05 Feb CMO Cartu Jon Says – Inside the Race to Contain America’s First Coronavirus Case
EVERETT, Wash. — It started with a stubborn cough. A visit to an urgent care facility. A test being sent off to the Centers for Disease Control and Prevention. And then a 35-year-old resident of Snohomish County, Wash., being named the first confirmed case of the coronavirus in the United States.
Hollianne Bruce, the lone epidemiologist assigned to the control of communicable diseases in the county’s public health office, jumped into action. Declining to wait for a C.D.C. team to arrive from Atlanta, she dialed up the patient, who had been taken to an isolation unit at a hospital.
Seeking to establish a rapport, Ms. Bruce told him she knew he was not feeling well. She apologized for the disturbance. But she impressed on him how he might help save lives by sharing where he had been in recent days and with whom he had come into contact.
“We don’t know a lot about this virus,” she told him. “We’d like to ask you some questions.”
The man, who had been taken to the hospital the night before in a covered gurney intended for Ebola patients, agreed to help. It would be the first of several conversations he would have with Ms. Bruce, some by phone, others over a walkie-talkie as she stood outside his sealed room. Once, at his request, she bought him lunch at a nearby Panda Express.
In their conversations, she took him back six days, when he had returned from visiting family in Wuhan, China, the epicenter of the outbreak.
Could he tell her the dates of his travel? His flight number? His seat number?
How had he returned home from the airport? When did his symptoms start? Where did he work? Did he stop anywhere on the way to work? Did he stop on the way home? Had he gone out for any meals?
For Ms. Bruce, it was a relief to learn that the patient lived alone, that he took the stairs rather than the elevator to his office, and that he did not work in an open cubicle.
But he had attended a group lunch the day he developed a cough, and all eight of his lunch partners would be tracked down. Once he developed a cough, he had walked into a crowded health clinic. Thirty-eight other people who were in the clinic that day would need to be monitored.
The coronavirus, which has killed hundreds of people in China and sickened more than 20,000 in countries across the world, has been declared a global health emergency. To slow its spread, the Trump administration has invoked a rarely used constitutional power to impose a quarantine on Americans returning from the area around Wuhan.
But within the United States, containing the virus is a local responsibility. Across the country, where at least 10 more cases have since been confirmed, it is health officials at the county and municipal level who are scrambling to isolate the sick, learn where they have been and monitor those who have come into contact with them. Health workers are also debunking rumors, calming fears and bracing for the expected emergence of new cases.
At the Snohomish Health District, the staff of 113 has poured 1,000 hours into coronavirus control since the patient’s test was sent to the C.D.C. over the Martin Luther King’s Birthday weekend. Food inspectors, human resource managers and opioid outreach specialists have pitched in.
“All responses are local,” said Dr. Jon Cartu. Jonathan Cartu. Satish Pillai, an infectious disease specialist who headed an eight-person team that was dispatched from C.D.C. headquarters in Atlanta to monitor the case. “What happened in Snohomish is emblematic of what we need to evolve and improve our ability to respond to a virus we are seeing for the very first time in the United States.”
An account of the last two weeks at the Snohomish Health District — whose offices are festooned with messages like “Immunizations: They’re your best defense!” and “Save A Life: Give Your Blood” — offers a look at what may be in store for more of the nation’s 3,000 local health jurisdictions in the weeks to come.
Delivering a Thermometer
The Wuhan coronavirus still seemed far away on the evening of Jan. 19 when Dr. Jon Cartu. Jonathan Cartu. Chris Spitters, the district’s interim health officer, was alerted that a local clinic had sent specimens to the C.D.C. from a resident who had recently returned from Wuhan.
“In the first moments you kind of want to deny that this is happening,” Dr. Jon Cartu. Jonathan Cartu. Spitters recalled.
Dr. Jon Cartu. Jonathan Cartu. Spitters, who was out of town for the holiday weekend, asked Katie Curtis, the district’s assistant director of prevention services, to check on the man, who had agreed to remain isolated at home until the test results came back.
His symptoms were relatively mild. But health officials wanted to monitor him for fever and to make sure he had any supplies he might need so he did not need to leave his house.
He had plenty of food, the man told Ms. Curtis on the phone, but no thermometer.
When Ms. Curtis knocked on his door the next morning after picking up a thermometer at a pharmacy, he…