February 26, 2020

'This might be bad': CDC says US should prepare for more coronavirus cases

Daily Briefing

    Trump administration officials on Tuesday warned that Americans should prepare to see more cases of the new coronavirus in the United States—and for the virus to spread locally—as cases of the virus have started spiking in countries across the globe.

    Background

    Reports of the new coronavirus first surfaced in early December 2019 in Wuhan, China. According to the World Health Organization (WHO), the main symptoms of the virus are fever and lesions in both lungs. Some patients also have reported difficulty breathing, WHO said.

    As of Wednesday, officials reported more than 81,900 cases of the virus globally, with most of those cases occurring in mainland China. Officials said as of Wednesday there had been more than 2,770 deaths linked to the virus, and all but 55 of the deaths occurred in mainland China.

    However, while the number of newly reported cases in China has started to slow, the number of newly report cases in other countries has surged over the past week. For instance, experts noted that Iran, which had reported no cases of the virus at the start of last week, reported 139 cases and 19 deaths from the virus as of Wednesday. Italy also has seen a large spike in cases, growing from no cases to more than 322 cases and 12 deaths in less than a week.

    The virus' global spread shook the global economy this week. In the United States, the Dow Jones industrial average continued to fall, declining by 3.4% on Tuesday. According to the Washington Post, Dow Jones lost more than 1,900 points over two days, which is the biggest loss the average has seen in two years.

    Officials says Americans should prepare for local spread

    In the United States, CDC as of Monday reported a total of 53 confirmed cases of the virus, and officials warned that more cases are likely in the coming weeks.

    CDC said 39 cases involved Americans who contracted the virus elsewhere and then repatriated to the United States, 12 cases involved patients who had traveled to China and were diagnosed after they returned to the United States, and two cases involved patients who contracted the virus via human-to-human transmission in the United States from patients who had traveled to China.

    While human-to-human transmission of the virus has been low in the United States, Trump administration officials on Tuesday said Americans should prepare for local transmission.

    According to Reuters, Nancy Messonnier, director of CDC's National Center for Immunization and Respiratory Diseases, during a conference call with reporters said, "The data over the past week about the spread in other countries has raised our level of concern and expectation that we are going to have community spread here." She continued, "It's not a question of if this will happen, but when this will happen, and how many people in this country will have severe illnesses."

    Messonnier added that Americans should "prepare for the expectation that this might be bad."

    Separately, HHS Secretary Alex Azar during a Senate subcommittee hearing on Tuesday said, "While the immediate risk to individual members of the American public remains low, there is now community transmission in a number of countries, including outside of Asia, which is deeply concerning."

    Azar during the hearing requested that Congress appropriate $2.5 billion for the United States' response to the coronavirus epidemic, including funding for medical supplies, disease surveillance, and other efforts. However, Democratic senators have said that amount of funding is insufficient, and criticized the administration's handling of the virus so far.

    For example, Senate Minority Leader Chuck Schumer (D-N.Y.) said the administration doesn't have a comprehensive plan to combat the virus and called for at least $3.1 billion in additional funding for response efforts.

    US hospitals struggling to prepare

    CDC for the past two months has urged U.S. hospitals to prepare to treat coronavirus patients, but some hospitals are reporting problems accessing needed tests and equipment.

    For example, the testing kits CDC sent to local governments earlier this month included a faulty component, meaning only about a dozen state and local laboratories are properly equipped to confirm coronavirus diagnoses in the United States, according to the Post.

    Further, some hospitals have only a week's worth of protective gear that health care workers would need to treat patients with the virus, the Post reports. Azar during the Senate subcommittee hearing on Tuesday said the United States would need 300 million N95 face masks to help protect health care workers against the virus, but the country currently has just 30 million stockpiled.

    Lauren Sauer, who oversees preparedness and response for Johns Hopkins Medicine and the Johns Hopkins University system, said, "Personal protective equipment is not what you think about day-to-day." She asked, "What is the plan for allocation of scarce resources? Is it going to be who has the most face time [with HHS officials] who gets the most supplies?"

    But CDC spokesperson Kristen Nordlund said the agency's current guidance for hospitals must be flexible. "We can't be too specific, because it might not be something a health department or hospital can do, or it might not fit their needs at the moment."

    How Americans can prepare

    While federal officials are warning the public about the potential for the new coronavirus to spread in the United States, other experts said individuals shouldn't start panicking about the virus—at least not yet.

    Marguerite Neill, an infectious disease expert at Brown University, said, "The mantra is, 'Keep calm and carry on.'"

    Experts said Americans should "use common sense" when it comes to disease prevention, such as washing their hands and avoiding going to school, work, and crowded places when they're sick, the New York Times reports.

    Experts also recommended ensuring necessary medications are filled and stocking up on food and other household staples. "Don't wait until the last minute to refill your prescriptions. You want to comfortably have at least a 30-day supply," Neill said.

    Messonnier suggested that, if the coronavirus does become widespread in the United States, businesses should consider allowing workers to telework, schools may need to cancel classes, and local governments should consider rescheduling large events. "I understand this situation may seem overwhelming and that disruption to everyday life may be severe, but these are things that people need to start thinking about now," she said (Baker, Axios, 2/26; Lai et al., New York Times, 2/26; CDC website, 2/24; Steenhuysen/Bartz, Reuters, 2/25; Werner et al., Washington Post, 2/25; Erman et al., Reuters, 2/25; Kolata, New York Times, 2/25; Sun et al., Washington Post, 2/25; Funk, Associated Press, 2/26).

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