How to slow down COVID-19? Ideas from the Philadelphia Health Community

The Philadelphia Department of Health convened experts in public health, disease control and related research on Wednesday to discuss what is being done to stop transmission of the coronavirus and prepare the city to handle COVID-19. Although other parts of the region have already reported presumptive positive cases of the virus, Philly’s first case was not reported until Tuesday.

Here are five takeaways from the symposium:

Limit gatherings

Steve Alles, director of the Division of Disease Control at the city’s Department of Public Health, said the current recommendation is not to attend gatherings of more than 5,000 people. But it’s also worth applying more generally, he said: think about the who, what and where.

The what: Avoid events that involve singing, chanting, or cheering. The coronavirus, Sars-CoV-2, spreads via viral droplets that can travel in the saliva of infected people. When you clap or shout, you simply increase the chances of spreading the virus.

The Who: Consider who will be at a social gathering. Groups of people in high-risk categories, such as the elderly or those with pre-existing conditions, should be limited.

The where: Consider space. Social distancing is the name of the game. The Centers for Disease Control and Prevention suggests 6 feet, so imagine your tallest friend lying down and try to keep that distance from other people. Restricted spaces make transmission even more likely, as they hinder social distancing.

fight the rise

Jessica Caum, manager of the city’s bioterrorism and public health preparedness program, spoke about health care guidelines and what’s called “flattening the curve.” Essentially, we want to stop the exponential spread of the virus. One person, without taking precautions, would transmit the virus to between 1.5 and 3.5 people, and they would transmit it to 1.5 to 3.5 other people. If the virus were allowed to spread in this way, the number of cases would swell and strain essential services, such as hospitals. Limiting the spread of cases is essential.

So, postpone elective or non-essential surgery. This prevents people from going to the hospital. Move appointments and procedures to outpatient facilities – it does the same thing, keeping people out of hospitals. Consider using telemedicine, whether for a routine appointment or to get a COVID-19 assessment, to reduce traffic in hospitals and doctor’s offices. Fewer people in hospitals means less risk of infection for everyone and more resources to move around the hospital.

Stay home when you are sick

Following the best advice, the city’s health commissioner, Thomas Farley, joined the symposium remotely. He was staying home because he had cold symptoms.

The coronavirus has a four to six day incubation period, Farley said. This means it will take four to six days from infection to the onset of symptoms, so even if you are not sick but have reason to believe you have been in contact with a case of COVID-19 , talk to your doctor. If you feel sick, stay home.

Know the risk factors

Kristen Feemster, medical director of the city’s health department, presented some statistics on the death rate from COVID-19 and the risk for Philadelphians in general.

The mortality rate is 2.0-2.3% overall, with the highest rate, 14.8%, in patients over 80 years of age. For patients over 60, those in the 70-79 age group had an 8% mortality rate, and those 60-69. were at 3.6% mortality rate. For patients under age 60 with no other health problems, the mortality rate was 0.9%.

What is the risk for all of us? At high risk, Feemster said, are those who live with someone who has COVID-19 and don’t take recommended precautions, or who don’t know the person they’re living with is sick. People at medium risk are those who come into contact with a COVID-19 case and use precautions, or people who have recently traveled to an area with an outbreak.

If you have been in contact with a case of COVID-19, even if you and that person were in the same physical space, you are still at low risk.

A vaccine is coming, but not quickly

Pablo Tebas, a researcher at the University of Pennsylvania, said Inovio, which is based at Plymouth Meeting, is working on a vaccine, INO-4800. It is in preclinical testing and will be ready for human testing in early summer. But this does not mean that the general public will have access to it at the beginning of the summer. Security testing will not be done until late August or early September, at the earliest.

big picture

Slowing the spread of COVID-19 is everyone’s responsibility. Many strategies such as public distancing and self-quarantine rely on people’s choice. If you think you have COVID-19 and need to go to the doctor’s office or the emergency room, call ahead so they can be prepared. Even if you are not very sick, if you are part of the healthy population with a very low mortality rate, you could transmit the virus to someone at high risk. So stay healthy, keep washing your hands and stay informed.

Philadelphia has launched an emergency operations center that will coordinate activities for the fire department, health department, SEPTA and more. You can sign up for free city alerts by texting COVIDPHL to 888-777. You can also get updates from the Department of Public Health website.