"w 7? war wv-r 'A?urwvx-Vw 2'1 amt. .. f? an: Mam max-raw Lindquist, Scott (DOH) Lindquist, Scott (DOH) From: Sent: Thursday, January 23, 2020 11:01 PM To: Kay, Meagan Cc: Kawakami, Vance Subject: Re: SeaTac case I would test him. Scott On Jan 23, 2020, at 10:01 PM, Kay, Meagan wrote: Hi Scott, we checked in with the case from SeaTac tonight and his fever is gone. His temperature was 98.6 and 99.0. He is feeling better. Slight cough improvement on his runny nose still has an itchy throat. If we check in with him tomorrow morning and his temperature is also normal, does DOH still want us to proceed with testing? Please let us know as soon as possible tonight. We are not able to make arrangements for him to get to a healthcare facility because he has no transportation, so it will be our staff going out to collect the specimens ?rst thing in the morning. Please get back to me and Vance tonight by email about your desire for testing. Thanks! . Rigid? ?1va It might also be to anticipate what the strategy will be if transparency results in an insufficient proportion of subjects being willing to participate. Will stay tuned for talking points, which may address my questions above. Thanks for considering, Chris From:"Biggs, Holly Date: Saturday, January 25, 2020 at 12:09 PM To: "Duchin, Jeff" Christopher Spitters Scott Lindquist Cc: Satish Pillai Subject: Response to test results from enhanced contact tracing investigation Dear Jeff and Chris, I have attached draft guidance on responding to test results as part of the enhanced contact investigation. Please let me know what you think. I am finalizing one thing on the talking points, then will circulate for review as well. Thank you, Holly Holly Biggs, MD, MPH Medical Epidemiologist Respiratory Viruses Branch Division of Viral Diseases National Center for Immunization and Respiratory Diseases US. Centers for Disease Control and Prevention Of?ce: 404-639-3989 Lindquist, Scott (DOH) I I I II From: Lindquist, Scott (DOH) Sent: Saturday, January 25, 2020 3:32 PM To: Trevor Bedford Cc: MacCannell, Duncan Gregory Wentworth, David E. Jernigan, Daniel B. nax3@cdc.gov Subject: Re: CDC genome We reinterviewed him and he is adamant no travel outside Wuhan except for ?ight through Shanghai Scon On Jan 24, 2020, at 1:32 PM, Trevor Bedford wrote: I thought you might want to see this ?rst: It clusters with recent cases in Shenzhen. Are you sure travel history is direct to Wuhan? (I don't know these details) I suspect the clustering represents shared transmission history back in Wuhan, but thought I should con?rm. - Trevor Lindquist, Scott (DOH) Lindquist, Scott (DOH) From: Sent: Sunday, January 26, 2020 8:23 AM To: Kay, Meagan Cc: Duchin, Jeffery, MD Biggs, Holly Lofy, Kathy Pillai, Satish K. Kawakami, Vance; Spitters, Christopher Clark, Shauna Subject: Re: Response to test results from enhanced contact tracing investigation I can?t do until noon either Scott On Jan 26, 2020, at 8:10 AM, Kay, Meagan wrote: can?t do it this morning. From: Duchin, Jeff Sent: Sunday, January 26, 2020 8:02 AM To: Biggs, Holly Kay, Meagan Lofy, Kathy KL (CDC doh.wa.gov) Pillai, Satish K. Lindquist, Scott SL (CDC doh.wa.gov) Cc: Kawakami, Vance Spitters, Christopher Clark, Shauna Subject: Re: Response to test results from enhanced contact tracing investigation I can do this at noon, if Meagan can do this am that is ?ne. Jeffrey S. Duchin, MD Health Of?cer and Chief, Communicable Disease Epidemiology Immunization Section Public Health - Seattle and King County Professor in Medicine, Division of Infectious Diseases, University of Washington Adjunct Professor, School of Public Health 401 5th Ave, Suite 1250, Seattle, WA 98104 Tel: (206) 296-4774; Direct: (206) 263-8171; Fax: (206) 296-4803 E-mail: jef?ducliin?ukingcountvgov From: Biggs, Holly Sent: Saturday, January 25, 2020 11:10:10 PM To: Kay, Meagan Lofy, Kathy KL (CDC doh.wa.gov) Duchin, Jeff Pillai, Satish K. Lindquist, Scott SL (CDC doh.wa.gov) . . Cc: Kawakami, Vance ; - utters comcast. her.s sults Subject: Re: Response to test re important to us. Be cautious gt; Email Notice! External communication/11a nksor attachments-._ . ressed. I think it would be helpful to havc a fconcems being exp eps. It will be important to make . lick or open Suspimous ll 7 0 0t 0 through these and agree on next st I appreciate that there are a ituation and response to this Virus. call tomorrow to try to work. . decisions soon given the rapidly evolvmg 8 Would 9:30 am tomorrow work? Thank you, Holly Get Outlook for From: Kay, Meagan Sent: Saturday, January 25, 2020 10:00:42 PM gov>; Duchin, Jeff (CDC kingcountygov) To: Lofy, Kathy KL (CDC doh.wa.gov) Cc: Kawakami, Vance (CDC kingcountygov) Spitters, Christopher Clark, Shauna Subject: RE: Response to test results from enhanced contact tracing investigation When we talked to EOC tonight they said that they can?t give us an expected TAT for test results They said that posmve tests would be resulted sooner but negative results could take several days to come back. They weren?t providing any specifics. From: Lofy, Kathy (DOH) Sent: Saturday, January 25, 2020 9:53 PM To: h' Pillai Biggs, Holly I . I . . 8 we ov>, LlnquIst,ScottW(DOH) sgza an.Ka kin count . ov>; Kawakami Vance . aml ingcountv.gov>; itters I Clark, Shauna (shclark km counT 0V9) (DOHI) Sent: Saturday, January 25, 2020 9:19:52 PM To: Biggs Holly - - - Pillar, Satrsh K. . - - Lofy, Kathy (DOH) Lmdqurst, Scott Cc: Kay, . Meagan; Kawakami, Vance; Spitters, Christopher Clark, Shauna Subject: Re: Response to test results from enhanced contact tracing investigation This info from the webpage below implies all close contacts of everyone being tested are being Identi?ed and given instructions on monitoring. We have been providing this info to PUI and their HH members, but not tracing all contacts until confirmed (for example UW students who appear very low risk). We need additional manpower if that is the expectation. What is CDC's and DOH's guidance? Prevention Steps for Close Contacts If you have had close contact with someone who is confirmed to have,or being evaluated for, infection, you should: Monitor your health starting from the day you first had close contact with the person and continue for 14 days after you last had close contact with the person. Watch for these signs and 0 Fever. Take your temperature twice a day. 0 Coughing. Shortness of breath or difficulty breathing. Other early to watch for are chills, body aches, sore throat, headache, diarrhea, nausea/vomiting, and runny nose. . If you develop fever or any of these call your healthcare provider right away. . Before going to your medical appointment, be sure to tell your healthcare provider about your close contact with someone who is confirmed to have, or being evaluated for, 2019-nCoV infection. This will help the healthcare provider?s of?ce take steps to keep other people from getting infected. Ask your healthcare provider to call the local or state health department. . If you do not have any you can continue with your daily activities, such as going to work, school, or other public areas. caregivers Froi Sent To lnterim Guidance for Preventing 2019 Novel Coronavirus (20l9?nCoV) from Spreading to Others in Homes and Communities about 2019 novel coronavirus (2019-nCoV) and - - . current! know . This interim gurdance is based on what lS I update this interim gurdance as needed and as transmission of other viral respiratory infections. CDC 'l viruses additional information becomes available. Coronavrruses are a large fami 0 Thanks. Jeffrey S. Duchin, MD (he/him) Health Of?cer and Chief, Communicable Disease Epidemiology Immunization Section Public Health - Seattle and King County - Professor in Medicine, Division of Infectious Diseases, University of Washington Adjunct Professor, School of Public Health 401 5th Ave, Suite 1250, Seattle, WA 98104 Tel: (206) 296?4774; Direct: (206) 263-8171; Fax: (206) 296-4803 E-mail: jeffIduchingazkingcounty. gov From: Duchin, Jeff Sent: Saturday, January 25, 2020 9:08 PM To: Biggs, Holly Kay, Meagan Pillai, Satish K. Christopher Spitters Lindquist, Scott SL (CDC doh.wa.gov) Kawakami, Vance Clark, Shauna Subject: Re: Response to test results from enhanced contact tracing investigation Only ones. Can you please point me to the CDC guidance for management of contacts of We can't seem to find it on the website. We have not identified and placed under monitoring all contacts of people being tested. Jeffrey S. Duchin, MD (he/him) Health Of?cer and Chief, Communicable Disease Epidemiology Immunization Section Public Health - Seattle and King County Professor in Medicine, Division of Infectious Diseases, University of Washington Adjunct Professor, School of Public Health 401 5th Ave, Suite 1250, Seattle, WA 98104 Tel: (206) 296-4774; Direct: (206) 263-8171; Fax: (206) 296-4803 E-mail: From: Holly Sent: Saturday, January 25, 2020 8:51 PM To: Duchin, Jeff - Ka . y, Meagan Pillai, Satish K. Christopher Lindquist, Scott SL (CDC doh.wa.gov) Kawakami, Vance Clark, Shauna Subject: Re: Response to test results from enhanced contact tracing investigation Email Notice! External cominunication is: important to us. Be cautious of phishing attempts. Do not click or open suspicious links or attachments. - Hi Jeff, Can I con?rm- are your contacts currently on isolation? Thanks, Holly Get Outlook for From: Duchin, Jeff Sent: Saturday, January 25, 2020 8:48:57 PM To: Kay. Meagan K. (CDC kinscountv-sOV) ?aw? Biggs. Hollv Pillai, Satish K. ; Christopher Spitters Lindquist, Scott SL (CDC doh.wa.gov) Kawakami, Vance (CDC kingcountygov) Clark, Shauna Subject: Re: Response to test results from enhanced contact tracing investigation we are not starting this until our concerns are addressed and DOH agrees - will keep you posted Jeffrey S. Duchin, MD (he/him) Health Of?cer and Chief, Communicable Disease Epidemiology Immunization Section Public Health Seattle and King County Professor in Medicine, Division of Infectious Diseases, University of Washington Adjunct Professor, School of Public Health 401 5th Ave, Suite 1250, Seattle, WA 98104 Tel: (206) 296-4774; Direct: (206) 263-8171; Fax: (206) 296-4803 E-mail: ieff.duchin@kingcounty.gov From: Kay, Meagan Sent: Saturday, January 25, 2020 8:43 PM To: Biggs, Holly Duchin, Jeff Pillai, Satish K. Christopher Spitters Lindquist, Scott SL (CDC doh.wa.gov) Kawakami, Vance Clark, Shauna Subject: RE: Response to test results from enhanced contact tracing investigation Hi Shauna and Holly, Holly is with CDC and she is coordinating 1'1. . aul cl Snohomish case. This email a each other. Sh is to introduce you to ft he con rm 6 enhanced Contact tracing and testing of contacts 0 ten you get in before we start calling the dinate with each other to make a plan Please Connect With her ?rst thing tomorrow morning wl this enhanced contact tracmg for monitoring. You both need to coor a out ?0 inform the contacts that we are monitoring 0 ?wemgatmn' HOW, please send a good contact number for you. Thanks Shauna! Meagan groin: Holly Tent. Saturday, January 25, 2020 8:26 PM JigECifi?n, Jen Pinai, Satish K. (CDC dghc- ChI?lStORher LinquiSt? Scott SL (M63 a Kay, Meagan b? n. Kawakami, Ject. RE. Response to test results from enhanced contact tracing investigation {eerR NAL EmmiN?ti-c?ttExtemat 01? Open SHSpicious: hnksoratta Hi Thanks so much, really appreciate the offer to integrate with your team. I attached the consent forms and script. We are also working on a script tailored to this setting. I also attached the broad protocol for which the CDC research determination was made. This is 1n draft format and is intended to use across states as additional cases are identi?ed and investigated. Thank you, Holly Sent: Saturday, January 25, 2020 10:59 PM To: Pillai, Satish K. ; Biggs, Holly Christopher Spitters Lindquist, Scott SL (CDC doh.wa. gov) Kay, Meagan K. (CDC kingcounty. gov) Kawakami, Vance (CDC kingcountygov) Subject: Re: Response to test results from enhanced contact tracing investigation A few cements attached. Is there a script/consent for the subjects? Meagan will integrate your team with ours. Jeffrey S. Duchin, MD (he/him) Health Of?cer and Chief, Communicable Disease Epidemiology Immunization Section 6 Public Health - Seattle and Kin . County Professor 1n Ad'unct rune, Dmsron of Infectious Diseas to esSS?r, School of Public Health es, U?wemty ofWashington 401 5th Ave, Suite 1250, Seattle, WA 98104 T61: (206) 296-4774' DirectE-marl: ef??duchin kin cougt .)02v63 8171,Fax. (206)2964803 From: Pillai, Satish K. CDC . gent: Samday, January(25, , ; Kawakamr, Vance Ject. RE. Response to test results from enhanced contact tracing investigation n? attempts Donot Dear Jeff, Chris Simply to echo Holly, i wanted to reiterate how much we appreciate your input and review to date. I think the attached talking points help to nicely frame the purpose of this very important investigation. And, the continued cases being reported in China and elsewhere reinforce the critical need to better understand this virus. Thank you again for all your support to date. Best, Satish From: Biggs, Holly Sent: Saturday, January 25, 2020 9:44 PM To: Duchin, Jeff (CDC kingcountygov) Christopher Spitters Lindquist, Scott SL (CDC doh.wa.gov) Kay, Meagan K. (CDC kingcountygov) Kawakami, Vance (CDC kingcountygov) Cc: Pillai, Satish K. Subject: RE: Response to test results from enhanced contact tracing investigation Hi Jeff and Chris, I?ve attached draft talking points for internal use. I hope this answers a lot of the questions that might come up in discussion with contacts. I also attached both the CDC research determination and the WA exempt determination. Jeff, in response to the concern about staff. We have 2 from Atlanta who arrived today and another EISO and LLS fellow arriving tomorrow. We anticipate that the will conduct the field interviews and sample collection. The LLS fellow will coordinate processing and shipping of specimens to Atlanta. We are also happy to be the ones to relay the results back to the contacts if that would be helpful (defer to your preference on this). We would anticipate needing limited involvement of your staff to provide information on the contact line list, including contact information, and if possible making a phone introduction to our team (an EISO is working on the script based on the attached talking points 7 . to et started as right now). We will supply all ofour own equipment and suppl'esr and we are rea 3 soon as tomorrow. I ositive and is wouldn . - - ts . . To respond to the questions you raised, If the contact tes . who ate anticipate a contact investigation. For an contact who tests posntivehl meetiilationp'rhe the next step would be to do a clinical assessment, repeat PCR and place them on o! more about prudent approach may be to follow them until negative, but this could change as we ear this evolving situation. Thank you so much for your support on this. We are eager to get the investigation underway as we believe it is critical to learn more about the new virus as the situation continues to evolve every day. i would be happy to have another call to discuss any questions or concerns. Thank you, Holly From: Duchin, Jeff Sent: Saturday, January 25, 2020 3:33 PM To: Christopher Spitters Biggs, Holly DVD) Lindquist, Scott SL (CDC doh.wa.gov) Cc: Pillai, Satish K. Subject: Re: Response to test results from enhanced contact tracing investigation i think they need to be isolated until PCR negative and all resolved Jeffrey S. Duchin, MD (he/him) Health Of?cer and Chief, Communicable Disease Epidemiology Immunization Section Public Health - Seattle and King County Professor in Medicine, Division of Infectious Diseases, University of Washington Adjunct Professor, School of Public Health 401 5th Ave, Suite 1250, Seattle, WA 98104 Tel: (206) 296-4774; Direct: (206) 263-8171; Fax: (206) 296-4803 E-mail: ie?iduchin?lkingcountygov From: Christopher Spitters Sent: Saturday, January 25, 2020 12:30 PM To: Biggs, Holly Duchin, Jeff Lindquist, Scott SL (CDC doh.wa.gov) Cc: Pillai, Satish K. Subject: Re: Response to test results from enhanced contact tracing investigation Email Noticel] Externalcommunlcatlonislmpo click or open suspicious, links or?att?achr?ehtsti it: Reviewed and noted. Will you be informing the subjects prior to testing of that contingency plan for isolation and further evaluation in the event their results are positive? How long would they be isolated if positive and and will you inform them of that during the pre?test counseling, as well? If unsure about potential duration of isolation, then maybe they should at least be told that. I am not trying to be difficult and I continue to support the effort, but I do think it is best to be fully transparent with them about the potential consequences of submitting to voluntary testing. 8 Lindquist. Scott (DOH) Lindquist, Scott (DOH) From: Sent: Monday, January 27, 2020 9:23 AM To: Satish K. Pillai; Hawkins, Vivian (DOH) Subject: Fwd: Can you please forward to Satish? Coronavirus call with Helen Chu [no phi] Satish See invite below Scott Begin forwarded message: From: "Hawkins, Vivian Date: January 27, 2020 at 9:17:20 AM PST To: "Lindquist, Scott Subject: Can you please forward to Satish? Coronavirus call with Helen Chu [no phi] I thought I couid find Satish Pillai?s email in the CDC directory but didn?t see an email listed. Can you please forward this invite to him? Thanks ?-??Original Appointment From: Hawkins, Vivian (DOH) Sent: Monday, January 27, 2020 8:59 AM To: Izzy Brandstetter; Trevor Bedford; lstarita; Podczervinski, Sara DOH-DIVS DOH-IC Boysun, Mike Harry, Wickersham, Kevin Robin A Prentice; Helen Chu; Caitlin Wolf; Lindquist, Scott Davis, Jerrod (DOH) Subject: Coronavirus call with Helen Chu [no phi] When: Monday, January 27, 2020 1:00 PM-2200 PM Paci?c Time (US Canada). Where: Call Call in information below, coronavirus call with Helen Chu. Background attached. We will only be using the call in number (not web). Coronavirus call Mon, Jan 27, 2020 1:00 PM - 2:00 PM (PST) Message: RE: Call today at 1 pm. Potential collaboration with Seattle Flu Study/WA DOH: coronavirus [no phi] Please join my meeting from your computer, tablet or smartphone. You can also dial in using your phone. (For supported devices, tap a one-touch number below to join instantly.) United States: +1 (872) 240-3212 - One-touch: Access Code: 532-912-549 Join from a video-conferencing room or system. Dial in or type: 67.217952 or Meeting ID: 532 912 549 Or dial directly: 532912549@67.217.95.2 or 67.217.95.2##532912549 New to GoToMeetingready when your ?rst meeting starts: s: lobal. otomeetin .com install 532912549