DOYLESTOWN >> The Bucks County Health Department announced on March 11 that the county-owned Neshaminy Manor Nursing Home has been closed to visitors as a precaution against the spread of coronavirus.
Dr. David Damsker, director of the health department, made the announcement during a news briefing held with other county officials in Doylestown. In a conference call on March 12 with administrators of other facilities housing the elderly in Bucks County, Damsker recommended that they all take similar action.
COVID-19 has caused intense focus on students and school closings, but Damsker emphasized that while children appear to be at minimal risk for life-threatening symptoms, the elderly and infirm are especially vulnerable.
Limiting visits at nursing homes and assisted-living facilities, he said, “is important. We think this is the population where we are going to see the most severe illness and death. So we’re going to get out in front of the curve before we see large-spread community transmission.”
On Damsker’s advice, Bucks County’s prisons also have closed to most visitors, including volunteers involved in community programs offered at the prison. Any prisoners admitted with cold- or flu-like symptoms will be isolated and the Health Department will be contacted for followup. Only essential vendors and contractors such as food, healthcare and legal professionals will be admitted.
Damsker continued to caution against broad panic about coronavirus, which he said has led to unwarranted hoarding of supplies such as hand sanitizer and face masks, leaving hospitals and physicians’ offices vulnerable to shortages.
On a day in which Gov. Tom Wolf directed Montgomery County to close all of its schools, colleges, gyms, entertainment venues and community centers, selected school districts in Bucks announced that they would close for one day Friday, most of them to provide instruction to staff on conducting classes remotely in the event of longer closings in the future.
Those who announced closings included the Centennial, Central Bucks, Council Rock, Morrisville, New Hope-Solebury, and Pennsbury School Districts.
At the March 11 briefing, Damsker cautioned against closing schools in which coronavirus exposure has not been documented, saying it could prove counterproductive. Among other things, he said, parents who work in healthcare and community centers would be forced to stay home with healthy children, further taxing the abilities of physicans and hospitals to care for patients who are sick with life-threatening conditions.
“We are taking this virus very seriously. But we also want to take leadership on this and tell people that panicking is not going to help anything,” Damsker said. “As we know, this virus is clearly not affecting children in any large amounts. Thus far, around the world, it has not caused fatalities in any young children.”
On the other hand, he said, “this virus definitely has the proclivity for affecting our elderly and those with immunosuppressive conditions, and we are going to be working really hard … implementing measures that help the elderly and those in long-term care facilities in Bucks County.”
The Neshaminy Manor announcement came as part of a broader briefing held for the media after Bucks County’s first two presumed positive coronavirus cases were made public late Tuesday night.
Two adults living in the same home tested presumptively positive several days after attending an out-of-state event where they came into contact with two people who later tested positive. Both of the Bucks County residents are in isolation at their home with mild symptoms.
“They’re doing fine,” Damsker said. “They’re resting at home.”
Since the source of their infection is known, and came from out of state, Damsker said, there still has been no community spread of the virus documented here.
Bucks County health officials, meanwhile, have located and contacted anyone who has been in touch with them since their symptoms appeared.
“We have spent time contacting anyone who they were in close contact with – called contact tracing – and we have asked those people to quarantine for 14 days,” Damsker said. “We will be monitoring them for symptoms. If they do develop symptoms, we would then test them for coronavirus.”
Damsker was joined at the briefing by Bucks County Commissioners Diane M. Ellis-Marseglia, Bob Harvie and Gene DiGirolamo, and Emergency Services Director Scott T. Forster.
Forster echoed Damsker’s caution against panic, saying he has conducted many meetings and conference calls with emergency responders, school leaders, government officials, hospital administrators, and longterm care providers to provide guidance on minimizing the spread of COVID-19 and to prepare for any contingencies.
“The best way we can do that is as a team, with factual information, keeping calm and making good decisions,” Forster said. “And so far, we’ve done that. We will continue to work with our community partners so that everybody has the best information and guidance we can provide them in order to keep all citizens safe and protected from this illness.”
In addition, Forster said, daily meetings and conversations continue in the event that the county has to take action to help keep essential government operations running and provide services to county residents.
Twenty-two coronavirus cases have now been detected in Pennsylvania, none fatal. More than half have been in Montgomery County, which Wolf called “the epicenter of this epidemic at this point.”
While there have been a number of precautionary school closings in the area since last week, Damsker stressed that no Bucks County school students have tested positive for coronavirus.
The commissioners praised Damsker, Forster and their staffs for working long hours to keep the situation under control to date and to maintain calm and perspective.
“It’s a great team we have up here and they’re working very, very well,” Harvie said. “While we certainly hope that the number of cases we have doesn’t spread, I think in reality we know it’s likely.”
DiGirolamo said he has been “incredibly impressed” by the ability of Damsker, Forster and their employees to carry out their duties and keep others informed. “I think it goes without saying that the health, safety and welfare of the residents here in Bucks County, and all 2,400 of our employees is our number one priority,” he said.
Damsker said the health department’s call center has had up to 12 persons at a time working to answer inquiries about COVID-19.
He urged the public to stop making panic buys of face masks and unreasonably large amounts of hand-sanitizer.
“It’s becoming a self-fulfilling prophecy,” he said. “If you hear there’s very little hand sanitizer, every person decides they are going to buy all the hand sanitizer they can buy in every store [and] hospitals have trouble buying it.
The average person doesn’t need N95 masks, he added, but because many people are buying them anyway, “hospital systems and physicians’ offices are having trouble finding them. The county is having to look harder to find these kind of supplies, which should not be hard to find.”
Damsker continued to urge residents to practice preventive steps such as:
Frequent hand-washing with soap and warm water for at least 20 seconds
Avoiding close contact (within six feet) with people who are sick
Avoiding touching one’s eyes, nose and mouth
Staying home when sick
Covering one’s coughs or sneezes with a tissue and throwing the tissue in the trash
Cleaning and disinfecting frequently touched objects and surfaces with household cleaning sprays or wipes
The incubation period for a person exposed to COVID-19 – the time between exposure and first appearance of symptoms – is between two and 14 days. Those who have been in contact with a person known to have COVID-19, or those who have traveled recently to areas where there have been outbreaks, are asked to self-quarantine themselves for 14 days from the time of potential exposure.
According to Damsker, county health department continues to contact all travelers returning here from countries where there have been COVID-19 outbreaks, directing them to self-quarantine and helping them monitor for symptoms of the virus.
Common sense and keeping informed should be paramount for persons who develop cold- or flu-like symptoms, Damsker said.
“We want people to self-quarantine” when sick, Damsker said. “We don’t want people rushing into emergency rooms because they think they have coronavirus, when people who are really ill need the emergency room. There’s not a lot of excess space in hospitals, [and] if we have even 100 people in a day running to an emergency room who don’t need to be there, that puts extra pressure on the staff and makes them use extra resources.”
County health officials are working with healthcare providers and the Pennsylvania Department of Health to determine on a case-by-case basis whether testing is appropriate. This is done in the interest of not depleting resources by testing every person who has a respiratory illness.
Much remains unknown about COVID-19, including fatality rates. Early indications are that children are at much lower risk of severe illness from COVID-19, and, as with influenza, the elderly and those with immunosuppressive conditions are at higher risk of severe illness.
Current reports of fatality rates are most likely overestimates, Damsker said, given that most of those infected have had either asymptomatic or mild infections. While that is positive news, he added, it makes the virus easier to spread unnoticed by those with minor or no symptoms.
Because there is currently no medication or vaccine for COVID-19, Damsker said, simple preventive steps such as good hygiene, avoiding sick people and staying home from work when sick are the best course of action.
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