In the weeks leading up to Friday morning, as the new coronavirus swirled across the globe, Austin Public Health officials cautioned residents that their concern was not if the illness would come to the city, but when.

"When" came after shortly midnight: A woman in her 30s and a man in his 60s were presumed to be Austin’s first cases of COVID-19, the illness linked to the coronavirus. After state testing came up positive, their samples are being sent to the federal Centers for Disease Control and Prevention for final confirmation.

Then, just before 1 p.m., University of Texas President Gregory L. Fenves revealed that his wife, Carmel, tested positive for COVID-19. He added that it was possible that a second member of his family, whom he did not identify but said works at UT, also might have the virus.

Fenves said he has been tested for the coronavirus, and that he, his wife and the other family member were in self-isolation. He also asked anyone who recently had close contact with him or his family members to self-isolate right away, regardless of whether they are showing symptoms of illness.

The university canceled all classes and operations Friday ahead of an extended two-week spring break prompted by concerns over the coronavirus.

The first two cases are not related nor were they community spread, in which someone obtains the virus from an unknown source, Austin Public Health interim authority Dr. Mark Escott said.

Instead, health officials said the woman’s case was linked to the Houston area, and the man also contracted the virus outside of Austin.

Neither patient is an Austin resident — the woman, whom health officials did not identify, is staying in town from the Houston area and the man, also not identified by officials, was sent to an Austin-area hospital from an undisclosed rural part of the state, Escott said.

The woman was tested Wednesday at St. David's Emergency Center-Bee Cave and was released the same day to self-quarantine, St. David's HealthCare President David Huffstutler said in a statement.

The man arrived at St. David's Medical Center in Austin on Wednesday and was placed in isolation, Huffstutler said. He is in critical condition, Huffstutler said.

"Our hospitals are safe. Everyone entering our facilities — patients, visitors, employees, physicians and vendors — undergoes a brief verbal screening before entering to ensure that people coming into our facilities are safe and appropriately triaged," he said.

Before the woman’s COVID-19 diagnosis, health officials were monitoring her after Montgomery County officials alerted the city that she had been under medical investigation in the Houston area.

She alerted health officials of mild symptoms and was tested outside of a hospital, Escott said. The people she is staying with have so far exhibited no symptoms or mild symptoms.

The man who was brought to Austin from a rural area was tested after a clinician caring for him suspected he had COVID-19 and requested a test.

No evidence suggests he was outside of the hospital in Austin, Escott said.

’We have this under control’

With the confirmed cases, the city is now in Phase 3 of its five-phase pandemic flu plan. But operations will remain mostly as they have been.

"We don't yet have a vaccine. We don't have an identified treatment, although we have folks around the world working hard to try to identify a treatment," Escott said. "We’re trying to identify medications that can be given in the case of exposure or be given to health care workers and first responders to help prevent the spread of disease."

But until then, he added, "our strongest defense is those simple messages: washing your hands, not touching your face, coughing or sneezing into a bent elbow and, most importantly, staying home if you're sick."

Authorities are continuing to evaluate mitigation strategies, and it’s likely more public health orders will be issued to help strengthen the city’s defenses.

"We have this under control. We have plans. We have engaged partnerships with all of our health care systems, with our city and county government, with our local governments from around Travis County and around the region," Escott said. "We are standing strong together, and we must act as one community and one government to do better and to weather this storm."

Earlier this week, Escott issued new rules to long-term care facilities like assisted living and nursing homes. Residents in those facilities with an unexplained fever of 100.4 degrees or higher now have to be sent to the hospital. All employees and visitors of those facilities will not be allowed inside if they have a fever of at least 100.4 degrees.

If the illness does spread in the diagnosed woman’s household, then the local response would move to Phase 4, which is limited person-to-person spread, Escott said. But the quarantined woman is acting responsibly and having others bring food to her, he said.

Austin Chief Epidemiologist Janet Pichette said officials are working to track down individuals the two patients might have come into contact with in the area. It is possible that control orders could be issued to those individuals, she said.

Two epidemics: COVID-19 and fear

For the past week, eight state labs have conducted testing in Texas on oral or nasal samples gathered by doctors. Officials have said the turnaround time for such samples is about 24 hours.

While Escott did not state the exact number of people being tested for COVID-19 in Austin, he did say samples are being sent for testing every day.

Escott said health officials expect to see more cases, and they need the public’s help to mitigate the spread of the virus.

Texas has 39 confirmed cases of COVID-19, Gov. Greg Abbott said Friday as he declared a state of emergency in response to the virus outbreak. The figure did not include the announced cases in Austin. No deaths have been reported as a result of the illness in Texas, but at least 41 people have died nationwide.

Escott said the community was afflicted by two epidemics: COVID-19 and fear.

"We have faced adversity before ... and we can choose two paths. One path is to choose fear and panic. The other path is to choose strength and resiliency. We have to choose strength. We have to choose strength, and that means we need people to start planning, we need them to do things which are reasonable to mitigate this risk, to prepare themselves, their family and to not spread rumor and panic," Escott said.

Travis County Judge Sarah Eckhardt echoed Escott’s plea for the public to remain calm.

"Panic will make us weaker," she said.

CORRECTION: This story has been updated from a previous version that incorrectly spelled the name of UT President Gregory Fenves’ wife. Fenves also said a second family member was presumed to have COVID-19, but that person’s illness has not been confirmed by health officials to be linked to the coronavirus.

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