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Coronavirus Evacuees Passed Through Travis AFB. Did the Safety Plan Break Down?

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Coronavirus Evacuees

 

The good news came on Feb. 18 for about 180 people who'd been holed up at the Westwind Inn, the on-site hotel at Travis Air Force Base in Fairfield. The two weeks in quarantine after their evacuation from China had crawled by as they interacted with a team of local, state and federal health officials.

On that Tuesday, most everyone who'd visited Wuhan was cleared to go home. A handful had been sent to local hospitals for monitoring. The others dispersed, many boarding flights from Sacramento to their homes throughout the U.S.

About the same time, two American evacuees from the Japan-docked Diamond Princess cruise ship were being admitted into isolation rooms at a Napa hospital. One traveler had tested positive for COVID-19, the other showed symptoms of the virus. In a radio interview that day, Feb. 18, a Napa County spokesman repeated the line that's been trumpeted continuously in recent weeks, at least in the U.S.: For the public, there's "minimal risk of exposure."

As eyes increasingly turned to the Fairfield military base, a Solano County woman went to a small Vacaville hospital 8 miles away with symptoms associated with the new coronavirus. She stayed at NorthBay VacaValley hospital for four days, her condition apparently worsening, and on Feb. 19 staff moved her on a ventilator to UC Davis Medical Center in Sacramento.

The nation would learn about a week later that, although she apparently had no close contact with any travelers to China, she had been diagnosed with the new coronavirus.

It was the nation's first infection that had unknown origins. The director of California's Public Health Department last week called her case a "turning point" that could signal widespread infection is increasingly difficult to stop.

The woman's case unleashed a deluge of questions and concerns about how local, state and federal officials responded to the mounting public health concern after the evacuees arrived at Travis Air Force Base -- and what future responses might look like. A U.S. government whistleblower now says federal workers did not have the necessary protective gear or training when they were deployed to help quarantined people, including those at Travis.

Since the Solano County woman's illness became known, teams of health care investigators have fanned out across Northern California trying to understand exactly how -- and how widely -- the virus has spread.

"We have deployed there," Secretary of Health and Human Services Alex Azar told McClatchy this week. "We'll send whatever we need to assist the state and local public health authorities with the contact tracing and getting to the bottom of her case."

But sharp questions are being asked about the timeline between the arrival of hundreds of people at Travis and the coronavirus infection of a woman who lived in the same county as the military installation.

For investigators, that timeline could shed light on how the disease is spreading and whether federal authorities botched the re-entry process for those returning from China. For others, the sequence of events is too coincidental to be ignored. Did health authorities allow the Travis evacuees to bring COVID-19 to California -- and for those who came in contact with them to spread it?

Local Health Authorities are Skeptical

Dr. Bela Matyas, a Solano County public health officer, told The Sacramento Bee that concerns about ill-prepared personnel working with evacuees did not extend to Travis Air Force Base. By the time repatriation flights landed at Fairfield, Matyas said, a robust federal operation had been established.

"They were CDC folks -- we met them. They were very meticulous," Matyas said. "We couldn't enter without the proper equipment. They've handled three planeloads and we're grateful. They've helped to protect our community."

Azar on Friday said the department was conducting interviews and gathering information about the whistleblower's concerns, adding that he was unaware of the complaint when he testified before a House committee earlier in the week.

"We will take remedial measures if needed," he told reporters Friday. "...We will very transparently investigate, and if there's any problem, we will take remedial action."

How February Unfolded at Travis

On Feb. 1, federal officials announced Travis Air Force Base would be among three installations in California to house travelers who may have come in contact with the virus that originated in Wuhan, China. The base would soon be populated with hundreds of travelers.

A flight carrying some 181 American evacuees landed on a chartered Boeing 747-400 during the predawn hours of Wednesday, Feb. 5.

Medical personnel had screened and monitored them before, during and after the 11-hour flight over 6,500 miles, officials said. Passengers considered high-risk were kept in a separate part of the plane, divided by a plastic sheet.

The first passengers, some holding luggage, were escorted one by one and in small groups out of the plane. Officials walked them beneath the jumbo jet, emblazoned with the name of cargo carrier Kalitta Air, and into the adjacent Hangar 16.

Between deplaning passengers, KGO-TV video showed personnel in white protective suits, some wearing respirators, unloading luggage from the cabins using the air stairs. The passengers were met with applause as they exited the plane and headed toward their temporary home at the Westwind Inn.

Jeff Ho was among the first passengers from China to land at Travis. He had been visiting his in-laws during the Chinese New Year festivities early in January as the series of lock-downs and quarantines rippled near Wuhan. Ho, who works in San Bernardino as a mechanic, coordinated with the U.S. embassy to secure his flight to California.

"I got lucky and had three seats to myself," Ho told The Sacramento Bee on Saturday. Airport and embassy staff in China wore protective suits, but on the plane, the atmosphere was more relaxed. Travelers and workers wore masks and goggles.

When they landed at Travis, emergency vehicles were parked near the hangar, Ho said. They turned in their paperwork at tables inside the hangar and, at the end of the line, received their room keys.

"No one was really wearing the full suit anymore because they already screened the people," Ho said, adding they instead wore masks and eye protection but otherwise normal clothing. "We were there at that quarantine because we were not sick."

In the two weeks that followed, he binge-watched movies, documented his day on social media and befriended the workers who regularly took his temperature. He returned to his home in Southern California on Feb. 19, where he continues to video-chat daily with his wife and daughter -- they remained with his in-laws.

Ho disagreed with critics and the whistleblower who allege workers were untrained and did not properly protect themselves from spreading the virus. He's spoken with some workers and others who were quarantined with him in recent days, and they also said they did not see anything that would corroborate the whistleblower's complaint.

"I'm actually more worried that people are going to go crazy and overreact," he said.

After Ho's arrival at Travis, another flight landed on Friday, Feb. 7, and 53 passengers from China were sent into isolation, bringing the total number to 234 passengers at the base. Ultimately, none of those Wuhan evacuees housed at Travis tested positive for the new coronavirus -- it is possible, however, to carry the illness without knowing it.

Dr. Henry Walke, an infections-preparedness official with the CDC, previously described the early quarantines at Travis as an "unprecedented action." But, he added, "this is an unprecedented threat."

"We know this situation may be concerning to people in the Travis Air Force Base community," he said. "Based on our experience with other coronaviruses, we don't believe these people pose a risk to this community because we are taking measures to minimize any exposures."

Whistleblower Offers Doubt

Suspicion about the Travis Air Force base protocols, and the comings and goings of those assigned to work with travelers, jumped into public view when The Washington Post reported that a whistleblower had filed a complaint with the Office of the Special Counsel.

The whistleblower alleged about a dozen personnel with the Administration for Children and Families responded to Travis Air Force Base but were "not properly trained or equipped to operate in a public health emergency situation," even though they had face-to-face contact with travelers.

Although team members had gloves at times and masks at other times, they lacked full protective gear and received no training on how to protect themselves in a viral hot zone, according to a description provided to the Associated Press. They had no respirators but noticed that workers from the CDC were in full gear to protect them from getting sick.

"Our client was concerned that ACF staff -- who were potentially exposed to the coronavirus -- were allowed to leave quarantined areas and return to their communities, where they may have spread the coronavirus to others," said Lauren Naylor, an attorney representing the whistleblower, according to the law firm's Twitter profile.

Rep. Jimmy Gomez, D-Calif., said the whistleblower had contacted his office and was alleging retaliation by higher-ups for having flagged the alleged safety issues.

In response, the U.S. Department of Health and Human Services, which manages the Administration for Children and Families, said it was evaluating the complaint.

"We take all whistleblower complaints very seriously and are providing the complainant all appropriate protections under the Whistleblower Protection Act," HHS spokeswoman Caitlin Oakley said in a statement to The Bee.

'Floating Disaster'

By the middle of February, as quarantines came to an end for the Wuhan travelers isolated at Travis, stays would soon begin for passengers from a cruise ship being denied ports around the world -- a petri-dish at sea.

The 3,711 people aboard the Diamond Princess cruise ship were on their final night of a two-week luxury cruise when the captain came on the intercom. A person had left the ship nine days earlier and tested positive for the virus. It was unnerving, guests would later recount, but it did little to dissuade many from mingling in theaters and bars in what would later be described in the New York Times as a "floating epidemiological disaster."

As a two-week quarantine dragged on, an international argument intensified: How to handle repatriating citizens without allowing the virus to increase its rate of spread?

By the middle of the month, the U.S. had crafted a plan to fly Americans to bases in California and Texas, citing measures that were "consistent with the most current medical assessments available, and the careful policies we have instituted to limit the potential spread of the virus," the State Department wrote in an letter dated Feb. 16.

That day, after a testy debate between the State Department and the Department of Health and Human Services, hundreds of mask-wearing Americans -- including 14 confirmed to have had the virus -- were cleared to return to the U.S. While 178 people arrived at Travis from the Diamond Princess, the CDC reported, 144 others went to Joint Base San-Antonio-Lackland in Texas.

At Travis, six passengers were immediately sent for care at the National Quarantine Unit at the University of Nebraska Medical Center/Nebraska Medicine in Omaha. More than 600 travelers who had been on the ship later tested positive for the virus. At least six around the world would later die.

Following screening procedures at Travis, 16 other passengers were sent to hospitals near the base for isolation and further evaluation. None were sent to Sacramento-area hospitals. And four travelers in the coming days developed symptoms of respiratory illness while quarantined at Travis, despite being cleared in Japan days earlier.

Then, on Feb. 18, the officials in Napa County said two evacuees who arrived at Travis were hospitalized; one tested positive for the new coronavirus and the other had symptoms. They were being treated in isolation at Queen of the Valley Medical Center, 30 miles west of Travis.

As evacuees and workers dispersed, it became increasingly difficult to keep track of their whereabouts. Counties up and down the West Coast -- including several that do not yet have known cases of COVID-19 -- declared local health emergencies.

Solano County and Travis Air Force Base followed suit last week.

"This is an emerging, rapidly evolving situation," base officials said in an announcement. "We will continue to partner with local agencies to ensure the safety and welfare of our force and families."

Quarantined travelers, however, might not have been the most concerning piece of the puzzle.

A Unique Case in Sacramento

The same day last week that whistleblower complaint was filed in Washington, hospital officials in Sacramento issued a memo with the news many had long feared: The first confirmed case of COVID-19 that had unknown origins had finally emerged in the United States. And that woman, who checked into the Solano County hospital, had been transferred to the UC Davis Medical Center.

"This is not the first COVID-19 patient we have treated, and because of the precautions we have had in place since this patient's arrival, we believe there has been minimal potential for exposure here at UC Davis Medical Center," according to the memo sent to staffers Wednesday night.

UC Davis Medical Center nevertheless sent several dozen employees home to await further testing. On Friday, the National Nurses United union said there were 124 nurses and health care workers sent home.

In a separate staff memo Thursday, UC Davis Chief Medical Officer J. Douglas Kirk said the "incident is not impacting our ability to provide care for any patient, any time, or anywhere."

"This incident involves a patient, a real person, with a real family, who is worried about their loved one's condition and thankful for the care delivered by our teams here," he wrote. "As such, we must respect the patient and the family's privacy."

Additionally, Solano County public health officials on Friday said 93 people at Vacaville NorthBay VacaValley came in contact with the patient before her transfer to Sacramento. Of the 93, 82 people without novel coronavirus symptoms are under home quarantine.

Eleven more who are showing symptoms have been told to isolate themselves at home away from family members and other contacts and have been tested for the virus. Test results are expected "in the next day or two," Matyas, the county public health officer, said Friday. Matyas said that number may change.

The people represent the entire spectrum of the care team from nutrition services to medical assistants to the bedside physician.

"We're double-checking and ensuring we've identified everyone," said Steve Huddleston, a hospital vice president. "We look at everybody who had clinical contact with the patient. We are looking at every hour of hallway camera to verify visitors who signed in and were badged (and) went into that room."

That roster of names was sent to local, state and federal public health agencies.

Their investigation is two-pronged, Matyas said: interviewing the patient's contacts at the hospital and in the community. There's a three-day window where the patient was probably able to spread the illness. Contacting family and co-workers was relatively easy, Matyas said.

Finding other contacts outside that circle is more vague.

"But," Matyas said, "it has to be done."

By Saturday evening, more than 86,000 people globally had been infected, with increasingly growing pockets outside of China, according to a map maintained by Johns Hopkins University. That country has also suffered the vast majority of 2900-plus deaths from new coronavirus.

"Our greatest enemy right now is not the virus itself. It's fear, rumors and stigma," World Health Organization Director General Tedros Adhanom Ghebreyesus said in a Friday morning press briefing.

Santa Clara County on Friday announced the second known instance of person-to-person transmission in the general public.

Hours later, Oregon, announced the third.

And on Saturday, officials in Washington state announced what might be the latest turning point, capping a month already filled with them: A man died near Seattle, marking the first COVID-19 death in the U.S.

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