It’s been two weeks since Santa Clara County health officials announced the first Bay Area case of the potentially deadly novel coronavirus, but while they say the patient is in good condition, he hasn’t been cleared to leave home.
In fact, it is not evident that any of the 15 people in the U.S. confirmed to have come down with the virus has been deemed to have recovered enough to return to work and resume normal life. They remain in isolation, either at hospitals or at home, where local officials keeping tabs on them have told them to stay put.
Their plight raises questions about how long it might take for people suffering even mild symptoms from the new disease, now officially called COVID-19, to fully recover, and for health officials monitoring them to feel confident they can safely send them back into their communities.
“Part of the problem is there’s still so much that’s not known about the infectiousness,” said Wendy E. Parmet, director of Northeastern University’s Center for Health Policy and Law. “I don’t know if there’s any well-established guideline for when somebody ceases to be infectious.”
Federal and local health authorities have been cagey about the status of the 15 coronavirus cases they have confirmed in California and six other states. Four of those cases were reported in the greater Bay Area — two in Santa Clara County and two in San Benito County.
The U.S. Centers for Disease Control and Prevention did not answer questions about the status of the 15 U.S. cases and whether any have recovered and returned to their communities. The World Health Organization said the virus has sickened at least 64,000 in two dozen countries, most of them in China where the outbreak originated in the city of Wuhan.
Most of the more than 1,300 deaths, including at least one American, have been in China as well. There have been two fatalities outside China, one each in the Philippines and Japan.
Santa Clara County health officials announced the first Bay Area case Jan. 31 in what they would only say was “an adult male resident of the county” who recently traveled to Wuhan and became ill upon returning home.
County officials said the man was seen at a local clinic and hospital but was never sick enough to require hospitalization and was “self-isolating at home” while they monitored his condition.
Two days later, Santa Clara County officials confirmed a second, unrelated novel coronavirus infection in someone they described only as “an adult female” who also had recently traveled to Wuhan and arrived Jan. 23 to visit family in the county.
They said she has stayed home since she arrived except for two occasions when she sought outpatient medical care, was never sick enough to be hospitalized and also has been regularly monitored.
But although county officials Friday said both remain in “good condition,” they said neither has been cleared to leave home and resume their normal lives. The patients declined interview requests.
The Santa Clara County Public Health Department said the decision to clear confirmed cases of novel coronavirus is made locally by the county health department in conjunction with the U.S. Centers for Disease Control and Prevention.
The county health department said only that “a final determination is based on a combination of tests, symptoms, and other factors.”
“The goal of these actions is to prevent any further spread of the virus and protect the health of the community,” the Santa Clara County health department said.
Two other Northern California cases were confirmed Feb. 2 in San Benito County, a husband and wife both age 57. San Benito County health officials said the husband recently traveled from Wuhan, but his wife did not and was believed to have been infected through him. They were later transferred to the University of California San Francisco hospital for a higher level of care.
San Benito County health department spokeswoman Samela Perez said they were “not at liberty to discuss” the couple’s condition but would not offer further explanation. The San Francisco Department of Public Health said Friday the couple were discharged from UCSF “in good health,” but did not indicate whether they had been cleared to resume their normal lives.
Dr. Arnold S. Monto, professor of epidemiology and global public health at the University of Michigan, said any delay in clearing sickened people to return to their communities may have to do with testing.
Until this week, local health officials had to send specimens to the CDC for testing. And although the CDC has shipped testing kits to local laboratories, many of them were flawed and had to be recalled.
“If you’ve got somebody who you think is a threat you’d screen before you release them,” Monto said. “You take a specimen and test if the virus is still present. The only problem is the test kits are in short supply. That may be the holdup, unless they know something they’re not telling us.”
Dr. Robert Quigley, regional medical director of International SOS, a major security and medical travel risk firm, said individual recoveries also will vary.
“Health professionals cannot give a number of days because everyone’s immune system reacts differently,” Quigley said. “Somebody with a strong immune response would battle the infection with more rigor than somebody who does not. Each person and their body is like a different snowflake in that each snowflake is different from the next. Because each body has a different immune system and reacts differently, consequently our bodies address infections differently as well.”
