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The Centers for Disease Control and Prevention on Tuesday warned that it expects the novel coronavirus that has sparked outbreaks around the world to begin spreading at a community level in the United States, as a top official said that disruptions to daily life could be “severe.”

“As we’ve seen from recent countries with community spread, when it has hit those countries, it has moved quite rapidly. We want to make sure the American public is prepared,” Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases, told reporters.

“As more and more countries experience community spread, successful containment at our borders becomes harder and harder,” she said.

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There have been 14 cases of the virus diagnosed in the U.S., all in people who traveled recently to China or their close contacts. Another 39 U.S. residents have been infected in other parts of the world before being repatriated and quarantined. But CDC officials say the country could soon see more cases as the virus starts to spread through communities in areas outside China, including Iran, South Korea, and Italy.

The CDC urged American businesses and families to start preparing for the possibility of a bigger outbreak. Messonnier said that parents should ask their children’s schools about plans for closures. Businesses should consider whether they can offer telecommuting options to their employees, while hospitals might need to look into expanding telehealth services, she said.

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“Disruption to everyday life might be severe,” Messonnier said, adding that she talked to her children about the issue Tuesday morning. “While I didn’t think they were at risk right now, we as a family ought to be preparing for significant disruption to our lives.”

The CDC’s messaging seemed to be at odds with the position of the World Health Organization, which reiterated Tuesday that countries could stop transmission chains if they acted swiftly and aggressively.

A new type of coronavirus is responsible for the outbreak of respiratory illnesses that began in Wuhan, China in December 2019. While experts are still unclear how exactly these viruses are transmitted, coronaviruses such as those that caused the SARS and MERS outbreaks in years past offer clues. Hyacinth Empinado and Alex Hogan/STAT

Bruce Aylward, a senior WHO official who led a recent international mission to China to see how that country had dealt with Covid-19, the disease caused by the coronavirus, said the lesson from China was that the impact of the new virus can be dramatically curtailed. But countries have to be prepared to wage a full-on assault, he insisted.

“Think it’s going to be there tomorrow,” Aylward said during a briefing for journalists at WHO headquarters in Geneva. “The thing you’ve got to think is: If it hits us, we’re going to stop it. You have to think that way. I keep hearing, ‘Oh, if it hits us we just have to accept it and it’s going to spread.’ Why? You’ve lost before you’ve started.”

Messonnier said the CDC is evaluating data on measures that could be used to stem the spread of the virus, including school closures and other social distancing strategies, voluntary home quarantines, and surface cleaning methods. The CDC is using data from past flu outbreaks to study those strategies, but will tailor its recommendations for the new virus.

In a press briefing Tuesday afternoon, other top health officials pushed back on the perception that the public needs to take direct action now to prepare for community spread of the virus. They also doubled down on the message that the U.S. has successfully contained the spread of the virus thus far.

“Our efforts at containment so far have worked,” said Anne Schuchat, the CDC’s principal deputy director. At the same time, Schuchat said, “we don’t want to delay thinking about these other possibilities.”

Department of Health and Human Services Secretary Alex Azar said the government is committed to “radical transparency” in keeping the public informed about its response and preparedness planning. Messonnier, he said, was “just previewing for the American people” the strategies that health officials have in their toolbox as additional cases appear.

“Transparency is being candid with people about what the continuum of potential steps are, so they can … start thinking about, in their own lives, what that might involve. Might. Might involve,” Azar said.

“We cannot make predictions with any degree of certainty about how a virus will spread or what will happen,” he added.

Messonnier said the CDC is also in conversation about whether to change the case definition that triggers a sick patient to be tested for the virus. Currently, health officials recommend testing only for people who have respiratory symptoms and have recently traveled to China, or those who have been in close contact with someone who was infected. But as community spread picks up in other countries, the case definition could change.

  • Hi Harriet,

    Agreed! Frequent hand washing would definitely help…the problem is, most people don’t (will not??) do it properly. Scrubbing for a full 20 seconds nearly never happens, unfortunately.

    Also, as I mentioned in a previous post, there are people who are infected with the coronavirus who feel just fine, so they would have no reason to see a doctor/hospital to get help. Just makes this thing that much more dangerous!

    Thanks,
    Mike

  • Why is it that the “healthcare workers,” in many photos that we see, are wearing what we are told are “protective” suits, but WITHOUT EYE PROTECTION? To me, this seems to be a critical oversight of the manufacturers of those suits, or possibly the agencies/companies by whom those workers are employed. They look to be as effective a means of health protection, against this bio-(fill in the blank), as a Tyvek suit that a painter would wear, but without even the requisite “safety” goggles. Are the workers provided with a suitable means of protecting their eyes, but choose not to wear them? Is there REALLY a problem, or is it all disinformation to panic us into a lemming-like rush for a so-called GOV solution to save ourselves? We’re really infecting ourselves with (yet another brand of) stupidity, if we don’t take into account those who will gain from our actions, or our mindlessness.

    • The virus can enter through any orifice, eyes, nose, mouth or rectum….protect all 4.

  • Seems to me that it might help to stop the virus if the banks disinfected the money that is passed out….I never have trusted it…dirty..

    • Robert,

      I highly doubt that transmission of the coronavirus is occurring via paper money or coins…that’s a stretch!

      Even if it was, use some common sense:
      1. Don’t use it! Nearly every single business accepts cards (debit, credit, gift, etc.)
      2. You can pre-pay online for many transactions and not have to touch money (Uber, Lyft, Most Restaurants, Door Dash, Grubhub, Amazon, Instacart, the list goes on-and-on)
      3. Wear gloves
      4. Don’t expect Banks to clean the money for you. Bills/Money passes from: Individual –> Business –> Individual –> Business –> Individual. Some Businesses will make deposits of cash, just as some people will, but it’s already gone through a number of hands before it ever gets to them.
      5. Clean your own money: https://www.nytimes.com/2018/03/20/magazine/how-to-clean-paper-currency.html

      Ask nearly any 20-something year old how much cash they have in their wallet…the answer is likely to be $0!

      Good luck!!

  • This is an outrage on American soil that the Democrats allowed this Coronavirus to come into a country and kill our people. The affected people should have never been allowed to leave China. Now they’re here killing us American’s needs to wake up vote Republican in this election.

    • Since the Democrats control only the House, while the GOP has controled the Senate & the Presidency since 2016, how is the coronavirus of 2019 the fault of the Democrats ??
      Was your post a typo??

    • I don’t get involved in choosing political sides, so my post has nothing to do with that, but this has got to be one of the dumbest statements ever! Really?!?

      You, my friend, need to do a bit of research on how the coronavirus is transmitted before posting such a ridiculous comment! There are people who feel PERFECTLY FINE, who have been exposed to the virus; how are they supposed to know that they are infected and that they should try their best to not infect anybody else?

      Simply ludicrous!

    • Daniel M Williams a/k/a Trump, Jr.:
      Nice try, but your Daddy, Mr. Trump gave the okay to have the infected AMERICANS come back to America, and ordered them contained for an additional 14 days in camps in the U.S. Stop your B.S. and blame your orange and yellow Leader, Trump. Your leader Trump is a republican who first claimed it was all a hoax and did nothing for a long time. So when you get infected and you probably will, just remember to thank your American leader for not lifting sanctions to an angry Kim Jung-u ’cause your leader Trump didn’t keeping his promise…
      Hope you find a cure for Kim’s “Chrwistmaz wift”.

  • Frequent hand washing and protection from those with active symptoms Like sneezing, coughing, flushed face, fever, even low-grade fever, loss of appetite, lethargy, or anything unusual. We must be active in our preventative activities.
    As advertised, this is a serious disease and so far there has been no development of a vaccine to prevent his illness. It must be taken seriously and those with symptoms must be isolated from the general public not the other way around!The other thing that must be done is to prevent panic-panic kills!!! At the first time sign of illness – for instance a runny nose, lethargy, headache, the doctors advice should be sought!!!

    • Hi Harriet,

      Agreed! Frequent hand washing would definitely help…the problem is, most people don’t (will not??) do it properly. Scrubbing for a full 20 seconds nearly never happens, unfortunately.

      Also, as I mentioned in a previous post, there are people who are infected with the coronavirus who feel just fine, so they would have no reason to see a doctor/hospital to get help. Just makes this thing that much more dangerous!

      Thanks,
      Mike

  • I get the sense that the US have basically given up in the idea of containing it. Question is, does that produce a Shanghai/Hong Kong scenario or a Wuhan?

    I calculated, FWIW, 1800 deaths in Wuhan a day at the peak, and 75,000 to 100,000 total.

    • Based on what calculation? I’m also skeptical of China’s numbers. However, so far, outside China there’s yet to be a clear indication that China has misled us about the nature of the virus, but time will tell.

      South Korea looks to be setting the benchmark of a scientifically rigorous testing program, especially that they, unlike China, include numbers not just of positive but negative results. Very important! S Korean is also doing sweeping testing, not narrowly focused, giving a better picture of community spread. In contrast, the U.S. CDC is doing next to nothing and fumbling left and right. Shocking!

    • Cremation director in Wuhan, taped by undercover reporter, said they did 124 on busiest day, which was 4-5x normal. So that’s an excess of 100 per day. There were 18 such facilities in the area. So, ballpark 1800 a day at peak.

      BTW: 60% died at home and 85% of infections were acquired in the home.

    • @Adam,

      Can you please post your source(s) as I’m interested in hearing/seeing this information?

      Thanks,
      Mike

    • What gives you the sense of “given up” in any way? Are you only listening to media/political messaging, or examining what’s being done.
      The US has been incredibly proactive. Just a couple of quick points:
      * Look at the press conf ~ 1/29… since 1/27 more than a dozen agencies have had daily coordination for fast response. That began only four days after the WHO’s first emergency meeting to look at the situation.
      * Look at the actions. Immediate blocking of immigration from the main source, and quarantines.
      * If you examine the health professionals involved, they are actively considering what actions will *effectively* discover and deal with this.

      As Harriet Forman notes above, panic serves nobody. Sadly, too many are encouraging panic. I’ll add: promotion of useless ineffective measures is incredibly harmful:
      * Provides a false sense of security
      * Increases anger and panic when others do NOT implement those useless measures

      Perhaps biggest right now: face masks. So many wear them, with no idea of what is effective or not. (Only an N95 vented mask, with training, and at least daily careful adjustment to ensure tight face-fit, will protect the wearer (and not anybody else)… and then only in combination with doing everything else right — washing hands, avoiding face touches, etc etc etc.)

      (I have a friend who is a recent amazing survivor of an extreme infection and wears a face mask. Unfortunately, they act like most people: wearing it loosely, pulling it down from mouth/nose whenever uncomfortable… ie it is useless.)

  • There is nothing radical about being transparent. Sadly the Dept of HHS thinks it is a radical concept. Which is why nobody trusts the gov’t. In today’s social media platform things go viral in about 5 minutes, so what CDC needs to do is be honest given what they know because people are already talking like the Olympics is being cancelled based on the comments of a few officials.

  • Based on what we have seen, a nursing home is not a safe place for the elderly during this epidemic.

    Prisons should also be in total lockdown. No visitors. Employees housed in site.

    • I wonder why people infacted with this deadly virus are allowed to travel back to US.they should be quarantine for at least 60 days not 15 days.the symptoms apear up to 2 weeks so how do we know if that person carries the virus.

    • It’s tough to stop unless you’re going to stop all air travel. Now, they’re not even bothering to stop flights from Italy and Korea. Essentially given up on that.

    • Panic won’t help.
      For now, ANYwhere in the US is a safe place for people during this non-US epidemic.
      Bonnie suggests longer quarantine. At this point, we do know that symptoms — if they WILL show — will show within two weeks. No reason to go beyond that.
      At this point, we need to understand that while this virus is more infectious than the flu, we don’t have evidence that it is more deadly than the flu in the general population. (Yes, among those with symptoms 2% are dying… but how many are exposed and not getting it? We don’t know yet but the number must be large.) It COULD be more deadly than the flu, so we work to block it from coming into the US quickly. But panic? No.

      Adam, they are not stopping flights from Italy and S Korea because it honestly is not all that prevalent even there! I just looked at S Korea — ONE community (a secretive church) is home to over half of all cases, and ONE hospital home to over half of all deaths. YES, they have a problem, but it’s not spread into the whole nation. In fact, the large increase in cases there is because all 200,000+ members of that church, and over 60,000 trainees, were tested.
      Similarly in Italy.
      Yes, it is possible that some are carriers without symptoms.

  • Regarding Remdesivir, it seems to me that, if you can determine that the treatment group doesn’t fare worse than the placebo group, that would be enough. In the absence of alternatives, “no worse” is a high-enough bar until trials are complete.

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