State health directors across the country are taking steps to prepare for the eventual spread of the coronavirus that has broken out in China and several other nations, revising health plans and contingencies at care facilities in their areas.

In interviews with several public health directors, who met this week for a pre-planned annual gathering in Washington, they said their teams were working with hospitals, school systems and the business community to prepare for what could be thousands or even millions of cases of COVID-19 to spread inside the United States.

They said their agencies are well practiced in coordinating large responses to public health emergencies, whether from outbreaks of new viruses like the H1N1 pandemic a decade ago or more regular occurrences like a particularly bad flu season. The plans they implement for those occasions will be the templates for this outbreak.

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“While this is a novel virus, this is not a novel response,” said Washington state Health Secretary John Wiesman. “The process we know. We do this all the time in our public health work.”

Wiesman’s office was the first in the United States to handle a coronavirus case, when a man who traveled to Wuhan, China, returned to his home north of Seattle and began showing symptoms. That man, who has not been publicly identified, recovered from the virus.

“When you get that first call, you’re like, 'Oh no, really?'” Wiesman said. “Nobody wants to be the first patient, nobody wants to be the first hospital or the first health department to deal with something new.”

In the months since, the state health department has held webinars and conference calls with the organizations whose members will be on the front lines of any outbreak, including the state hospital association and medical and nurse’s groups to brief them on preparations and to reiterate best practices. They have begun to consider a response to an outbreak that could include shuttering schools and public transportation to choke off the virus’s spread.

States are also considering how to handle a surge in cases that might outstrip the number of beds currently available in hospitals. Officials in China built a hospital capable of handling 1,000 patients in the space of just a week, something that is not possible in the United States.

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“We’re starting to work with hospitals and EMS systems initially to make sure that they have all the capacity that they need,” said Nirav Shah, director of the Maine Center for Disease Control and Prevention. “We start thinking about the strength of our EMS system, to make sure thy can transport people from rural areas if things get bad.”

Most public health officials agree that the spread of the coronavirus in the United States is likely. Rapid outbreaks in South Korea and Italy in the last week rattled health officials, and a case in California of a woman with no apparent connection to anyone at risk of the virus — an occurrence known as community spread — put departments across the country on high alert.

“If we see community spread in the United States and Pennsylvania, it’ll be a challenge for all of us,” Pennsylvania Secretary of Health Rachel Levine told reporters. “But the Pennsylvania Department of Health, the [Gov. Tom] Wolf administration, is up to that task.”

Some health officials said the goal of their preparations is not to stop the virus altogether — an enormous and probably impossible task. Instead, they said, the aim is to slow the virus’s spread in order to allow hospitals to treat those who do come down with severe cases of the virus without going over capacity.

“The goal is to slow down the spread and have it happen over a larger period of time so that hospitals aren’t overwhelmed and supply chains can keep up,” Wiesman said. “It’s important for the public to understand what that goal is so that they’re not confused and say, 'Hey this isn’t working.'”

Several officials praised the Centers for Disease Control and Prevention (CDC) for staying in constant contact, even as the agency comes under fire for testing kits that apparently do not work. Shah said his office interacts with the CDC several times a day.

Still, health officials are concerned that misinformation spread through social media will become as much of a challenge as fighting the virus itself. States have set up detailed websites with frequently asked question sections in an effort to combat that misinformation, which might lead to the virus spreading further or discrimination against groups and individuals.

“My concern is that fear and misinformation will spread much faster than this virus will,” Shah said. His department conducted a forensic analysis of the misinformation and rumors that cropped up during the H1N1 outbreak a decade ago, hoping to get ahead of the misconceptions that spread most readily.

The rise of social media has brought with it a surge of misinformation that has become common whenever there is a new outbreak — something some public health experts call an infodemic. In an interview last year, Sylvie Briand, director of infectious hazard management at the World Health Organization, said those infodemics can hinder a response.

“Rumors can be more devastating than the disease. And every time you have an epidemic of disease, you have an epidemic of rumors as well,” Briand told The Hill. “Managing the infodemic is really a challenge, so we try to improve this management.”