with so these are a broad family of
viruses
that are actually named after their
microscopic appearance a corona looks
like a crown
and they're you know again dozens of
these there's a few of them that are
known to infect
humans that largely cause relatively
mild upper respiratory disease or
common cold and then more recently we've
had outbreaks of
coronaviruses that can cause severe
lower respiratory tract disease
or pneumonia so the first of these that
we became acquainted with
you might remember your viewers might
remember sars they
also came out of china back in 2003 more
recently we've had murs which is known
as the mideast respiratory syndrome
virus
which is coming out of the arabian
peninsula so now this is the third kind
of novel coronavirus that we're having
experience with
that can cause severe lower respiratory
tract disease
these typically spread from person to
person via
large droplets respiratory droplets so
when somebody coughs or sneeze
it can be transmissible that way
there were reports that this started at
a food market it is not a food borne
illness though this is something that
spread
just via the air correct so many of
these coronaviruses have a natural
reservoir
in animals and so we know that in
certain instances they've been able to
infect camels or
cats or bats and the
original descriptions of this new
coronavirus coming out of china
to a food market where they had
live animals that they would sell so the
hypothesis is that there may be an
animal reservoir that is now transferred
into humans
so there has been at least one case here
in the u.s someone that had traveled to
that area of china
what is your message to people here i
mean how concerned do people need to be
about
this virus so maybe i'll turn to a
doctor lawler who's our expert
on global health security and he might
be appropriate to answer that question
so i think right now the risk in the
united states
and in most countries outside of china
is very low the the outbreak really
seems to be
concentrated in in the city of wuhan
which is
in uh kind of central eastern china
and in in the u.s we should probably be
much more worried about
influenza and respiratory diseases that
we know cause
significant morbidity and mortality
every year so
on an average year 30 000 americans die
of influenza
so we've had one detected case of this
new coronavirus in the u.s so i think
it's
it's appropriate for folks to to temper
their
their alarm but it is i think reason to
be aware that
we are vulnerable to emerging infections
anywhere in the world with modern
transportation you can be
anywhere in the globe in 24 hours and so
you know i think the good thing is it
highlights that we've become much better
at detecting uh you know these types of
events or
surveillance is much better than it was
even in 2003 with sars
and i think the fact that just a couple
of weeks into the outbreak we have a
much better idea of
what the pathogen is we have systems
already in place that are doing
uh surveillance and and detection and
tracking
and so i think we're well ahead of where
we have been with previous outbreaks but
but again this is uh unfortunately
something that's going to continue to
happen
new and emerging diseases are are not
going to stop anytime soon
can you talk a little bit about would
nebraska medicine have any role
the bio containment unit in responding
to this particularly if it continues to
grow
angela why don't you take that as our
director of the biocontainment unit sure
so yes we we definitely in the nebraska
biocontaining unit follow this and
any other outbreak going on in the world
very closely and i do feel like that in
our role
as a biocontainment unit and also um you
know as one of the leaders in the united
states in biocontainment
that we should not only be monitoring
this closely but also serving as an
example for others
as far as doing appropriate travel
screening here at nebraska medicine
making sure that when
people come to our emergency department
or our clinics that we're asking that
question have you traveled somewhere
outside the united states
not necessarily just for for this virus
that we're discussing but for other
other pathogens as well there are other
outbreaks going on in the world as well
but yes in the biocontainment unit i do
feel like that we should serve in that
leadership role
and to provide that guidance for others
in their
their infection control management of
these type of pathogens
you talked a little bit about the change
in response to
these these kinds of illnesses as
compared to sars
15 years ago i suppose um can you expand
on that a little bit and talk about what
the global response looks like in terms
of containing this type of
outbreak and treating it if that's
something that's occurring sure
i think overall this response has been
much quicker and much more
open and transparent than what happened
in 2003 with sars so
sars was going on and there were cases
that were popping up in hospitals and
transmission was occurring for months
before anybody really became aware of it
outside of
you know the the local endemic region
and then
it took quite a while to to identify
what the virus was
and to implement appropriate travel
screening and precautions and by that
time
you know the virus had escaped and was
in hong kong was in singapore was in
vietnam
ended up in canada and so you really had
a worldwide outbreak at that point
hopefully so far we seem to have done a
much better job of identifying
cases and implementing the appropriate
public health measures to prevent spread
as i mentioned the the chinese
government has actually been very
transparent and open about
sharing the status of the outbreak and
identified and notified partners in the
world health organization very quickly
the who is apparently meeting to discuss
whether this should be declared a public
health emergency of international
consequence you know i think at this
point
uh most experts predict that that will
not happen that
uh the who will be satisfied with the
status of response right now and the
fact that
this appears to be you know so far uh
relatively confined
except for uh you know a few cases that
have kind of
uh gotten out on on airplanes and so
i think overall it does demonstrate that
the world has made significant progress
in combating these types of emerging
disease threats
and if i could elaborate just a little
bit on that um clearly here in the
united states
we're being very proactive so travelers
from
wuhan china are actually being funneled
into five airports in the u.s now where
they are being screened
for any kind of respiratory or febrile
illness
if they were discovered they would be
observed carefully and quarantined
similarly they're being given
information that if they
arrive here and then become ill that
they should seek a medical attention
and obviously alert medical personnel
that they've been potentially exposed in
wuhan
so we're very much ahead of the ball
game as opposed to where we were
years ago and are being very proactive
with this
here at nebraska medicine as dr hewlett
mentioned we clearly have already put in
travel screening for people coming into
our clinics and emergency department
we have the biocontainment unit on alert
if we uh if we needed them
one question that we've heard from staff
here is
people locally have had children or
friends or known people who have been
diagnosed with coronavirus
and it's confusing to them they hear the
word and they think it's the same thing
can you explain the differences there
yeah so um
clearly the coronaviruses are a large
family of viruses that cause everything
from
the common cold which is what you're
referring to
to more severe lower respiratory tract
disease which is what these newer
novel coronaviruses are sometimes
associated with
we're particularly concerned with these
novel coronaviruses and other
coronaviruses sometimes
in very immunosuppressed hosts and so
sometimes they can cause more severe
disease even the more common
coronaviruses
in our bone marrow transplant patients
or somebody who is immunosuppressed or
the very young or the very old so
you know we do have a wealth of
experience with coronaviruses in general
and are learning more about this new one
as days go by
you said the biocontainment unit is
ready i mean would
someone with a very severe case of this
particular strain of the coronavirus
potentially come to the bio containment
unit for treatment or quarantine
there's a chance that that could happen
we you know as dr butt mentioned we are
travel screening and if we did have a
person who presented to our
emergency department or to our clinics
that had an appropriate travel history
and also appropriate symptoms then we
would consider
bringing them into the biocontainment
unit mainly for diagnosis and then
appropriate monitoring
and um and supportive care you know
we do serve as um as a leader both in
our region and the united states
there's a chance that if there were a
patient that were infected with this
illness
in our region as well that we could care
for them in the unit
also and we do stand ready for this in
any other pathogen
last question i think i have is i know
that you we don't want to be alarmist
because the flu is a larger threat for
people here in the us but
um if people have travel plans to go to
some of these locations where
the disease has been detected i mean
what are the symptoms or what should
people be aware of
is there any any sort of message of what
people should be looking out for
so the cdc has issued a fairly low level
alert for people traveling
to that specific part of china that they
should be careful
avoid sick people um you know just some
common sense sort of precautions
again the coronaviruses generally cause
kind of a febrile flu-like illness and
so it could be
easily confused with you know much more
common viruses that we're seeing
and as dr lawler mentioned i think that
it's important for viewers to keep this
in perspective
that you know we currently have widely
circulating a virus influenza
that causes anywhere from 25 000 to 50
000 deaths per year in our country
every year um and so we need to be you
know making sure that we're taking
appropriate precautions to prevent the
spread of those viruses
while being on lookout for this normal
coronavirus at the same time
i have a question from a reporter online
asking how if we are currently working
with the cdc
and who and monitoring or preparing for
the coronavirus does the global center
for health security play
a role sure so
the the global center for health
security is involved
in long-standing programs to to help
train
uh first responders and other uh
healthcare workers
in appropriate infection prevention and
control we work very closely with our
biocontainment unit colleagues and also
with
folks here at the university and at the
hospital who are
part of the ebola treatment and
education center
which is the main resource for training
hospitals across the nation
in appropriate infection prevention and
control and so um
you know all of those efforts together
really over over years
have done a significant amount to
increase preparedness
in hospitals to manage these types of
highly dangerous pathogens that's
another advantage that we have over 2003
is that
after ebola and with the advent of netec
and other efforts
we've we've done a much better job of
preparing hospitals to manage
patients with potentially highly
infectious diseases and
um that's uh that's a real resource that
i think could be relied on and will
significantly improve our ability to
manage
you know an outbreak beyond one or two
patients if that's uh if that's what
occurs
how is it something like this different
than an ebola type situation
where you have such high levels of
travel as compared to
not seeing that as much in western
africa with ebola
well china is a very common travel
destination
both for you know for business travelers
as well as for um
for people going on vacation and so we
don't see quite as much travel
to those areas affected by ebola and the
democratic republic of congo
namely currently as we do to china which
is a very common travel
destination so that is one you know one
difference about
ebola versus this outbreak is that you
know
there are a lot more travelers returning
to the u.s and to other places
from china than from the affected area
in the congo
the other thing i would point out is
that the lethality of these diseases
differ
very markedly with ebola being
associated with a
much higher rate of fatality than the
coronavirus infection
currently we have a handful of deaths
due to coronavirus in china
uh it appears to be less transmissible
and less severe
perhaps than sars or even mers so we
have
that to our advantage as well is there a
way to compare
uh how transmissible this might be
compared to
the flu that we're experiencing and how
um
lethal it might be compared to other
we've had several deaths in the area
we have flu already correct and that's
why i think that it's so important for
people to keep those things in
perspective that
we're dealing with um very minimal risk
right now from this coronavirus where
we're dealing with a much higher level
of risk from very common viruses that we
are used to encountering each and every
year
anyone have anything else okay
great thank you folks thank you thanks