3/14/2020 Update: The Tompkins County Health Department (TCHD) was notified by the New York State Department of Health (NYS DOH) of a positive case of COVID-19 analyzed at the NYS DOH Wadsworth Laboratory in Albany, NY. The sample has been sent to Centers for Disease Control and Prevention (CDC) for confirmation. The individual has been in isolation since the samples were collected for testing. TCHD public health nurses have begun a contact investigation to determine if there were any additional exposures.

The Tompkins County Health Department conference room was packed Monday for a news conference on how county health officials are dealing with the threat of the COVID-19 novel coronavirus.  Tompkins County Administrator Jason Molino, Tompkins County Public Health Director Frank Kruppa, and Cayuga Health System CEO Dr. Martin Stallone detailed the current situation and how they coordinating the county administration, Health Department, and health care providers to address it.  The gist of their message was, 'Don't Panic, Stay informed, Take Precautions, Act As a Community to prevent the spread of the coronavirus in our community'.

"It's important to acknowledge that this is an evolving situation and there are currently no cases of COVID-19 in Tompkins County and the risk remains low," Molino said. "Risk is determined in the manner in which we respond to an incident and our goal is to be prepared to minimize the risk to our community."

	For the latest statistics on quarantines and confirmed cases: Tompkins County Health Department New York State Health Department

As of Monday there were no cases of COVID-19 in Tompkins County, but one case was under investigation.  Health officials said that they anticipate cases locally, but as of 3pm Thursday there were still no confirmed cases in Tompkins County.  47 were being monitored in quarantine and 15 test results were pending.  A Health Department press release explained that 'Persons Under Investigation (PUI)' are people who are being evaluated by a health care provider, and that samples were collected and sent to a lab to be tested for COVID-19, and the individuals were placed in isolation with daily monitoring by community health nurses.

State-wide cases Wednesday numbered 216 total individuals testing positive for the virus, most of them clustered around New York City and Long Island.  121 were confirmed in Westchester, 52 in New York City, 28 in Nassau County, 6 in Rockland County, 6 in Suffolk County, 2  in Saratoga County, and one in Ulster Countyas of late Wednesday. 

"On February 2nd travel restrictions were put in place, at which point the Health Department began implementing precautionary quarantines for travelers from the Hubei province in China as well as mainland China," Kruppa said. "Those returning travelers were placed in precautionary quarantine for 14 days post their last time and in China. The reason for 14 days is the incubation period for COVID-19 is between two and 14 days and we want to ensure that they do not become symptomatic before returning back to their regular activities. Last Monday on March 2nd the travel restrictions expanded to include Italy, South Korea, Iran, and Japan."

For the past several weeks, TCHD Community Health Nurses have been monitoring individuals who are healthy and asymptomatic in quarantine. Quarantine  means  separating  a healthy person or group of healthy people who have been exposed to a contagious disease away from others.   Quarantine occurs in a specific designated location (i.e. home) for the purpose of observing and monitoring for the development of symptoms consistent with COVID-19. Basic essential daily living items like food, water, and prescribed medications will be supplied to the person throughout the duration of the quarantine order. The person must stay quarantined in the specific designated location until the health department releases the individual. The person cannot leave the location to go to work, school, play, or other public places. Tompkins County Health Department nurses monitor health status for the 14-day period daily by  phone  asking for temperature once a day and other health questions. If a person in quarantine develops symptoms, the nurse will determine if the person should seek medical attention and will inform the individual of any precautions to protect others.

	Should I Wear a Face Mask? Tompkins County Public Health Director Frank Kruppa says, "We are only recommending that healthcare workers that are providing care to potential or confirmed cases need to be wearing appropriate PPE, including an N 95 mask unless someone is actually sick. And at that point they're wearing the mask to protect the rest of the people around them, so they're not  spreading their illness. But other than that, we are not recommending masks for the general public."

Kruppa and Stallone detailed quarantine procedures, saying that most treatment and monitoring can be done in the outpatient setting, mostly in individuals' homes if they can be separated there from other people during the 14 day quarantine period.  This is for people who may have been exposed, but are not sick.  Kruppa said that so far everyone who has had to be quarantined has been cooperative, accepting that they would have to be away from work or school for 14 days.

"The great news is to date, everyone has been extremely responsive. They understand the situation and they get their personal responsibility and helping us prevent the spread," he said. "So we've been fortunate that we've not been faced with that. But if we do, we will work with those individuals to help them navigate quarantine as best we can."

Stallone said that Cayuga Medical Center has negative pressure rooms for people who test positive for CVID-19, which ensure the air circulation is contained to the patient, so not spread elsewhere in the facility.

"It is spread by respiratory droplet. The virus is shed from the upper respiratory mucosa and spreading happens most substantially when patients are actually ill," Stallone explained. "The symptoms of the disease include fever, chills, coughing and sneezing, body aches, and when those symptoms are at, their highest is when the transmissibility is greatest. That's actually an asset in a situation. Unlike other viruses that are more contagious before the patient becomes symptomatic and so spread is somewhat a cult or not understood at the time that it's actually happening. So that's some good news."

The Tompkins County Health Department is recommending you protect yourself from COVID-19 by taking these precautions: Avoid close contact with people who are sick. Avoid touching your eyes, nose, and mouth. Stay home when you are sick. Cover your cough or sneeze with a tissue, then throw the tissue in the trash. If a tissue is not available, cover your cough or sneeze into your elbow. Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe. Avoid handshakes and hugs, use an elbow bump instead Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.  If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty. For information about handwashing, seeCDC’s Handwashing website

Many local institutions are taking extra precautions to fight against the threat of the coronavirus.  Lansing School Superintendent Chris Pettograsso said that Health Department employees have been in close contact with the district (see accompanying story).  The Hangar Theatre announced that all scheduled events would take place as planned, but on Wednesday Cayuga Nature Center announced that their annual Maple Fest has been canceled.  Foodnet Meals On Wheels cancelled their2020 Mac 'n Cheese Bowl fundraiser. Kitchen Theatre Company Managing Director Stephen Nunley and Producing Artistic Director M. Bevin O'Gara issued a statement Tuesday afternoon outlining precautions they are taking, and encouraging patrons to protect themselves.

"As we approach the start of our next run, we are taking additional precautions to ensure that our theatre remains a safe environment for all our patrons and staff. In accordance with CDC (Center for Disease Control) Guidelines, our Front of House and Production Teams are taking extra care to keep the theatre and lobby clean and germ-free. Moving forward, we will be increasing our janitorial services, using clorox wipes to clean all public surfaces (including bathroom doors, seat backs & arms) between every performance, recycled programs books will not be reused for 72 hours, and upgrading our soap dispensers."

Molino said he has not heard reports of local business suffering because of the coronavirus, but he urged local business owners to look at their continuity of operation plans.

	Protect Yourself The Tompkins County Health Department says the best ways to protect yourself and slow the spread of illness are to take everyday actions - stay home if you are sick, cover your cough and sneeze with a tissue or elbow, and wash your hands well and often. "We recognize that our community is concerned about large gatherings and upcoming community events," said Public Health Director Frank Kruppa. "It is important that we give each other permission to practice social distancing, including staying home if you are sick and simple actions such as elbow bumps instead of handshakes and hugs."

"I think that's the best advice we can give to businesses small and large is that now's the time to look at your continuity of operations, understand your critical services that you need to continue to provide the staff that you need to do that, he said. "And if there are other alternative means, let's have to continue to do that work. You have to evaluate those circumstances based on their needs."

The Lansing Schools have cancelled all school trips outside of the United States, and health officials are concerned about the many students who may travel abroad over the upcoming college spring breaks.  Kruppa said that at this point the concern is especially high for travelers returning from China, Italy, South Korea, Iran, and Japan, but as the coronavirus spreads to areas in the US like New York City, more precautions may be needed.

"This is certainly an evolving situation and related to travel," he said. "Right now it's those five countries that we're still monitoring. Certainly we'll be, we'll be keeping track of those events like spring break and where additional travel might occur. "We are obviously following the disease in New York state as it's moving to other counties and are we are prepared and ready to respond in the event that we do have the case here. Our real ask right now is we need folks to take personal responsibility and as this evolves, if they're finding they've traveled to a country that has been added to a list by the federal government that they, you know, let us know when they return so we can work with them. And certainly, if anyone becomes symptomatic, we would want them to reach out to the Health Department."

Cornell announced they were implementing enhanced cleaning of campus buildings, and they had an unexpected solution to the spring break travel concern.  On Tuesday Cornell President Martha E. Pollack announced that the university was moving the remaining portion of the semester from campus to the Internet.  All on-campus classrooms would be closed after March 27th.  Instead instructors are directed to finish their courses online.  In essence students are being told to go home for spring break and not come back.

Group events of more than 100 people were suspended, as well.  Pollack said that university officials are still hoping to be able to hold commencement weekend, but that a final decision won't be made until later this month.

"We are asking faculty to adjust their plans and to take on the significant task of developing different ways to deliver education. We are asking staff to perform a host of additional work as they provide critical support for these changes. But all of these actions are necessary if we are to be responsive to the recommendations of public health officials regarding how best to slow the spread of COVID-19 and to protect the health of our community, especially of the most vulnerable among us," Pollack wrote.

Ithaca College is taking a phased approach. President Shirley M. Collado Tuesday postponed campus visits and events, and new approval was imposed on any college sponsored travel. She said any students, faculty, or staff returning from foreign travel would be required to self-quarantine for 14 days. Wednesday she issued a new statement saying that Spring Break would be extended for an additional week through Friday, March 20th and as a result classes would also be extended through May 11th. She said remote instruction would begin March 23rd with the hope that students may return to campus on April 6th, depending on how the situation evolves.

Wells College also announced they would be extending Spring Break by one week, with instruction resuming on campus March 23rd.

Last Saturday Governor Andrew M. Cuomo declared a state of emergency to help New York more quickly and effectively contain the spread of the virus.  He announced Monday that the state will provide alcohol-based hand sanitizer to New Yorkers free of charge.  On Wednesday morning he was proposing a similar plan for New York City businesses similar to Cornell's approach -- for workers to stay home and do their work over the Internet.  He also announced Wednesday that the State University of New York (SUNY) and the City University of New York (CUNY) will implement plans to maximize distance learning and reduce in-person classes, beginning March 19th.

"I'm going to speak to business leaders in New York today," Cuomo said Wednesday morning. "I'm going to ask them voluntarily to do telecommuting, two shifts, a morning shift and a late shift, and let people work from home voluntarily. We have closed some schools. We've closed schools in this hot spot in New Rochelle. At the same time, we're trying to slow it down but ramping up the testing and hopefully the federal government is going to release the handcuffs - they've been controlling the process."

Other businesses across the State have also suspended at least some of their in-person activities.  The New York Independent System Operator (NYISO) in Rensselaer, NY, whihc manages the state's power grid, announced Monday that all stakeholder meetings are indefinitely suspended to protect staff and visitors from COVID-19.  Thursday Cuomo announced he had talked to the organizers of the Saint patrick'sDay Parade and they had agreed to postpone it.

Cuomo deployed the National Guard Tuesday to a state Health Department command post in New Rochelle to assist with cleaning and other support efforts.  He also said the state will produce up to 100,000 gallons of hand sanitizer each week in 1.7 oz., 7 oz. and gallon bottles, which will be distributed first to high risk communities.  The state also appropriated $40 million to increase the response to the disease.  On Tuesday he asked New York State Comptroller Thomas DiNapoli to reevaluate the proposed state budget in light of challenges presented by COVID-19.  DiNapoli had previously warned that legislators should budget cautiously in light of a $6 billion deficit.

The coronavirus is being blamed for a dramatic drop in the stock market, and has also incited violence.  A woman of Asian descent was attacked in New York City Tuesday morning, punched while walking on 34th Street, reportedly for not wearing a face mask.  Cuomo was outraged, and directed the State Police Hate Crimes Task Force to assist local law enforcement in investigating the incident.

"The attack was apparently motivated by the bigoted notion that an Asian person is more likely to carry or transmit the novel coronavirus," Cuomo said. "To be clear: there is zero evidence that people of Asian descent bear any additional responsibility for the transmission of the coronavirus."

Kruppa said that all local health providers and institutions are being kept up to date with the latest information.  Stallone noted that is made easier for participants in the hospital affiliated Cayuga Medical Associates practices.  The group has about 150 providers -- doctors, nurse practitioners, and physician assistants -- and work in close collaboration with the larger network of about 400 providers.  He said members number 40 practices two urgent care centers and an array of clinics and facilities.

"I can report that the hospital and practices have a sufficient supplies of materials like masks and other materials, gowns and personal protective equipment," Stallone said. "Our first priority is to keep our workforce healthy, to be able to respond to cases in the community. And we're working with community partners to streamline processes and do the same in the event that a patient does need hospitalization."

The Health Department's strategy in Tompkins County is to get the facts into the community, and said there would be future meetings scheduled to "help community partners to be prepared and respond."  He said that individuals should take responsibility to take measures to stay healthy, and to be in contact with their doctor and health officials if they do get sick.

"Stay home if you're sick, cover your coughs and sneezes and wash your hands with soap and water," he advised. "Often sanitizers are an alternative taken when hand-washing is not available, but we would encourage folks to use soap and water as their first course of action for hand-washing. It's important that we all take personal responsibility to help prevent the spread of COVID-19."

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