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February 28, 2020
Coronavirus Disease 2019 Update No. 4
The Rhode Island Department of Health (RIDOH) and national public health officials continue to respond to coronavirus disease 2019 (COVID-19). Although there have not been any cases of COVID-19 confirmed in Rhode Island, we want to make sure that our communities and our healthcare system are prepared. Being informed is an important part of being prepared. For that reason, we intend to send regular Partner Briefings, such as this, for the near future to our community partners with updates and key information. Please share this briefing with your colleagues and networks.

Someone's risk for COVID-19 is closely tied to their recent travel history, and the travel histories of their immediate contacts—specifically, travel to areas with community transmission of COVID-19 or close contact with a person confirmed to have COVID-19. One of the most important messages for us to remember is that someone’s nationality alone is not a risk factor for COVID-19.

Coronavirus Disease 2019 Situation Update
  • This week, the World Health Organization discussed calling this outbreak a pandemic. While the WHO is still holding off on this label, the WHO and the CDC state that it is likely that this will be a pandemic.
    • There are three criteria for a pandemic: a new virus for which people do not have immunity, a virus that has the potential to cause illness and death, and worldwide spread. At this stage, the WHO states that COVID-19 meets the first two of these three criteria.  
    • It is important to note that declaring something a pandemic refers to the geographic spread of a virus, not the severity of the illness caused by the virus.
  • Over the past week, there has been an increase in cases in countries outside of China. Specifically, there is now community transmission in Iran, Italy, Japan, and South Korea in addition to China.
    • Community spread, or community transmission, means that new cases of COVID-19 are occurring without a known source of exposure.
  • The CDC has issued new travel guidance:
    • The CDC recommends travelers avoid all nonessential travel to China and South Korea.
    • The CDC recommends older adults and those with chronic medical conditions should consider postponing nonessential travel to Iran, Italy, and Japan.
  • As the CDC states, it is likely that there will be more cases in the United States.
  • As of February 27, there are 60 confirmed cases in the United States (including 2 cases of person-to-person spread, 12 travel-related cases, 42 cases among the 329 people repatriated from the Diamond Princess cruise ship in Japan, and 3 cases among people repatriated from Wuhan).
    • On February 26, the CDC reported one possible instance of community exposure in a person in California. The CDC states that while the source of infection is unknown, it is possible the patient may have been exposed to a returned traveler who was infected.
    • There have been no confirmed cases in Rhode Island.
The Local and National Response
  • The US has implemented a very aggressive containment strategy, involving travel restrictions; detecting, tracking, and isolating all cases; repatriating citizens from high-risk areas; and supporting self-quarantine and self-monitoring when necessary.
    • As a result of these aggressive measures, there are few cases in the country. However, the CDC expects to see community spread at some point in the US.
  • RIDOH continues to take extensive preparedness measures locally, including coordinating closely with State agencies, community organizations, healthcare providers, healthcare facilities, schools, and numerous other partners as part of readiness planning and to provide education, guidance, and support.
  • RIDOH’s Incident Command System remains activated to coordinate the preparedness steps being taken throughout the Department and in collaboration with other State entities.
    • On February 20, RIDOH issued a press release on its preparedness steps (available here and below, under Resources)
    • On February 27, RIDOH issued a press release and held a press briefing, “Director of Health Available to Discuss Coronavirus Disease 2019, Seasonal Illness” (available here and below, under Resources)
  • In accordance with federal guidance, RIDOH is coordinating a process to ensure that anyone who has been to China in the previous 14 days is self-monitoring at home for symptoms of COVID-19 with public health check-ins. Once 14 symptom-free days pass since someone’s last potential exposure to COVID-19, there is no longer a health concern about that person getting sick or spreading the illness.
  • RIDOH is also coordinating with other State agencies and community organizations to ensure that people who are remaining at home after travel in China have the support services they need, such as groceries and prescription medications.
  • RIDOH is regularly providing local healthcare providers summaries of the national situation, criteria to guide evaluation of patients, and guidance on specimen collection, testing, and reporting.
  • RIDOH is working closely with healthcare facilities and EMS providers (through calls, surveys, and written communications) to support their preparedness.
  • RIDOH is monitoring and disseminating federal guidance for specific populations (e.g., businesses, healthcare professionals, school superintendents, pregnant women and children, laboratories)
    • On February 27, RIDOH distributed CDC’s Guidance for Businesses and Employers to Prevent Seasonal Illness and Plan/Respond to COVID-19 (available here and below, under Resources)
    • On February 27, RIDOH distributed a Novel Coronavirus Update for School Superintendents, Administrators, and School Nurses (available here and below, under Resources)
  • RIDOH has linked to several COVID-19 fact sheets and resources from the CDC in multiple languages (available below, under Resources).
What you can do
  • At this time, the CDC does not recommend use of facemasks among the general public. The CDC’s position is that if you are not sick, you should not wear a facemask. The masks should be reserved for those who are sick, so they can prevent further spread of the virus.
  • Because human coronaviruses are most commonly spread through respiratory droplets, RIDOH recommends the same measures that prevent the spread of flu and other similar viruses.
    • Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.
    • Avoid touching your eyes, nose, and mouth with unwashed hands.
    • Avoid close contact with people who are sick.
    • Stay home when you are sick.
    • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
    • Explore, understand, and update policies and resources for sick-leave and telework.
    • Clean and disinfect frequently touched objects and surfaces (desks, tables, countertops, door handles, railings, etc.).
      • Clean the surface first to remove all organic matter. Thorough cleaning with soap and water will remove most microorganisms.
      • Use “EPA-approved” disinfectant to clean high-touch surfaces and patient care areas.
  • We can all work collaboratively to share accurate information and to reject potentially harmful myths. Remember that people who returned more than 14 days ago from areas where COVID-19 is active and do not have symptoms of COVID-19 do not put others at risk.
Resources Please contact RIDOH Infectious Disease Communications Coordinator Aaron Frechette (aaron.frechette@health.ri.gov) or 401-222-7624 for assistance with educational materials and communication resources. To be added to this distribution list to receive future communications, email Anna Tomasulo (anna.tomasulo@health.ri.gov). Please contact the RIDOH Health Information Line at 401-222-5960 with any other questions.
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