San Antonio prepares for possible outbreak of virus

SAN ANTONIO — With the expected release Monday of 134 of the quarantined cruise ship evacuees who have remained healthy, San Antonio health officials are starting to shift their attention to a new priority: What to do if the novel coronavirus spreads beyond Joint Base San Antonio-Lackland.

Dawn Emerick, who became San Antonio’s Metro Health director about a month ago, said her department was caught off guard by the urgency of recent comments from the Centers for Disease Control and Prevention, which prompted worried residents to call her office and fueled the stock market’s worst week since the 2008 financial crash. The city had this far been focused on housing the 91 evacuees from Wuhan, China, for quarantine on Feb. 7, and then 144 evacuees from the Diamond Princess cruise ship.

The rising fear and uncertainty have added a new dimension to what already was a careful balancing act: informing the public about a serious health risk without causing unwarranted alarm.

If the virus spreads farther in the U.S., Metro Health would rely on operating guidelines developed in response to the 2009 pandemic of H1N1, commonly known as swine flu. The department is adapting the 114-page document into a “respiratory disease plan” for the novel coronavirus.

The plan outlines the logistics of handling widespread illness in the community, including responding to recurring phases of a pandemic.

Some of the sections of the report, including details about how long an infected person remains contagious, can’t be easily amended for the new coronavirus, about which a good deal remains unknown. The existing plan includes the logistics of distributing large amounts of vaccines and antiviral medications, neither of which exists yet for this virus.

The city would establish a hotline, where residents, schools, health care workers and businesses could call with questions. It also would activate a network of medical and mental health volunteers from city and state health departments and medical staffing agencies.

Hospitals, clinics and other medical facilities would complete frequent online logs on ill patients, requirements that already allow Metro Health to monitor seasonal flu activity.

The department also would receive daily reports from two school districts to help gauge student attendance rates. Absentee rates of 18 to 20 percent could trigger school closures.

Depending on the severity of the outbreak, city services could be curtailed. But unlike China, where many major cities ground to a halt as the government sought to contain the virus’ spread, the San Antonio report assumes city departments and the City Council would remain operational, to some extent, during a flu pandemic. Some employees could be directed to work remotely and limit their direct contact with the public.

In the coming days, Emerick said she plans to contact the leaders of places where large groups of people convene in close quarters — schools, universities, day care centers, churches and businesses.

In the case of a pandemic, Metro Health would distribute guidelines to local businesses about how to plan and respond to the virus, as is indicated in the existing flu plan.

That advice includes directing businesses to adopt more flexible policies, similar to the ones that would be introduced for city employees. That could include workfrom-home options, limited contact with customers and clients, canceling large gatherings, limiting business-related travel and moving work spaces farther apart.

Employees should be encouraged to assess themselves for symptoms before work each day and asked how they’re feeling when they arrive. Anyone who starts feeling sick at work should be sent home promptly, the guidelines say. Businesses should consider expanding leave for workers who are ill themselves, or those who are caring for loved ones who are.

Businesses should brace for the possibility that large numbers of workers may be unable to work for extended periods of time. Contingency plans could include hiring temporary workers, or training employees to complete tasks that fall outside their normal duties.

If a vaccine becomes available, it should be offered to all employees.