Latest Update on COVID-19 in Maryland

By CHHS Extern Emma Evans Eiden

Just one week after announcing Maryland’s first three cases of COVID-19, Maryland has identified its first community transmission case of the virus bringing the total number of COVID-19 cases to 12.  A Prince George’s county resident, with no travel outside of the state, tested positive on Wednesday.

During a Thursday afternoon press conference, Governor Hogan announced major updates to Maryland’s COVID-19 response plan.  MEMA is elevated to its highest activation level.  The Governor issued an executive order to activate the National Guard.  All nonessential state employees will enter telework duty, if eligible, and public access to state buildings will be restricted.  Maryland prisons will be closed to all visitors.  The Governor has also ordered all senior activity centers to close.

Governor Hogan also issued a state-wide prohibition on events and gatherings of over 250 people.  All certifications and permit expiration dates, including for driver’s licenses, will be extended until after the state of emergency ends.  Hospitals must implement new visitor policies, including a one visitor limit per patient, no minor visitors, and no visitors who have recently traveled internationally.  The Governor urged that essential services, such as grocery stores and gas stations, should remain open.

State Superintendent of Schools, Dr. Karen Salmon, announced state-wide school closures beginning Monday, March 16 through Friday, March 27.  Plans are in process to ensure that free-and-reduced meals will continue and to ensure childcare for essential emergency response personnel.

Maryland Department of Health Deputy Secretary Fran Phillips outlined three goals for what she described as these “extraordinary measures”: slow the spread of infection, protect vulnerable people, and maintain essential services.  Dr. David Marcozzi of the University of Maryland Medical Center endorsed the Governor’s plan and recommended that similar measures for the private sector.  Dr. Marcozzi also assured the public that the health system is prepared to handle care for all individuals requiring care.

MDH issued a letter to clinicians on Wednesday, March 11 urging patient evaluation via phone or other telemedicine platforms.  Any patient with respiratory symptoms should immediately receive a facemask.  COVID-19 testing is now available in commercial and hospital settings, and providers should direct samples to those sites whenever possible.

The MDH loading dock will remain open on Saturday and Sunday to accept COVID-19 test samples.  MDH is no longer reporting the number of processed samples and negative results.  Of the 12 positive cases, two patients remain hospitalized.  Three patients have fully recovered and have passed the required quarantine window.



COVID-19 Reaches Maryland

By CHHS Extern Emma Evans Eiden

Thursday night, Governor Larry Hogan announced three confirmed cases of COVID-19 in the State of Maryland.  While residents are encouraged to continue their daily routines, including work and school, the Governor declared a state of emergency to mobilize funds and activate full coordination between the Maryland Department of Health (MDH), the Maryland Emergency Management Agency (MEMA), and other agencies.  Also under the Governor’s emergency authority, on Friday the Maryland Insurance Commissioner was directed to eliminate all patient costs and pre-authorization requirements for COVID-19 testing.

The first three cases were identified in Montgomery County and were contracted on a cruise that returned on February 20, 2020.   At the time the three individuals returned, only travelers who visited China were being screened for the virus.  The patients developed flu-like symptoms and were contacted earlier this week after the CDC determined that the cruise was exposed to the corona virus.  The patients are now under quarantine in their homes. Contact tracing continues to identify additional exposures.

After the Governor’s announcement, Montgomery County officials including County Executive Marc Elrich reiterated that there is currently no cause for panic, while urging reasonable precautions in the event that additional cases are found in the county.  For example, residents should have enough food, medications, and other supplies to remain at home for up to two weeks.  Montgomery County Public Schools remain open but the school system is prepared to deploy a modified digital curriculum in the event of closures.

Dr. Travis Gayles, Montgomery County Health Officer and Chief of Public Health Services, is responsible for determining if and when to close county buildings, including schools.  Dr. Gayles explained that there is currently no evidence of community spread of the disease, and the existing travel related cases are clinically doing well which suggests a mild to moderate form of the virus.

In a Friday evening press conference, Governor Hogan announced that the three Maryland cases were contracted on an Egyptian cruise on the Nile River which is also linked to six cases in Texas. Two instances of public contact by the Maryland patients have been identified so far. One of the Maryland patients attended an event in Philadelphia, PA where contact was made with local students. Pennsylvania health officials were notified, and five schools in the Philadelphia suburbs closed as a result.  Another Maryland patient attended an event at a retirement community, the Village at Rockville, with over 70 attendees on Saturday, February 29.  Governor Hogan encouraged attendees of the Rockville event to contact the MEMA call center.

On Sunday, Governor Hogan’s office announced two additional positive results in the state, both were contracted during overseas travel.  One of the new cases is located in Montgomery County, and the patient doing well at home after a brief hospitalization. The second case is located in Harford County, and the patient, who is over 80 years old, remains hospitalized.  The hospitalized patient contracted the disease on travel to Turkey, and it is the first known case to come from that country.  Officials believe the risk of community exposure remains low but are advising individuals over the age of 60 years old and those with compromised immune systems to stay home as much as possible because they are significantly more susceptible to COVID-19 and experience higher mortality rates.

During a Monday afternoon press conference, Governor Hogan announced that he had just signed into law emergency legislation, unanimously passed by the Maryland legislature, authorizing the use of $50,000,000 of Maryland’s “rainy day fund” for the COVID-19 response. State employees have been directed to cancel all out-of-state travel, and all state agencies are preparing to enter a period of mandatory telework.

Governor Hogan explained that there are six additional Marylanders under self-quarantine who were on the Nile River Egyptian cruise line during different dates from the initial three Maryland cases.  Two of those individuals are exhibiting symptoms, but all six will be tested for COVID-19.  Also, there are 12 Marylanders aboard the Grand Princess cruiseship, which is currently docked off the coast of California, who will be transferred to military bases for examination and quarantine but are not exhibiting symptoms.

On Monday evening, a sixth Marylander was confirmed positive for COVID-19.  The patient contracted the disease during out of state travel and is now located in Prince George’s County.

Last Tuesday, March 3, a memo informed Maryland health officials and providers that the MDH Laboratory was authorized to perform the 2019-Novel Coronavirus Real-time RT-PCR Diagnostic Panel.  Samples may be collected locally then transported to the MDH laboratory.  A provider must consult with an MDH epidemiologist prior to collecting and submitting a sample.  The sender is responsible for compliance with all requirements and regulations for packaging and shipping a potentially infectious sample; however, MDH may provide some transport and courier services.  Training and certification is required to package potentially infectious materials, and the certification must be renewed through the CDC every two years.

Criteria for a person under investigation (PUI) for coronavirus include a combination of clinical and epidemiological factors.  Currently there are three different criteria for PUIs:

  1. Fever OR respirator symptoms (not necessarily requiring hospitalization) AND contact with a person with a confirmed case of COVID-19;
  2. Fever AND respiratory symptoms requiring hospitalization AND travel to China, Iran, Italy, Japan or South Korea within 14 days of onset; or
  3. Fever AND respiratory symptoms requiring hospitalization with no alternative diagnosis AND no known source of exposure.

As of Monday, MDH has processed 73 patient samples, with 6 positive results.

Episode 1: 100 Years After the Great Molasses Flood

How bad could a flood of molasses really be? In this kickoff episode, Trudy and Christine explore some emergency management basics in context of the Great Molasses Flood.

Hotwash Episode One Transcript

COVID 19 Webinar Series Part IV: Updates and COOP Discussion

Part IV of the CHHS Webinar Series on the CoVID 19 outbreak is below. CHHS Public Health Program Director Trudy Henson, Senior Law & Policy Analyst Christine Gentry, and Public Policy & External Affairs Program Director Ben Yelin provide updates on the outbreak, and discuss Continuity of Operations (COOP).


If your organization is interested in drafting or revising your Continuity of Operations (COOP) Plan, please check out our page:

CHHS Webinar on the Coronavirus: Part II

CHHS Public Health Program Director Trudy Henson and Senior Law & Policy Analyst Hassan Sheikh discussed the ongoing issues related to the coronavirus, in Part II of the CHHS webinar series.

Watch the video here:

Updates on the Coronavirus Outbreak

By CHHS Extern Benita David-Akoro

Over the last few weeks, the novel coronavirus known as 2019-nCoV has received significant media attention. 2019-nCoV is a coronavirus originating in Wuhan, China, but now with confirmed cases in at least twenty other countries. Yesterday, the World Health Organization announced it was declaring the 2019-nCoV outbreak a Public Health Emergency of International Concern, a declaration it declined to make just over a week ago. The decision to declare a PHEIC coincided with a sharp rise in cases and a spread of the virus to other countries; WHO’s director-general cited concerns with the virus’ spread into countries with less-robust healthcare systems as one reason for declaring a PHEIC.

Globally, there is need to take action: as of January 31, 2020, the Johns Hopkins 2019-nCoV surveillance tracker reports 9,976 confirmed cases with an estimated 213 fatalities since it was first detected in December 2019. These numbers now surpass the November 2002 to July 2003 outbreak of SARs. In that outbreak, public health officials reported 8,098 infections of SARS globally, with 774 SARS-related deaths.

Public health officials worldwide agree that swift and effective measures are necessary to curtail the spread of the virus. Countries with reported cases of infections have taken various steps – from investigation to screening, quarantine and risk communication. In the US, the CDC is taking measures to ensure the early and immediate detection of the virus, including issuing a level 3 travel warning for China—recommending that travelers avoid all nonessential travel to China—and implementing public health entry screenings at 20 airports and land crossings.

Many affected countries, including the United States, have learned significant lessons from previous outbreaks and have robust public health preparedness & response plans at the ready. Currently, the U.S. has identified 6 cases, five of which were acquired outside of the U.S., and one which was transmitted from an infected patient to their spouse. Elsewhere, countries have taken sweeping measures to control the virus’ spread:  Chinese authorities have declared a quarantine in Wuhan, a city of 11 million people, and imposed travel restrictions in other smaller cities in the province. Russia has closed its border with China; and some airlines have suspended flights into the country.

Certainly, the 2019-nCoV outbreak has already affected travel, economic activity, and global markets. Perhaps of more concern are the shortages of medical supplies, such as surgical masks, gloves, and disinfectants, as well as food and other household supplies. While some preparation is important, panic can lead to unintended consequences: as seen during the 2014 Ebola outbreak, surge in demand of personal protective equipment by the general public and even officials purchasing resources in preparation, can create shortages for responders and healthcare providers caring for patients in the affected areas. Additionally, misinformation about the effectiveness of prevention methods, such as disposable surgical facemasks, may lead to underutilization of more effective prevention methods, such as hand washing.

The spread of the 2019-nCoV is certainly cause for concern in a novel virus outbreak, and precautions and planning are essential to curtail the virus’ spread. Many U.S. health officials, however, are reminding people that domestically, seasonal influenza currently remains a much bigger concern, which, comparatively, kills 650,000 people worldwide every year, and in the U.S. alone this season, is responsible for 8,000 deaths. And, of course, it’s an important reminder that as you go about your day, whether you are looking at potential policies and plans for implementation if the 2019-nCoV spreads to your jurisdiction, or whether you are going about your regular day: washing your hands remains the best way to prevent the spread of viruses—whether it be the flu, or the novel coronavirus.

CHHS Webinar on the 2019 Novel Coronavirus

CHHS Public Health Program Director Trudy Henson and Senior Law & Policy Analyst conducted a webinar to discuss legal issues related to the 2019 Novel Coronavirus. Watch below:

Legal Preparedness and the 2019 Novel Coronavirus

In the last week, a novel coronavirus, first identified in the Chinese city of Wuhan, has dominated headlines as cases continue to rise. Fifteen countries have confirmed cases of the virus within their borders, and health officials in China and elsewhere are monitoring thousands of potential more cases. Although the mortality rate of the disease remains relatively low, the speed of transmission and its presence in densely-populated cities have public health officials across the globe on high alert.


The World Health Organization has currently declined to declare the Wuhan Coronavirus outbreak a Public Health Emergency of International Concern (PHEIC). However, in the U.S., legal preparedness and public health response mechanisms are already in motion to help monitor the disease’s spread. In times like these, knowing the public health emergencies powers available to officials at the federal, state, and local level is key to an effective, measured response.


The Center for Health and Homeland Security (CHHS) has over 18 years of expertise responding to public health emergencies. From legal preparedness, to planning and testing, to “boots on the ground,” CHHS has helped clients with responses to seasonal flu, H1N1, measles, tuberculosis, Zika, and Ebola.


Our expertise extends beyond the academic to the practical. In addition to teaching courses at the Maryland Carey School of Law on the Law and Policy of Public Health Emergencies, CHHS has advised clients on isolation and quarantine plans and setting up vaccination clinics for health department clients. We have also helped create legal toolkits for resource sharing and allocation. Through a cooperative agreement with the State Department, we have held training seminars for the West African countries’ public health officials most directly impacted by Ebola.


We regularly prepare emergency legal handbooks for states, cities, counties and quasi-governmental institutions (such as the Maryland Department of Health and Washington Suburban Sanitary Commission). These handbooks highlight both federal and state emergency declaration laws, and are invaluable for helping officials understand not only their powers, but their duties, as well the duties and powers of those around them, in order to affect a more coordinated response.


If the number of coronavirus cases grows in the U. S., many states will likely declare emergencies, which trigger extraordinary powers to the Governor and public health officials and can be challenged by civil liberty groups. Such emergency declarations were seen for SARS and Ebola, as well as H1N1. CHHS staff are ready and able to help clients with their legal and public health preparedness needs.


For additional information about CHHS, please visit our website. For questions, please email


For additional information about the novel Coronavirus, see: