It had all the makings of a panic. An unknown fast-spreading sickness, shortages of protective masks, mandatory two-week quarantines.

But government health officials kept a lid on the frenzy, relying on tried-and-true response plans to keep people informed and their teams prepared as the coronavirus outbreak hit the U.S.

In states where coronavirus cases were confirmed, the state health departments took the lead, often providing daily updates on confirmed cases and people being tested for the virus. The health departments also pushed messages familiar for this time of year: wash your hands, stay home when you’re sick and cover your coughs and sneezes.

The response kicked off just as quickly as the outbreak, leaving little time for extensive planning. The problem with planning ahead for an outbreak is that officials can sound alarmist, says Jack Kalavritinos, senior director at APCO and former director of intergovernmental and external affairs for the Department of Health and Human Services (HHS).

“[Former HHS Secretary Mike Leavitt] said something very interesting when we were planning for the avian flu in 2006,” Kalavritinos recalls. “He said, ‘Pandemics are hard to talk about because when we discuss them in advance we sound alarmist, but after a pandemic starts, no matter how much preparation has been made, it will be inadequate.’”

The coronavirus, officially named COVID-19 by the World Health Organization, is a respiratory illness from the same virus family as SARS and MERS. The outbreak began in Wuhan, China, in December, where researchers suspect the virus jumped from animals to humans, but they have yet to pinpoint the source.

In a few short weeks, the coronavirus went from a localized illness to a global outbreak. As of mid-February, more than 70,000 people have been infected globally and more than 1,700 people have died.

While most of the cases are in China, more than two dozen countries have had at least one confirmed case, including the U.S. Governments have ordered quarantines and began screening some international travelers for the virus in airports.

The Centers for Disease Control and Prevention (CDC) initially took the lead on coronavirus communications in the U.S., holding frequent briefings and building a dedicated website. As the ability to test for the virus became more available, states also built similar efforts to keep the public informed.

Massachusetts, which had one confirmed coronavirus case, launched a full-scale media relations and web-based communications effort in multiple languages to keep its citizens informed.

“[The Massachusetts Department of Public Health] uses its social media channels, including our Twitter account with 29,000 followers, a dedicated coronavirus website that’s updated each weekday, fact sheets in multiple languages, stakeholder conference calls, press releases and media interviews to communicate information on coronavirus cases,” explains Ann Scales, director of media relations for the Department of Public Health.

“Our goal is to share accurate information, first and foremost. With a rapidly evolving public health situation such as this, we are committed to sharing as much information and guidance that we can as soon as we are able,” she adds.

The Washington State Department of Health launched a similar operation after a case was confirmed in the state, says Jessica Baggett, public information officer for the Washington State Department of Health.

Washington also focused on social media, web, press and distribution list communications to keep its residents informed about the virus. The state wants to ensure it is a “credible source of information” for the public about the virus, Baggett says.

Ensuring that information comes frequently and from a calm, trusted source is a best practice from Kalavritinos’ time at HHS.

“When government spokespeople and authorities speak from a place of trust because of the position they hold and from previous communications, that’s key,” he explains. “Also that they speak quickly after the risk occurs, speak regularly throughout the time of people’s greatest concern and that they show they’re collaborating not only within the U.S. government, but also with international partners. They need to speak in a measured way and resist the urge to sow any seeds of panic.”

The main message from health officials is that the public does not need to be concerned about the virus right now. With so few cases in the U.S., it does not pose a risk to the general public.

After that, health officials are focusing on keeping people healthy. Those messages mirror preventive information about the flu. They emphasize the importance of hand washing and avoiding sick people.

Beyond educating the public, health officials also want to ensure that doctors are prepared with the latest information about the virus.

Massachusetts has several methods to get information to doctors, including its emergency alert system Health and Homeland Alert Network and Listservs that reach every healthcare professional in the state, Scales says.

Washington’s health department is also updating healthcare professionals on a regular basis. Officials are partnering with local health organizations to amplify the state’s messaging about the virus, Baggett says.

“The right message at the right time from the right person can save lives,” she says.

The final wrinkle in the coronavirus response is misinformation. Like any issue, misinformation can spread quickly on social media. While health officials typically focus on getting out accurate information, they are also tracking potential misinformation.

Scales says her team constantly monitors for misinformation on social media and through calls to its call center. If a certain question or issue keeps coming up, the team may adjust their messages.

“We use the feedback from each of these channels to inform subsequent revisions to our online fact sheets, coronavirus-themed tweets, talking points used by [the Department of Public Health] subject matter experts in media interviews and other communications venues to set the record straight where there is misinformation and underscore the key messages that we want residents to understand and share in the community,” Scales explains.

The quick response and near-constant updates may seem overwhelming to the average person, but Kalavritinos says a lack of information or a government that withholds information can set back efforts to contain an outbreak.

The CDC and state governments rely on playbooks and lessons learned from previous health emergencies. The CDC’s Crisis and Emergency Risk Communication (CERC) is the gold standard in these situations.

Along with those previous lessons, the CERC pulls from research in public health, psychology and emergency risk communication, Baggett says. The program provides training, tools and resources to health communicators and leaders to help them communicate during such emergencies, she added.

Kalavritinos believes the government response has hit the mark so far, saying it has “instilled confidence that the government is greatly prioritizing this, and that people should not be fearing this virus in their daily lives.”