illustration courtesy of the CDC via Unsplash

Gov. Gavin Newsom declared a state of emergency on March 4 as the number of positive cases of coronavirus or COVID-19 rose in the state, and in Los Angeles County, the Department of Public Health announced one additional case of COVID-19, bringing the total number of cases up to 24 and one death as of March 11.

The Centers for Disease Control and Prevention reported a total of 938 cases and a total of 29 deaths in the United States as a result of the virus, as of March 11. However, a new study conducted by Cedars-Sinai Medical Center estimates more than 9,000 people in the U.S may have already been infected by the novel coronavirus.

“Everyone should be thinking about how we can reduce transmission of the infection with simple things such as staying at home if you feel unwell, regular and thorough handwashing and avoiding touching your face,” said Dermot McGovern, professor of medicine and biomedical sciences at Cedars-Sinai and senior author of the study.  “Our study suggests even modest reduction in transmission rates may slow the peak of the epidemic, which is important for our ability to cope with the number of people likely to be sick.”

According to researchers, the Cedars-Sinai study suggests the window to contain the epidemic of COVID-19 in its early stage is closing. The study was posted online on a forum where physicians and researchers share information.

“Cedars-Sinai is committed to the global efforts to combat COVID-19,” said Dr. Shlomo Melmed, executive vice president of academic affairs and dean of the medical faculty at Cedars-Sinai. “We believe that early dissemination of this study and the free sharing of the code that underlies the model will help in those efforts.”

The study used conservative methods to estimate the number of COVID-19 cases such as limiting COVID-19 cases to only those that arrived directly to the U.S. from the area of Wuhan, China, where the virus was first discovered, before Jan. 23, when the Chinese government locked down the city and assumed it had stopped the virus from spreading.

The scale of the COVID-19 epidemic in the U.S. was calculated based on air traffic data between Wuhan and the U.S., totals of confirmed cases publicly released by the CDC and transmission dynamics as estimated from previous research. The study also took into account the identification and quarantine of individual domestic cases in the U.S.

The Cedars-Sinai study estimated a total number of people in the U.S. infected with COVID-19 as of March 1 to be between 1,043 and 9,484. McGovern said the disparity between the two estimates has important implications for controlling the epidemic.

“From a medical perspective, we need to listen to public health experts and follow their advice,” McGovern said. “For researchers, we need to work together and share information as much as we can.”

Cedars-Sinai said in a statement that they want to assure the community they continue to utilize CDC-approved infection prevention protocols and their care teams are prepared in treating new and emerging diseases.

Cedar-Sinai infectious disease specialists were unable to provide further information regarding COVID-19 test kits and other tools available to combat the virus at press time.

The study and health officials emphasize the importance of social distancing, personal hygiene and restricting large-scale gatherings.

Dr. Suman Radhakrishna, an infectious diseases physician, and Dr. Thomas Horowitz, family medicine specialist, from CHA Hollywood Presbyterian authored an article on understanding COVID-19.

“In an outbreak, social distancing helps reduce exposure to asymptomatic and mildly symptomatic carrier of the infection,” Radhakrishna said. “Currently, we have around [20] COVID-19 cases in Los Angeles county, suggesting the percentage of asymptomatic and mildly symptomatic carriers in the community is low.”

Both doctors urge individuals who are ill, regardless of the cause, to avoid work and social gatherings, and hopefully reduce spread of illness in the community.

State and local governments provided guidelines for schools, colleges and large public events to prepare and protect Californians from COVID-19.

“It’s a question of when – not if – some California public schools will face closure because of COVID-19,” Newsom said in a statement. “School districts must prepare for these scenarios so that parents and children can plan for what would happen if their local school faced closure.” 

The Los Angeles Unified School District Board of Education took precaution and declared a state of emergency related to COVID-19 on March 10. This administrative action will allow the district to be more streamlined in its preparations against the virus.