Stay home and call if you are sick. That is part of the message that Madison Regional Health System wants to get out now that South Dakota has confirmed cases of COVID-19 as well as one death, possibility linked to the virus.

"The best thing to do is call before you present yourself to the ER or clinic," Kathy Hansen, director of quality, preparedness and safety at MRHS, told members of the Local Emergency Planning Committee on Wednesday night in a regularly scheduled meeting.

In her report, Hansen provided an update on actions MRHS is taking as a result of news released earlier this week regarding coronavirus in the state. She also provided an update on the situation in Lake County.

"As far as we know, there are no confirmed cases in Lake County," she told committee members.

MRHS is being proactive in addressing the possibility that will change. Thus far, the response team has met and developed scripting for speaking with individuals who call.

When individuals call, they will be asked a series of questions -- whether they have a fever over 100 degrees, a cough, shortness of breath, or have been exposed within the last 14 days to someone who has tested positive. Staff will determine what action the symptoms require.

If the risk is low, Hansen said, individuals will be advised to stay home. However, if the risk is high, they will be advised to come in for an evaluation.

"Based on symptoms, the clinician will determine whether testing will take place," Hansen said.

MRHS is recommending that EMS and first responders use N95 masks, which provide a better fit and filtration system than surgical masks. Currently, MRHS emergency room personnel may use, as part of their personal protective gear, air-purifying respirators instead of N95 masks.

At present, MRHS is not restricting visitors, but Hansen said that could change if the situation changes.

Much of the discussion at the meeting centered on how to alert law enforcement, who are often first on a scene, that COVID-19 is a concern.

Madison Police Chief Justin Meyer said he has taken the precaution of getting gloves, glasses and masks for his officers. He wanted to know if dispatch could ask screening questions.

April Denholm, director of 911 Communications, was receptive to the idea but said the fast response time within city limits would affect what dispatch could learn. Too, she said her staff would need guidance to do this.

"When do we ask these questions?" she asked, noting that some calls they receive are vague. People simply indicate they aren't feeling well and ask for an ambulance.

Denholm was also concerned about HIPPA guidelines, which protect patient privacy. She wanted to know how she could alert law enforcement without violating federal law. The general consensus, after some discussion, was that officers could simply be advised to use personal protective gear.

Meyer emphasized the importance of this preventive measure, noting the city has a limited number of police officers.

"We have to keep them healthy as long as possible," he said.

Ramona Fire Chief Myron Nagel wanted to know whether MRHS had a plan in place for dispensing a vaccine should one become available. Hansen said the medical facility does have a POD (point of dispensing) plan in place and would begin by administering vaccines to those in the medical profession and first responders such as law enforcement officers.

"We're fortunate that way," Hansen said. "Our county works well together."

She encouraged people to stay calm and noted pragmatically that they could as easily pick up the flu or RSV (respiratory synctial virus) as COVID-19. She encouraged people to take good infection prevention measures such as washing their hands, cleaning frequently touched surfaces, covering sneezes and coughs, and staying home when ill.