It’s a busy time to be an epidemiologist, but Nevada County’s Holly Whittaker took the time to answer some basic questions about what we know about the coronavirus outbreak, in the region and overall.
MI: Tell us a little about your background and experience that brought you to this role.
HW: Bachelor of Science in environmental toxicology, Master of Science in epidemiology. Experience: California legislature policy analyst specializing in agriculture and health. Nevada County Public Health.
MI: This is called a novel virus. Could you tell us what that means and how it affects us as humans?
HW: Coronaviruses are a large group of viruses that are common among animals and humans. This novel coronavirus that causes COVID-19 is a newly discovered coronavirus that has not been previously detected in animals or humans. The source of this virus has not been determined.
MI: Thus far, what do you think about how we’ve handled the coronavirus pandemic in the nation? In our state?
HW: State and local health jurisdictions have been working together for several months to respond to the coronavirus situation. Both entities have also incorporated planning for such events in their public health emergency response plans and exercises throughout the years with state and federal funding. Local public health jurisdictions work with their local healthcare partners to determine their needs and how best to provide resources if available to them. Although personal protective equipment (PPE) and other medical supplies have been limited, multiple levels of public health staff at the state and local levels are attempting to address, mitigate, and obtain resources from a variety of supply chains for our medical providers. California has also in many ways been leading the nation in social distancing measures to flatten the curve and stem the tide of the coronavirus. We were one of the first states to implement school closures[and]guidance for bars and pubs to close, as well as the directive for our senior population to stay at home. Ultimately, we were the first state to order all residents to stay home, except for essential services.
MI: A couple of weeks ago, Gov. Gavin Newsom projected that roughly 56% of California’s population will be infected with the virus over an eight-week period — is that still a reasonable projection?
HW: Projections are projections based on the best modeling at the time. As the state and federal officials have also mentioned frequently in recent days, it’s hard to speculate about a projection being reasonable because information is constantly changing. Follow the state guidelines to shelter in place and this will help diminish the number of cases of illness, thus saving lives.
MI: Is the order from Newsom to “stay at home” the right advice? When will we be able to leave the house and start hanging out with each other again? Should we be wearing masks?
HW: Our primary goal right now is to mitigate and eliminate the spread of COVID-19 in our communities. As we recognize community transmission exists, it is critical we each do our part to stay home in place to protect our loved ones and the most vulnerable populations in our communities. Diminishing the spread of illness will also be a benefit to our frontline healthcare workers.
Staying home and mindfully limiting our interactions with other people is our best tool for protecting one another and diminishing and ultimately eliminating the spread of coronavirus in our communities.
Leaving our homes and “getting back to normal” is dependent on how successful we are on limiting our exposure to one another and curbing the increase in cases across the state.
The California Department of Public Health, along with the CDC, both recently came out with guidance recommending “wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain.” Nevada County Public Health follows the recommendations of the CDC.
We are still learning how [this] disease transmits and progresses.
MI: What studies have you been keeping an eye on? What do we still need to know?
HW: I have been reading a variety of academic journals. I also follow the Centers for Disease Control and Prevention and California Department of Public Health’s (CDPH) published guidance.
I strongly recommend the public utilize resources such as CDC and CDPH as well. The guidelines and resources published are on a wide variety of topics from health care providers to the general public. Additional information such as case counts, and minimal demographic information is published.
MI: Where does the 14-day window estimate for symptoms to appear come from? How certain is that window?
HW: While this particular virus is novel, we know symptoms may appear two to14 days after exposure, based on the incubation period of MERS-CoV viruses Currently it seems most symptoms are apparent on or around day five. Studies and evaluations have been conducted with data from cases all over the world.
MI: How many tests have been conducted in Nevada County? How many test kits do we have in stock?
HW: Unable to adequately answer this question because Nevada County Public Health Department does not have access to the number of test kits sent to the commercial laboratory. Unable to answer the number of test kits in stock because of the fluctuations of testing being conducted throughout the community as well as the supply chain.
MI: There was news circulating last week about development of at-home testing, and more news yesterday about French scientists attempting to modify existing measles vaccines using fragments of the new coronavirus. Are efforts like these realistic?
HW: I am optimistic such tests can be performed, but cannot be reliant on such testing without knowing additional confirmatory testing.
MI: The Guardian reports that 35 companies are actively racing to develop a vaccine and currently testing on animals, and there has been talk of deregulating the vaccine testing industry and widespread tests on humans to speed up the vaccine process. Do you think this is wise? What do you believe it will take to develop a vaccine, and how long would it take to distribute?
HW: When asking about vaccines, all the current development timelines are projections. While we know there are vaccines being developed for COVID-19, it’s hard to compare and confidently say when one may be ready for use. Initially, we heard numbers like 12 to 18 months until a COVID-19 vaccine would be ready for use, but also know that the vaccine for H1N1 was available in about six months.
MI: How are you feeling? Scared? Hopeful?
HW: I am feeling proud in this moment to see my colleagues, my partners at the hospitals and at our nonprofit organizations pooling resources and talent to meet this major challenge head on. I am encouraged to see how adaptive our community can be. The years of planning for emergencies including but not limited to pandemics have provided a good framework for responding to such events in our communities. Adaptation by our county residents to new educational mechanisms, ways to obtain services such as drive-thru food picks-ups with the food banks demonstrates our resiliency.
MI: How do we know when this is over?
HW: Outbreaks conclude when [the] number of new reported cases return to the number normally to be expected. This may be difficult as this is a novel virus, but evaluation of the epidemic curve is critical to determine when cases are declining. Public health staff and the health care community will continue to monitor illness and conduct surveillance of COVID-19 in the community for an extended period of time.