With an incubation period as long as two weeks and an outbreak already underway along the West Coast, there’s a chance the COVID-19 virus has already made its way to Missoula, health officials told the City Council on Wednesday morning.
It’s just hasn’t presented yet.
To prepare for that likelihood and establish a coordinated response, the City-County Health Department has established an incident command team with a point of contact and a call center. It also has arranged a coalition of community partners, from local schools to hospitals and Missoula’s assisted living centers.
“Learning late last week the extent this was discovered on the West Coast was really a trigger for us to activate the things we’ve been planning,” said Health Officer Ellen Leahy. “It is fairly contagious and we’re preparing and actually looking for its presence.”
The first case of COVID-19 in the U.S. was reported in the state of Washington in late January. Since then, according to that state’s health department, 27 cases have been confirmed and 9 patients have died.
More than 230 individuals in Washington are under the supervision of public health officials.
“There are no cases of COVID-19 in Montana or Missoula, but we’re preparing just in case,” said Cindy Farr, a health official who is leading the local response. “It’s probably not a matter of if it comes here, but when. We’ve seen a large spike in Washington state. Once they started testing, they started finding more cases.”
The day before the City-County Health Department’s briefing with City Council, the state also activated its Coronavirus Task Force. The Montana Department of Health and Human Services now has the ability to test for the virus, but only on a limited basis.
Farr said any testing will begin with a patient visit to a local health care provider. The local health department will work with that provider in getting patient details. Those details will determine if the patient undergoes testing at the state level given limited resources.
“We don’t want people thinking that wearing masks will protect them,” said Farr. “The incubation period is 2 to 14 days, with an average of six days. Once you are exposed to it, you can carry the virus for 2 to 14 days before you start showing symptoms.”
Health experts believe the symptoms generally last from two weeks to a month, though that depends upon the individual. Most of those who show symptoms don’t experience adverse outcomes beyond a cough or shortness of breath, but there’s much about the virus that remains unknown given its novelty.
“The people at the highest risk of bad outcomes are people over the age of 60 and those who have other underlying respiratory conditions,” said Farr. “When you see a lot of deaths in Washington state, the reason for that is an outbreak in a nursing home. That does cause worse outcomes with this disease.”
The virus surfaced in China, though Farr said that country’s tracking and reporting isn’t useful to determine the potential impacts on public health in the U.S. Those details will become clear over the coming weeks.
“In our country, we’re not sure what the mortality rate is going to look like,” Farr said. “We don’t know what’s going to happen until it happens. Right now, they think the mortality rate is somewhere between a half a percent to 2.5%. When we look at the mortality rate from Influenza, this is about 10 times higher.”
Local health officials are now working to spread awareness in Missoula, urging simple precautions such as hand washing and disinfecting commonly touched items. They’re also asking anyone who has traveled to one of the five most infected countries – China, Japan, South Korea, Iran and Italy – to contact the local health department.
Once a case of COVID-19 appears in Missoula, other cases will likely fallow, Leahy said.
“You generally see spikes with a respiratory disease,” she said. “When you find your first case then several more, those are alarming, just to prepare you for that. This one has a long incubation period compared to the flu, so there’s a little bit more concern that it may be out there and not presenting itself yet.”
In preparing their response, health officials have already met with Missoula County Public Schools and on Tuesday, they met with the University of Montana. Other local partners including hospitals, nursing homes and Mountain Line, have also been looped in.
“We’ll be working closely with the health department to ensure those stakeholders; those employers with a lot of employees, the school districts, the university – all those people that have a role to play or decisions to make based on what happens – that they have a voice at the table and the best information possible,” said Adriane Beck, the county’s director of Disaster and Emergency Services.
They suggested those with travel plans over spring break to consider alternatives. The number to the new public hotline is 258-INFO (4636).