20200307

presumptive flu?

43% increase in confirmed cases in u.s. since this morning (233 to 336 per hopkins tracker), likely reflecting more, faster testing rather than increased community transmission. but.

maryland health authorities have shared some information on what our three patients were doing between their return from a nile river cruise feb. 20 and getting tested march 4.
One patient attended a school event in the Philadelphia area. As a precaution, the Central Bucks Schools District closed five schools Friday.

Another patient attended an event at the Village at Rockville retirement community Feb. 28. The Maryland Department of Health determined the time period of risk of exposure is from noon to 6 p.m.
that retirement community is about a mile from my parents' home. mom & pop have lately been visiting some such facilities seeking activities/support/services related to pop's developing dementia, so i sent mom the article and asked whether she'd been there, and read on. the article continues
"The facility there has a workforce staff that they will be looking after, monitoring to make sure that those health care workers do not develop symptoms. They also are very cooperative in making sure that residents that may have been exposed only at that one gathering, that one day, that one gathering, if those residents have any symptoms," said Fran Phillips, of the Maryland Department of Health.

The MDH recommended that members of the public who attended the event should monitor themselves for symptoms of a respiratory infection, including fever, cold-like symptoms, cough, difficulty breathing or shortness of breath, until March 13.
the article followed with the phone number of the Maryland Emergency Management Agency call center. but i was stuck on "the residents that may have been exposed only at that one gathering, that one day," because transmission occurs from fomites -- objects or surfaces capable of carrying/transmitting infectious agents -- not just being present in the same space, and i've been to retirement communities and assess it as doubtful they've been routinely sterilizing all the surfaces in that facility since february 28. mom wrote back
We've been to the Village several times in the last few weeks -- that's where [friend & spouse] and [person whom my parents routinely drive to medical appointments] were!
when pressed on timing, mom said they'd been there feb. 4, 18 and "maybe one other time." she learned from the emergency management call center that the event between noon and 6 pm on feb. 28 was a funeral: "I KNOW we didn't do that!" it was late, so i have been unable to grill her on her use of the past tense referring to her friends' residency there (pretty sure [friend & spouse] have recently transferred to a more acute-care setting, but thought the chauffeuring was ongoing). anyway, that there were cases in montgomery county was striking; to learn that it is that close, physically and socially to my parents, is somewhat more distressing.

i imagine those three patients bought groceries and attended some sort of community religious observations, perhaps visited libraries, coffee shops or gyms nearby. i have some faith the state health department includes such considerations in contact tracing, though that paragraph above about that one 6-hour window of risk does not foster a great deal of confidence on that score.

meanwhile, little oomph seems to have the flu. babymama & i have been trying to elicit descriptions of symptoms (beyond coughing in our faces, vomiting in our dinner, sneezing everywhere & running a fever, which are patent) without tipping off little oomph we're probing for covid symptoms. but little oomph is pretty savvy and just as scared of the flu. babymama thinks they shouldn't visit weekly at grandparents', as is their wont, due to that possible, if attenuated, exposure risk; i'm not certain they should bring flu into that home (though g'parents got their flu shots). also, they're expecting a houseguest from hawaii who will be transiting LAX on sunday, and then staying for several weeks and meeting clients in their home. mom reports he's "going to bring masks and Clorox wipes."

ray of hope: that oft' cited WHO report notes very low proportion of cases among persons younger than 18 years observed in surveyed population, and lower proportion of critical cases, though it drew no conclusions.

i appreciate all y'all's sharing, sympathize with your anxieties and frustrations. thanks for the space to share my own. -- (reported u.s. cases rose by two while i was writing).