Home : Benzie-Leelanau District Health Department



left-2114550JOSHUA MEYERSON, MD, MPHMedical Director100 Woods Circle, Suite 200Alpena, MI 49707Phone 989.356.4507Fax 989.356.3529220 W. Garfield Ave.Charlevoix, MI 49720Phone 231.547.6523Fax 231.547.62387401 E. Duck Lake Rd., #ALake Leelanau, MI 49653Phone 231.256.0200Fax 231.256.0225JOSHUA MEYERSON, MD, MPHMedical Director100 Woods Circle, Suite 200Alpena, MI 49707Phone 989.356.4507Fax 989.356.3529220 W. Garfield Ave.Charlevoix, MI 49720Phone 231.547.6523Fax 231.547.62387401 E. Duck Lake Rd., #ALake Leelanau, MI 49653Phone 231.256.0200Fax 231.256.0225To All Area Providers-The COVID 19 (coronavirus) outbreak is expanding and public health response and planning, which had been mostly in a “containment” mode, is now switching to “Mitigation”. We continue to monitor individuals under self-quarantine who are at risk from recent travel. The CDC has stated that we should now ALL prepare for the eventual spread and transmission of this illness nationwide. The Health Department has plans that are coordinated with our State and Federal partners to respond to a widespread epidemic of communicable disease, with Pandemic Influenza being the typical model that we are using for our response plans.Considerations for Investigation and Testing for Novel Coronavirus:On February 27, 2020, CDC updated the criteria for Evaluating and Reporting Persons Under Investigation (PUI)Fever or signs/symptoms of lower respiratory illness (e.g., cough or shortness of breath) AND any person, including health care workers, who has had close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onsetFever and signs/symptoms of a lower respiratory illness (e.g., cough or shortness of breath) requiring hospitalization and a history of travel from affected geographic areas within 14 days of symptom onsetFever with severe acute lower respiratory illness (e.g., pneumonia, ARDS) requiring hospitalization and without alternative explanatory diagnosis (e.g., influenza) and no source of exposure has been identifiedThe criteria are intended to serve as guidance for evaluation. In consultation with public health departments, patients should be evaluated on a case-by-case basis to determine the need for testing. Testing may be considered for deceased persons who would otherwise meet the PUI criteria.The CDC has added additional travel advisories and included now for consideration for testing is recent travel (within 14 days) to China, Japan, South Korea, Italy, and Iran. Screening patients for recent travel is recommended. I would suggest going to their website to check as it may change frequently. The current fillable form for requesting testing for Coronavirus: If a provider has a PUI, they should take appropriate infection control actions to reduce the risk of spread and contact the Health Department (Local or State). You can call the health department in the county the patient resides and ask for a Communicable Disease Nurse who can assist with gaining approval for specimen submission. We will need state approval for testing submission with their contact number listed on the form – note they have 24/7 coverage: The MDHHS CD Division can be contacted at: (517) 335-8165 during business hours, or at: (517) 335-9030 after-hours and on holidays. Specimens include upper respiratory (NP and OP swab) and lower respiratory if a productive cough.Considerations for Community Mitigation:The current goal of public health action is to slow down the spread and reduce overall transmission rates within a community. Without vaccine or medications to use, the mainstay is “Non-Pharmaceutical Interventions” that involve personal, environmental, and community based interventions to reduce the spread of disease. Personal interventions include the same types of things we promote for all respiratory infections such as staying home when you are sick, covering your cough, and washing your hand.Environmental interventions include thorough cleaning and disinfecting of surfaces, especially those that are touched or handled frequently. Community Interventions include actions to increase social distancing and include self-quarantine for household members of sick individuals, coordinated school dismissals and closures, increasing options for “telecommuting” and other remote work arrangements to increase social distancing, and postponing large events and mass gatherings. These Interventions will be considered and instituted as needed to respond to local disease activity. Currently, there is no community-based spread of coronavirus in the United States and the current risk to US residents is very low. Influenza disease remains widespread and continuing to vaccinate and other steps to reduce the spread of influenza can reduce the number of individuals ill with respiratory disease needing care.For specific travel-based advice, please consult the CDC website for the latest recommendations. Individuals should not be concerned about current infection risk but should begin preparing for the possibility that we will see widespread disease locally that could affect the health of themselves and their families, and that actions may need to be taken, together and cooperatively, to limit the impact of this epidemic on our communities, with emphasis on protecting our most vulnerable citizens.Attached is some information that may help answer questions you and others may have. For up to date information on the outbreak I would go to the CDC or MDHHS Coronavirus websites. coronavirus Joshua Meyerson, MD, MPH ................
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