California recorded a new case of the coronavirus Friday in Santa Clara County, heightening concerns that the disease is spreading in the United States.
Health officials in Santa Clara County said the new patient had no known exposure to the virus through travel or close contact with a known infected person.
The individual is an older adult, a woman with chronic health conditions who was hospitalized for a respiratory illness, officials said at a news conference Friday. Her physician contacted the public health department this week to discuss the case and request testing for the novel coronavirus. The department is working to identify contacts and understand the extent of exposure.
“This new case indicates that there is evidence of community transmission but the extent is still not clear,” said Dr. Sara Cody, health officer for Santa Clara County and director of the Santa Clara County Public Health Department. “I understand this may be concerning to hear, but this is what we have been preparing for. Now we need to start taking additional actions to slow down the spread of the disease.”
Friday night, Washington state health officials announced two new coronavirus cases Friday night, a woman who had recently traveled to South Korea and a high school student whose school will be closed and sanitized.
The new cases comes as officials in Northern California are searching for people who might have come in contact with a Solano County woman who is believed to be the country’s first novel coronavirus patient who did not recently travel outside the U.S. or come in contact with someone who did.
Authorities said her case might indicate that the virus is already spreading within the local community, a significant leap, making it essential that they quickly find anyone who might have been exposed to her.
The woman was hospitalized more than a week ago but was not tested for several days because she did not fit screening criteria set by the Centers for Disease Control and Prevention, which include both symptoms of the virus and either a recent history of travel to China or close contact with another coronavirus patient.
“It is important to recognize that we have moved from containment to mitigation,” Dr. Bela Matyas, the county’s health officer, said in a statement. “We are investigating potential exposures and ensuring that proper evaluation and care are provided if they become sick.”
Before she was transferred to UC Davis, the woman was hospitalized for three days at NorthBay VacaValley Hospital in Vacaville, Aimee Brewer, president of NorthBay Healthcare Group, said in a statement.
She was taken by ambulance to the UC Davis facility in Sacramento once her condition worsened, Brewer said.
“As for the patient’s care in NorthBay VacaValley Hospital, at no time did the patient fit the existing CDC criteria for COVID-19, and therefore a test was not immediately administered,” she said.
After learning of the diagnosis, the hospital “launched a meticulous tracing” of anyone who might have been in contact with her, Brewer said. The hospital remains open and is operating normally.
UC Davis officials said the woman arrived on Feb. 19 but was not tested until Sunday. The hospital said that precautions had been put in place because of caregivers’ concerns about her condition and that a “small number” of employees had been asked to stay home and monitor their temperature.
Sacramento County Director of Health Services Peter Beilenson said the woman had been transferred to the hospital under virus containment protocols, but additional measures, such as isolation in a negative pressure room, which prevents air from escaping, were now in place.
Beilenson said he did not expect additional cases of the virus based on those in contact with the patient in Sacramento, where she is receiving treatment, but did expect more cases in Solano County, where she is from.
The woman was “in her community” for a number of days before accessing care, California Health and Human Services Secretary Dr. Mark Ghaly said.
Investigators are now working to identify and locate anyone who may have come in contact with the woman. The CDC has sent 10 staffers to help trace her contacts, officials said.
“Contact tracing is super important because it can help reduce transmission,” said Dr. Brandon Brown, an associate professor at the UC Riverside School of Medicine’s Center for Healthy Communities. “The worst-case scenario is that outside of close contacts — family, friends and coworkers — there were other people exposed to the virus in places where this person visited.”
The tracing will likely start with the infected patient’s family and coworkers, who would be isolated and tested, and then move out to those who might have come in casual contact with her in places she’s visited within the past two weeks, which is believed to be the incubation period of the virus.
In order to identify individuals who came into contact with the woman at the hospital, Northbay VacaValley officials sifted through medical records to see which clinicians entered her room. Additionally, three days’ worth of security footage from 8 p.m. Feb. 15 to mid-morning Feb. 19 were scoured to ensure that all visitors and non-clinicians – like workers who brought in food trays or refilled bathroom supplies – were tallied.
Sacramento County health officials said that dozens of people might be quarantined at home based on having contact with the woman. UC Davis spokesman Steve Telliano disputed that the number could be higher than 70 but refused to say if more or fewer people were quarantined.
Steve Huddleston, vice president of public affairs of NorthBay Healthcare, said that the quarantine affected dozens connected to the hospital.
Huddleston said that the hospital staff is comprised of about a couple hundred. Those employees who have been home, due to quarantine or unrelated matters, have been backfilled.
On Friday afternoon, Makayla Lara, 20, sipped iced green tea on the porch of a Starbucks that’s a short walk from Northbay VacaValley Hospital, the first medical facility to care for the first community-based case of the coronavirus in the United States. (The woman is now under treatment at UC Davis Medical Center in Sacramento.)
“I don’t think people are super freaked out,” said Lara, a nursing student at Solano Community College. “I don’t think it’s anything to be afraid of. Just take like the necessary precautions that you do with any virus. If you are sick, don’t go out. Wash your hands, you know.”
At the Lowe’s homes improvement store in Vacaville, the shelves have been stripped of protective masks and hand sanitizer for weeks.
Employees said customers have been buying them by the case and they fly off the shelves as soon as new supplies arrive. The employees did not have authority to speak on behalf of the store and asked to remain unnamed.
Customer Teresa Del Rio, 48, said she’s not worried about the spread of the virus at this point because she’s a nurse and knows how to avoid risks of transmission. But she’s worried about the healthcare providers who cared for the patient at a local hospital who was later confirmed to have the virus.
“The only anxiety is that I don’t think people are being proactive enough knowing that the patient exposed a bunch of nurses who probably went out into the community,” said Del Rio, who works at a different medical facility. “I think they needed to be more proactive with their testing.”
From Northbay VacaValley Hospital, it’s easy to spot planes landing to the south at Travis Air Force Base, the federal facility that accepted some of the first Americans evacuated from Wuhan, China — the epicenter of the outbreak.
According to the Washington Post, a whistleblower reported that the Department of Health and Human Services sent a crew of workers to the base without the adequate protective gear or proper training on viral outbreaks.
Beilenson, Sacramento County‘s director of health services, said “definitely we will have more cases here.”
“You shed virus before you are symptomatic so it’s already out of the bag in a lot of ways,” Beilenson said. “It’s going to spread; it’s just going to spread.”
Beilenson said most people that contract the virus – more than 80% – will have mild or no symptoms, but still be able to pass COVID-19 to others.
On Thursday night, the CDC revised its testing guidelines to allow for more people to be tested for the coronavirus. Previously, only people with flu-like symptoms and a travel history to China or close contact with someone who traveled to China.
Now, doctors can order coronavirus tests for anyone with flu-like symptoms who has recently traveled to China, Iran, Italy, Japan and South Korea. In an even bigger change, Patients hospitalized with fever and pneumonia and no travel history could be tested by doctors.
The change is widely interpreted to be a response to the UC Davis patient, who had no travel history. It took several days for the CDC to allow testing of the patient, who was severely ill.
Beilenson said new community cases were more likely in Solano than Sacramento, “predominately because the UC Davis case came ensconced (in protective measures). If it would happen anywhere it would happen in Solano County,” he said.
Three UC Davis students are under 14-day isolation as one awaits test results after showing mild coronavirus symptoms, officials said.
The students are roommates at Kearney Hall, UC Davis Chancellor Gary S. May said.
One student has been off campus since Tuesday and has been tested for COVID-19. The student is in isolation at their home, UC Davis spokeswoman Melissa Lutz Blouin said Friday.
The other two have not shown any symptoms and have therefore not been tested, but they have been isolated since Wednesday night as a precaution. They were moved to a vacant on-campus apartment and are in self-isolation for 14 days, the time symptoms would appear if they had a virus.
Yolo County Health Officer Dr. Ron Chapman said officials know the source of the possible exposure for the student who might have the virus, but could not disclose that information because of privacy rules.
When the university first learned about the exposure, officials alerted all students, faculty and staff. Housing and dining services personnel also have increased cleaning rounds at those campus facilities, disinfecting doorknobs, tables and other areas with lots of student contact.
UC Davis is following the direction of the Yolo County Public Health Department in its response to the incident.
Just outside the Kearney Hall dorm at the university, freshman Dominic Alvarez sat on a concrete bench casually texting friends on Friday. He was unfazed about reports of the students who were reportedly exposed to the coronavirus.
“Me and friends, we’re not gullible,” said Alvarez, a mechanical engineering student from Los Angeles. “We’re keeping up with the medical news. For young healthy adults with healthy immune systems, it’s just like the flu. Older people have to worry, and younger kids, though.”
Another student parking his bike outside the dorm was more concerned. The student, who asked only to be identified by his nickname “Vac,” was wearing a protective mask over his mouth and nose and black medical gloves on his hands.
“I’m super worried,” said Vac, 21, an environmental engineering student. “We’re in classes every day with other students who may have been exposed.”
Vac is from northern China and has been in constant contact with his family. He says they are fine but that he, along with many other foreign students from all over Asia, are concerned for their loved ones.
“They’re hearing from families and friends who say it’s scary out there, because that’s exactly how it’s been in China and Japan for the past month,” he said.
There will now be eight public health labs capable of coronavirus testing in California in the counties of Los Angeles, Orange, Ventura, San Diego, Contra Costa, Alameda, Santa Clara and Tulare, said Charity Dean, deputy director of the California Department of Public Health.
On Friday night, Solano County formally announced two cases — but both patients appear to have contracted the virus through foreign travel. They had previously been counted as coronavirus patients.
One patient had been on the Diamond Princess cruise ship when an outbreak occurred and had been housed at Travis Air Force Base, according to the county. A second resident — who was also housed at Travis — was tested positive by Japanese officials.
Times staff writer Soumya Karlamangla contributed to this report, as did AP.