Dr. Ricardo Maldonado

Dr. Ricardo Maldonado, center, infectious disease specialist, observes the doffing and donning of personal protective equipment at EAMC in early March prior to the confirmed outbreak of Covid-19 in the Auburn community

East Alabama Medical Center, Auburn University and the city of Auburn continue to make preparations for an expected outbreak of COVID-19 in the Auburn community. 

"We shouldn’t be surprised that we could see a case of COVID-19 in our community anytime. This is probably just going to happen. We just have to be prepared," said Dr. Ricardo Maldonado, infection prevention director at EAMC. "This shouldn’t fall just on a hospital. We all have the responsibility to respond to this epidemic. Every single member of this community should know what to do.

"I believe that every member of our community can have an impact to stop this epidemic or control it."

COVID-19 is a novel, or new, virus in the coronavirus family, one that Maldonado says causes more serious infections. COVID-19 symptoms, which may appear two to 14 days after exposure, include fever, cough and shortness of breath.

About 80 percent of patients with COVID-19 will only have a mild symptoms.

"Those patients should be able to just treat it at home like any other influenza or cold," said Maldonado. "We actually want you to get treated at home on the comfort of your couch."

About 15 percent of patients will have a more serious infection that might require hospitalization even though there's no treatments at the moment. 

"There’s no medication right now that we have available to treat our patients," said Maldonado, who added that 5 percent of patients will be very sick and require critical care. "Now, if you have more than just mild symptoms — so it’s not just the aches, cough or the mild fever — but rather it’s a persistent fever or you have a hard time breathing, that means that you might require medical care. Again, that would be only about 20 percent of patients. If that happens, we want you to call your primary doctor or your local hospital. We have a hotline here that we can call. We want to know when you’re coming to our office or to a hospital. But we don’t want you to come when you have mild symptoms."

COVID-19 spreads like other respiratory infections — through coughs, sneezes or contaminated surfaces. 

"This means that when you’re close to somebody, within six feet, when you cough or you sneeze you can spread that infection to other people," said Maldonado. "Cough etiquette is going to be extremely important. Ideally, we should cover our cough and sneeze with a disposable tissue. We should not cover our cough with our hands. They become contaminated and we could spread this virus somewhere else, including surfaces.

"What we want to do really here is cover our sneeze or cough with tissue, if possible. If you do not have tissue available, even your sleeve would be better than using your hand."

Maldonado stressed the "paramount importance" of frequent hand-washing with soap and water, and that using hand sanitizer would be helpful if soap and water aren't available. 

"There’s no need to panic right now," he said.

The city of Auburn has also been making preparations in the event of an outbreak in the community, making contingency plans to prevent services to residents from being disrupted. Deputy Director of Public Safety Will Mathews is overseeing the city's preparations.

The Alabama Department of Health also announced that state officials are preparing for the possibility of an outbreak, despite there being no confirmed cases of the virus in Alabama. 

The COVID-19 virus was first detected in Wuhan City in the Hubei Province of China. One of the largest nations in the world, China has struggled to contain the virus, with nearly 5 million people traveling outside the region prior to discovery of the novel virus. As a result, isolated infections of the disease continue to affect humans in other parts of the world, including the United States.  

Previously, all cases of the virus in the U.S. involved persons who had traveled in the affected areas of China or persons with prolonged contact with a traveler from the affected areas.  As of Feb. 27, officials from the CDC announced the first case of novel coronavirus with unknown origin— marking the first signs of community transmission in the U.S.  

New developments of the virus continue to arise daily as officials begin discussing prevention and containment measures. So far, 13 states have reported cases of the coronavirus, including Florida and Georgia, with 10 confirmed deaths. The vast majority of cases in the U.S. have occurred in California and Washington.  

With flu season at its peak and the new coronavirus symptoms matching some seen in the common flu, Alabama officials are asking the public to get the flu shot if they have not already done so.  

“The best way to avoid infection is what we already know is effective in reducing the risk of transmission,” said Dr. Mary McIntyre, chief medical officer of the Alabama Department of Public Health. “These are the everyday precautions to help stop the spread of germs, such as frequent hand-washing, covering coughs and sneezes, staying home if you have fever, taking flu antivirals if prescribed, and using appropriate equipment the right way every time.” 

Auburn University also released statements to concerned citizens about the virus.  

With the softening of the enrollment cap on undergraduate numbers in 2013 and the introduction of Auburn Global in 2015, more international students were recruited to the campus into a pathway program that feeds undergraduate programs while contributing to the growth of Auburn’s masters programs.  

As of Fall 2019, according to the Office of International Programs, China landed number one for countries of origin by semester with 1,882 students enrolling. Over 100 students from South Korea also enrolled followed by 64 students from Nigeria and 36 students from Iran, all of which are countries currently working to contain the coronavirus.  

In a statement released to faculty, staff and students on Feb 27, the university stated that “campus leaders, including health experts, emergency management personnel and others, are closely monitoring the evolving situation with the coronavirus (COVID-19) and potential effects to campus. To keep the campus community informed, the university is providing updates and answers to common questions about coronavirus and its impacts to campus at https://ocm.auburn.edu/news/coronavirus/. The university encourages students traveling for spring break, particularly those traveling to countries affected by the virus, to take necessary precautions to ensure their health and the health of others.” 

As of March 2, the university released a statement canceling all Summer 2020 study abroad programs and recalling students studying abroad this semester.  

This comes after Auburn had already suspended university travel to China, Italy, Iran and South Korea due to the coronavirus.  

University health officials are encouraging those who have returned from those countries in the last four weeks or have been exposed to someone who is ill to contact the Auburn Medical Clinic.  

Dr. Fred Kam of the AU Medical Clinic echoed the information and advice given by Maldonado.

"There is no reason to panic, but there is reason to get prepared," he said. "We're not treating this as an if; we're treating this as a when. I think everyone in the community has an individual responsibility to start the process of getting prepared."

East Alabama Medical Center released a statement last Friday notifying the public of its awareness of the issues.  

Noting “Auburn University’s diverse population and local industrial ties with some of the affected countries,” EAMC officials say they are taking the necessary steps to prepare for the possibility of the COVID-19 outbreak in the east Alabama region.  

“In the past two months, we have already had no less than seven multi-disciplinary meetings regarding the Coronavirus with EAMC,” Laura Grill, president and CEO of EAMC, said. “We also participated in several conference calls with the CDC, the ADPH and the Alabama Hospital Association.” 

As the hospital continues to track the spread of the virus, instructional signage has been placed at the main entry points of EAMC, EAMC-Lanier and the Auburn Medical Clinic.  

“We are continuing communication to all area physicians to make them aware of our action and plans,” Grill said. “At the hospital, several staff members are being trained on every component of caring for a patient with COVID-19, including the donning and doffing of personal protective equipment (PPE) so as not to spread the virus to other patients or employees.” 

Hospital officials are asking that citizens treat preparation for a possible outbreak like they would for flu season.  

Taking precautionary steps such as the top 10 things to do to fight the flu is recommended. These 10 steps include: 

Get Vaccinated 

Wash Your Hands 

Cover Your Coughs and Sneezes 

Stay Home With Fever 

Stockpile Supplies 

Clean and Disinfect 

Know Your Office Emergency Plan 

Learn Home Care 

Call Your Doctor If Symptoms Get Worse 

Stay Informed 

According to EAMC, the elderly, the very young and those who are immuno-compromised are the ones who are most at risk. The CDC does not recommend the wearing of facemasks for people who are well and showing no symptoms. 

For more information and to follow the latest updates on the coronavirus outbreak, go to www.cdc.gov/coronavirus/2019-nCoV/index.html. EAMC also has a hotline for those who feel they are sick and have traveled to affected regions. The number is 334-528-SICK  

“Good hygiene, covering your cough and limited public exposure are the best ways to prevent the spread of COVID-19,” Grill said. “Therefore, everyone is asked to please wash their hands often, avoid touching their face, routinely clean and disinfect frequently touched surfaces and stay home when sick.” 

“We are watching closely,” Grill added. “Prepare but don’t panic.” 

Audio of the EAMC Press Conference can be found here:

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