DENVER — With eight positive cases of the novel coronavirus in Colorado, we sat down with Dr. Neal O'Connor, an emergency medicine physician with the HealthONE system in metro Denver. Watch our full conversation with O'Connor in the video above.
Here are some of the key questions we covered:
A big concern for a lot of people is whether they'll have to stay home from school or work. Are we getting to a point where extra precaution like that is needed?
I think we're there right now. If you have upper respiratory symptoms, you should stay home. We do not have a large number of tests available for coronavirus in the state. That will improve over time, and hopefully in the next week or two weeks, we'll be able to expand our testing so people can get definitive results. Now there is a restriction on the number of tests available, about 160 per day, according to the state health department. Tomorrow for example, when I'm working in the emergency department, if I have a suspected case, I would have to work with the health department to decide if somebody is appropriate for testing for the coronavirus.
What is your protocol in an emergency room for treating someone with coronavirus symptoms?
Understand, there's no specific treatment for this virus. It's like any other virus. The only virus we have effective treatment for is influenza. So it's what is called supportive care. If somebody needs oxygen or other respiratory care, we do that. If they need hydrated, we hydrate them. If they are truly sick, we may need to admit them to the hospital. But by and large, most people will have mild symptoms. Many may be asymptomatic.
So what it's like in the ER, right now everybody is being cautious, but we're not panicking. We're taking precautions that we would normally do in any sort of viral outbreak. If you're having respiratory symptoms, you would be masked and screened for fever. If you screen positive for travel, shortness of breath, things like that put you at a higher risk for having this illness -- you will be put in either a negative airflow room or private room to prevent the spread in the [emergency department]. The providers are taking precaution with personal protection using gloves and masks and eyewear depending on the severity of the patient.
One positive patient in Colorado flew to Denver International Airport before he was showing symptoms. Gov. Polis on Thursday said that made the man a low risk for spreading the virus, that he was asymptomatic at the time. Is that your understanding?
That's my understanding, based on CDC guidance. And that is very important because that does affect the spread of a virus — how early in the disease process are you symptomatic? Are you spreading the virus when you are asymptomatic? What's fortunate about this virus is that it seems people are most contagious when they are most symptomatic. There doesn't appear to be a long period where the people are asymptomatic, yet contagious. That will hopefully help limit the spread of this.
Another detail we learned from Summit County officials on Friday was that the virus would not have been contagious on surfaces in the man's condo after two hours. Is that generally the time period you have seen?
That's the number that we've heard. And I think that's probably pretty reasonable. In the healthcare setting, if we have somebody with suspected coronavirus and they're in a room, we're going to do the waiting, but we're also going to do a deep clean of that room. There's two stages to that. Yes, you want to wait two hours is probably a reasonable [time] if somebody sneezed on your coffee table. Wait for a couple hours but then use some disinfecting wipes after that.
With two positive coronavirus cases in the state, what should people do if they develop symptoms and they suspect they may have COVID-19?
So far I've not diagnosed anybody with coronavirus. What stands out to me, though, is that there is a palpable anxiety about this infection. I think that panic doesn't make any situation better, it only makes it worse. We need to be cautious, we need to be thoughtful about our actions if we have presumed illness, and do what we can as good citizens to try to curb the spread. That means if you're sick, stay home.
If you're going to go to your doctor, call them ahead of time to let them know. Make sure they have what you think you need. Don't go to the doctor's office thinking you're going to be tested for the coronavirus. They may not be able to do so. Same as urgent care. Give them a heads up that you're coming in and they can guide you. In the emergency department, coming in for mild symptoms is unlikely to be a benefit for the patient. There's no specific treatment. We're not testing everybody. Don't come to the emergency department with mild symptoms, expecting to be tested. We have to test in conjunction with guidance from the state health department. So it's not guaranteed you'll be tested if you come into the ED.