SAN JOSE, Calif. _ The federal government is disputing University of California assertions that there was a delay in testing a critically ill Solano County woman for the coronavirus, saying it responded as soon as requested.
The timing is important, because the delay exposed health workers and people in the community to unnecessary risk. An undisclosed number of health care workers, as well as two students from American River College and Cosumnes River College who had contact with the patient off campus, are now being quarantined and monitored.
The incident has raised difficult questions about the government's responsiveness and supply of test kits, the shortage of which has hampered timely test results.
But America's experience with the virus continues to look very different from those in many other nations who don't have U.S. public health capabilities. As of Friday, the coronavirus outbreak has sickened more than 83,800 people in at least 56 countries. Sustained local transmission of the virus has been reported in South Korea, Japan, Italy and Iran.
On Friday, the U.S. Navy ordered dozens of ships, with thousands of service members, to stay at sea for the next two weeks, after visiting Pacific ports, according to the New York Times. And several flights to affected countries have been curtailed.
On the day the Solano County woman was admitted _ Feb. 19 _ hospital administrators at University of California, Davis Medical Center in Sacramento say that they immediately requested a test from the U.S. Centers for Disease Control. She was transferred to UC Davis from the smaller NorthBay VacaValley Hospital in Vacaville, where she was admitted after seeking emergency department care on Feb. 15.
But the test was not conducted, UC Davis said, because the patient did not qualify for a test under federal criteria: She had not traveled to China and had not been in contact with anyone known to be infected. On Thursday, after the woman's saga become public, those criteria were expanded. The test was administered on Feb. 23; the positive result was reported back to the hospital on Feb. 26.
In response, "our clinical team has not said no to any request for testing," said Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, at a news conference on Friday.
"The first call to the CDC about the patient was on Feb. 23," four days after the patient's admission. UC Davis has not responded to the government's timeline.
The case offers the first indication that the virus is spreading in the community. Health officials are investigating how the patient was exposed to the virus but have reached no conclusions. That's important because others could have also been exposed.
The circumstances are suspicious because she lived in Solano County � the same region as Travis Air Force Base, where overseas travelers have been repatriated and quarantined, and are due to be released Monday. The county's hospitals also are treating patients.
On Friday, Messonnier said they were studying whether the woman was exposed "through contact with a reunited traveler who was infected."
Meanwhile, the CDC announced on Friday that two more evacuees quarantined at the Travis military base in California have tested positive for the virus. It also said that additional tests are on their way to California and other states for use by the state's public health department. According to Gov. Gavin Newsom, the state has only 200 test kits.
"Our goal is to have every state and locality online by the end of next week," said Messonnier.
In addition, next week the CDC will start using public health labs in six cities, including San Francisco, to start screening for the presence of coronavirus. These labs, part of the CDC's existing influenza surveillance system, normally monitor only flu-related illness and hospitalization. Now all specimens that test negative for flu will also be tested for coronavirus.
Soon the number of labs in the surveillance network will expand from six cities to all 50 states, according to Messonnier.
Issues with the test have delayed the rollout of this broadened surveillance. The new and improved test has abandoned use of a chemical that was causing problems in test's sensitivity and specificity.
To reduce risk of newly introduced infections, the CDC is now warning against all nonessential travel to South Korea and China. And it advises older and at-risk travelers to avoid Japan, Italy and Iran.
"The epidemic situation in China and other countries is really different than in the U.S.," said Messonnier. "The U.S. acted quickly. We aggressively control our borders. And we were able to slow the spread into the U.S.
"This goal," she said, "has allowed us to focus our efforts ... on those at higher risk."
