U.S. hospitals are bracing for a potential escalation of the coronavirus outbreak that has disrupted travel to and from mainland China, sending markets plummeting.
Universal Health Services Inc., one of the largest hospital companies in the country, activated its emergency response team Jan. 15 even though the risk level remains low, said Paul Stefanacci, the company's chief medical officer and vice president of quality management.
Jenna Mandel-Ricci, vice president of regulatory and professional affairs for the Greater New York Hospital Association, said protocols like identifying, isolating and treating patients, which hospitals use for all infectious diseases, would kick in if a patient arrived at an emergency department and was suspected of having the virus, known as 2019-nCoV.
"This is very much in [hospitals'] wheelhouse," Mandel-Ricci said. "Measles is far more contagious than what we know of this coronavirus so far. And if you compare it to Ebola, again it's not in the same sort of sphere."
The Greater New York Hospital Association, which helped manage a measles outbreak in New York City between 2018 and 2019, is coordinating with city, state and federal health agencies to get the most up to date information about the number of cases and locations of patients. Mandel-Ricci said the association is coordinating with the Centers for Disease Control and Prevention and travel officials to help monitor any potential patients coming through the John F. Kennedy International Airport in New York City. The New York airport is one of 20 in the U.S. where patients are being screened as they arrive from China.
Mandel-Ricci said effectively sharing information is crucial, "especially with something like this that is so fast-moving."
While hospitals are addressing the escalating situation with the virus, Jennifer Hirt, senior director of communications for the District of Columbia Hospital Association, told S&P Global Market Intelligence that influenza is taking up more time and effort for hospitals compared with coronavirus because the risk to patients is greater.
At least 180,000 hospitalizations and 10,000 deaths related to the common strain of the flu have occurred between Oct. 1, 2019, and Jan. 25, in the U.S., according to estimated figures from the CDC.
The CDC reported Feb. 3 that 11 patients in the U.S. have tested positive for the 2019 novel coronavirus. Another 82 patients are currently under investigation and 167 had negative test results but are still being monitored. U.S. Department of Health and Human Services Secretary Alex Azar declared a public health emergency on Jan. 31 and mandated a 14-day quarantine for Americans who have visited China's Hubei province in the last two weeks.
Meanwhile, the virus has escalated at a much more rapid pace in Asia and other countries. The number of confirmed cases was 17,391 from 24 countries as of Feb. 3, according to the World Health Organization. The organization's latest situation report also showed 361 deaths in China and one death in the Philippines.
Treating and handling patients
Patients suspected of having the coronavirus would be placed into an isolation room with negative pressure, which prevents airflow from getting outside of the room and spreading throughout the facility, Stefanacci said. Once the patient is isolated, healthcare workers then have to follow numerous protocols like using the appropriate equipment when interacting with that patient.
Stefanacci said the hospital will then work with the CDC to determine the risk level of the patient and coordinate testing.
Both Mandel-Ricci and Stefanacci said identifying a patient's travel history and the travel history of others close to them is an important step in treating patients since the virus originated in China.
Multiple patients have come into Universal Health hospitals and been tested for the 2019-nCoV, but so far none have been diagnosed as of Jan. 31, according to Stefanacci. He could not say the exact number of patients, but said it was less than five. Some of those patients have already been cleared, while others are still under evaluation.
Increasing supply inventories
Hospitals across the country are monitoring and increasing their supply inventories to be prepared for a possible escalation of the outbreak. Stefanacci said Universal Health is working on increasing inventories of gowns, face masks, gloves and goggles by 10%, which is about a three-day supply.
Past events like the SARS epidemic in 2003 and the recent Ebola outbreak have provided the industry with some recent examples of the supplies needed during outbreaks, said David Gillan, senior vice president of sourcing operations for Vizient Inc., which helps manage and deliver supplies to hospitals.
Gillan said that hospitals should not over purchase supplies unnecessarily, as anticipatory purchasing could add stress to the hospital supply chain and potentially lead to shortages.