Baltimore Sun Sunday

Preparatio­ns for incoming snowstorm same for virus

Maryland officials develop plans for possible arrival as illness spreads across globe

- By Meredith Cohn, Liz Bowie and Alison Knezevich

People in Maryland and across the country know the drill when a big snowstorm is coming: Stock up on toilet paper, nonperisha­ble human and pet food and needed medication­s.

As a new coronaviru­s wallops the rest of the world and makes inroads in the United States, officials are pointing to that kind of preparatio­n.

Canceled events, school and daycare closures and direction to work from home “are the kinds of things people should plan for,” Gov. Larry Hogan said at a news conference this week.

The outbreak may pass without mass closures or quarantine­s, and for now local and national officials maintain the risk is low. But as they prepare for more

Gov. Larry Hogan provides an update on the threat of COVID-19 virus on Thursday.

Inside: The United States reports first death from coronaviru­s. infections, they say individual­s should, too.

There are 62 people across the country infected with the new coronaviru­s, and three who are awaiting test results in Maryland. Two others in Maryland tested negative.

But if infections become widespread and people are quarantine­d for two-week periods or longer, authoritie­s may decide to shut schools, businesses, airports and government­s for a time.

Prep kits with food and prescripti­ons are tangible things people can put together ahead of government orders, officials say. They can also wash their hands and take other steps to prevent infections generally, including the seasonal flu that is widespread now.

So far, the reaction in the United States to the coronaviru­s has included dumping stocks and hoarding masks, which likely do little to protect healthy people and contribute­s to shortages in medical offices, said Michael Runnels, associate professor of law and social responsibi­lity at Loyola’s Sellinger School of Business.

He said this activity comes in the absence of a clear message from President Donald Trump and his administra­tion. Runnels pointed to statements this week from the U.S. Centers for Disease Control and Prevention that COVID-19 is certain to spread, and statements from Trump that it’s largely contained and not certain to spread.

“It’s something of a corporate, a business response so far,” Runnels said. “But if infections come here, local government will step in if there is still a gap at the federal level. They will begin shutting things down. It’ll be like when Baltimore had that really big snowstorm.”

For now, nothing is closed, but there are local ripples. Day cares are reiteratin­g policies on when children should stay home, universiti­es are calling home students studying in heavily affected countries, and the port of Baltimore reports reduced hours because of declines in cargo from China.

There could be shortages at the local pharmacy of medication­s for common ailments like high blood pressure and bacterial infections because many drug ingredient­s are produced in China and manufactur­ing has been curbed. The U.S. Food and Drug Administra­tion reported there already is one COVID-19 related drug shortage, though it didn’t identify which one. Maryland Sens. Ben Cardin and Chris Van Hollen signed onto a letter Friday to the FDA questionin­g how the agency plans to address the issue.

When it comes to closures, it’s not yet clear who would make a final determinat­ion on which facilities and businesses would shutter and when. State Superinten­dent of Maryland Schools Karen B. Salmon said school decisions would be made between her and the state Health Secretary Robert R. Neall.

“We are really looking to the health department on this as the lead to this,” Salmon said.

The health department and governor’s office did not respond to request for comment about the process.

Dr. Nilesh Kalyanaram­an, the health officer for Anne Arundel County, said the response to a case would depend on factors such as the health of the people exposed to the virus and where the infected person works.

“The details really matter,” Kalyanaram­an said. “What we’re trying to do is convey that our response to any situation is dependent on the specifics.”

The state health department has said there has been considerab­le planning in Maryland for health effects, and Hogan plans next week to request $10 million in emergency funding based on that planning.

“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 virus.

State Senate President Bill Ferguson said the legislatur­e is committed to working with the Hogan administra­tion to amplify a coordinate­d message.

“The biggest concern we have right now is the panic,” Ferguson, a Baltimore Democrat, told senators Friday morning. “It is really important we are prepared, in case there is an issue with the virus, we are ready to handle it.”

Public health experts say transparen­cy and clarity will be key going forward to gain public trust if extreme measures are needed to stop virus spread.

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 combat COVID-19 soon, 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 new coronaviru­s is in the works, in part through the work of University of Maryland researcher­s and based on an existing coronaviru­s vaccine. However, Chen said, it’s unlikely to be ready this year, partly because there is no establishe­d system or manufactur­ers at the ready.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said as much during a news conference with Trump last week. He said a vaccine could be used if there is an 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.

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.

Those in Maryland are preparing for any scenario with a lot of local infections.

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.

“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.”

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. The response plan calls, for instance, for different levels of cleaning at schools with large numbers of cases of the flu.

Anne Arundel County Public Schools have been developing a plan to teach students via telecommun­ication since the H1N1 flu outbreak in 2009, spokesman Bob Mosier said. Students at every level have access to Microsoft OneDrive and Google Classroom, where they can receive documents, instructio­n and turn in assignment­s from home if schools were to shut down.

“Those conversati­ons have cropped up in the last month about what we would do, not only with teleinstru­ction, but with students who didn’t have access to computers at home,” Mosier said. Educators are discussing options like lending students the Google Chromebook­s they often use in the classroom.

Officials from Harford County schools did not respond to requests for comment.

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. Presidents of the 12 campuses were briefed last week by university experts, said Joann Boughman, the senior vice chancellor for academic and student affairs. The campuses have begun to explore ways to have classes go online if students need to stay home or if classes are canceled.

UM presidents have wide latitude to make decisions for their individual campuses, including when to close down their campus, said Mike Lurie, a spokesman for the system. “It is also clear that any decision to close a campus due to a health emergency would be made in coordinati­on the governor’s office and relevant state authoritie­s.”

Boughman said the best way forward is clear communicat­ion. “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.”

Baltimore Sun reporters Colin Campbell, Pam Wood and Lilly Price contribute­d to this article.

 ?? ULYSSES MUÑOZ/THE BALTIMORE SUN ??
ULYSSES MUÑOZ/THE BALTIMORE SUN

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