Frederick County first responders are preparing for a potential first case of the new coronavirus disease in the county, as the number of cases in Maryland continues to rise.
Maryland Gov. Larry Hogan announced three more cases of COVID-19 — two more in Prince George’s County and another in Montgomery County — bringing the total of cases in the state to nine. All nine Maryland cases are travel-related, with the majority connected to a Nile River cruise.
The guidance for anyone presenting with the common symptoms of COVID-19, including a temperature of 100.4 or higher, a cough and shortness of breath, is to contact their doctor. But there could be cases where a person may be too ill and require an ambulance trip.
The 911 call-takers will screen callers using questions about symptoms, travel history and potential exposure to someone with a confirmed case of COVID-19, County Executive Jan Gardner announced Monday.
Emergency management is drawing from experience handling severe acute respiratory syndrome, Middle East respiratory syndrome and Ebola, said Jack Markey, director of the county’s Emergency Management Division.
Emergency management has a call protocol that uses structured questions to find the needed resources and determine how to help the person on the line, Markey said. That protocol allows them to ask questions about emerging infectious diseases.
If a person were to answer in such a way that they meet the criteria for possibly having COVID-19, emergency management services personnel will transport them as if they had the disease, Markey said. That is how they would also transport someone with another communicable disease such as tuberculosis.
This would require sending a specialized unit, Markey said.
If fire and rescue personnel identify someone who they believe may be symptomatic, they will offer to take them to a hospital if the person wishes, but simply having the virus does not mean a person must be hospitalized, said Tom Coe, newly minted chief of the Frederick County Division of Fire and Rescue Services.
Emergency rescue personnel will not handle testing for any patients, Coe said. The county health department coordinates testing.
When it comes to where a patient might go, emergency management personnel would use a consult protocol to see which hospital they should take the patient, Markey said. If the patient is in a central part of the county, it is likely Frederick Health Hospital, but on the outskirts of the county, some hospitals in Pennsylvania and Washington County are closer.
Some hospitals also have additional capabilities, he said.
“We run into communicable diseases of many different types, throughout the ordinary transaction of business throughout a year so, hospitals are fully prepared to deal with that,” Markey said. “Even before coronavirus was a thing.”
Inventorying suppliesPublic safety agencies are also preparing for the potential arrival of the virus in Frederick County. While Frederick police are encouraging officers to follow the same common-sense tips that most residents are hearing to protect themselves from contracting the virus, the department is looking further ahead, said Lt. John Corbett, who is overseeing the agency’s efforts.
“We’re looking at our staffing levels and forecasting so that, should we start experiencing attrition within our ranks, we know where can we start looking to shuffle things around in order to maintain our service levels,” Corbett said.
The department has also done a complete inventory of its medical supplies, including gloves and masks — which are used in many routine situations by police and crime scene technicians — to make sure they are stocked up enough for their ordinary needs as well as any additional demand that may arise from the virus, Corbett said.
“We’re in good shape, and the city has resources as well. This was just a timely opportunity to look at those supplies and whether we need to expand beyond that in the future,” Corbett said.
The department also attends weekly meetings at the Frederick County Health Department along with representatives from Frederick Health Hospital, Fort Detrick, the Division of Fire and Rescue Services and other local agencies to discuss their ongoing efforts to prepare and ensure everyone is on the same page, Corbett said.
The Division of Fire and Rescue Services also examined staffing and took inventory of masks and other equipment, Coe said.
While Coe said the division’s supplies are more than adequate at the moment, emergency medical personnel are still cognizant of the virus and the chances that they will be called to respond to someone who might have it.
“Some of the things that we’re looking for are really based on what we’re hearing from the [Centers for Disease Control], and that includes travel to different regions or known contact with an individual who has the virus, combined with symptoms including a fever, trouble breathing or coughing, things like that,” Coe said. “And understand that those symptoms are evolving as the virus continues to evolve and we learn more about it.”
In terms of medical equipment, rescue personnel will handle potential cases of coronavirus in much the same way that they handle people suspected of having the flu, Coe said. Personnel typically wear masks, gloves, protective eye equipment and gowns in those cases, the chief said.
Supply right now is not the concern, Markey said, although the supply chain might be a challenge. That is, in part, why they ask people to not wear masks and leave them for emergency personnel and medical professionals.
Masks aren’t appropriate for the public at this time, he said.
More than anything, both Coe and Corbett encouraged residents to avoid panicking and to seek information about the virus from reliable sources.
“The CDC and the Frederick County Health Department, those are really the only reputable sources where you should be getting your information about this particular situation, and especially avoid social media,” Corbett said.
COVID-19 and jailsThe Frederick County Adult Detention Center is also taking steps to prepare for a local outbreak of cases, said Lt. Col. William V. DeLauter, the corrections bureau chief. Because many of the people booked into the jail stay there for only a few days before being released, someone with the virus could infect others inside and spark a pandemic in the closely confined community.
Taking a cue from similar steps they adopted in the midst of the avian influenza scare several years ago, DeLauter said that all new arrivals to the detention center are subject to screenings before they enter central booking.
“We have a series of questions that we’re going to ask when they come in the door and if the answer to any of the questions is yes, we will alert our medical staff, who are available 24 hours a day, to come down and make a further assessment and give the inmate a surgical mask,” DeLauter said.
Along with symptoms such as coughing and sore throat, the screening involves being subject to a temperature reading with a thermal thermometer. Finally, the screening also involves questions about whether the people have recently traveled to China, Iran, South Korea, Japan or Italy in the last two weeks or if they have otherwise had contact with anyone suspected to have the virus, according to DeLauter.
“In addition to all that, if someone is suspected [of having the virus] we also will contact the health department and advise them and take any direction that they may have for us,” the warden added.
To prevent the virus from arriving with visitors from the outside, signs have been posted in the visitation wing asking anyone who is ill and especially those who might have had exposure to the virus to consider refraining from visiting, DeLauter said.
While detention center employees have ready access to hand sanitizer, the people in detention will have to make do with soap and water, DeLauter said, explaining that hand sanitizer is considered contraband.
“Those hand sanitizers contain alcohol and inmates will find a way to turn it into alcohol,” DeLauter said. “But still the best practice we’re hearing is just frequently washing your hands with soap and water.”