Three people in Maryland were diagnosed Thursday with the coronavirus, in the first positive cases in the Washington, D.C., area.
The patients, a woman in her 50s and a married couple in their 70s, live in Montgomery County and fell ill after taking a cruise in Egypt on the Nile River.
They may have unknowingly exposed people in Maryland to the virus after they returned on Feb. 20, health officials said. One of the patients went to a senior center in Rockville, where there were at least 70 people.
Another of the patients had contact with students and school staff in the suburbs of Philadelphia, prompting the Central Bucks School District to close five schools Friday.
Twelve crew members who were on the same cruise ship as the Maryland patients were in quarantine, according to the World Health Organization. These cases also were linked to six confirmed cases in Texas.
The Maryland couple and woman are retracing their steps, officials said. They did not travel as a group.
One of the patients attended an event Feb. 28 at The Village at Rockville, a retirement community, where they were in the presence of 70 to 100 people, including residents, staff and visitors.
Anyone who attended the gathering between 12 and 6 p.m. should watch for symptoms such as fever, coughing, difficulty breathing and shortness of breath until March 13. They should check their temperature twice a day. Anyone who develops symptoms should contact their health care provider and health department to get instructions about testing and care.
A woman whose 89-year-old father lives at the retirement community said she and her 12-year-old daughter were visiting Friday evening when they heard Hogan warn of the possible risk on the news.
“I’m in my father’s room, he’s eating his dinner, he’s a double amputee, he’s 89 years old,” Peggy Weldon said. “And on comes Gov. Hogan to make the announcement. I’m sitting there with my 12-year-old daughter, and we hear Gov. Hogan say, ‘The Villages at Rockville.’ I go and talk to the nurse staff. They weren’t aware of it. I told them. I said, ‘You folks need to have masks.’”
The Village at Rockville said in a statement it is working closely with the health department and following its recommendations. No residents or staff have been diagnosed with the coronavirus or are showing any symptoms.
“Our primary focus is to maintain our highest level of well-being for our residents and team members,” said Kyle Hrebren, executive director at The Village at Rockville. “We will remain diligent in taking the necessary precautions to ensure the health and safety of our community and the greater Rockville community.”
Students in the Montgomery County Public School district recently visited the retirement community. The principal at Robert Frost Middle School said in a letter to parents that district officials said students who visited were not at risk of contracting the virus.
The Maryland patients were not tested upon their return from the cruise because federal guidelines had not been updated to include the countries they visited, officials said Friday.
When the couple went for medical attention, doctors were able to take precautions to protect themselves and other patients, county public health head Dr. Travis Gayles said.
All three people quarantined themselves at home. The patients were in good condition and did not require hospitalization.
Health officials learned of the patients Tuesday evening and contacted them Wednesday morning.
Maryland Gov. Larry Hogan announced the three diagnoses Thursday night and declared a state of emergency to boost the response to the virus.
“With this declaration, I am officially authorizing and directing the Maryland Department of Health and the Maryland Emergency Management Agency to ramp up coordination among all state and local agencies and enable them to fast-track coordination with our state and local health departments and emergency management teams,” the governor said.
"I encourage all Marylanders not to panic but to take this seriously and to stay informed as we continue to provide updates,” Hogan added.
The state of emergency declaration allows Hogan to access certain resources and funding to ramp up efforts to stop the spread of the virus. He can dip into the state's rainy day fund and is requesting an additional $10 million in support.
Hogan also told the Maryland insurance commissioner to waive all costs associated with testing for the coronavirus.
Metro elevated its response to the virus on Friday after the cases in Maryland were diagnosed, General Manager Paul Wiedefeld told employees.
Phase 2 of Metro's response plan includes "targeted deployment of hand sanitizer supplies to frontline employees (who may not have easy access to washrooms), expanded monitoring of absence trends, and more frequent communication with customers and employees."
Montgomery County houses several federal agencies, including the National Institutes of Health and the Food and Drug Administration. About 18% of the capital region's federal workers live in the county, the Metropolitan Washington Council of Governments said last year.
County officials say they prepare for public health emergencies on an ongoing basis and have been preparing for coronavirus for weeks.
"We believe that Montgomery County is ready for this new challenge. We aren't glad to be facing it by any stretch," said Earl Stoddard, local director of the Office of Emergency Management and Homeland Security. "But we believe we have a robust system of partners who are very committed to providing services to our residents."
Montgomery County Public Schools sought to reassure families and said schools will remain open.
"State officials have shared that they do not believe these individuals have had contact with MCPS students," the district said in a statement late Thursday.
"We encourage all MCPS families to remain vigilant through this situation and consult your health provider if you are experiencing symptoms that you may believe are related to the coronavirus," they continued.
Forty-four people have been tested for the new virus in Maryland so far. Forty-one tested negative. Friday's results include three Jewish school students who had contact with a coronavirus patient in New York.
Another 374 people were being monitored because of indirect contact, Hogan said.
D.C., Maryland and Virginia all are testing more potential cases as of Saturday. Here are the latest numbers.
The virus has infected almost 98,000 people worldwide and killed more than 3,300.