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No coronavirus cases yet in NC, but Duke Hospital is preparing for it

Amid the current outbreak of a novel coronavirus that originated in Wuhan, China, hospitals throughout the United States are preparing treatment plans for patients infected with the virus. Duke University Hospital is no exception.

As of Feb. 5, the World Health Organization reported 24,363 confirmed cases in China and nearly 200 additional cases in 24 countries, 12 of which have appeared in the United States. Currently, there have been no reported cases in North Carolina, and the Centers for Disease Control and Prevention calculates a low risk of getting coronavirus in the United States.

If the virus makes its way to the Durham area, however, Duke Hospital has its own plan to stick to.

“We've been preparing for multiple years, really since 2009 H1N1, for the next respiratory viral outbreak,” wrote Associate Professor of Medicine Cameron Wolfe, an infectious disease specialist at the hospital, in an email to The Chronicle.

H1N1 was a novel influenza virus that broke out in the United States in 2009 and quickly spread around the globe. There were cases of the pandemic in more than 100 countries, whereas only 25 countries have confirmed cases of coronavirus at the moment.

The foremost step to handling a potential case is risk assessment, Wolfe explained.

“It’s all about figuring out who's at risk based on their symptoms and travel history,” he wrote. “If you haven't been to China within 14 days, you're probably exceptionally low risk.”

He added that whether patients will be admitted to Duke Hospital depends on their level of sickness. 

“Many people with mild illness may be managed at home, if they can quarantine and isolate themselves,” Wolfe wrote. “But if they're sick enough, absolutely we will admit them.”

The hospital can only take in as many patients as they have beds and resources with which to treat respiratory disease patients. Since recent renovations and additions to the building such as the new isolation capacity, the hospital now has a greater capacity to handle more severe cases.

Wolfe did not rule out the possibility of an outbreak in North Carolina.

“I worry about coronavirus because our community has no real immunity to it yet, nor any vaccine way of assisting with protection,” he wrote.

While the individual case fatality or severe illness is rather low—lower in comparison to the 2002 Middle East respiratory syndrome coronavirus or the 2003 SARS coronavirus—Wolfe noted that the greater issue might be the number of people at risk.

Recently, Duke banned all University-funded travel to China in an effort to curtail the spread of the virus. On Feb. 2, President Donald Trump’s administration introduced a mandatory 14-day quarantine for U.S. citizens who have been to the Hubei Province of China—the epicenter of the coronavirus—within the past 14 days. Foreign nationals traveling from China who are not immediate family of U.S. citizens or permanent residents will be denied entry.

Although Wolfe hoped that the travel ban might delay the spread of the disease at least in the United States, he expressed considerable doubts at the same time.

“I think our risk of an outbreak is just as proportional to how many other cases pop up in other countries, because if they do, then a single travel ban to China won't stop the flow of people and the virus from other places,” he wrote.

In order to stop the virus before it could wreak havoc, Wolfe stressed the importance of early identification and following the sick person’s contacts. 

For now, Wolfe advised students and residents to be careful and protect themselves as in any respiratory viral season. 

“Lots of good handwashing, sneeze and cough hygiene, and being respectful and staying off campus and out of class if you're sick,” he wrote.  

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