Nicole Alexander-Scott, MD, MPH, the Director of the Rhode Island Department of Health (RIDOH), provided an update to reporters today on preparedness efforts underway in Rhode Island related to coronavirus disease 2019 (COVID-19), and discussed general steps people can take to help prevent the spread of seasonal illnesses like the flu.
"Rhode Island has been taking extensive preparedness steps over the last several weeks as the COVID-19 situation has continued to evolve internationally," said Dr. Alexander-Scott. "Although the general level of risk for Rhode Islanders is still low and there have been no confirmed cases in our state, everyone can contribute to our preparedness work by taking simple, everyday steps to limit the spread of viruses. Those steps include washing your hands regularly, covering coughs and sneezes, and staying home when you are sick."
Some of the same steps that can help prevent the spread of coronaviruses can also help prevent the spread of other viruses, such as the flu and norovirus. While there have been no confirmed cases of COVID-19 in Rhode Island, a lot of flu is circulating here right now. The preparations to protect yourself and your loved ones against coronavirus are the same steps people should already be taking to protect against the flu. This flu season in Rhode Island there have been more than 650 flu-related hospitalizations and 11 flu-related deaths.
All Rhode Islanders should:
- Get your flu shot. Flu shots are your best protection against the flu, and they help protect the friends and loved ones around you who may be more at risk of getting very sick because of the flu, such as pregnant women, infants, and older adults. Flu vaccine can also help people avoid flu-related hospitalizations. This allows hospitals to focus on patients with more severe illnesses. - Wash your hands regularly. When washing your hands, use warm water and soap. If soap and water are not available, use alcohol-based hand gel. - Cough or sneeze into your elbow. Flu is spread through coughing or sneezing on other people or into your hands. Cover your coughs and sneezes to prevent others from getting sick. - Stay home from work or school when you are sick. - Avoid touching your eyes, nose, or mouth. Germs spread this way. - Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious foods. - Keep surfaces (especially bedside tables, surfaces in the bathroom, and toys for children) clean by wiping them down with a household disinfectant.
The Centers for Disease Control and Prevention (CDC) does not recommend that people who are well wear a facemask to protect themselves from respiratory illnesses, including COVID-19. You should only wear a mask if a healthcare professional recommends it. Facemasks are generally used to prevent sick people from getting other people sick.
Business owners can also take a number of steps to create healthy workplaces. They should:
- Actively encourage sick employees to stay home. Employees who have symptoms of acute respiratory illness are recommended to stay out of work until they are free of: fever (100.4° F [37.8° C] or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines. - Ensure that sick leave policies are flexible. - If possible, maintain flexible policies that permit employees to stay home to care for a sick family member. - Emphasize respiratory etiquette and hand hygiene by all employees. Employers can do this by displaying posters that encourage cough and sneeze etiquette and hand hygiene. - Routinely clean all frequently touched surfaces, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label.
Additional guidance for business owners from the CDC is available online. (See link below.)
Since late December there have been more than 80,000 cases of COVID-19 diagnosed and more than 2,700 fatalities worldwide. The vast majority of these cases and fatalities have been in China. As of February 26, there have been 59 U.S. cases. That figure includes travel-related cases, cases of person-to-person spread, and people repatriated from China and other areas of the world.
Given the global dynamics of the COVID-19 outbreak, it is possible that Rhode Island could have a case in the near future. While RIDOH is reminding Rhode Islanders about the health measures they can take to help prevent the spread of virus in the community, Rhode Island is continuing to coordinate with the federal government to limit of prevent the spread of COVID-19. RIDOH is coordinating a process to ensure that anyone who has been in China in the previous 14 days is self-monitoring for symptoms for 14 days and is limiting their movement. (People in this situation are being instructed to not attend work or school, and to avoid public places and gatherings for 14 days.) Once 14 symptom-free days pass since someone's last potential exposure to COVID-19, there is no longer a health concern about that person getting sick or spreading the illness.
RIDOH is partnering with federal officials to implement this monitoring program, which started on February 3, 2020. The U.S. Department of Homeland Security is routing all flights carrying people who have traveled to China within the last 14 days through one of 11 U.S. airports designated to receive and screen travelers. People returning from Hubei Province, which is the center of the outbreak in China, are not continuing their travel; they are being quarantined domestically near the international airport where they landed. People coming from other areas of China are being screened for symptoms at their U.S. arrival airport. People who are symptomatic are being isolated near their arrival airport. People who are not coming from Hubei Province and who are not symptomatic are continuing to their final destinations.
For those whose destination is Rhode Island, RIDOH is notified of their arrival and is coordinating with these travelers so that they understand the self-monitoring guidance and guidance on how to seek medical care if it is needed. 26 people have been a part of this self-monitoring process in Rhode Island since early February. There are currently six people doing self-monitoring (however, the monitoring period for three of those people is ending today).
RIDOH is coordinating with other State agencies and community organizations to ensure that people who are remaining at home after traveling from China have the support services they need. This includes support with everyday needs, such as prescriptions and groceries. The organizations that have offered support include agencies throughout the Executive Office of Health and Human Services (EOHHS), the Rhode Island Food Bank, the American Red Cross, and other members of Rhode Island's Voluntary Organizations Active in Disasters (VOAD).
In addition to coordinating the process for returning travelers, RIDOH has taken a number of other preparedness steps. They include:
- Establishing an Incident Command System response, which is how RIDOH and other State agencies organize to prepare for (or respond to) an urgent situation that requires extensive coordination. It includes staff from the Rhode Island Emergency Management Agency (RIEMA), the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals (BHDDH), the Rhode Island Department of Human Services (DHS), and the Rhode Island Department of Environmental Management (DEM). It also includes staff from RIDOH's State Health Laboratories, Center for Acute Infectious Disease Epidemiology, Center for Emergency Preparedness and Response, and Center for Public Health Communication, among other areas of RIDOH. - Regularly communicating with RIDOH's Infectious Disease Epidemiology Advisory Committee (IDEAC) to track any clinical and epidemiological developments related to COVID-19. (IDEAC is a group of infectious disease physicians throughout Rhode Island that provides guidance to RIDOH leadership on emerging infectious disease matters.) - Maintaining a robust system to receive and follow up on illness reports from Rhode Island healthcare providers. - Regularly sending to local healthcare providers summaries of the national situation, criteria to guide evaluation of patients, and guidance on specimen collection, testing, and reporting. - Coordinating closely with healthcare facilities and emergency medical services (EMS) providers to ensure their preparedness. - Communicating regularly to community partners, such as schools, and municipal officials.
More information about COVID-19 is available in multiple languages at health.ri.gov/covid