When the coronavirus comes to the US, schools, nursing homes, and hospitals could be the hardest hit. Here's what they're doing to prepare.

• With coronavirus likely to spread to the US, the CDC says that schools, nursing homes, and hospitals are likely to be some of the hardest-hit institutions.
• An infectious disease expert told Business Insider how hospitals could be impacted by the outbreak.
• Reports also show how schools are jumping into high gear over coronavirus.
• Visit Business Insider's homepage for more stories.

The coronavirus situation in the US took a turn this week, when a patient in California tested positive for COVID-19 in what is believed to be the first sign of human-to-human transmission in the country. Previously, all of the patients being treated in the US had caught the virus during international travel or from close loved ones who had traveled.

The director of the National Center for Immunization and Respiratory Diseases is now saying that it's no longer a question of if, but when the disease will start to spread in the US.

With that in mind, the US Centers for Disease Prevention and Control released a memo about what would likely happen if the virus started spreading domestically.

The CDC said institutions like "schools, childcare enters, workplaces, and other places for mass gatherings may experience more absenteeism." Meanwhile, "public health and healthcare systems may become overloaded, with elevated rates of hospitalizations and deaths" and "health care providers and hospitals may be overwhelmed."

"Other critical infrastructure such as law enforcement, emergency medical services, and transportation industry may also be affected," the memo added.

Lucky it's flu season

Brian Garibaldi, director of the Johns Hopkins Biocontainment Unit, told Business Insider how these institutions are gearing up to combat the outbreak.

Garibaldi said that most health systems regularly practice how to deal with an outbreak, so they should be prepared to deal with coronavirus patients.

He said one of the advantages that hospitals have is that it's the middle of flu season, so they are already cautious about patients presenting with symptoms of respiratory infections.

Whenever someone shows up at the hospital with these symptoms, Garibaldi said they're immediately given a surgical mask and usually sent to a negative pressure room that limits the airborne spread of the virus.

But one of the issues that may come up is hospitals running out of space with a mass amount of patients showing up, and supplies running low.

"Do we have enough masks and gowns to meet the demand? I think we have enough for the initial surge, but it depends on whether we have sustained transmission for a long period of time," Garibaldi said.

Could the US response mirror the Chinese one?

China shut down entire cities to contain the outbreak - leading some to wonder whether the US government would ever resort to such extreme measures.

Garibaldi said that when "push comes to shove," the US would implement the same measures, but that the biggest focus of virus containment is going to be "effective messaging" in explaining "why we're asking the public to do certain things."

This applies to schools and offices shutting down, something Garibaldi said could happen if the US starts to see the kind of transmission rate that was happening at the beginning of the outbreak in Wuhan, China. While we're nowhere near that number, with a few dozen of contained cases in the US so far, Garibaldi said it's "important for people to be thinking about these" possibilities already.

A report from the World Health Organization this week concluded that China's extreme containment strategy seems to have worked, with the virus slowing there.

"It's possible that we could contain this," Garibaldi said. "It just depends on where it shows up and how aggressive."

Nursing homes closely following the outbreak

Genesis HealthCare, one of the biggest nursing home chains in the country, and sent a statement to Business Insider about how they're preparing for coronavirus.

Spokeswoman Lori Mayer said the company has been meeting regularly about coronavirus since the outbreak began in China in January.

"Our regional and center leaders are currently receiving regular updates on the latest admission screening guidelines and infection control protocols. Everything we are doing is in collaboration with the Centers for Disease Control and Prevention (CDC) and the Departments of Public Health," Mayer said.

Schools getting ready for long closures

Some of the country's biggest school systems are already knee-deep in preparations for how the outbreak may impact schooling.

In Japan, Prime Minister Shinzo Abe announced every school in would close for at least a month. In China, all schools are closed until the coronavirus is no longer a public-health emergency. About 180 million children in China are learning from home, taking classes online, or watching primary-school classes on TV.

The Associated Press reported that schools across the US have been canceling student trips abroad, are preparing online lessons, and considering doing away with perfect attendance awards that are commonplace.

Some schools are buying disinfectant sprayers used in hospitals to keep their classrooms and hallways clean. With the potential for weeks of school closures possible, they are also looking into how to educate students remotely, like in Miami where public school leaders said they're getting 200,000 laptops to send kids home with.

• Read more:
• The CDC outlined an ominous hypothetical scenario about what could happen in the US as the coronavirus spreads. Here's what to expect.
• How to talk to your kids about the coronavirus, even if you're feeling anxious
• Here are the US professions with the biggest risk of getting hit by coronavirus - and the threat goes way beyond hospitals
• The coronavirus death toll is approaching 2,900, with more than 83,000 infected. Here's everything we know about the outbreak.
• Photos show how the 1918 flu pandemic brought the world to its knees