Major cities around the U.S. didn’t wait for federal health officials to tell them to brace for an outbreak of the coronavirus -- some have been preparing for weeks.

In San Francisco, local officials have declared a state of emergency despite no confirmed cases. In Illinois, they’re checking stockpiles of gloves, gowns and masks. In Dallas, they’ve set up war rooms to monitor the spread of the disease worldwide, designated quarantine beds and assigned medical teams for potential patients.

“We’re as prepared as we can be,” said Dallas County Judge Clay Jenkins, who coordinated the city’s response to an outbreak of the Ebola virus in 2014.

Virus anxiety soared around the country on Tuesday when an official with the Centers for Disease Control and Prevention warned that the agency expects the disease, called Covid-19, to begin spreading among U.S. communities, and that businesses, schools and local governments should prepare for the possibility of major disruptions. On Wednesday, federal authorities said they've identified the first U.S. case with an unknown origin, suggesting a possible wider outbreak.

Earlier in the day, New York Governor Andrew Cuomo attempted to bring a calmer tone at a press conference to announce a $40 million initiative to hire additional staff and obtain extra resources to combat a potential outbreak. Of 27 possible virus cases examined in the state, 26 have come back negative and one test is pending, Cuomo said. And while the state is expecting to eventually see a confirmed case, there’s no reason for “undue fear,” he said.

Reassuring Residents
There have been 15 cases of the virus detected and diagnosed in the U.S., with another 45 among Americans repatriated from infection hotspots in Asia. Several cities are taking pains to assure residents that no one has been confirmed with the virus in their area yet. But concern will spike when independent transmission within communities takes hold, health experts say.

“It is not a matter of if, but a question of when, this will exactly happen,” said Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases.

Indeed, health authorities said late Wednesday they may have detected the U.S.'s first case of community transmission in northern California, in a patient with no known travel to China, or exposure to another case.  No details of the condition of that person, who made the 15th case, were provided.

At least four cities or counties in California have already declared a state of emergency -- mainly as a legal mechanism to authorize crisis planning and funding. Santa Clara County was first to call a local emergency on Feb. 10, after two travelers from China were confirmed with the coronavirus. San Diego followed after two people came down with the disease among 200 repatriated from China and quarantined at the nearby U.S. Marine Corps Air Station Miramar.

San Francisco declared a state of emergency Tuesday, even though it hasn’t identified any local cases yet. The city activated its emergency operations center on January 21 to focus on planning for a potential outbreak, according to a statement from the mayor’s office.  On Wednesday, Orange County declared an emergency despite no new cases since one local man recovered from the virus. Officials there are suing to stop federal and state agencies from implementing a proposal to use a state-owned facility in Costa Mesa as a quarantine site.

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