MIDCOAST — The spread of Coronavirus Disease 2019 (Covid-19) across the globe has galvanized local doctors to ensure infectious disease fighting systems are in place. They are in constant communication these days, amongst themselves and with colleagues statewide, as Maine’s public health network strengthens against this potential threat. There are choice messages the doctors want the Midcoast community to hear, as the world contends with a virus whose characteristics are just getting identified and catalogued.

And while washing one’s hands with soap and water seems simple, it is significant to the fight against a virus or any other pathogen, as it slows infection contagion rates. For the highly contagious Covid-19, washing hands and wiping down surfaces, again and again, is good insurance.

So is sneezing into one’s elbow, avoiding close contact with sick people, not touching one’s mouth, nose and eyes, cleaning and disinfecting surfaces and doorknobs, and stay personally healthy with good nutrition and sleep.

Dr. Cheryl Liechty, is the physician leader for infectious disease programs at Pen Bay Medical Center and Waldo County General Hospital. She has been focusing on the coronavirus and local preparedness since mid-January, when Covid-19 reared its crown-like head in China.

Her days are filled communicating with MaineHealth — the Portland-based nonprofit that owns Coastal Healthcare Alliance, itself a nonprofit umbrella organization that owns Pen Bay Medical Center, Waldo County General Hospital, physician offices, and longterm care facilities – as well as state and federal Centers for Disease Control.

Liechty spoke Feb. 27 to members of the West Bay Rotary, letting business leaders know that the Midcoast health care system is aware, and vigilant.

“These are things we have planned for for years, and a type of situation we have dealt with the possibility of before,” said Liechty, in a phone conversation, Feb. 27. “We have policies in place that gives us a framework. We have been actively working on this since it became a concern in January.”

Liechty has been at Pen Bay Medical Center since 2005 and studied infectious disease prior to her arrival in Maine. She has been through one pandemic, the H1N1 influenza spread in 2009.

The measures that China took in attempting to contain this new Covid 2019 to Hubei Province bought the medical world some time to understand the virus better, said Liechty.

She is in constant communication with clinicians, those doctors and nurses who treat patients in offices and at the hospitals. 

“Communication is most important,” she said. “People are familiar with what we want to accomplish. And we have systems in place to rapidly identify and take care of those people [infected with Covid-19].”

Her team meets regularly to talk about the latest developments in the virus’ pathology and patterns. Viruses are different from bacteria, and antibiotics are not effective treatments. Covid-19, as other viruses, are not living organisms. They are genetic material covered in surface protein and cannot replicate unless they have a host.

“And we are a good host,” said Liechty.

Still, and amongst all the concern about this novel virus, Liechty is just as concerned about the prevalence of influenza in the community. 

“We are not kidding when we say that flu is the immediate issue,” she said. “It still widespread, and serious.”

In its Feb. 25 weekly influenza report, the Maine Center for Disease Control indicated that influenza types A and B remained widespread in Maine; 21 deaths attributed to the flu were recorded so far this year in Maine.

As with all infectious disease, the public health protocol remains the the same, said Liechty: If you feel sick, stay home, do not go to work, school or other places where people congregate. 

“In our society, it is not easy to adhere to those guidelines,” said Liechty. But in advance of disease transmission, society is changing: In Japan, people are urged to work from home. Schools are closed in parts of Italy, and some international borders have closed.

If a person suspects being infected with Covid-19, Liechty urges first a call to the doctor’s office.

“If someone thinks they may have this illness, we want them to first get in touch by phone to the doctor instead of appearing in person,” she said. 

The office will take a patient’s history over the phone so that doctors understand better, “whether we should be concerned,” said Liechty. At the same time, this initial phone consultation prevents transmission of the virus to others in waiting rooms.

“We will take care of you well and take care of others,” she said. 

However, this does not mean avoiding the hospital if someone is severely sick.

“If clearly ill, go to an emergency room,” she said.

As for protecting health care workers, Liechty said: “We have equipment and follow CDC guidelines, and we have access to the things we need.” 

Currently, Maine hospitals do not have the testing capabilities to determine if a patient has contracted the virus. But that is changing. Earlier this week, the federal CDC announced it was shipping test kits developed by the CDC to select qualified U.S. and international laboratories. The test uses a technology that can provide results in four hours from initial sample processing to result, the CDC said.

That speeds up the diagnoses considerably from the 5-7 day testing period that has been the process over the last six weeks.

“Our goal is early detection of new cases and to prevent further spread of the coronavirus,” said CDC Director Robert R. Redfield, M.D., in a news release. “Distribution of these diagnostic tests to state laboratories, U.S. government partners and more broadly to the global public health community will accelerate efforts to confront this evolving global public health challenge.”

Currently, Covid-2019 testing in Maine remains coordinated through state and federal officials, said Liechty.

Hygiene and good respiratory habits are critical to public health, and Liechty emphasized the importance of hand-washing, sneezing into elbows and using alcohol sanitizers.

“Make more than a cursory effort to wash hands,” she said. “Alcohol hand sanitizers are good. They may not be as good as soap and water, but do clearly have benefits.”

Both hospitals and associated physician offices are outfitted with hand sanitizers and boxes of masks for those patients who have a cough and other symptoms of illness. After the H1N1 outbreak, hand sanitizers and masks became more of the norm. In addition to medical offices, grocery stores have them at the front doors, as do other public venues.

Use them, said Liechty.

As for masks for the general public, she, along with the CDC, is not advocating their use.

“The federal CDC does not recommend healthy people wear masks in public because they not so helpful,” she said.  “ If they are sick, then yes, they should wear masks. We want people to wear them. We would like people who are sick to not walk around with the public.”

Liechty cites the Sesame Street instructive episodes when H1N1 was widespread. Children got the message that year via public television and public health education evolved a little more.

In the Midcoast, there is a large population of elderly, and older people with chronic medical conditions. They are vulnerable to disease, and are another reason to practice good hygiene, and refrain from interacting with them in person if a virus becomes prevalent.

Whether or not Covid-19 survives on surfaces and doorknobs has yet to be fully determined, but Lietchy advises cleaning surfaces.

But there are few medications to treat influenza and viruses. 

“Antiviral medications for influenza have limited benefit, and we have no antiviral medications proven to be effective against coronaviruses,” she said. “Containment is one of first priorities.”

Reach Editorial Director Lynda Clancy at lyndaclancy@penbaypilot.com; 207-706-6657

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