In a sobering message Tuesday, federal health officials warned that America's businesses, neighborhoods, schools and families should prepare for the prospect of an outbreak of coronavirus.
This week's accelerating spread of the virus in Italy, South Korea and Iran reveals the power of the disease to ignite in communities far from China -- and preparation will help America reduce its deadly toll, said Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases.
In the event of an outbreak, strategies may include making sick-leave policies more flexible at work, temporarily dismissing schools, avoiding close contact with others, and canceling large public events, she said.
"It's not so much of a question of, 'If this will happen in this country,' any more, but a question of 'When this will happen,'" she said at a Tuesday news briefing by the Centers for Disease Control and Prevention.
"We want to prepare Americans for the possibility that their lives will be disrupted," she said.
Unlike in many other nations, the virus is still contained in the U.S. due to strict travel restrictions, quarantines and isolation measures, said Department of Health and Human Services secretary Alex Azar. There is currently no spread of the pathogen through America's general population.
"But we can't hermetically seal off the U.S." from the rest of the world, he added. "We expect to see more cases. We don't want people to be surprised."
The growing outbreaks in Europe and elsewhere in Asia have rattled investors, causing stocks to tumble two days in a row. On Tuesday, the Dow Jones Industrial Average fell nearly 900 points, following Monday's record sell-off. In the past two days, the virus has wiped out an estimated $1.7 trillion from the U.S. stock market.
As of Tuesday, there were 40 cases among U.S. residents who were passengers on the virus-stricken Diamond Princess cruise ship in Japan. An additional three cases were reported in people repatriated from Hubei Province, China, back to the U.S.
Another 14 cases of the virus were diagnosed in people who traveled recently to China or their close contacts.
The cruise ship passengers quarantined at Travis Air Force Base are being transferred to Bay Area hospitals if they test positive for the virus. On Tuesday, Contra Costa Health Services announced that three people from the base had been transported to hospitals within the county for treatment. One patient was sent to a Napa County hospital and another went to a Sonoma County hospital. Also on Tuesday, a person who had been monitored at Travis was flown to the University of Nebraska Medical Center for care.
Local health officials say their response to a pandemic would depend on the extent of infections locally, and school districts are looking to county health departments for guidance.
Santa Clara County Public Health Department spokeswoman Joy Alexiou said if the virus is spreading locally, "at some point, there would be things like closures potentially of big events." But she added that "closing schools would be a last resort."
Local hospitals, Alexiou said, already have plans in place in anticipation of an influenza pandemic. "Most every hospital has an emergency plan, which includes responses to a pandemic," Alexiou said. "Plans don't change because of the virus."
Communication about coronavirus varies among school districts, with some saying they have not issued any new guidelines for parents or students, instead sticking by the precautions to prevent spread of colds and flu, such as staying home if sick and covering the mouth when sneezing. Other districts provide information or referrals to health department sites. Dublin, Hayward, Palo Alto and East Side Union High in San Jose, among others, have gone further, advising students and staff to stay home and self quarantine if they have recently traveled in China, and providing steps people should take if they feel ill.
What alarms U.S. officials is the fast, widening globe scope of disease. Previously untouched, South Korea now has nearly 1,000 cases. Iran confirmed 95 cases and at least 15 deaths. In Italy, with 322 cases, the number of deaths grew to 10.
"When it has hit those countries, it has moved quite rapidly," Messonnier said. "We want to make sure the American public is prepared."
Because the coronavirus is new, we have no immunity against it. This allows the virus to spread quickly from person to person. There are no protective vaccines or therapeutic drugs.
Borrowing from emergency plans designed for pandemic flu, the CDC is urging communities to prepare to take specific steps called "nonpharmaceutical interventions" that can help slow the spread of deadly illness.
While no changes are required right now, "we want people to be ready, if we do see community spread," said CDC Deputy Director Anne Schuchat.
For families and households, they include:
-- Meet with household members, other relatives, and friends to discuss what should be done if a pandemic occurs and what the needs of each person will be.
-- Discuss ways to care for those at greater risk for serious complications, if the services they rely on aren't available.
-- If your neighborhood has a website or social media page, consider joining it to stay connected to neighbors, information, and resources.
-- Identify organizations in your community that can offer assistance. Consider including organizations that provide mental health or counseling services, food, and other supplies.
-- Create an emergency contact list. Ensure that your household has a current list of emergency contacts for family, friends, neighbors, carpool drivers, health care providers, teachers, employers, the local public health department, and other community resources.
-- Plan to have extra supplies of important items on hand, such as soap, hand sanitizer, tissues, and disposable facemasks.
-- Choose a room in your home that can be used to separate sick household members from those who are healthy. If possible, also choose a bathroom for the sick person to use. Plan to clean these rooms daily. Learn how to care for someone at home and how to clean a flu patient's room.
-- Prepare for possible school closures, identifying alternative childcare.
For schools, they include:
-- Be prepared to allow your staff and students to stay home if someone in their house is sick.
-- Increase space between people at school to at least 3 feet, as much as possible.
-- Modify, postpone, or cancel large school events.
-- Temporarily dismiss students attending childcare facilities, K-12 schools, or institutions of higher education.
For businesses, they include:
-- Be prepared to allow workers to stay home if someone in their house is sick.
-- Increase space between people at work to at least 3 feet, as much as possible.
-- Decrease the frequency of contact among people at work.
-- Modify, postpone, or cancel large work events. Postpone or cancel non-essential work-related travel.
-- Stay home when you are sick.
-- Cover your coughs and sneezes with a tissue.
-- Wash your hands often with soap and water for at least 20 seconds. Use at least a 60% alcohol-based hand sanitizer if soap and water are not available.
-- Clean frequently touched surfaces and objects.
Learn more about how to prepare at https://www.cdc.gov/nonpharmaceutical-interventions/index.html.
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