As the state responds to its first positive tests for coronavirus, officials say risk of transmission remains low but are urging Rhode Islanders to remain vigilant.
“I understand why many Rhode Islanders may be concerned or even frightened … My primary message to the people of Rhode Island this morning is that the risk here in Rhode Island at this point is low, and we have been preparing for this for weeks. We did not wake up today and just get started in our preparations,” Gov. Gina Raimondo told members of the media during a Sunday morning press conference at the Rhode Island Department of Health’s headquarters.
“We fully anticipated standing before you at some point to make the announcement that we are making today,” added Dr. Nicole Alexander-Scott, the state’s health director. “We are not seeing widespread community transmission in Rhode Island, and that means the general level of risk for Rhode Islanders is still low.”
In Johnston, local leaders are conveying a very similar message.
Mayor Joseph Polisena on Wednesday said his office has not received calls from residents concerned about the virus, but he assured that maintenance staff is cleaning door handles and surfaces every hour. He said EMA Director Joseph Razza of the Johnston Police Department has handled conversations with the state.
Polisena said he is confident Johnstonians will be “cool and level-headed,” as well a prudent in taking precautions, in response to the arrival of the virus in Rhode Island.
“I know a lot of people are panicking … maybe people will learn to wash their hands all the time,” he said. “ People come out of the bathroom at restaurants and they don’t wash their hands. It’s just simple. I tell my EMT students, remember what your mother told you, wash your hands. Don’t touch your face. We’re not going to have employees wearing masks.”
Johnston Superintendent of Schools Bernard DiLullo told the Sun Rise on Monday morning that he sent out two alert messages to parents over the weekend, updating them on developments regarding coronavirus.
He made families aware of the confirmed and potential cases in Rhode Island and said he does not see any connection in Johnston to those who are infected.
“The transmission is typically through someone who is infected and showing symptoms. That’s really what people need to be mindful of, to avoid contact that may be sick,” DiLullo said. “The district had a cleaning crew disinfect all the buildings, spraying disinfectants in every classroom and bathroom. I have contact with the bus companies to make sure bus companies are disinfecting buses. They have protocol coming down from administrative offices spelling out what they need to do to make sure buses are clean and not carrying disease.”
DiLullo said there were a few staff members out on Monday, but nothing that appeared to be concerning. He also said no one has reported flu-like symptoms.
Cases tied to Europe trip
There have been a number of developments since the state announced the local arrival of the coronavirus – known by the formal name COVID-19 – on Sunday.
The local cases – initially three, and now four – have been tied to a February trip to Europe organized by Saint Raphael Academy, a Catholic School in Pawtucket.
The three cases identified Sunday all involved members of a 38-person group that visited France, Spain and Italy – which has experienced a significant outbreak of the virus – before returning to Rhode Island on the weekend of Feb. 22.
“All three people went on the same trip to Italy,” Alexander-Scott said in a statement issued Sunday night. “This is precisely why we are being so aggressive in identifying contacts, ensuring monitoring, and testing people who are symptomatic.”
The first positive case, a man in his 40s, was announced Sunday morning. Officials say he remains hospitalized.
His case had considered a “presumptive positive,” meaning it had yet to be officially confirmed through the Centers for Disease Control and Prevention. On Tuesday, state health officials announced the CDC has confirmed the man’s COVID-19 diagnosis.
Later Sunday, officials announced that a teenage girl had also tested positive for the virus. Health officials on Tuesday night identified her as a Saint Raphael Academy student and said she is “recovering well.” Her case was still awaiting CDC confirmation as of press time on Wednesday.
The third potential case, a woman in her 30s who works as a staff member at Achievement First Academy and served as a chaperone on the trip to Europe, has tested negative for the virus through the Department of Health’s State Health Laboratories, it was announced Wednesday morning.
While the third potential Rhode Island case came back with negative results, a new case has emerged – this time a Massachusetts woman in her 20s who was associated with the Saint Raphael trip.
She received a “presumptive positive” COVID-19 diagnosis as a result of testing conducted by Massachusetts health authorities and is recovering at home while awaiting CDC confirmation, according to Rhode Island health officials.
“The Massachusetts Department of Public Health is coordinating the contact tracing for this individual and communicating very closely with RIDOH,” a Tuesday night update from the Department of Health reads.
Tuesday night’s update outlines the scope of the COVID-19 to date in Rhode Island. A total of 12 people have been tested at the state level – the two “presumptive positives,” six that have tested negative and four for whom results remain pending. Approximately 60 people are currently under self-quarantine as part of the state’s response.
Saint Raphael remains closed, while Achievement First Academy had closed its campuses on Hartford Avenue in Providence and Garfield Avenue in Cranston for cleaning on Monday and Tuesday but reopened on Wednesday.
Additionally, health officials said Meadowbrook Farms School in East Greenwich closed for cleaning “out of an abundance of caution” on Tuesday after the sibling of a student at the school developed symptoms upon returning from an overseas trip.
Testing and containment
Alexander-Scott said the State Health Laboratories has the capacity in place to conduct testing for COVID-19 locally but is taking a judicious approach to the use of the kits. She also said the CDC confirmation of any “presumptive positive” is part of a protocol that is being followed nationwide.
Health officials say all of the participants in the trip to Europe have been instructed to remain home from work or school for a period of 14 days and self-monitor for symptoms.
During a phone briefing with reporters Monday, Alexander-Scott said: “Outreach to the people who were in direct contact with any of these three individuals is extensively ongoing at this time. These direct contacts, who we will get in communication with, will be asked to self-monitor for symptoms at home for 14 days with public health supervision.”
In a press release, officials said the state’s Health Department is “coordinating with other state agencies and community organizations to support anyone doing self-quarantining to ensure that people who are remaining at home have the support services they need.”
“This includes support with everyday needs, such as prescriptions and groceries,” the release reads. “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).”
Risk still seen as low in RI
Alexander-Scott said the man involved in the first diagnosed case had not yet returned to work and has had “very limited travel in Rhode Island after returning from Europe.”
She also stressed that based on the current guidance from the CDC, the risk of transmission is considered low. As all of the cases to this point appear tied to travel, the state is not experiencing what is called “widespread community transmission” – in other words, cases that cannot be tied to a specific chain of transmission.
Additionally, Alexander-Scott said at this point the primary concern in terms of transmission centers on coming into contact with someone who has become symptomatic. She said the risk is considered “very low for someone who is a contact of a contact” – meaning someone who came into contact with someone who had themselves been in contact with a potential COVID-19 carrier.
“You need to be exposed to someone who actually has symptoms” to be at risk for transmission, she said.
In a follow-up message to the media Sunday, Department of Health spokesman Joseph Wendelken wrote: “The science continues to evolve and what we know about this virus is subject to change. However, the latest guidance from CDC is that risk of asymptomatic transmission is very low. (The main way the virus spreads is through respiratory droplets expelled by someone who is coughing.) If someone is not exhibiting any symptoms there is no need to change your daily routine.”
According to the CDC, symptoms of COVID-19 may appear between two and 14 days after initial exposure. Symptoms include fever, cough and shortness of breath.
Tuesday’s update from health officials provided the following additional background:
“There are many respiratory illnesses circulating in Rhode Island, such as the flu and the common cold. Having respiratory symptoms does not mean that you have COVID-19. People are at higher risk for COVID-19 if they have symptoms of COVID-19 (cough, fever, shortness of breath) AND if they were a contact of a confirmed positive case of COVID-19 (or have traveled to country with community transmission, such as China, Italy, South Korea, Iran, and Japan). Someone is considered a contact if they have had direct, face-to-face contact with a person with COVID-19.”
The update continues: Testing can only be done on individuals who have symptoms that are consistent with COVID-19. Testing individuals with no symptoms or history of travel can lead to inaccurate results. People who think they have COVID-19 should call their healthcare provider. These people should not go directly to a healthcare facility without calling a healthcare provider (unless they are experiencing a medical emergency).”
Global and national spread
According to the World Health Organization’s March 3 update, nearly 91,000 cases of COVID-19 have been confirmed across 72 countries. The vast majority of cases – more than 80,000 – are in China, where the outbreak originated.
South Korea, Italy and Iran have also experienced significant outbreaks. In the United States, the number of confirmed cases has exceeded 100.
There have been roughly 3,000 deaths associated with the virus in China and more than 160 elsewhere across the globe, according to the WHO. As of Wednesday, six deaths have been confirmed in the United States, all in Washington State.
On Monday, global health officials indicated the spread of the virus appeared to be slowing in China as the number of cases in the West continued to grow. Increasing unease about the virus has shaken global markets, and on Tuesday the Federal Reserve reduced its benchmark interest rate in a surprise move aimed at boosting the economy amid the uncertainty.
Virus concerns have also spurred a rush on basic goods and medical items such as facemasks. That effect has been seen in Rhode Island, where shelves at some stores have been cleared of items like hand soap.
Given the international origins of the virus – and the travel-related nature of the local cases – many Rhode Islanders may be reconsidering plans for trips overseas.
Janis Constantine, a travel agent at Global Excellence in Warwick, said none of her personal clients have canceled travel plans because of the virus but there has been a heightened level of concerns and questions. She said many airlines and cruise companies are allowing the rescheduling of trips to Asia as well as Italy without a fee.
Constantine said many travelers are considering insuring their trips. She said insurance would cover instances where the traveler became ill, however, she said, few policies would cover situations where people are fearful of contracting the virus and therefore want to cancel their trip.
“Most people are on a wait and see basis,” she said.
Constantine said most of her time at this point is spent trying to give her clients accurate information, “so they can make an informed decision.”
How to prepare
Raimondo and Alexander-Scott on Sunday both stressed that masks are not advised as a means of containing transmission in the general public, and asked residents not to take part in the rush on acquiring them to help ensure a shortage is not experienced in medical settings.
“Masks are not recommended for people in the general public who are healthy,” Alexander-Scott said.
In a press release, the health department elaborated: “The 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. A facemask should be used by people who have COVID-19 and are showing symptoms. This is to protect others from the risk of getting infected.”
Raimondo said the state has an “excellent plan in place” and has maintained “close collaboration” with municipal and school leaders. She said she has noted spoken directly with Vice President Mike Pence – who has been put in charge of the federal coronavirus response – but that her administration has been in contact with the White House.
“Here in Rhode Island, we are prepared for this … We are following the science, we are following best practices,” she said.
Information provided by the state mirrors CDC guidance on how Rhode Islanders may best protect themselves against COVID-19 transmission. In short, officials advise that the steps are like those that would typically be taken to avoid the flu and other viruses.
Specific guidelines include receiving a flu shot; washing hands frequently with warm water and soap, or, in lieu of that, an alcohol-based hand gel; coughing or sneezing into one’s elbow to avoid spreading viruses onto one’s hands; remaining home from work or school when experiencing symptoms of illness; avoiding touching one’s eyes, nose or mouth; and keeping surfaces such as bedside tables and children’s toys disinfected.
“Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious foods,” Department of Health guidelines state.
The guidelines additionally advise: “If you have recently traveled from an area with widespread or ongoing community spread of COVID-19 and you have symptoms of the disease (fever, cough, shortness of breath) reach out to your healthcare provider and call ahead before going to a healthcare facility. The healthcare provider or facility will work closely with RIDOH.”
Additional information is available in multiple languages by visiting health.ri.gov/covid or calling 222-8022.