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Health and Human Services, CDC officials host JBSA town hall on quarantine efforts

By Lemitchel King and Allison Miller | 502nd Air Base Wing Public Affairs | Feb. 10, 2020

JOINT BASE SAN ANTONIO-LACKLAND, Texas —

The Joint Base San Antonio commander hosted a town hall meeting Feb. 5 at JBSA-Lackland during which an official from the U.S. Department of Health and Human Services, or HHS, and Centers for Disease Control and Prevention, or CDC, briefed and answered questions from the base community including base employees and their families, as well as some city and state representatives.

Capt. Jennifer McQuiston, the lead for the HHS/CDC efforts at JBSA-Lackland from the CDC’s Division of High Consequences, Pathogens and Pathology, spoke to a crowd of more than 150 base community members about the operations, lodging and support being provided to the passengers who will be housed here.

“We’re really proud to be part of this operation at CDC to get the passengers home because their safety and health are part of our primary mission,” McQuiston said. “We're really appreciative of all the support that we're getting here at JBSA-Lackland. The goal of evacuating Americans is to remove them from the ongoing threat of virus, ensure that Americans here are safe from them as they're in their quarantine period and to limit the spread of virus.”

McQuiston said the metric of a successful quarantine period is having no one within this group become sick and having no spread of infection to others from this group.

“This coronavirus is not airborne like measles,” McQuiston said, “It’s spread from direct coughing, sneezing and fluid droplets of someone confirmed to be sick.”

A website with detailed information from the CDC, along with frequently asked questions, can be found by clicking this link: https://www.jbsa.mil/Information/CDC-Novel-Coronavirus-Response-Support/

Below are the questions asked and answered at the town hall event.

Q: Why was San Antonio chosen since it is the 7th largest city in America and people travel to JBSA-Lackland from all over the country?
A: The Secretary of Defense selected the military bases participating in this operation. The information that we have is there were certain criteria which probably had to do with housing capacity, local hospital capacity and services, and the ability to have isolated areas that could be kept separated from others.

Q: Will they have security ensuring that infected people will not leave the designated quarantine area?
A: We are working hand-in-hand with the U.S. Marshals and perimeter fencing is being put up around the established quarantine area. There is also 24/7 surveillance of the facilities. We are checking the individuals multiple times a day and there will be a clearly established way to keep them in and unauthorized people out.

Q: Who will clean the lodging after the passengers leave?
A: We are not housing ill patients, we are only housing healthy patients. If anyone began to show symptoms they will be immediately moved to a hospital equipped to care for persons with potentially contagious disease.

Cleaning services are being contracted out to a company that has experience to manage situations like this. Food delivery, cleaning, linens and waste management will all be contracted out.

Q: Have there been hospitals identified? Which are they?
A: So far, two have been identified, but the names cannot be released if we can provide the name to ensure patient privacy in the event needed. They are very ready to manage. They are equipped and off of the military installation. The City of San Antonio is one of our partners and is working to make that process go smoothly.

Q: What are the symptoms?
A: Primarily respiratory with fever over 100.4, which is the criteria for action. In the event someone might be sick, they will be sent to a local area hospital that is ready to respond.

Q: What is the plan for screening? Is everyone from the province in China? Do we know of sufferers who are not primarily Chinese?
A: Staff from CDC infectious program are part of the team, partnering with the national disease medical program out of HHS, whose members are on standby to come and do disaster medicine. We’re ready for any type of injury or illness, in full gear. Anyone who interacts with the quarantined will wear personal protective equipment. The gates will be manned by federal marshals and everyone entering and leaving will have to be cleared. The passengers cannot leave during the 14-day period and identification will be required.

The passengers are predominately coming out of Hubei province. We don’t have knowledge of if the disease affects one nationality over the other.

Q: If procedures fail, is there a protocol for what happens?
A: The last federal quarantine was in the 1960s and it’s rare that this happens. There is no knowledge of historical failure. This shows how seriously the CDC is taking the issue and ensures the safety of residents.

The virus is spread through close contact with coughing and sneezing. It’s not known to be airborne so you would have about a 6-feet zone of contraction. Community members would have to be up close and personal and passengers would have to be symptomatic.

Q: Are the American citizens who are sick in China also going to be repatriated?
A: We’re unsure of orders of future repatriation. That may be authorized after recovery.

Q: The virus is spread through close contact, what if they do start showing symptoms? Will the others’ quarantine start over?
A: There are two options: option one is the entire quarantine is reset for everyone, or option two is, a very thorough investigation of who that person has been in contact with by contact tracing, during which we watch only individuals who interacted with that person. But it may depend on the individual situation.

Q: What are the metrics for success? What is the timeline? How will we be notified?
A: The metrics for success are a successful quarantine period, any ill handled appropriately and transported to the local area hospitals that are already identified and equipped to handle the virus. JBSA-Lackland will provide notification, through the executive staff, ATHOC and appropriate channels.

Q: How will quarantined people access amenities? How can the people here help?
A: We really appreciate your question. These individuals being evacuated from China really deserve a lot of empathy. They have gone through a very frightening situation.

A lot of these families have small children who will probably be going stir crazy over 14 days. We have the Administration for Children and Families here specifically to help meet the needs of the people under quarantine.

We love the idea that the community wants to help. The Red Cross is planning to provide amenities and we will put that information out to the community if available.

Q: If the virus is airborne, what can we do?
A: We know a lot about coronaviruses, many common colds are caused by this virus, it is not very foreign to us.

The precautions that we are taking now already account for if the virus was airborne. Anyone who is in contact will be wearing PPE and reporting health status of themselves.

Q: Would clinicians be quarantined?
A: Anyone who is involved in this mission is also monitoring themselves for signs of illness and reporting their temperature back to CDC. They do not require a full quarantine because they will be wearing PPE and we will not be housing and ill people. By use of the proper PPE provided they are not subject to the virus.

Q: How long does the virus stay active on surfaces? What decontamination process will be in place for the lodging?
A: We don't necessarily know everything there is about it. But what we know about similar coronaviruses are that they can live for about three hours on surfaces. Coronaviruses are a type of virus called an enveloped virus and that means that they've got this outer layer to them and if that outer layer gets disrupted in any way by drying out or by disinfectants, then the virus doesn't work anymore and so it's actually a type of virus that that doesn't live for a very long time outside of the body.

There will be a thorough cleaning and disinfecting process after the passengers leave.

Q: Can it be transmitted by mosquitos?
A: We do not know of any coronavirus that can be spread by insects. It is an RNA virus with an RNA trail that leads us back to thinking it may have started in bats.

Q: Are you in need of support? Volunteers?
A: We really appreciate that. We will work with Brig. Gen. Laura Lenderman to identify ways that the community can provide support. I'm here because I care about this community and I care about these individuals and I really want to make sure that everybody is healthy and safe.

Q: How long will the virus last in water/ sewage?
A: It doesn’t last long, coronaviruses do not survive in that environment.

Q: How was lodging determined? Why not Wilford Hall (Ambulatory Surgical Center)?
A: There was a certain set of criteria that had to be met and Wilford Hall did not fit that criteria. It is very close to a demolition state and would require too much time and funding to repair. Single rooms without a shared bathroom, isolated areas and the ability to contain the most people in one spot were also requirements, and the lodging facilities available fit that requested criteria.

Q: Will any of our medics be attending to ill people?
A: No, none of our medics here on the installation at Wilford Hall or Brooke Army Medical Center will be involved.

Q: Is there any type of gear for people to wear to protect themselves?
A: The very first thing you can do is get a flu shot. You should also practice great hygiene. I do want to assure you that CDC is working with cities and hospitals all across America to make sure that they're prepared to deal with those potential realities. Our goal is to slow the entry of the virus into the United States. Using proper hand hygiene, cough etiquette and anything else you would typically do to protect yourself from a respiratory virus. 

Q: What will staff do off duty? Will they be free to roam?
A: There is not a plan to restrict the activities of the people offering care. Again, someone is only at risk of spreading coronavirus when they’ve been infected with coronavirus. The individuals involved in the response are being trained by our hospital’s infectious program about how to safely put on PPE and remove it. 

Q: Notification system?
A: There are several options for notifying the base populace of any updates. We currently have our CAT and EOC stood up. We would use AtHoc, senior leader email, social media and our public affairs team is working 24/7 to keep everyone informed.

We also created a website designed to provide information on the current ongoing with CDC at JBSA: https://www.jbsa.mil/Information/CDC-Novel-Coronavirus-Response-Support/

Q: Is the virus confirmed by blood test or other symptoms?
A: CDC is currently working to develop additional tests. All samples of suspected patients are currently sent to CDC for testing.

Q: Why did the virus spread so quickly in China?
A: We believe that the wet markets in China may have contributed to the spreading of this virus. There is a lot going on in those markets, a lot of people and animals interacting and it was the perfect environment for this virus to spread. Scientists will be studying this virus for a while, as they would with any new virus.  Every time a new outbreak occurs, we want to learn as much as we can from it.

Q: The media has reported that individuals at March Air Force Base, California, were allowed out of their quarters.
A: March Air Force Base was the first base to receive passengers and there are lessons to be learned. One of those lessons is a happy quarantined population is a calm one. We are working closely with Administration for Children and Families (a division of the Department of Health & Human Services) to ensure that the needs of the quarantined individuals are met.

Q: Was Wilford Hall considered?
A: No. It is close to demolition state. Too costly and timely.

Q: What if people want to leave? What do you tell them?
A: They are under federal quarantine order of a mandatory 14 days. It is important to think about the needs of the people, they are human. They are there for their safety. That is also why we have the US Marshals Service here, to enforce the federal quarantine order.