As China's Coronavirus Cases Rise, U.S. Agencies Map Out Domestic Containment Plans

Jan 28, 2020
Originally published on January 28, 2020 1:15 pm

China has reported a large surge of cases of the novel coronavirus — upping its count from under 3,000 to over 4,500 as of Tuesday morning. More than 100 deaths have been reported. It is spreading rapidly in many provinces, and sporadic cases have now been reported in 18 other locations outside of China, including Australia, France and Canada.

In the United States, the case count remains at five — all people who had recently returned from Wuhan, China. And at a news conference Tuesday, top U.S. health officials reiterated that the disease — while serious — is not currently a threat to ordinary Americans.

"At this point, Americans should not worry for their own safety," said Alex Azar, health and human services secretary, at the press briefing Tuesday.

While risk to most Americans remains low, Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention, noted that "risk is dependent on exposure" and that health care workers or others who know they have been in contact with a person exposed to the virus should take precautions.

The federal government continues to adjust its approach to preventing the disease from taking hold in the U.S. On Monday night, the CDC and the State Department announced that a travel advisory recommending that Americans avoid travel to China when at all possible.

Airport screening is also being expanded from five airports to 20, with the goal of screening all passengers returning from China and letting people know what they should do if they fall ill after they get home.

The CDC is conducting contact investigations of people known to have been in contact with the five patients with confirmed infections, monitoring them for symptoms and testing them if concerning symptoms emerge.

Officials at the CDC are eager to get into China in order to help scientists there answer key questions — such as whether the virus can spread from people who don't show any symptoms of illness. Azar said at the news conference that he had been pressing his counterpart in China for permission to send investigators.

That plea has been answered, at least to a certain extent. On Tuesday, the World Health Organization announced that it had the green light to send outside experts to China. It was not immediately clear whether that will include scientists from the CDC.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, explained that federal agencies are taking a three-pronged approach to respond to the novel coronavirus: developing and improving diagnostic tests, investigating experimental antiviral drugs, and working to develop a vaccine.

He said if it turns out that the virus can spread from someone who is not showing any symptoms, there would be some changes in the public health response. Similar coronaviruses from past outbreaks — severe acute respiratory syndrome and Middle East respiratory syndrome — did not spread in the absence of symptoms, but that doesn't mean the new one will behave the same way. Viruses such as measles and influenza can be spread from people who aren't showing signs of disease.

"Even if there is some asymptomatic transmission, in all the history of respiratory-borne viruses of any type, asymptomatic transmission has never been the driver of outbreaks," Fauci said. "The driver of outbreaks has always been a symptomatic person."

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Chinese officials reported a huge jump in cases of the newly discovered coronavirus. More than 4,500 people have been infected around the world, the vast majority of them in China. The State Department and health officials are now asking Americans to avoid travel to China if at all possible. There's one exception, though. Scientists from the Centers for Disease Control and Prevention are eager to get a team of investigators into China, as NPR's science correspondent Richard Harris reports.

RICHARD HARRIS, BYLINE: Back in 2003, when an outbreak of a similar coronavirus - SARS - started spreading in Guangdong province, the Chinese government kept it a secret until it spilled out across its borders. Their response to the new coronavirus doesn't compare, says Alex Azar, the U.S. secretary of Health and Human Services.


ALEX AZAR: Having lived through the SARS episode, I can say that the - the posture of the Chinese government levels of cooperation and interaction with us is - is completely different from what we experienced in 2003. And I want to commend them for that.

HARRIS: For example, the Chinese government has posted the full genetic sequence of the new virus, which allowed the CDC to develop a quick and accurate test to diagnose it. Still, scientists at the CDC have been waiting for weeks for an invitation to come into China and do some firsthand research. Finally today, the World Health Organization announced that it had reached agreement with China to allow outside scientists in.

Dr. Nancy Messonnier at the CDC says one key question is whether the disease can spread from someone even before they're showing any symptoms.


NANCY MESSONNIER: That's something we're watching closely. And obviously, as more information becomes available, we would have to change our operations if indeed that was a significant issue.

HARRIS: During the SARS epidemic, scientists found that only people with symptoms spread the virus. That made it much easier to keep the disease in check. If people without symptoms can spread the disease, health officials would need to expand their monitoring efforts.

At a news conference today where these federal health officials spoke, Dr. Anthony Fauci at the National Institutes of Health offered a bit of perspective on this question.


ANTHONY FAUCI: Even if there is some asymptomatic transmission, in all the history of respiratory-borne viruses of any type, asymptomatic transmission has never been the driver of outbreaks. The driver of outbreaks is always a symptomatic person.

HARRIS: Fauci says U.S. scientists are eager to get into China in order to understand not only how the epidemic is unfolding there but to understand the virus itself. That could help in developing new drugs as well as laying the groundwork for a future vaccine.

The natural history of this new virus is not an idle question for Americans living in Wuhan, where the outbreak is worst. Some, including U.S. diplomats and their families, are being airlifted out. There's concern for their well-being but also questions about whether they could pose a health risk to others when they return. Secretary Azar skirted that question when asked at today's news conference.


AZAR: We will be heavily engaged with that flight and the transport of those individuals. They'll be screened, evaluated constantly. There will be physicians on the flight. And we'll take whatever the appropriate evidence-based public health measures are with them, as we would in any other situation.

HARRIS: Right now, travelers returning from China in good health are mostly told to keep a sharp eye out for symptoms and to report any immediately to a doctor. But as health officials keep saying, this is a rapidly evolving situation, and recommendations are always subject to change.

Richard Harris, NPR News. Transcript provided by NPR, Copyright NPR.