A Conversation With Christina Tan, MD, MPH: Coronavirus, Public Health, and Infection Prevention

Segment Description: Christina Tan, MD, MPH, state epidemiologist and assistant commissioner with the New Jersey Department of Health, discusses the current coronavirus outbreak and how infection prevention efforts can help curb its spread.

Interview transcript (modified slightly for readability):

Infection Control Today®: So my first question is how did this novel coronavirus emerge and how is it different from other coronaviruses?

Dr. Christina Tan: Late last year we started to see a cluster of unusual pneumonias come up in China. That's when we first started to get an indication that there might be some sort of new, novel emerging infection that was going on. As we were following the progress of this cluster of unusual pneumonia illnesses in China, there was more information that was evolving and then subsequently, scientists were able to identify this novel coronavirus.

ICT®: Are there infection prevention protocols that should be reviewed at healthcare institutions to prepare for the event of a suspected or confirmed case?

CT: We definitely want to remind all healthcare facilities to be reviewing their infection control plans, whether in the middle of an emerging infectious disease issue such as COVID, or you know, just kind of routinely just to make sure that they're following infection control guidance and proper protocols. All healthcare facilities should have plans in place regarding dealing with respiratory illnesses. We have to remind ourselves that every single year we see seasonal flu, we see respiratory illnesses emerge. Keeping those infection control plans in mind and exercising those infection control protocols are really key to not only dealing with the routine, but also a step toward the prevention of emerging issues.

ICT®: What infection prevention measures are being activated when dealing with a novel pathogen such as this?

CT: Well, you know, as with other respiratory illnesses, we want to ensure that people follow those common sense things that we do, for instance, when we're in the middle of respiratory virus season. Covering your cough, making sure that you stay home when you're sick, making sure that you go see your healthcare provider if you're concerned about your health, and to give a call to your healthcare provider ahead of time so that they can be prepared for you coming in.

ICT: How do the symptoms of this coronavirus differ from that of other respiratory infections such as the flu?

CT: With COVID, this novel coronavirus illness, we're seeing a lot of individuals with severe respiratory illnesses. So, a lot of the cases that we're seeing have fever, shortness of breath, cough, a lot of lower respiratory tract illnesses. This is a little bit different, a little bit more severe than what we've been seeing with your routine respiratory virus illnesses.

ICT®: What constitutes a suspected, probable, and confirmed case of COVID-19?

CT: Currently, in the United States, we are looking at different criteria for COVID illnesses. For now, the criteria are looking at individuals with a history of exposure to the hot zone, Wubei Province in China, or contact with individuals who are confirmed cases of COVID and with clinical presentation of fever and respiratory tract illness. that include fever, cough, and shortness of breath.

ICT®: With person-to-person transmission reported with this virus, are there any preliminary estimates of just how contagious it could be?

CT: The information is still evolving about the transmission of the virus that causes COVID-19 illness. We have seen limited person to person spread. Primarily the person to person transmission that we've been seeing has been in China. Here in the United States, currently, as of mid-February, we've only seen about 15 cases of COVID in the United States associated with travel to China. Of these, there were only 2 that were associated with person-to-person spread.

ICT®: Does surveillance and screening for a novel virus present more of a challenge when compared to screening for established infectious diseases that we've seen in the past?

CT: With novel and emerging infections, we don't know too much at the beginning. There's always the challenge of dealing with potentially changing case definitions, potential information that becomes more evident later on as we get more information. We always try to get the balance of ensuring that we get the message out there to clinicians that sometimes things will change. Sometimes when you're looking for illnesses, you might need to modify what you're looking for based on the newest information that's available.

ICT®: Is the emergence of a novel coronavirus, overshadowing the 2019-2020 flu season?

CT: We're always concerned about the emergence of any infectious disease. Currently, we're also very concerned about the emergence of COVID-19, and how that might evolve and might impact what we see circulating in the community. But you know, it's important to know that this COVID-19 emergence is also occurring simultaneous to our regular seasonal influenza. What we're seeing in New Jersey, as well as elsewhere throughout the country, is we are seeing peak activity of influenza right now. January, February is typically around the time that we see peak activity So, this is an opportunity to remind everybody to be mindful that you know, if you haven't gotten your flu vaccine yet, get vaccinated for flu. Take those easy steps. Cover your coughs and sneezes, make sure you wash your hands all the time. Stay home when you're sick. Those types of precautions are helpful not only for seasonal flu, but also for whatever it might be emerging.