are area health care workers, hospitals prepared for the coronavirus?

As world health experts scramble to contain the newest deadly strain of coronavirus while also seeking a vaccine, Miami Valley health officials say they are “very prepared” to deal with an outbreak if one occurred here.

Local health officials years ago formed a coalition within the nine-county region, and have a plan in place to address medical emergencies. The plan was put in to action during the 2009 H1N1 outbreak and then again in 2019 after the Memorial Day tornadoes and the Oregon District mass shooting in August.

Led by the Greater Dayton Area Hospital Association, the coalition consists of 29 hospitals and health systems in the region, and stretches as far north as Auglaize County, east to Clark County and to Butler and Warren counties in the south.

Each county owns a piece of the emergency plan, and they conduct joint exercises annually to ensure everyone is prepared in case of a crisis, said Sarah Hackenbracht, GDAHA’s president and CEO. Given the scope of the plan, the level of training and their performance during the tragedies that struck the area in 2019, she’s confident the region’s health-care workers and hospitals are ready for any crisis — including the 2019-novel coronavirus.

“I would say that our region is very well prepared,” she said.

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Hackenbracht is among health care officials in Montgomery, Greene and Clark counties who talked to the Dayton Daily News about the area’s preparedness, and what Miami Valley residents can do to protect themselves against the virus.

Flu-like symptoms

Although Wuhan, China, is ground zero for the virus, cases have been confirmed in Thailand, Taiwan, Japan, Singapore, South Korea and the United States. In the U.S., two cases were confirmed in Washington state and Chicago. Both patients — a man and a woman — recently returned to the United States from Wuhan. They were in good condition Friday, according to media reports.

The Chinese government restricted more than 30 million people in that country from traveling in an effort to contain the virus.

As of Friday afternoon, more than 800 people worldwide have been infected and 26 have died, including a spike of 17 within a 24-hour period, according to media reports. In addition, 63 patients in 22 states were under investigation for the virus, according to the Centers for Disease Control and Prevention. Eleven other people in the U.S. tested negative for the virus, the agency said.

Ohio is not among the states with suspected cases of the virus, Ohio Department of Health spokesperson Melanie Amato said.

The ODH also issued a statement mandating that suspected cases of the virus be reported immediately.

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There are seven strains of coronavirus. They are commonly found in animals, though they can evolve and spread to humans, according to the CDC. Three strains — MERS, SARS and the 2019-novel coronavirus, can cause severe illness, including death, the CDC said. The latest strain, which the World Health Organization reported this month, is associated with an outbreak of pneumonia in Wuhan City.

Symptoms are flu-like, and they include runny nose, headache, coughing, sore throat, fever and a general feeling of sickness, said Laurie Fox, public information officer for Greene County Public Health. In addition, the virus can cause lower respiratory tract illnesses such as bronchitis, and people with a weakened immune system, particularly infants and older adults, may be more susceptible, she said.

‘People should not panic’

Although there are two confirmed cases of the virus in the United States, people should take the normal precautions to protect themselves against catching the cold, particularly since it is still flu season, said Dan Suffoletto, Public Health Dayton and Montgomery County public information supervisor. He recommends staying away from sick people; covering your mouth when coughing and sneezing; frequently washing your hands, especially when you’ve been in contact with animals; and staying home from work, school or other public places if you’re sick.

“Those general precautions are really recommended at all times, but particularly given the 2019-novel coronavirus,” Suffoletto said.

Even though some of the coronavirus’ symptoms are similar to the common cold, people should not panic if they are around others who have them, Fox said. She said it’s unlikely someone is infected with the virus unless they have recently traveled to China or other countries where multiple cases have been confirmed, or been in contact with people who’ve recently traveled there.

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GDAHA and health officials in each county in the Miami Valley region are closely monitoring the situation, and get frequent updates from the CDC and the state health department. The counties are in contact with each other, and they post the latest information on their websites and various social media platforms. Their goal is to get the latest information to people as soon as possible, said Christina Conover, director of Nursing at the Clark County Combined Health District.

Health officials are also on high alert for possible cases of the virus as they treat patients, she said.

“We really feel like this is what we do every day,” Conover said. “What we are doing right now with regards to responding to this new virus is very much an escalation of what we do every day, which is we work with our health care partners whether they be the physicians in the community or the other health care providers in the community, urgent care, the hospital, EMS workers. We work with them so that they can help us find cases of diseases that are easily transmitted, we investigate those cases and report those cases.”

Regional training exercise

To ensure that they are always prepared for the worst-case scenario, the region’s hospitals and health care workers participate in 12 to 15 joint training exercises per year to rehearse the regional plan, Hackenbracht said. Counties also rehearse their internal emergency plans.

The next regional exercise is scheduled for Feb. 11, and the scenario will be a pandemic flu crisis, said Kim Caudill, Greene County’s emergency response coordinator.

In general, Montgomery County’s plan calls for the emergency preparedness department to work closely with the health department in the case of an emergency, Suffoletto said. Those departments then coordinate with their counterparts in other counties in the region and GDAHA as well as the Ohio Department of Health to ensure everyone is on the same page, he said. They also form teams to work on strategies in terms of how to approach the emergency to help the maximum number of people in the shortest amount of time, informing the community and the like.

In addition, the counties cross-train staff so they are able to do each other’s jobs in case a colleague is unavailable, Caudill said. At the end of each exercise, there’s a review to evaluate performance and make changes as needed.

Surge capacity

An important part of the regional emergency plan is managing the 29 medical facilities in the counties. In case of a major emergency such as a coronavirus outbreak, for instance, it would be addressed in terms of “surge capacity,” Hackenbracht said — the ability of a hospital to flex in the event of a crisis to care for as many people as possible, and move patients to other locations if necessary.

“That’s also something that we train and prepare for,” Hackenbracht said.

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GDAHA manages the surge capacity with a system that’s also used statewide called Surgenet. It allows hospital officials to have ongoing electronic monitoring of all the region’s hospitals and emergency departments to monitor surge capacity. So in the event of a crisis, they will have the ability to know if one facility is receiving a larger number of patients that can then be diverted to another facility that is not as overwhelmed.

“It keeps the patients allocated in a way that makes sure that every institution is working at the right level of capacity, and all of our patients are taken care of safely,” Hackenbracht said. “It’s very cool. Surgenet is something that we’re actually very proud of.”

Surgenet was developed in 2000, and it evolved to a mass-casualty system for bed tracking in 2003. In 2015, GDAHA rolled out OHTrac, a statewide patient tracking system that was built within Surgenet for hospitals to use in the event of a mass-casualty incident. OHTrac was deployed and used by the region’s hospital partners, the Emergency Operations Center and the Family Assistance Center during the Aug. 4 Oregon District mass shooting, Hackenbracht said.

The Ohio Department of Health, which is also monitoring the situation, on Friday declared the latest strain of the coronavirus an immediate reportable disease. The declaration is a move to ensure the appropriate steps are taken if a case of the coronavirus is suspected in the state.

“This situation is at the heart of public health,” said Dr. Amy Acton, ODH director. “We are working proactively with health care providers and local health districts/partners to identify and appropriately address emerging threats like novel coronavirus.”

“Anticipatory action like this is critical to ensuring that we are protecting Ohioans,” she said. “It is our sincere hope that this virus does not spread, but if it does, Ohio’s public health system is prepared.”

What happens if a case of the 2019-novel coronavirus is reported?

• A case or suspected case of 2019-novel coronavirus is reported to a local health department.

• The Ohio Department of Health reports to the Centers for Disease Control and Prevention and, if indicated, patient specimens will be collected and shipped.

• Currently, testing for this virus must take place at CDC.

• ODH will work with local, state and federal partners to investigate reports of 2019-novel coronavirus order to

identify cases and prevent the spread of infection.

Experts at the Ohio Department of Health recommend these tips to avoid the virus:

• Practice good hand hygiene.

• Follow appropriate cough and sneeze etiquette.

• Don’t go to work or school when you feel ill. Stay home and rest.

• Avoid exposure to others who are sick.

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