Salem Hospital (Caleb Wolf/Special to Salem Reporter)

No new cases of the novel coronavirus were reported in Oregon Tuesday, but health officials say it’s more likely a matter of when, not if, cases appear in Salem.

While early response to the disease focused on people traveling to the U.S. from China or others they contacted, new cases reported over the weekend have local public health offices realizing infections are likely more widespread.

“We’re starting to see patients coming in that have no direct epidemiological linkage,” said Dr. Christopher Cirino, Marion County’s public health officer. Those include the third reported case in Oregon, a man employed by a Pendleton casino.

The apparent community spread of the disease should be cause for precaution, not panic, Cirino said. Seasonal flu remains a far bigger risk to most Oregonians and has so far killed 408 people this season, according to U.S. Centers for Disease Control data.

Still, the CDC is emphasizing to public health agencies that they should anticipate local cases of the novel coronavirus, Cirino said.

“They’re definitely taking this seriously and so are we,” he said.

WHAT TO DO

For now, county officials are advising the public to take the same precautions they would during flu season: washing hands well and regularly, sneezing and coughing into elbows rather than hands and staying home when sick.

Cirino said the public health response so far is modeled after seasonal flu, with shifts as scientists and health care providers learn more about how the novel coronavirus spreads. He expects the path of the disease will be similar to the swine flu outbreak in 2009, when the U.S. had a second, extended flu season.

The CDC expanded the pool of those who ought to be tested late last week after pushback from doctors frustrated with the agency’s slow response.

Now, the CDC recommends testing anyone with a fever and severe lower respiratory illness, like pneumonia, the requires hospitalization if there’s no other disease that could explain their symptoms, Cirino said.

Still, those guidelines focus on the most severe cases. People with mild or moderate symptoms of the disease - a fever, cough and shortness of breath - aren’t eligible for test - at least not yet. In Oregon, all testing is routed through a state health laboratory.

That may change as private companies work to develop tests, he said. Eventually, doctors may be able to test for the disease in clinics and hospitals, as they now can for influenza.

Cirino said patients who suspect any type of viral infection, whether the novel coronavirus or seasonal flu, should stay home while they have symptoms. Ideally, they would stay home for two weeks, he said, but people are most contagious when they have the worst symptoms.

Employers should plan for employees who might get sick to be sure they can take time off and avoid spreading illness to others, he said.

Cirino said patients with questions or concerns should contact their doctor’s office first, or a state information line by calling 211. Medical providers with questions can reach out to the county for guidance or to request testing.

No Marion County residents have been tested for the novel coronavirus, though county health officials have received questions from local doctors about whether their patients are eligible.

Salem Health had one patient come into a clinic seeking a test based on recent travel, according to Dr. Ralph Yates, chief medical officer. After consulting county health officials, medical providers determined he didn’t meet the criteria because of the length of time since he’d returned.

Video visits with doctors as another option for patients who suspect illness, Yates said.

Kaiser Permanents is asking patients with symptoms coming to a clinic in-person to call ahead so a plan can be made to avoid infecting others, spokeswoman Kimberly Mounts said. Patients can also complete an online visit to get care and advice.

HOW SALEM IS RESPONDING

As news broke Friday that the first coronavirus case had been detected in Oregon, Salem shoppers hit local drug, grocery and hardware stores, clearing the shelves of items like hand sanitizer and toilet paper.

Around 11 a.m. Monday, Salem’s Costco was out of toilet paper.

Customers circled the paper section, wondering if they had missed the toilet paper and opted to buy rolls of paper towels instead.

Rite-Aid in south Salem was out of hand sanitizer, face masks and antibacterial wipes.

Walgreens was also sold out of alcohol-based cleansers.

A Walgreens employee said people first started buying masks and have been steadily coming in to buy hand sanitizer.

Hand sanitizer sales are up 73% from Jan. 22 to Feb. 22, according to data firm Nielsen.

In west Salem, ACE Hardware was sold out of face masks. A sign read: “Due to a combination of limited supply and high demand, we are out of face masks for the foreseeable future. We are sorry for any inconvenience this may cause.”

And stores aren’t the only place residents are taking precautions.

Salem First Presbyterian Church is encouraging its congregants to greet each other with a wave rather than a handshake.

“Starting this Sunday, we are going to encourage everyone to offer a friendly wave rather than the shaking of hands during our fellowship time and passing of the peace. And for the near-term future, communion will be offered through individual servings of bread and juice instead of by intinction,” said an email last week from minister Rob Thrasher. 

VULNERABLE POPULATIONS

Jimmy Jones, executive director of the Mid-Willamette Valley Community Action Agency, said the homeless population is especially vulnerable to virus spread, because they don’t have access to regular handwashing and can’t stay home if they’re sick.

It’s also a sick population with underlying health conditions like lung disease, heart problems and diabetes, Jones said.

He said staff at The ARCHES Project are talking to homeless people one-on-one about the importance of regular handwashing, and the agency is adding additional handwashing stations.

Jones said they’ll likely put a handwashing station outside for people who gather for meals in the parking lot.

If there’s a positive test in the community, Jones said his organization, which has 360 employees, is putting together plans for closing Head Start school programs and encouraging employees to work from home.

“We’re exploring creative uses of our sick leave,” he said.

The state Corrections Department has an emergency management coordinator responsible for seeing the system is ready.  Inside the prisons, employees and inmates are disinfecting areas like stairwells and cells more often, spokeswoman Jennifer Black said.

Cherriots is offering individual-sized hand sanitizer at the Downtown Transit Center’s customer service area.

Marion County is still working on an outreach plan to let the public and community groups know what to look for and how to stop the spread of disease if cases do emerge. Officials there haven’t specifically reached out to senior centers, homeless service organizations or other groups of people likely to be especially vulnerable to the disease, said Katrina Rothenberger, the county public health administrator.

Correction: This article was updated to correct Dr. Ralph Yates' first name.

Contact reporter Saphara Harrell at 503-549-6250 or [email protected]. Contact reporter Rachel Alexander at [email protected] or 503-575-1241.

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