'Hope for the best, prepare for the worst': UNMC infection control chief talks coronavirus  

Mark Rupp, MD, chief of the infectious disease division and medical director of infection control and epidemiology at Omaha-based University of Nebraska Medical Center, discussed the ongoing COVID-19 outbreak with Becker's.  

Editor's note: Responses were lightly edited for length and clarity. 

Question: Currently, UNMC is treating evacuees from the Diamond Princess cruise ship in Japan, correct? 

Dr. Mark Rupp: Yes, UNMC is proud of the role we play as a national resource in caring for patients with highly communicable diseases. We are screening and quarantining a lot of people who visited China, and more recently, 13 people from the Diamond cruise ship who are most likely infected and contagious. Many of the passengers had positive test results in Japan, which we are confirming now. Until we have that confirmation, they are all in airborne isolation and are being cared for as if they have an active infection. 

Q: What's the most difficult part of handling an infection control outbreak such as coronavirus? 

MR: That depends on the nature of the outbreak, especially when a pathogen, such as the novel coronavirus, can spread very quickly. When an organism is spread primarily via respiratory droplets, such as the flu, the biggest challenge is getting people to pay attention and take the necessary precautions to protect themselves. Right now, we're working on informing the public of the main tools at our disposal. If the virus does take root in the U.S., there aren't medications or a vaccine yet, so we will have to depend on basic infection control practices. These methods include social distancing, minimizing how often people touch their eyes, mouths and nose, and good hand hygiene.

Q: What should U.S. hospitals do to prepare for a national spread of the virus? 

MR: Hospitals should use personal protective equipment when treating any patient who may be infected. We are screening anyone at our facilities who shows respiratory symptoms, has recently traveled to China or has had contact with anyone infected. A suspected coronavirus patient should be given a mask and taken to a private room, preferably a negative pressure airborne isolation room, where they can be further screened.  

Q: Are surgical face masks effective against coronavirus? 

MR: Masks are most helpful preventing an infected person from spreading the droplets. If you're not infected and wear the mask, you still have a pretty good chance of breathing around the mask and potentially coming into contact with the virus. The masks may, however, remind people not to touch their nose, mouth, eyes. Ultimately, it is not a tight-fitting mask and therefore doesn't have as much filtration capacity or protection as a respirator. 

Q: What's one key action hospitals should take amid the outbreak? 

MR: Hope for the best, but prepare for the worst. Most hospitals have a pandemic influenza plan, used during the avian and H1N1 influenza scares. Hospitals should have contingency plans in place for what they would do if there was a large influx of patients with flu-like illness because we may face that in this country. I'm very hopeful in the measures taken by our public health agencies, and hope we won't face a pandemic, but starting to prepare for a pandemic would be prudent. Consider how to bring in these patients and care for them, protect healthcare workers, screen visitors, assess stocks of personal protective equipment. The emergency plan needs to be taken off the shelf, dusted off and examined carefully to prepare for this. 

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