UC Davis hospital sends exposed workers home as Sacramento, California ramp up response

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Darrell Smith, Cathie Anderson, Tony Bizjak, Jason Pohl
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California will rapidly and “exponentially” expand its ability to test for COVID-19, Gov. Gavin Newsom told reporters in a news conference at the state’s public health headquarters in Sacramento on California’s response to the first-in-the-nation “community spread” case of the virus.

Newsom, vowing that “we will meet this moment,” said U.S. Centers for Disease Control and Prevention officials were talking with state health officials in the minutes before the briefing to boost California’s testing capability. The assistance will include 10 CDC personnel on their way to aid in the state’s response.

“We will meet this moment and we will, accordingly, attach ourselves to our history to meet this pandemic head on,” Newsom said.

The news comes amid a flurry of developments as federal and state officials prepare for expected spread of the virus in the United States. UC Davis Medical Center officials in Sacramento have told several workers exposed to novel coronavirus to stay home and monitor temperatures, but have indicated that Thursday otherwise is business as usual with normal operations despite at least one patient now confirmed as having the virus.

Wednesday morning, state health officials said the same in a news conference with Gov. Gavin Newsom about the nation’s first case of community exposure and the state’s response. They emphasized that Californians’ risk of contracting COVID-19 remains extremely low and that the state is not planning to make an emergency declaration.

“Right now, I don’t think it’s necessary,” Newsom said just after 11 a.m.

But the governor said new testing, protocols and personnel are on the way to bolster California’s response.

“The CDC is assuring us that testing protocols will be enhanced with urgency. The CDC is moving expeditiously on this,” Newsom said. “New protocols are being advanced and it can’t happen soon enough. We have been assured that we will exponentially increase our ability to test.”

Newsom said the state had but 200 kits at one point, calling the number “simply inadequate” for a statewide effort.

“There is nothing more important than point-of-contact testing,” Newsom said. “It’s our top priority.”

The hospital made national news Wednesday after local and federal health officials announced the Davis facility on Stockton Boulevard was treating the first U.S. case of COVID-19 from an unknown origin being treated at the Sacramento facility.

In a memo issued Wednesday night, hospital officials confirmed they are treating an intubated patient who was transported to the Sacramento facility a week ago from a Solano County hospital.

UC Davis Health leaders said in that memo that while this patient is the first in the U.S. who appears to have contracted the virus here at home without apparent contact with someone from China, the hospital has already treated other patients with coronavirus.

The patient, identified as a Solano County woman, apparently brought herself to NorthBay VacaValley Hospital Feb. 15, according to the Washington Post. She was not immediately tested for the virus under the CDC guidelines, but NorthBay staff inserted a tube in the woman’s lungs to assist with breathing, which could increase the risk of exposure to the virus, the Post reported.

Mark Ghaly, the state’s health and human services secretary, said at the news conference that the woman was in her community for “a number of days and then in the course of her care,” before being transferred to Sacramento.

“We’re working very closely with the health care systems (to determine) what community exposure existed,” Ghaly said.

“This underscores the importance of testing protocols,” Newsom added. “We have tracing protocol that’s ‘best in class.’

Staff who had direct contact with the woman have been tested for the virus and so far, all have tested negative, according to the Post.

Newsom and state health leaders at the mid-morning news conference repeatedly declined to say where in Solano County the woman and the people she contacted lived and worked.

However, they said the woman was not connected to the repatriation flights to Travis Air Force Base in Fairfield that delivered U.S. citizens from diplomatic postings in China and from cruise ships docked in Japan and Cambodia.

Newsom described an aggressive effort by health investigators to reach and debrief her contacts.

“We’re doing as we have in many situations like this. We’re engaging closely with that community. In real time, they are being interviewed. This is a very detailed protocol.”

Asked whether Solano County residents should be nervous about the real prospect of the COVID-19 virus in their neighborhoods, Newsom tried to strike a reassuring tone.

“Everybody in the country is rightfully nervous. We are meeting this moment. We don’t want to overextend the anxiety that people feel. What happened in Solano County did not surprise anybody. We want people to go about their everyday lives, but with common sense.”

Thursday morning outside UC Davis Medical Center, a employee in the clinical lab said he and other workers were not alarmed.

The man, who declined to give his name for fear of losing his job, said employees have been getting all-staff emails and feel well-informed. He also downplayed the seriousness and likened it to a regular flu.

Sonia Angell, the state’s public health director, said much the same at the Thursday news conference. For the majority of people, the virus will come with only mild symptoms. The most common are respiratory, Angell said, stressing that “the risk to the general public remains low.”

But Angell said the Solano County woman now being treated at UC Davis Medical Center in Sacramento “marks a turning point.”

COVID-19 “is part of a family of coronaviruses we are very familiar with,” but this strain is “a new member of this family.” Angell said.

Meanwhile, on the other side of the medical center, a fleet of black SUVs and an television news crew were camped out with camera trained on the facility.

Dr. David Lubarsky, the head of the hospital and UC Davis Health’s vice chancellor of human health services, and Brad Simmons, the health system’s interim CEO, said in Wednesday’s memo that the hospital is taking normal precautions, including send an undisclosed number of employees home after they had worked with the patient.

“Today we learned a patient we are treating here at UC Davis Medical Center for the novel coronavirus (COVID-19) is being investigated by the CDC as possibly the first patient to have received the infection from exposure in the community,” the leaders wrote.

“Since the patient arrived with a suspected viral infection, our care teams have been taking the proper infection prevention (contact droplet) precautions during the patient’s stay.

Upon admission, our team asked public health officials if this case could be COVID-19. We requested COVID-19 testing by the CDC, since neither Sacramento County nor CDPH is doing testing for coronavirus at this time. Since the patient did not fit the existing CDC criteria for COVID-19, a test was not immediately administered. UC Davis Health does not control the testing process.

On Sunday, the CDC ordered COVID-19 testing of the patient and the patient was put on airborne precautions and strict contact precautions, because of our concerns about the patient’s condition. Today the CDC confirmed the patient’s test was positive.

This is not the first COVID-19 patient we have treated, and because of the precautions we have had in place since this patient’s arrival, we believe there has been minimal potential for exposure here at UC Davis Medical Center.”

Lubarsky and Simmons’s note to workers continued: “Out of an abundance of caution, in order to assure the health and safety of our employees, we are asking a small number of employees to stay home and monitor their temperature.”

The Los Rios Community College District notified its student body that two of the employees attended classes on local campuses, one at American River College and the other at Cosumnes River College. In their note, school officials said: “County health experts have indicated that there are no indications at this time that members of the campus communities are at risk of potential exposure to the virus.”

Back at UC Davis, Lubarsky and Simmons said their staff are handling this case in the same way they manage other diseases that require airborne precautions and monitoring.

“We are in constant communication with the state health department and the CDC and Sacramento County Public Health about the optimal management of this patient and possible employee exposures,” the UCD memo stated. “As we regularly handle patients with infectious diseases, we have robust infection control protocols in place to handle this patient and others with more frequently seen infectious diseases. In this case, we are dedicated to providing the best care possible for this patient and continuing to protect the health of our employees who care for them.”