Health officials in Joplin as well as Jasper and Newton counties will follow procedures that are established for a pandemic flu outbreak if the coronavirus spreads here.

Using that policy, they would determine who should be hospitalized or isolated, and would advise the public of the status of any outbreak and what people should do to minimize their risk of exposure.

Dan Pekarek, the director of the Joplin Health Department who also has been serving as the interim city manager, said area health officials have been monitoring reports of the illness and are prepared with a plan on what to do if there is an outbreak here, he told the Joplin City Council on Monday night.

"It is probably not well known by the general public, but there is a lot of planning activities that go on at the local level for disasters," he said. "Some of that planning also goes on for things like this."

The Joplin, Jasper County and Newton County health departments participate in what is called the Emergency Health Care Coalition, which meets regularly year-round with health providers, including Freeman and Mercy hospitals, Access Family Care, nursing homes, dialysis centers and clinics.

"We draft plans together and we do exercises (drills) together" for all kinds of emergencies, including weather disasters and outbreaks of illness.

They also participate in a similar coalition that covers a much larger area, the western side of Missouri, and a statewide coalition so that each agency knows what to do in an emergency.

They hold conference calls about the status of an outbreak and, if it strikes in the area, will use the coalition's pandemic flu policy.

That policy would apply if coronavirus broke out here. In those cases, health officials would determine if those people are sick enough that they should be admitted to a hospital and isolated. "Some individuals might be well enough to stay in their own home," Pekarek said, and they would be advised to isolate themselves.

If the cases spread and involve enough people, the health departments would notify residents who are sick to do social distancing, meaning not to go anyplace where there are crowds.

Additional steps to try to control the spread would be taken if the rate of infection grew.

Coronavirus, like the flu, is considered a reportable disease by the state of Missouri, so if an individual were to show up in an emergency room or a physician's office, the health provider would be required to report that to the local or state health department.

"They know how to do that because they do it all the time for other diseases," Pekarek said.

It is difficult to know whether the illness is suddenly rapidly spreading or whether it just has not yet been diagnosed because there are no symptoms distinguishable from other common illnesses.

"It's so similar to even the flu. The symptoms are so much in line with fever, respiratory symptoms and so forth. The only distinguishing factor right now is the travel history. If you've been to one of the areas or you've been in contact with someone who's had the coronavirus, that's the distinguishing factor. And over time, if it continues to grow that will blur because so many people will have it. It's in 19 states now," Pekarek told the Globe after the meeting.

"A lot of people, based on what we've been reading about China and elsewhere, are either asymptomatic or only mildly symptomatic and don't go to an emergency room," he added.

Pekarek has not seen hard data on a large sector of people, but what information he has seen so far indicates that those who at risk for serious illness or death from the virus are either elderly or already have a condition that compromises their immunity, such as respiratory disease.

For people who are ill, specific information is important to give their health care provider in seeking treatment.

"Around here, it's going to be tied to whether that person has traveled to a location with the virus and starts having those symptoms or has been around someone who is known to have the illness and has been symptomatic and they become symptomatic," Pekarek said. "They should be notifying their health care provider that 'Hey, I think I may have something here.' Don't just show up a doctor's office or the emergency room. They should call first and let them know that 'I just got back from China and I have this cough, I've got a fever. What should I do?' And the health provider will instruct them on how to properly come to the emergency room."

There is no vaccine that can be given to prevent the illness or clear it up, he said.

But the western district of Missouri coalition held a conference call last Thursday, "and we're continuing to keep an eye on it," Pekarek said.

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