Dr. Mark Escott was home with his wife and two children during the Christmas holidays when he first saw news reports about a new virus sickening people in parts of China.

Over the next couple of weeks, as COVID-19 spread, he reviewed the earliest advisories from the World Health Organization and had several conversations with the city’s chief epidemiologist, Dr. Janet Pichette.

It would be only a matter of time, he predicted, until it got closer and closer and finally reached Austin.

"I said, ‘We need to be paying attention to this,’" said Escott, who currently is serving in dual roles as medical director for Austin-Travis County Emergency Medical Services and, since October, as interim health authority for Austin Public Health. "I did a little digging. There was the initial theory that it wasn’t spread person to person and I thought, ‘That’s not likely.’"

Map of coronavirus cases and deaths in the US

Then as the new coronavirus swept across the world in the ensuing weeks, sparking anxiety and leading to thousands of deaths worldwide, Escott stood with local government officials last week to announce the signing of a disaster declaration in Austin, which led to the cancellation of South by Southwest.

Officials had given heavy weight to Escott’s recommendation, for which he relied on his own studies as well as input from an advisory panel he recently created for Austin’s response to the virus.

"It was a struggle," Escott said of the decision to cancel the March music, film an interactive festival, which led to hate mail and social media attacks. "It was a struggle because it was going to be impactful either way. If we went ahead with it, we could be lighting a fire that couldn’t be controlled. But I live here and I work here. And I feel part of this community and I knew it would hurt this community."

As the first cases of the virus were confirmed in Travis County early Friday, Escott, who has mostly worked quietly behind the scenes in his four years in Austin, is now in a visible and key position. His opinions and recommendations will guide the city’s response, including worst-case scenario decisions, such as closing businesses and local government agencies and ordering quarantines.

On Tuesday, Escott addressed both the Austin City Council and Travis County Commissioners Court about testing that had been done on local residents, none of which had come back positive with coronavirus. On Wednesday, he ordered 300 nursing homes and other facilities housing the elderly to take immediate steps to stop the virus, including not admitting a patient with fever of more than 100 degrees and checking the temperature of anyone who enters the facility. And Friday morning, he urged people to remain calm but vigilant in announcing that the city had its first patients.

"Dr. Escott is a very calm, level-headed, deliberative influence in this process," said Travis County Judge Sarah Eckhardt, who has worked closely with Escott in recent weeks. "He wants to hear other people’s opinions, and that is really wonderful. He’s just wanting to make a good medical decision for our public health."

Working with a team of public health officials, Escott says he has had multiple conversations with hospital administrators to prepare the city for an outbreak, including calling for hospitals to increase the number of beds that can be housed in isolation.

He also is focusing on community education, helping coordinate messages about personal hygiene, such as hand-washing, and imploring people who feel sick not to go to work or go out in public.

Such steps "will work, but this is not something public health or city or county government can do," Escott told the American-Statesman. "It’s what the community can do."

He’s also trying to distribute such messages without stoking fears. "It’s not going to stress us if we have dozens of cases or even hundreds of cases," he said. "But we have to prevent — at all costs — thousands of cases."

In the past six weeks, Escott, 46, and others also have activated an operations center at the city’s public health office to track the number of patients being tested. He has helped coordinate daily conference calls among government bodies, including the University of Texas, to make sure they have accurate information to help inform — but not unnecessarily scare — the public.

A native of Spring, about 25 miles north of Houston in Southeast Texas, Escott has served as the director of emergency medical services and disaster medicine at Baylor College of Medicine in Houston and has worked as the health authority for the Montgomery County Public Health District.

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"I think he’s probably one of the best in the business," said Montgomery County Commissioner James Noack, who worked closely with Escott as a member of the county’s public health board. "He’s competent, very capable and can communicate the message to a broad audience that makes them feel comfortable."

Noack said Escott worked with the board during an outbreak of West Nile virus to develop a way to trap mosquitoes, test them and treat certain areas of the county where those that tested positive were. Noack said he thinks that kept the number of infected patients lower than it could have been.

Escott earned his medical degree from Flinders University in Adelaide, Australia, and received a Master of Public Health degree from the University of Texas Health Science Center in Houston. He holds a bachelor’s degree from Rice University.

Escott has been in Austin since 2016. As EMS medical director, he is responsible for medical training for Austin and Travis County emergency workers and for reviewing clinical care. The heath authority position became open in the spring of 2019, after Dr. Philip Huang left the position to work for Dallas County. Escott is the second physician to work in an interim role.

Under Texas law, as a local health authority, he is also responsible for gathering and reporting statistics for infectious diseases and "establishing, maintaining and enforcing jurisdictional quarantine orders."

Escott said he believes as the weather warms, it is possible that the number of cases nationally may decrease, but that the city must be ready if the virus persists.

"Our strongest defense is those simple messages," he said, "washing your hands, not touching your face, coughing or sneezing into a bent elbow and — most importantly — staying home if you are sick."