The four patients receiving treatment for the novel coronavirus, or COVID-19, at Sacred Heart Medical Center were not showing symptoms when they were transported to Spokane on Thursday, officials with the Centers for Disease Control and Prevention said late Friday.

While health officials are still working to confirm exactly how COVID-19 is spread, other coronaviruses are spread through what the CDC calls “airborne respiratory droplet transmission,” which is coughing or sneezing. So if the patients did not have those symptoms, the risk for the disease to spread is lower.

Those disclosures come after community scrutiny Thursday of how the patients were transferred from a jet to an AMR ambulance at Spokane International Airport.

A front-page photograph published Friday in The Spokesman-Review of two of the patients being transferred into the waiting ambulance show two emergency management workers in personal protective equipment, with suits, booties and gloves. One worker appears to be wearing a full face shield, while the other is not wearing eye protection. Two other people are standing near the patients with no protective gear on at all.

The picture and scores of others were taken Thursday – the same day health and hospital officials offered assurances of “zero risk” of danger to the community.

The Spokesman-Review

The CDC recommends different gear depending on the distance a person stands from a patient as well as how they interact with a patient. A person not wearing protection gear should be six feet away from a patient with confirmed COVID-19. If a person is within three feet, they should be wearing a mask and eye coverage, and a person within a foot of a confirmed case should be wearing full PPE gear.

Providence officials said that all caregivers were following protocol in a statement on Friday.

“The photo used by the Spokesman-Review does not accurately represent the distance between the individuals. All caregivers remained a safe distance away as defined by the CDC,” the statement said.

AMR officials confirmed that their workers had on all the necessary protective gear to transfer the patients.

“Our employees had all the required protective gear on, including eye protection, it is just not visible in that photo,” Jason Sorrick, with AMR, said in an emailed statement.

Patients transferred to Spokane on Thursday did not have fever, coughing or other respiratory symptoms, said Scott Pauley, a CDC spokesman.

“These are asymptomatic people, so the risk is pretty low for it to have transferred,” he said.

Sacred Heart officials released very little patient information on Thursday, however, saying only that the four patients were in satisfactory condition.

The patients were passengers on the Diamond Princess cruise ship in Japan, which had hundreds of confirmed cases of the virus. They were flown from Travis Air Force Base outside Sacramento, Calif., on Thursday to Spokane. So far, there are 34 confirmed cases of COVID-19 in the United States. Eighteen of those coronavirus patients were cruise ship passengers.

In a news conference Friday, CDC officials said they expect more cases of COVID-19 to be confirmed in the United States in coming days. Passengers from the Diamond Princess cruise ship are now blocked from re-entering the United States for two weeks after their disembark date. Other passengers are in quarantine at Travis Air Force Base and Joint Base San Antonio-Lackland.

So far, there is no community spread of the novel coronavirus in the United States, as there is in other countries like South Korea.

“We’re not seeing community spread here in the U.S. yet, but it’s very possible, even likely, that it may eventually happen,” Nancy Messonnier, director at the CDC, said at a teleconference Friday. “Our goal continues to be slowing the introduction of the virus into the U.S. This buys us more time to prepare our communities for more cases, and possibly sustained spread. This new virus represents a tremendous public health threat; we don’t yet have a vaccine for this novel virus, nor do we have a medicine to treat it specifically.”

Locally, health officials maintain that the risk to the public is small.

“In general, the risk to the public from novel coronavirus remains low,” said Dr. Bob Lutz, health officer at the Spokane Regional Health District.