“This virus is extremely contagious. It doesn’t take very much to get it from what I can tell and from the reports that I’ve heard. That’s why I think the isolation measures are so critically important. Hand hygiene can’t be stressed enough. I’m not a germaphobe and I’ve washed my hands more on any given day than I have in a week in times past so I think that’s a key thing.”
Jefferson County health officer Dr. John Hossler
“This virus is extremely contagious. It doesn’t take very much to get it from what I can tell and from the reports that I’ve heard. That’s why I think the isolation measures are so critically important. Hand hygiene can’t be stressed enough. I’m not a germaphobe and I’ve washed my hands more on any given day than I have in a week in times past so I think that’s a key thing.” Jefferson County health officer Dr. John Hossler
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Local health officials responding to the COVID-19 pandemic have tested a few Jefferson County residents to date — and are currently looking at a couple of people of interest who they know have been in contact with others who have the virus — but so far nobody has tested positive.

For a new form of coronavirus that’s infected 4,226 in the U.S. and more than 185,000 worldwide with 75 deaths in the U.S. and more than 7,500 worldwide — including two in Indiana — that’s good news so far but it’s not likely to last.

According to Dr. John Hossler, health officer for Jefferson County, it’s not a matter of if there will be positive cases locally, but when and how many. He said a virus that spreads as easily as COVID-19 will find a way into Jefferson County and most likely has already.

“Two or three have been tested and that’s all that I know of right now. And these were just people who have been in contact with people that had it ... but it’s something that’s evolving day to day and hour to hour,” Hossler said. “As of now we don’t have it. But again, we are going to get it in our county.”

Hossler and other local and county officials answered questions at a press conference Tuesday to provide details on the community’s response so far, plans moving forward and to explain some of the measures that have been put in place to protect both the public and local workforce.

Whether by national, state or local directives, restaurants and bars have been ordered closed and Madison City Hall and the Jefferson County Courthouse are open by appointment only with much of the routine business at both directed to their websites. Businesses can remain open for now but there are recommendations on limiting the number of patrons at a time and for exercising precautionary measures for workers.

Essentially, the recommendation is to isolate and stay home when possible because that might be the best way to limit the spread of COVID-19 once it shows up after being brought in from outbreaks in other communities.

The way in which people contract COVID-19 has been one of the key markers in assessing how big of a problem a community may have. Cases in Indiana so far have been linked to person to person contact with another infected individual, but once people start testing positive for the virus and a person to person link cannot be established, the outbreak will have gone communal and the number of cases will potentially be much larger and that’s one of the things precautions like closing restaurants, bars, schools and other highly visited locations hopes to contain.

“Community acquired is you get it but there is no reason why you got it. Everything early on is with people who have been to a high risk region, so it was logical that you could get it because of that,” Hossler said. “But community acquired is when it just pops up and there is no reason why you have it. Once I saw that happen first in California or Washington, then I knew it wasn’t if we were going to get it, but just a matter of when. So I think it’s going to happen, we’re going to get it and we’re going to have a few cases.”

As local, state and national virus prevention experts have said throughout the pandemic, and Hossler reiterated Tuesday, the best people can do in the way of prevention right now is to isolate as much as possible and diligently practice safe hygiene, especially proper hand washing. He said even that won’t be enough to prevent cases of the COVID-19 locally but it could be the difference between a manageable outbreak and a widespread communal illness.

“People need to understand that this is an event that probably only happens every 50 to 100 years. It’s not that any of us have a lot of training or understanding how to handle something like this. That’s why things are constantly changing on a day to day basis,” Hossler said. “This virus is extremely contagious. It doesn’t take very much to get it from what I can tell and from the reports that I’ve heard. That’s why I think the isolation measures are so critically important. Hand hygiene can’t be stressed enough. I’m not a germaphobe and I’ve washed my hands more on any given day than I have in a week in times past, so I think that’s a key thing.”

COVID-19 is a new strain of a coronavirus group that has been around for years in both humans and animals — Hossler likened it to a mutation — but unlike previous variations of the bug, COVID-19 is a stealthy infector that passes through human to human and possibly indirect contact and then takes eight or more days to present itself in symptoms like a fever, cough, sneezing or shortness of breath. Droplets from coughs and sneezes are the most direct source, but an infected person can leave the virus on surfaces they touch — for instance up to 24 hours on cardboard and far longer on plastic and stainless steel — until someone comes into contact with the germ and is infected when they touch their own mouth, nose or eyes.

By the time a person who has COVID-19 realizes they are sick, they could have already passed it on to family members, co-workers, acquaintances — anybody they have come into close contact with — facilitating the spread throughout the community.

Those who contract the virus and are healthy may experience only mild symptoms and ward off the disease in a couple of weeks on their own — in fact, they may not even realize they have COVID-19 — but those who already have life-threatening conditions like heart disease, hypertension, diabetes, chronic obstructive pulmonary disease even others, could be hit hard and spend days in an intensive care unit — possibly on a ventilator — battling for life with some losing that battle, Hossler said.

He noted that hospitals have the capacity to treat only so many patients needing that level of care and the disease can take more than two weeks to either recover from or die of so the strain on the healthcare system is ongoing and extensive.

“I’ve done some reading quite a few years ago on the 1918 influenza virus, the Spanish flu, which is the major hallmark that most medical people look at and was a worldwide epidemic that killed 30-50 million worldwide. I think this virus varies a little bit different,” Hossler said. “That virus, from what I have read, you could develop symptoms in the morning and be dead by the afternoon ... this virus, from what I’ve read, takes about eight days for symptoms to peak and the average death is up to about 18 days so you can imagine how that really straps healthcare personnel. When you tie up hospital beds with critically ill people for 18 days you’re going to quickly run out of beds so I think that is something that is different in regards to this virus.”

With that in mind, local officials are gearing up to fight the virus for the long haul because the nature of COVID-19 is that it could still be making the rounds several months from now unless a vaccine is developed, the virus mutates or the population gradually becomes more resistant to the new strain of a coronavirus that has been around for years.

“If you contain it and eliminate the spread you continue to have a tremendous amount of people who are susceptible and I’ve heard that voiced elsewhere. So what this means is we have to remain vigilant, and once this wave passes there’s still a bunch of people who could get it and if that virus ever came back in the community, we then would start all over again,” Hossler said. “The measures we are implementing, even if we relax them, hand washing, isolation, trying to avoid large crowds need to be in effect for a long period of time.”

Hossler said work is being done to develop a vaccination but that it would still need to be tested and released. Once a pool of people has been vaccinated it will be easier to control the spread of the virus. He said having 70% or 80% of the people vaccinated would likely contain COVID-19 to where it no longer spreads as easily from person to person.

Meanwhile, Hossler said many patients who get COVID-19 may never know they’ve got it unless tested. The virus takes days before the infected start showing symptoms and even then some people — the lucky ones — will experience mild enough symptoms that they might even brush off the illness as seasonal allergies or a cold.

Unfortunately, for those who come into contact with someone who has been exposed but remains asymptomatic, that does not make them any less contagious and the model health care professionals are using for COVID-19 is that one person can expose three people who can then expose nine people who can then ... well, it’s easy to get the pandemic picture at that point.

“I think really the vast majority of this virus is relatively benign and asymptomatic. Kids get it but they just don’t seem to be affected by it nearly as much ... we’re going to get it, it’s just a matter of when and how bad. We just want to isolate ourselves as much as possible and pray for a vaccination,” Hossler noted.

Mayor Courtney said the pressing issue right now is to control the spread of the virus and provide care for those who need it but the underlying issue is the impact on day to day life in the community and the commerce that keeps local business people and the employees they provide for afloat.

“The first wave of this crisis is going to be from the healthcare perspective. The second wave is going to be from the economic perspective and the impact that it will have on small communities,” Courtney said. “So what we will start working on right away is working with the county, state and federal governments to determine what assistance we can add that will help our communities. I think that is critical. As you know, small businesses in cities the size of Madison and all over the state of Indiana thrive because of tourism and local commerce and that is going to be disrupted ... so we have to be prepared for that and to support one another in these difficult times.”

Lindsay Bloos, executive director of the Madison Area Chamber of Commerce agreed, noting that local businesses need the community’s support now more than ever. She said the next few weeks will be particularly difficult for small business owners and their employees but the Chamber of Commerce is providing resources to help with forms for assistance and information on its website.

“Our businesses are resilient but they need our help. They need us to spend our local dollars here,” Bloos said. “Buy local and buy gift cards now and shop here as well. There’s likely to be distraction in all of our lives in the coming weeks but if we can all come together we can minimize the impact on our local economy.”

In the end, if everybody does what’s needed to prevent COVDI-19 from being widespread in the community, local healthcare should be able to focus on those who are most sick. Although there have been two deaths in Indiana to date, many more people have recovered from the virus and Hossler said since most people probably don’t even know they have it because they are asymptomatic and have not been tested, the morality rate of COVID-19 is actually pretty low.

He said a fever is one of the first and best signs and anyone with a temperature of 103 or 104 degrees Fahrenheit should seek medical attention and be evaluated for testing — especially if there are other symptoms present. He said while test kits remain in short supply there are more now that when the virus was first being diagnosed and even more kits are expected in the coming days.

Hossler was also asked about public reaction to date, including picking store shelves clean of some items, and whether there were items people actually need to have on hand.

“I’m not sure toilet paper is high on the list. At least in my mind,” Hossler laughed, referring to the run on toilet paper in Madison and across America. “A lot of hand sanitizer. Soap and water works well. I would prefer soap and water. Hand sanitizer on a minute to minute basis but soap and water works great for 20 seconds — sing Happy Birthday but just don’t sing it fast — and from what I’ve read it doesn’t make any difference whether it’s cold water or hot water. The main thing is you’re washing your hands. Supposedly whether it’s regular soap or antibacterial soap doesn’t make a whole lot of difference. If you want to get antibacterial soap, go for it.”

Hossler also said many people will experience coronavirus mild enough that the fever and respiratory symptoms can be treated with over the counter cold medications, acetaminophen and ibuprofen but anyone showing symptoms, should still be checked by a doctor to be properly diagnosed.