As countries across Asia and Europe continue to report new coronavirus cases, and more than four dozen cases are logged in the United States, Maryland officials say they are preparing for what might come.
Gov. Larry Hogan confirmed Thursday that two Maryland residents were being tested for the virus.
The officials outlined their readiness after the U.S. Centers for Disease Control and Prevention warned states and residents to start making plans for inevitable cases, though President Donald Trump denied at a Wednesday news conference that there was much of a threat. He said the risk remains low because of steps taken to close the border to potentially infected visitors.
“I don’t think it’s inevitable,” Trump said after announcing he had put Vice President Mike Pence in charge of overseeing further preparedness and pointing to a Johns Hopkins index that showed the United States to be well-positioned for a health threat. “It may get bigger and may not get bigger at all.”
The Maryland officials, however, said planning had been ongoing since well before the CDC made its recommendations.
In hospitals, schools and businesses and at the Maryland Department of Health, which is coordinating the state’s response, officials are relying on what’s known about this virus and outbreaks of other viruses, including the flu, which is currently widespread in the state and country.
“The State’s preparedness builds on decades of planning, experience and expertise gained from previous public health events such as SARS, MERS, H1N1, Zika and Ebola,” said a statement from the health department about the new disease, called COVID-19.
The health department said it “continues to coordinate across all state and local agencies and to regularly provide COVID-19 guidance to the state’s physicians, nurse practitioners, pharmacists and local health departments.”
Two people in Maryland have tested negative for the virus since it first appeared in the United States earlier this year.
But the planning continues, given public health warnings that the virus could become a pandemic, meaning the outbreak has spread globally.
The CDC warned Tuesday that the virus likely would continue spreading to the United States and that preparation is necessary. Individuals should be prepared for cancellation of events, closing of schools and orders to quarantine at home if there is extensive “community spread,” meaning it’s unclear how patients became infected. The first suspected case was reported Wednesday in California.
“I understand this whole situation may seem overwhelming and that disruption to everyday life may be severe,” said Dr. Nancy Messonnier, the head of the CDC’s National Center for Immunization and Respiratory Diseases.
Unlike during the last pandemic that heavily affected the United States, the 2009 H1N1 flu, there isn’t likely to be a vaccine ready to prevent spreading COVID-19 this year, said Dr. Wilbur Chen, an infectious disease doctor and scientist for the University of Maryland School of Medicine’s Center for Vaccine Development and Global Health in Baltimore.
He was a principal investigator on the vaccine trials for the H1N1 pandemic, also known as swine flu, and Chen said a vaccine was ready in months. Scientists prepare a new flu vaccine every year with new strains and there is an established system.
A vaccine for the coronavirus is in the works, in part through the work of University of Maryland researchers and based on an existing coronavirus vaccine; however, it’s unlikely to be ready this year, partly because there is no established system or manufacturers at the ready, Chen said.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said as much during the Trump news conference. He said a vaccine could be used if there is a new outbreak next year, though a treatment could be ready this year.
Chen said the state and federal governments will need to rely on other methods that some may find “draconian" if the outbreak becomes a pandemic.
“We need to be very transparent with the public and tell them why we are doing these things,” Chen said. “Some may interpret them as draconian and others may say they sound reasonable. But there will be no public trust, or cooperation, without transparency that starts early on.”
He said that’s what the CDC intended with its comments, to ensure such measures don’t come as a shock if they are needed.
Chen said there are several possible scenarios with the virus. One is that the virus is contained through measures such as travel bans and quarantines overseas before it’s widespread in the United States. A second is that it continues over weeks and months into a pandemic that is far harder to contain. And a third is that the infections abate in warmer weather, much like the flu, then return with a larger wave in the fall.
Others in Maryland are preparing for any scenario in which many people here are infected.
Hospitals are laying out plans to operate with fewer medical staff and send office staff home to telework, said Dr. David Marcozzi, who is in charge of COVID-19 preparedness for the University of Maryland Medical System.
Hospitals already were prepared to quarantine patients, but now there are protocols to care safely for COVID-19 patients, who could grow rapidly in number.
They also are evaluating circumstances in which health professionals could forgo masks, gloves and other protective equipment so they can be stockpiled, as supplies are becoming low. (Masks, the doctors noted, shouldn’t be stockpiled among the general population because they only help prevent spread from someone already infected and are unlikely to protect people from becoming infected.)
“We know this will be coming to Maryland. The question is how large of an impact will it have,” said Marcozzi, also associate chair of population health in the Maryland medical school’s department of emergency medicine and assistant chief medical officer for acute care at the University of Maryland Medical Center.
“Our plan not only speaks to care for our patients, but our facilities,” he said. “Everyone needs a plan: schools, businesses, community leaders, city and state leaders. Things like telework don’t happen overnight. You need to plan, steps need to be in place when we realize there is significant disease burden in our community, though we hope it doesn’t get to that point.”
It’s the same story at local schools, where officials said they are coordinating with local health officials.
“We are very closely monitoring the development of the virus,” said Charlie Herndon, a spokesman for Baltimore County schools. “It’s a matter right now of getting as much information as we can.”
Filipa Gomes, supervisor of health services for the Carroll County schools, said officials are emphasizing precautionary measures similar to those used to prevent the spread of flu — such as washing hands with soap and water and coughing into a tissue.
The Baltimore City school system is following the direction of the state health department and has handed students a fact sheet in English and Spanish, said Gwendolyn Chambers, a schools spokeswoman.
The Howard County Public School System has developed an infectious-disease response plan to deal with flu that will be used, according to spokesman Brian Bassett.
Some schools could close, as they did in 2009. Acting on recommendations from the CDC, then-Gov. Martin O’Malley closed several schools where students were suspected of being sick with H1N1.
The University System of Maryland also began preparations before the CDC recommendations. Presidents of the 12 campuses were briefed last week by University of Maryland Baltimore experts, said Joann Boughman, the senior vice chancellor for academic and student affairs.
“If the people in leadership feel they are prepared, then it brings down or helps reduce the fear and eliminates the sense of panic," she said. "I think continuous calm but substantial communication is one of the greatest assets we might have.”