Gov. Gavin Newsom announced Thursday that he believes California can respond to the spread of COVID-19.
It comes as the sense of concern heightened this week after state officials confirmed what is believed to be the first case of community transmission of coronavirus, in a patient from Solano County being treated at Sacramento’s UC Davis Medical Center. Newsom stopped short of declaring a state of emergency, but said officials are actively monitoring people who might have come into contact with the virus.
Today in a special segment of Insight, Washington Post Health and Medicine Reporter Lenny Bernstein, who broke the story about the Solano County patient, joined us to discuss the virus. Here are some highlights from the conversation.
This interview has been edited for brevity and clarity.
On tracking people who may have been in contact with the Solano County patient
The term for this is contact tracing, and it's extremely labor intensive, and it's extremely critical that it be done. The woman in Solano County had gone about her life for three to four days with symptoms of the coronavirus. It's a highly contagious virus. She was in her community, and presumably went to a job, went to a school, went to church.
We don't know where she lives, but in [the Vacaville] area because she presented to a hospital in Vacaville when she finally brought herself in for care. That means that the public health authorities have to go backwards through her life and reach out to everyone she may have come in contact with. So all the people at the hospital, most of whom are now home inside for self-isolation. If she stood in line somewhere, they've got to try to figure out who those people were. Maybe by looking at security camera footage. If she has a spouse, obviously that person is going to be isolated and monitored. If she has gone to a school, they would have to go into that school and and and check those people and talk to them now. We haven't heard that, and we've been checking. So it's a very essential part of public health. And unfortunately, as this virus spreads, which everyone expects it to, there will be more of this.
On whether or not contact tracing is intrusive
Yes and no. All they do is come to you and talk to you and say, when were you in contact with this person? How do you feel? Would you mind taking your temperature twice a day? If you have symptoms, then we are going to need to step things up. We are going to need to get a swab from you. We're going to need to test you for the virus.
If you get quarantined or if you are sick and they have to isolate you in some fashion, then I suppose you could make an argument. But right now, it's not that intrusive. They're just trying to find out whether you were in touch with that person and how you feel.
On there being no connection between this patient and the Travis Air Force Base evacuees
They have ruled out definitively any contact between the woman who is in UC Davis [Medical Center] and anyone from Travis Air Force Base. Of course, your immediate thought is, wait a minute... You've been bringing evacuees with the virus here, and the first community exposure shows up in a county that has that air force base. But they've been asked over and over again, public health authorities at the county level, at the state level: Did she run into anyone from there who maybe was evacuated, or who left after 14 days and got sick again? And they're telling us flatly, no. We know of no exposure between her and someone from Travis.
But of course, all of our minds are going to go there. This isn't a foolproof system. Maybe a mistake was made, but right now they're saying, coincidence. I also have heard one authority say, well, maybe because we were more vigilant because of the Travis situation, and we're just finding the first community exposure, but there's probably community exposure elsewhere in the country as well.
On the patient’s stay at NorthBay VacaValley Hospital before UC Davis Medical Center
[NorthBay VacaValley Hospital] has sent quite a few people home to monitor their own symptoms. They are on paid leave. They wouldn't give us an exact number. They said it is between dozens and 100. So that's not very specific.
Those people are going to spend 14 days watching themselves for symptoms, essentially, taking their temperature, making sure they don't develop the flu-like symptoms that are characteristic of COVID-19, this disease. They're also going through security footage, day by day, as this woman was in the hospital, looking to see who she might have come in contact with, that's everybody from people who might have brought her food into the room, people who might have cleaned her room, the nurses, the doctors, to make sure that they are checking on those people.
Then they have to go through the people who actually treated her even more intensively. She was intubated, which means they put a pipe down into her lungs to help her breathe. That creates an aerosol of the droplets that normally come out of someone's mouth when they sneeze or cough [which spread the virus]. So that creates an aerosol. Those droplets are finer, they are more dangerous. On the other hand, you would expect those medical professionals to have been protecting themselves when they did that.
On the conflicting answers from UC Davis Medical Center and the CDC
We have a conflict here. UC Davis sent out an email to all its personnel saying that this person came in on Feb. 19 [and that they] immediately asked the CDC to test her. They said she didn't meet the criteria. And for four days she went untested. Finally they agreed to do it on Feb. 23.
CDC says no, we were not asked until Feb. 23. And as soon as we were asked, we did it. And the test came back on Feb. 26 and it came back positive.
We are trying to sort through that and see if we can figure out who was telling us the correct story ... They cannot be both [accurate]. Nope. Those two versions can't live side by side.