DPH Statement on Novel Coronavirus Activities from Director Dr. Karyl Rattay, MD, MS

With recent cases of 2019 novel coronavirus (2019-nCoV) reported in several countries including the U.S., health officials across the nation are increasing monitoring efforts to identify potential cases. The Division of Public Health (DPH) has posted information on its website https://dhss.delaware.gov/dhss/dph and is issuing this statement to provide details about activities related to the outbreak.

While the available information suggests a low immediate health risk for the general public, we consider any new infectious disease a serious concern and are working with health care providers such as yourselves to promptly identify and evaluate any suspected cases. It is important to recognize that the current investigation and response are dynamic, and new information about the disease may impact the approach to this disease.  DPH will keep you updated as the situation evolves.

Currently the risk to the general public is considered low. At this time, there are a small number of individual cases in the U.S.  Risk is based on exposure. As you know we are in the heart of flu and respiratory disease season, and with over two thousand cases statewide, most of the population is at greater risk of contracting seasonal influenza than coronavirus. Those individuals with recent travel to any area of China, or contact with someone who has recent travel and is ill, have an increased risk for becoming ill. DPH is not recommending exclusion from work/school of asymptomatic persons arriving from China.

Delaware has a strong disease surveillance system in place that includes partnerships with hospital and clinic systems as well as local health care providers such as you. We continue to ask providers to alert us if a person with recent travel to any area of China, becomes sick with respiratory symptoms. If this is the case, we ask that you contact the DPH Office of Infectious Disease Epidemiology at 1-888-295-5156.  When cases are reported, laboratory samples are collected and submitted to the Centers for Disease Control and Prevention (CDC) for confirmatory testing. This testing can take several days.

We have had a handful of calls from providers and have followed up.  If at any point testing confirms a case of novel Coronavirus in a Delaware resident, the available details and protective recommendations would be shared with both the affected parties and the public as quickly as possible.

Symptoms are most similar to lower respiratory infections with patients having fever, cough, and shortness of breath. CDC believes at this time that symptoms of 2019-nCoV may appear in as few as 2 days or as long as 14 after exposure. This is based on what has been seen previously as the incubation period of MERS viruses. There is no specific antiviral treatment recommended for 2019-nCoV infection. People infected with 2019-nCoV should receive supportive care to help relieve symptoms.

The public is being encouraged to call ahead to their health care provider if they are concerned about the possibility of having been infected with 2019-nCoV.  Patients arriving for evaluation should be asked to wear a surgical mask as soon as they are identified and be evaluated in a private room (three walls and a door) with the door closed, ideally an airborne infection isolation room if available. Patients being sent to another health care facility from their primary care provider, or urgent care center, should be masked to limit transmission of respiratory secretions. Health care personnel entering the room should use standard precautions, contact precautions, airborne precautions, and use eye protection (e.g., goggles or a face shield). See the CDC’s health care personnel checklist or hospital personnel checklist for more specific information. Immediately notify DPH at 1-888-295-5156.

Additionally, DPH has issued guidance to Emergency Medical Services responders regarding what to do if they are called to transport someone suspected to be infected with 2019-nCoV.  DPH is holding frequent internal calls to ensure a constant flow of communication, and we are developing materials such as flyers to help the public understand what this virus is, and what they can do to protect themselves. We ask that you post the attached flyers around your facilities to educate patients on the virus and prevention techniques.

When a new disease is circulating, it’s natural for people to ask what they can do to protect themselves and their families. The best guidance at this point is to advise patients to take the same precautions recommended for avoiding colds and flu: People should stay home when they are sick, cover their cough and practice good hand washing. Patients who have recently returned from a trip to China and are feeling sick, should call their health care provider and let them know of their travel and symptoms.

2019 Novel Coronavirus, Wuhan, China

DPH ANNOUNCES SECOND NEGATIVE TEST RESULT FOR CORONAVIRUS

DOVER (February 13, 2020) – The Delaware Division of Public Health (DPH) is announcing that one of two pending test results for 2019 novel coronavirus (now known as COVID-19) has come back negative. The individual has been discharged from the hospital and is continuing to recover from their underlying illness at home. Test results for one other person are still pending from the Centers for Disease Control and Prevention (CDC) and are expected in the coming days. The individual, a New Castle County resident, remains hospitalized until test results are returned. No additional information is being provided about either individual.

In addition, DPH continues to monitor 13 asymptomatic travelers (travelers who are not sick with fever/cough/shortness of breath) arriving in the U.S. from mainland China after Feb. 3. The CDC recommended that such travelers be monitored for 14 days after their return. During the 14 days after their return from China, these persons are being asked to remain at home while self-monitoring for symptoms. If any of these persons shows symptoms of fever, cough and/or shortness of breath, they should call DPH right away to determine next steps, which may include transport to a local hospital for evaluation, isolation and testing.

DPH is emphasizing that these individuals are not sick, and exhibit no symptoms consistent with coronavirus. Individuals being monitored for symptoms are NOT considered Patients Under Investigation (PUI), which are those individuals who meet criteria for testing based on symptoms and travel history. DPH began reporting the number of returning travelers being monitored, as well as PUIs, on its website https://dhss.delaware.gov/dph on Monday, Feb. 10. Numbers will be updated every Tuesday and Friday afterward.

Individuals who traveled from China prior to Feb. 3, 2020, are asked to self-monitor for symptoms for 14 days after their return. If they become ill within 14 days of their return, they should avoid contact with others, and call ahead to their health care provider to discuss their recent travel, symptoms, and next steps. The health care provider should in turn contact DPH to coordinate next steps. Individuals who returned from China prior to Feb. 3, 2020, do not need to be excluded from school or work. DPH continues to encourage employers and administrators to review their own health policies to make decisions regarding exclusion from work/school for these individuals.

Both CDC and DPH continue to state that the risk of COVID-19 spreading to the general public remains low. While the number of cases are increasing in the U.S., there is no spread of the virus in the community. Risk is based on exposure. Only those individuals with recent travel to China or who have had contact with someone who has had recent travel and is ill, have an increased risk of becoming ill. For persons without an associated travel risk, it should be assumed that most respiratory illnesses are not COVID-19. As of Feb. 3, 2020, all persons returning from Hubei Province in China, as well as symptomatic persons returning from mainland China, will be quarantined for 14 days near a United States airport of entry, per federal orders.

DPH officials are also emphasizing that Asian American/Pacific Islander individuals are at no higher risk of carrying the 2019 novel coronavirus than any other individual. DPH urges people not to make assumptions that someone might be ill or could become ill based on their accent, background or skin color.

Most Delawareans are at greater risk of contracting seasonal influenza than coronavirus. COVID-19 has not been found to be spreading widely in the U.S., so there are no additional precautions recommended for the general public. The best guidance is to take the same everyday precautions recommended for avoiding colds and flu:

  • Get your flu vaccine if you have not already.
  • Stay home when you are sick and avoid well people as much as possible.
  • Cover your coughs and sneezes.
  • Practice good hand hygiene frequently wash hands with soap and water or an alcohol-based hand sanitizer.

Trauma Informed Delaware

In October, 2018, Governor Carney signed Executive Order 24, making Delaware a trauma-informed state.  This order directs the Family Services Cabinet Council to develop tools for training state employees and community partners on the impact of exposure to adverse childhood experiences (ACEs), to promote ACE awareness, and to improve services and  interventions for children and families exposed to trauma. The Family Services Cabinet Council is leading efforts to ensure that Delaware becomes a trauma-informed state
by promoting a Trauma Awareness Month in Delaware.

Since that time, First Lady Tracey Quillen Carney has brought together a variety of partners to launch Trauma Informed Delaware (TID), a statewide public-private-nonprofit coalition. The goal is to coordinate a sustainable, community-based trauma awareness, prevention, and early intervention system that advances resilience through:
• Access to quality behavioral and integrated health care
• Strength-based services for youth and adults
• Education for providers and the community

 

DPH LAUNCHES MY HEALTHY COMMUNITY DATA PORTAL

DOVER (May 13, 2019) — Today, the Division of Public Health (DPH) launched a data portal allowing Delawareans to assess the overall health of their communities. The My Healthy Community data portal delivers neighborhood-focused population health, environmental and social determinant of health data to the public. The innovative technological showpiece, which was unveiled at the Rt. 9 Library and Innovation Center in New Castle, allows users to navigate the data at the smallest geographical area available, to understand and explore data about the factors that influence health.

“This is another example of how we are making data more transparent, accessible, and easy to understand,” said Governor John Carney. “Sharing community-level statistics and data allows Delawareans to understand what is occurring in their neighborhoods, make informed decisions about their health, and take steps to continue improving our quality of life.”

Delaware residents are able to explore a variety of data indicators in the following categories: community characteristics, the environment, chronic disease, and mental health and substance use. Air quality data, asthma incidence data, public and private drinking water results, and drug overdose and death data are currently available. Over the next several months, additional categories and data indicators are expected to be added including community safety, maternal and child health, healthy lifestyles, health services utilization, infectious diseases, education, socioeconomic influencers, lead poisoning, suicide and homicide, and populations vulnerable to climate change.

“Our health and the environment in which we live are inherently connected,” said DHSS Secretary Dr. Kara Odom Walker. “The portal will allow communities, governments and stakeholders to better understand the issues that impact our health, determine priorities and track progress. Communities can use the data to initiate community-based approaches, support and facilitate discussions that describe and define population health priorities, and educate residents about their community’s health and the environment in which they live.”

Residents can search health indicators by street address, ZIP code, census tract, neighborhood, town/city, county and state. In addition, they can compare their community’s health measures with other Delaware communities, their county, and the state as a whole, as well as view data trends over time. To ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA), not all data can be made available at the community level therefore, the system is designed to provide data for the smallest geographic area possible.

“Access to data is a key factor in making progress toward a stronger and healthier Delaware. The ability to easily access such crucial information like substance use and overdose data by ZIP code enables Delawareans to compare it to larger areas and examine trends,” said Lt. Governor Bethany Hall-Long. Drug overdose deaths, non-fatal drug overdoses, and youth use of prescription pain medicines are available through My Healthy Community. Also for the first time, Emergency Department non-fatal drug overdose data from DPH, and Prescription Monitoring Program (PMP) data will be available thanks to a partnership with the Division of Professional Regulation.

“Addiction, air quality, chronic disease and drinking water quality impact every one of us,” said DPH Director Dr. Karyl Rattay. “When communities become aware of the level at which these issues are occurring in their neighborhoods, it can spur action that can improve the quality of life for current and future generations.”

“People want to know detailed information about the health of their communities,” said Rysheema Dixon, Wilmington City Council Member At-Large. “Providing this data with a neighborhood lens is going to open Delawareans’ eyes to how healthy – or unhealthy – their communities really are.”

My Healthy Community has been years in the making through a partnership among several DPH programs, the Department of Natural Resources and Environmental Control (DNREC), the Division of Substance Use and Mental Health (DSAMH), and the Delaware Health Care Commission (HCC). $138,500 in seed funding for this project was provided by DNREC in 2016, $79,000 for the initial research phase, and $59,500 for construction of the of the data portal’s framework with supplemental funding from DPH through Centers for Disease Control and Prevention (CDC) grant funds ($30,000 for development). DPH’s contractor for this project was Green River of Brattleboro, Vermont.

“Health and environmental agencies have a long history of separately tracking trends, when, in fact, environmental conditions and health outcomes are often closely related,” said DNREC Secretary Shawn M. Garvin. “This public-access portal brings health and environmental data together and puts this information at the fingertips of all Delawareans, including healthcare and environmental professionals.”

Additional funding was provided by DSAMH for substance use disorder (SUD) data and from the HCC to build in additional health indicators starting this summer, that will also serve to highlight Delaware’s progress in meeting health care benchmarks (obesity, tobacco use, preventable Emergency Department visits, etc.) as part of DHSS’s ongoing efforts to bring transparency to health care spending and to set targets for improving the health of Delawareans. Future funding has been secured from DNREC for data on vulnerable populations and climate change, and from DPH through CDC grants for violent death data and internal sharing of timely SUD data.

My Healthy Community encompasses the Delaware Environmental Public Health Tracking Network (EPHTN), and benefits from participation in an Environmental Public Health Tracking Peer-to-Peer Fellowship program through the Association of State and Territorial Health Officials (ASTHO), with the Kentucky Department of Health as Delaware’s EPHTN mentor.

Access the My Healthy Community data portal at MyHealthyCommunity.dhss.delaware.gov. Comments can be submitted via an online feedback form.

U.S. Surgeon General releases new video “The Doctor Is In”

U.S. Surgeon General Jerome M. Adams, M.D., M.P.H., released a new video, “The Doctor Is In,” on the topic of  vaccinations. As the Nation’s doctor, VADM Adams wants to share the message that vaccines are safe and effective ways to protect your children, your family, your neighbors, and yourself.

This is particularly timely, given that CDC announced yesterday that from January 1 to May 3, 2019, 764 individual cases of measles have been confirmed in 23 states. This is an increase of 60 cases from the previous week. This is the greatest number of cases reported in the U.S. since 1994 and since measles was declared eliminated in 2000.

In the video, Dr. Adams responds to frequently asked questions about vaccination.