In the course of just a few days, people infected with the new coronavirus have been identified in many communities around the country, raising the possibility the virus could pop up almost anywhere.
The first known case in New York state was disclosed Sunday evening by Gov. Andrew Cuomo. The patient, a woman in her 30's, recently traveled to Iran and may have acquired the virus there.
She was quarantined at home and said to be in good health.
No other cases had been identified in the state as of Monday morning, but that could change soon as coronavirus testing is done on other people who may have been exposed.
Relaxed rules on testing have led to a wave of virus carriers being found in Washington state, Oregon and northern California. Some experts say the coronavirus may have been being passed from person to person in Washington for as long as six weeks before the infections were found.
At least two people in Rhode Island who were on a private-school trip to Europe have tested positive, and dozens of students and adult chaperones are now in quarantine. Other cases have popped up in Florida and Texas.
Monroe County Executive Adam Bello reiterated on Sunday that the risk of coronovirus in the Rochester area remains low.
He also said now is the time for institutions and individuals to think about preparations for a local eruption of COVID-19, as the illness caused by the coronavirus is known.
Bello, county public health commissioner Dr. Michael Mendoza and other experts said Thursday that the Rochester area is relatively well-prepared should an infected person appear locally. But much remains unknown about what would happen in such an instance.
They also offered advice for the general public in these unsettling times:
Bello recommended that citizens go about their day-to-day lives as normal but lend extra attention to news reports about the coronavirus.
Local information and guidance can be found at a county government web site, www2.monroecounty.gov/health-coronavirus and also by following @MonroeHealth on Twitter.
The state Department of Health has a toll-free hotline, (888) 364-3065, to answer questions about coronavirus and about the rules governing overseas travel.
In the event that coronavirus becomes an issue locally, the county government will have basic charge of the situation. County officials have been meeting frequently with other government agencies, local universities and other stakeholders.
Mendoza is overseeing preparations and any response needed and would issue directives related to health matters. In the unlikely event measures such as a restriction on public assembly became necessary, Bello has the authority to declare a state of emergency and order such steps, county officials said Thursday.
Sick? Call first
If you or someone you know comes down with a respiratory illness, it probably will be seasonal influenza or another common virus. There's an exceedingly tiny chance it could be coronavirus.
But whatever the nature of your respiratory infection, the experts want you to call a primary-care physician, urgent-care center, community health center or hospital before you do anything else.
"If people are ill with a sickness like the flu and you're sick enough to contemplate going to the doctor or to the emergency room, call first so we can expect you," said Dr. S. Paul Graman, clinical director of infectious disease and hospital epidemiologist at Strong Memorial Hospital. "We'll meet you at the door with a mask we can put on right away and take you to a room apart from other people so that we can protect the people around us."
COVID-19 causes fever and respiratory distress. Most people are only mildly debilitated and some who are infected show no symptoms at all.
But some people fall seriously ill and need hospitalization, and 1 to 2 percent of those infected die as a result, experts say. As is the case with influenza, most deaths seem to occur among the elderly and people whose health has been compromised by other sickness or disease.
Children can get sick but generally do not seem to be targeted by the infection. https://jamanetwork.com/journals/jama/fullarticle/2762130, where the most of the world's coronavirus cases have arisen, found that 87 percent of those who got sick were between the ages of 30 and 79.
No need to stock up but ...
Asked on Thursday if people should be stocking up on food, water and cleaning supplies in case they must spend extended time at home, Bello said no.
"I don't think there's any reason right now to panic and have that level of alarm that you would stock up like that," he said Thursday. "If conditions change and there is a reason to do that ... obviously we'll update the public.
"Until the conditions change, there's really is no reason to do anything different here."
He repeated that admonition at a news conference Sunday.
However, based on dozens of social-media posts, that is already happening throughout the greater Rochester area.
Tweets and Facebook posts describe shelves devoid of hand sanitizers at Wegmans and other stores, for instance.
In other cities, there were out-and-out runs on groceries and big-box stores, with many items quickly selling out.
Why you shouldn't buy a surgical mask
That's right — don't bother with a gauze mask.
"Masks are an important protective resource when used properly by the right people in the right setting," Mendoza said. "Used any other way, they provide a false sense of security."
Some people believe that wearing gauze face masks is a way to protect themselves against viral infection, and the masks have sold out of retail stores in many communities, including Rochester.
But the expert advice from local officials is to not hop on the face-mask bandwagon. Buying up masks eats needlessly into the supply, worsening the shortage for people who really might need them.
Who needs them? Health-care workers and people who actually have a respiratory virus; masks will lessen the risk that those folks will spread the contagion.
But you? They said it will do you no good.
"People who are well are not contagious. They have nothing to spread. Wearing a mask will not protect them from somebody who is," Mendoza said. "We know it is spread through airborne respiratory droplets and the average mask does not seal well enough for the average well person to feel protected. Our view is it's really a false sense of security and a waste of good masks."
In lieu of wearing a mask, practice good hygiene to protect yourself and others.
Wash your hands frequently front and back for at least 20 seconds. Cover your mouth when you cough with a tissue or your sleeve, and encourage those around you to do the same.
If you feel sick, do not go to work or school. If someone in your workplace or classroom shows up coughing and wheezing, strongly encourage them to go home.
And if you're feeling ill, don't you dare get on an airplane, train or bus and leave town.
Travel and quarantine
To date, 31 people in Monroe County have quarantined themselves at home for two weeks as a precaution against coronavirus in accord with federal guidelines. These are people who returned to this area from China who agreed to avoid public contact until it was clear they were not infected.
Twenty-five of the 31 have completed their two weeks in quarantine. The other six were still waiting things out at home as of Monday morning.
None of the 31 have shown any signs of illness, county officials said.
The number of returning travelers confined at home for two weeks will grow if the federal government adds other countries with coronavirus outbreaks, such as South Korea or Italy, to the quarantine list.
Mendoza said he expects the travel rules will change as time goes by, though he can't predict how.
In South Korea and some other countries, large numbers of people are being tested for coronavirus on a proactive basis.
In the U.S., the approach is different. Until this weekend, the U.S. Centers for Disease Control and Prevention kept a tight rein on testing. In the face of complaints from public health officials and political leaders, the agency has loosened the reins and allowed more states, including New York, to begin testing for the virus.
The federal testing criteria remains that the patient must have been China, South Korea, Japan, Iran or Italy, or in proximity to someone who was confirmed to have the virus and must be displaying symptoms consistent with coronavirus — fever, cough or shortness of breath.
A physician at Strong Memorial Hospital said Monday Strong generally would follow those criteria, but would discuss testing with public health officials if a case arose that didn't meet the criteria but still merited further investigation.
"I would say that this is a rapidly evolving target," said Dr. Brenda Tesini, associate hospital epidemiologist at Strong.
At present, locally ordered testing would be done at the state health department's Wadsworth Center laboratory in Albany. But Tesini said University of Rochester Medical Center is working with the state to arrange testing capability at URMC.
Hospitals would be stressed
Local hospitals are filled to brimming at present with people suffering from seasonal influenza.
Since last fall, about 4,700 county residents have been diagnosed with the flu and about 540 of them hospitalized, Mendoza said Thursday. The week ending Feb. 23 brought the biggest surge in flu patients that Strong hospital has seen so far this season, according to Graman.
"The hospitals are full. If were having to accommodate additional patients with, say, coronavirus, should that occur, that would certainly be stress on the hospitals and we would need to try to find ways to create more space for patients," Graman said.
Strong now has "dozens" of isolation rooms where a patient with an infectious illness can be segregated from the rest of the hospital population, he said. Other local hospitals also have isolation facilities.
Monroe County hospitals, like those in other parts of the country, are continuing to look for new sources of protective equipment. Shortages have been reported in some places because the coronavirus has made Asian suppliers unable to meet demand here.
But at present, the local facilities are well-enough outfitted.
"Right now we're considered safe. We monitor very closely, almost on a continuous basis, our supply of masks and protective equipment," said Dr. Emil Lesho, an infectious disease physician and epidemiologist at Rochester General Hospital.
Readiness is being reassessed three or four times a week, Lesho said.
"We're making pretty detailed preparations in case we need to hospitalize patients with coronavirus if it turns out they do happen in our area," said Strong's Graman. "We're doing everything we can to prepare."