What Law Enforcement Officers Should Know About the Coronavirus

The World Health Organization on 1/30/2020 declared the new coronavirus, named 2019-nCoV outbreak, a global public health emergency after human to human transmission was discovered in the United States. While nearly 99 percent of the diagnoses have been limited to China, cases have been diagnosed in 18 other countries

That means that this is starting to get real for us here in the USA. The World Health Organization (WHO) has only applied the emergency designation six times.

1. 2009 H1N1 Swine Flu
2. 2014 Polio
3. 2014 Ebola
4. 2016 Zika Virus
5. 2019 Ebola
6. ...and now the 2019-nCoV

A global emergency does not equal a pandemic. Currently [January 31, 2020], 2019-nCoV is only an epidemic, and that epidemic is only in China.

According to two separate scientific analyses, each person infected with coronavirus is passing the disease on to between two to three other people at the current transmission rate. Chinese scientists, however, place the transmission rate much higher; one patient, on average, will have spread the virus to 5.5 other people. It is believed that the mortality rate of the 2019-nCoV is 2-4%. Since this is a new coronavirus, no one knows for sure.

Coronaviruses 101
(All You Really Need to Know About 2019-nCoV)

A novel coronavirus (nCoV) is a new coronavirus that has not been previously identified. Coronaviruses are a large family of viruses that are common in many different species of animals, including camels, cattle, cats, birds, and bats. Rarely, animal coronaviruses can infect humans. Humans can transmit the virus from person to person. Bats carry more diseases than any other species of animal (including rodents). Bat carriers infect other animals via their poop or saliva, and the unwitting intermediaries transmitted the virus to humans.

The 2002 to 2003 SARS outbreak in China was the result of bats infecting palm civets (large cats served as a delicacy and used in the perfume industry) and raccoon dogs (more like a fox and used in the fur industry). Those animals were skinned alive. The 2012 MERS outbreak that was started in Saudi Arabia was a result of bats infecting dromedary camels.

The current 2019-nCoV outbreak in China is believed to have also come from bats to some yet to be identified species (but snakes are not the likely culprit). It has not been associated with eating bats.

In early January, virologists identified the strain of a virus sickening people as a novel coronavirus.  This identification was tied to a specific “wet market” in the city of Wuhan China. Wet markets have been known to transmit coronaviruses before. In wildlife markets in China and Southeast Asia, there may be 40 species of living animals for sale, including birds, mammals, reptiles, amphibians, and fish for sale. These animals are frequently stacked on top of each other, the resultant mixture of air and secretions allows viruses to exchange, potentially creating new strains.

Culturally, people in this region, want to see the specific animals they’re buying be slaughtered in front of them, so they know they’re receiving the products they paid for. This means the animals are skinned alive, and as a result, aerosolizing diseases which then are transmitted airborne, by droplet to humans. Adding insult to injury, these markets are generally crowded increasing the spread of the virus. 

The Current State of Affairs

As the disease is spreading, updates can be confusing and wrong. Every day things look worse. Right now it would be useless to give you statistics on diagnosed cases and mortality numbers as those statistics would be outdated in an hour. This is a global health emergency that relies on updates from the WHO and the CDC. Please only refer to reliable sources for additional revised information, such as the CDC.

Yes, conspiracy theories abound, but this is not a conspiracy. Keep in mind, the actual number of cases is probably significantly higher (up to 30X according to Chinese researchers). No, this is not a cover-up. Many people may have had only mild symptoms or none at all. These people probably wouldn’t go to the doctor and get tested for the virus. Symptoms are similar to a common cold or seasonal flu. You would treat it with OTC meds and not rush to an emergency room for a simple cough or runny nose. People tend to only seek medical treatment when symptoms of respiratory failure emerge.

Keeping Things in Perspective

This flu season is projected to be one of the worst in a decade. However, the CDC reports fewer than half of American adults got a flu shot last season, and only 62% of children received the vaccine.

Currently, there is another virus that poses a significantly higher threat to Americans; it has already infected 15 million Americans across the country this season. It has killed more than 8,200 people including 54 children. No, it is not a new pandemic, it is influenza (the 2019-2020 seasonal flu). At least 140,000 people have been hospitalized with complications from the flu so far, and we are only halfway through the season. This flu season is projected to be one of the worst in a decade. However, the CDC reports fewer than half of American adults got a flu shot last season, and only 62% of children received the vaccine.

In comparison, the Chinese SARS outbreak of 2002-2003 global emergency resulted in 8,422 laboratory-confirmed cases of infection with 774 deaths, with an 11% fatality rate. In the United States, only 8 people had confirmed laboratory evidence of SARS-CoV infection.

Since the original outbreak of MERS in 2012 there have been 2,494 laboratory-confirmed cases of infection with 858 deaths, with a 37% fatality rate. Only two patients in the USA have ever tested positive for MERS-CoV infection.

As of the evening of January 30, 2020, there have been 213 Wuhan-nCoV deaths; all of these deaths have been in China. Five of the six USA cases had recently traveled Wuhan, China. The additional case was the person-to-person transmission of one of Wuhan travelers to their medically compromised spouse. There have been no deaths on this continent. Most of the related Chinese deaths have been in older adults, with existing health conditions.

Bottom Line: If you have flu-like symptoms but have not traveled to Wuhan, China recently or been in close contact with someone who has, you're likely in the clear. However, if you do have concerns, do not hesitate to contact your local health care provider. If you haven’t received your flu vaccine, do so. If you are at high risk for respiratory compromise ask your physician about pneumococcal pneumonia vaccinations as well.

Precautions for LEOS

The diseases that should most concern law enforcement are those that are spread by casual contact between individuals. If a respiratory disease, such as influenza or measles, is spreading throughout the community, officers will be exposed repeatedly. As the incidence of a disease increases in a specific community, it also will increase among law enforcement officers, unless specific measures are taken to prevent further infection.

The simple act of stopping and speaking with someone can result in the inhalation of pathogens. Handling a recently infected item (driver’s license or car registration) or during a search can also result in contagion. Additionally, physical contact and altercations dramatically increase the risk of transferable disease.

Tips for Protecting Your Health from Communicable Diseases

1. First and foremost, make sure you and your loved ones are up to date on recommended vaccinations every year.
2. Avoid close contact with anyone who has symptoms of respiratory or gastrointestinal illness. close contact specifically means being within six feet of someone for a prolonged period of time without wearing recommended personal protective equipment such as a disposable face mask.
3. Avoid direct contact with infectious secretions of someone who presents with symptoms of an infection.

The key principles for preventing acquisition and transmission of respiratory illnesses include:

• Wash your hands regularly and correctly.
• If soap and water aren’t available, use disinfecting gels or wipes.
• Cover coughs and sneezes with your inner elbow.
• Avoid touching your eyes, nose, or mouth with your hands.
• Stay home if you have a fever or other signs of a respiratory infection.
• Stay at least six feet away from people who have signs of a respiratory tract infection: runny nose/coughing/ sneezing.
• Paper masks and eye shields also provide protection against droplet infections.
• Frequently ventilate your work environment, home, and patrol car.
• Disinfect your vehicle after transporting prisoners.

Department Preparedness for Epidemics or Pandemics

Public health emergencies pose special challenges for law enforcement. This is an appropriate time to refresh your memory and review your department’s guidelines for true pandemics and epidemics. Not only does WHO have global plans, but there are also additional national, state-wide, county, and city plans to address communicable disease emergencies that you should familiarize yourself with.

Policing strategies will vary depending on the cause and level of the threat, as well as the potential risk to the responding officers. In a public health emergency, law enforcement agencies need to quickly coordinate its response with public health, EMS and other medical officials.

Critical and early planning is key. PPE should be stockpiled well before a pandemic or another outbreak occurs. It is imperative that all PPE is disposed of as hazardous medical waste

The three main classes of PPE that should be made available to law enforcement:

1. Hand sanitation (hand washing, alcohol gels, antibacterial wipes)
2. Protection against blood and body fluids (antimicrobial gloves, gowns, masks, goggles)
3. Respiratory protection (including respirators that have been fit tested)

Any law enforcement officers who may be required to wear any type of respirator should have a physical exam beforehand. Respirators must be fit-tested to ascertain that the officer can wear the mask appropriately.

Additional risks that officers may be tasked with:

• Crowd control at large events
• Transportation of prisoners to jails
• Corrections officers are at a significantly increased risk as respiratory diseases spread quickly in jails and prisons
• Close contact with those who are also at heightened risk for exposure (emergency department staff and ambulance personnel).

In some situations, public health officials may ask law enforcement personnel to locate an infected person who is either knowingly or unknowingly spreading a disease.

Diseases, such as the 2019-nCoV that spread rapidly by direct respiratory contact may compel restricted movement of individuals. If not segregated, a single individual could infect and cause the death of thousands in a pandemic. China has quarantined 50 million people so far this year, but that could backfire as people rebel such confinement for a long period of time.  2019-nCoV incubation period lasts up to two weeks. High-mortality diseases can easily create social disorder and the need for major assistance from law enforcement.

LEOs in conjunction with public health officials will need to work together to decide:

• When to move from voluntary to mandatory orders,
• How quarantine and isolation orders will be enforced,
• and, if necessary, maintained by legitimate instruments of force

Supervisors Responsibilities Include:

1. Informing the force of ongoing epidemic containment plans.
2. Briefing on the status of operations: staffing, equipment, and support.
3. Briefing on the status of epidemic (geography, virulence), etc.
4. Reviewing emergency health and operational policies.
5. Implementing a mandatory stay-at-home policy for symptomatic employees.
6. Securing backup personnel. 

Just as there is no vaccination for 2019-nCoV infection as of yet, there is also no specific antiviral treatment being recommended by health experts. Nonetheless, people infected with 2019-nCoV should receive supportive care to help relieve their symptoms.

Supportive Care for all Respiratory Illnesses Include:

• Rest
• Increased intake of oral fluids
• OTC medications, such as
  1. Acetaminophen or ibuprofen can be used to reduce fever and body aches.
  2. Antihistamines
  3. Antitussives (cough medications) or honey
  4. Oral decongestants or nasal sprays
  5. Combination Medications
• Prescription Medications, such as
  1. Steroids
  2. Codeine
  3. Antibiotics for bacterial respiratory illnesses: e.g.- sinusitis, bronchitis, pneumococcal pneumonia

For severe cases, hospitalization is appropriate. Treatment goals are aimed at providing additional care to support vital organ functions (brain, heart, kidneys, liver, and lungs).

The best that you can do at this point for any contagious disease, including the 2019-nCoV, is to be aware, be informed, and be prepared. 

Editor's Note: Developments can update on a daily basis, make sure to find the most up to date information on any medical concerns from trusted, reliable sources.