Audrain County Health Department Administrator Sandra Hewlett, standing, leads a meeting Thursday at the department with leaders and elected officials from the county along with first responders and others regarding coronavirus prevention plans. [Charles Dunlap/The Mexico Ledger]

The big question around coronavirus, or COVID-19, is not if there will be a case in Missouri, but when.

As of Friday morning, there are no confirmed cases in Missouri, but there are investigations underway, Audrain County Health Department Administrator Sandra Hewlett said.

The health department held a meeting Thursday morning with county stakeholders to discuss COVID-19 and response practices. The health department has been preparing since December for the eventuality of the viral respiratory illness coming to Missouri and now is bringing in other entities to have more concrete conversations.

The novel coronavirus first emerged in China in December and has since spread around the world. Almost 100,000 people have become ill and 3,300 people have died, according to the Associated Press. The first case was confirmed this week in Tennessee and five people have tested positive in Illinois.

The health department regularly sends communications to business leaders, emergency responders, school districts and private schools, health care professionals, clinics and hospitals and city and county governments, among others with updates on the virus.

Leaders from each of those entities was present for the Thursday’s meeting and weekly meetings now are planned.

“The purpose of this meeting today is we are being bombarded on the news, radio, television, social media, print ads and it is all coronoavirus,” Hewlett said. “It has created a lot of panic.”

So, the purpose of the meeting was to dispel myths for community leaders and to discuss what they have done so far to inform employees, students, parents and more.

“Between Friday and Sunday night, I had taken 53 phone calls and they ranged on a variety of topics. By Monday evening, that had jumped up to 117,” Hewlett said.

Coronavirus now is present in 18 states, with 27 states where investigations are underway on potential COVID-19 infections, Hewlett said. Because of rapidly changing information, daily fact sheets from the Centers for Disease Control and Prevention are out of date within an hour, she added.

“This has become our new normal,” she said.

Public information updates

The health department currently is monitoring any reporting from CDC, and the state to inform the public.

Missouri Military Academy Commandant Rick Grabowski also provided an update. An informational letter was sent to parents since the academy houses several international cadets. Volunteer host families are taking in the international cadets over spring break and the academy also is hosting cadets over the break. For those that do travel, they will be screened upon return, Grabowski said.

The state emergency management agency is using the Missouri Pandemic Influenza Response plan to address Coronavirus. There also is an education campaign underway about proper hand washing techniques and and hand sanitizer application.

The health department has a supply of hand sanitizer and other cleansing materials which entities can request, Hewlett said. The county requested hand sanitizer for general use at the Audrain County Courthouse and for polling stations for Tuesday’s presidential preference primary.

The best practices people can do is to wash their hands for at least 20 seconds, by rubbing between fingers and at least 1 inch up their wrist. People also should avoid touching their face. Those who are sick should stay home, Hewlett said.

Coronavirus testing

The COVID-19 test is highly accurate, Hewlett said. The test includes the collection of a sputum sample. This means a person has to cough out mucus from deep within their lungs into a collection tube.

“It is not [just] a nose swab because that is not where it exists,” SSM Health Urgent Care Dr. Simon McKeown said.

Missouri had its state testing lab approved 10 days before other states, Hewlett said. Around $1 billion dollars of the $8.3 billion allocation for prevention and containment will go to public health agencies throughout the U.S., she said.

Patients will have a clinical evaluation before a test is administered as there is a limited number being sent to health departments. Audrain County has received two test kits, while cities like St. Louis and Kansas City have received five, Hewlett said. Test kits are replaced as they are used. Other medical facilities in the county likely will request their own test kits the coming days, Hewlett said.

“If you came in with fever, cough, shortness of breath, we would have to call the state epidemiologist, we have to fill out an assessment form and then they tell us whether we can use one of those kits,” Hewlett said.

Face masks

The CDC does not recommend individuals purchase N-95 face masks, unless you are sick, so that there is supply available for first responders. There also is a process for putting on and removing a mask. You also have to make sure you are using a mask that fits properly.

Hewlett took a fit test consensus of those present Thursday.

“OSHA requires [fit testing] annually. Audrain County fit testing is abysmal. In the state, 80% of health department a year ago when Ebola was ending were not fit testing nor did they have the equipment to fit test,” she said.

The health department is offering free fit testing for entities, such as first responders or schools. Entities will have to arrange that with the health department. Mexico school District 59 is planning a training session and fit test for its nursing staff March 26, Hewlett said.

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