“There are things about the coronavirus that we don’t know and so that makes it a little bit more difficult, having those uncertainties,” Westchester County Commissioner of Health Sherlita Amler told the Business Journal after her appearance at a forum on the 2019 novel coronavirus.
The forum was held Jan. 31, the day after the United Nations’ World Health Organization declared that a “Public Health Emergency of International Concern” exists because of the outbreak.
The Valhalla-based Center for Disaster Medicine at New York Medical College (NYMC) brought together medical experts, elected officials and staff from city and state health departments for the event at the Touro College Manhattan Campus. NYMC is a member of the Touro College and University System.
“We’ve been through a lot of infectious issues ”“ Zika, SARS, MERS, Ebola,” Amler said. “We’ve done a lot of infectious disease-related activities with our medical community, so I think we are very well prepared.”
In addition to Amler, who also is an associate professor at NYMC, the featured speakers included: Alan Kadish, president of the Touro College and University System; Marisa A. Montecalvo, a professor of medicine at NYMC and an infectious disease specialist; Edward C. Halperin, chancellor and CEO at NYMC; Chandra Shekhar Bakshi, associate professor of microbiology and immunology at NYMC; and Robert W. Amler, dean of NYMC’s School of Health and Sciences and Practice.
Sherlita Amler told the Business Journal that the county’s health department is fully aware of the role air travel can play in the spread of the coronavirus and other diseases and the potential risks should infected people be on airliners and private aircraft using the Westchester County Airport. Although there are no international commercial flights directly to Westchester, private aircraft on international flights do occasionally use the airport.
“We have worked with the airport in the past around infectious disease issues,” Amler said. “We did that when we were prepared for Ebola, so they know what to do and, certainly, if there are any concerns they know how to reach us. I think just having them know us, and us know them, gives us a heads-up for any potential problems.”
As of the forum, cases were reported in 26 countries. It first appeared in mid-December in China’s city of Wuhan, where as of the end of January more than 10,000 confirmed cases had resulted in 304 deaths. The disease had spread to 26 other countries including the U.S. Initial symptoms are similar to influenza and it can quickly develop into serious viral pneumonia.
Amler pointed out that the first symptoms are very similar to flu with cough and respiratory problems. She said people who have not had a flu shot this season should get one because not being so vulnerable to the flu makes it more likely that, should symptoms appear, they would not be dismissed as being the flu.
“If you think you might have been exposed to someone from the area of concern in China in the last 14 days (the apparent incubation period) and you become symptomatic, you want to call your provider and tell them you’re coming in,” Amler said. She said that it would be appropriate to give health care providers ample notice so they can either put on protective gear or direct a patient to a facility where a risk of contaminating others could be mitigated.
Researchers have found that the genetic makeup of the coronavirus is about 80% similar to the SARS (Severe Acute Respiratory Syndrome) virus that caused an outbreak in Asia beginning in 2002.
Less clear are similarities to the MERS (Middle East Respiratory Syndrome) virus that appeared in Saudi Arabia in 2012 and was spread to humans from camels.
A study in Germany raised suspicions that the coronavirus can be spread from person to person before the carrier exhibits any symptoms of being infected.
“It is not clear where this virus originated but when the genome sequence is compared with the coronaviruses from bats it appears that it may have originated from bats. What happens is that bats harbor this virus and the virus replicates in bats but they themselves do not get sick,” Bakshi told the Business Journal.
There is a theory that bats may have transmitted the disease to a wild animal called the civet cat. The civet cat is considered a delicacy in China. Another theory is that it was transmitted from bats to snakes and then to humans.
Bakshi explained that the coronavirus has a type of protein spike that enables it to bind with receptors found on the cells of humans, cats, pigs, monkeys and some other animals.
“We do not have a vaccine nor do we have a very good treatment, therapy, for these coronavirus infections,” Bakshi said. “I cannot predict how long it is going to take to have an effective vaccine or any effective therapies.”
Kadish told the Business Journal, “We feel we have an obligation to use the resources of the Center for Disaster Medicine to try to educate people. We do train hospitals. We train health care professionals. We prepare protocols.”
“It appears that the fatality rate is much lower than with some other recent outbreaks,” Kadish said. “It seems like … 2% to 3% of people are dying.”
He said the college likely will use the handling of the coronavirus outbreak as a teaching element.
“When it dies down ”¦ we’ll try to look and see if we can figure out which of the measures that were undertaken were responsible and, therefore, what we can teach our students about how to deal with the next episode,” Kadish said.
Kadish said people have no reason to panic.
“They should do things they should be doing anyway like frequent hand washing, making sure they get the available vaccines and hold off doing things that can damage their lungs.”
