A top federal health official said Monday that the evolving coronavirus outbreak could persist in the United States into next year, while stressing that public health interventions could still reduce the spread of the virus and cases of illness and death.

“As the trajectory of the outbreak continues, many people in the U.S. will at some point, either this year or next, get exposed to this virus,” Nancy Messonnier of the Centers for Disease Control and Prevention said on a call with reporters. “And there’s a good chance many will become sick.”

Messonnier noted, however, that officials do not expect most people to suffer severe cases of Covid-19, the illness caused by the coronavirus. She pointed to data from China, where the outbreak began and thousands of cases have been reviewed, that showed that some 80% of cases were mild and only a few percent were critical.

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The most common symptoms of Covid-19 include fever and cough. In more serious cases, it can cause pneumonia. There have been more than 500 confirmed cases in the United States, and more than 20 deaths.

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Messonnier, the director of CDC’s National Center for Immunization and Respiratory Diseases, used the press briefing Monday to urge Americans who face higher risks of developing more severe disease, including seniors and people with underlying health conditions, to take precautions and prepare. Such steps include avoiding crowds and contact with people who are sick, and frequent hand washing.

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She also said that high-risk Americans should stock up on their medications and groceries, and that family members of those high-risk people should create a plan should they get sick and they can no longer help their relatives.

“You may need to identify backups,” Messonnier said.

She added: “I understand these recommendations may not be popular and that they may be difficult for some people.”

Messonnier’s suggestion that the virus could last into next year fits with the predictions of some experts that the virus will circulate for a long time, given how difficult contagious respiratory illnesses are to halt. Some experts have said they see the virus becoming endemic, that is, spreading permanently in the human population like some viruses that cause colds and the flu.

The concern with the novel coronavirus, however, is that no one had any existing immunity to it, so initial exposure is more likely to lead to more severe illnesses for some patients. The most vulnerable include seniors, those whose immune systems are suppressed, and those who are already dealing with other health conditions.

Messonnier noted that most communities in the United States are not experiencing community spread of the virus and said that people need to make decisions based on where they live and their own needs. She also advised that people who are not at high risk for severe illness, particularly those not living in places like communities in Washington state and California where the virus is known to be spreading, to act prudently. Masks, for example, should really be saved for health care workers.

“This is a time for people to prepare for what they might need to do, but not a time for people to clear out the shelves,” she said when asked about people buying household and cleaning supplies in bulk.

If people think they have been exposed to the virus, they should stay at home and alert a health provider if they become ill, particularly if they are in a high-risk group, Messonnier said.

She said that her parents, who are in their 80s, do not live in an area where the disease is known to be actively spreading, “but I’ve asked them to stick close to home.”

During the briefing, Messonnier explained that more public health response efforts, which are largely led by state and local officials, will increasingly move from containment to mitigation, but she described that transition not like an on-off switch but like a dimmer. Containment efforts, which included isolating individual cases and following their contacts to see if they develop disease, could continue even as officials implemented the broader mitigation efforts that are designed to address wider community spread.

“We can really mitigate the impact of this disease,” she said.

Wrangling the spread of the virus will require individuals to act as well, she said. People need to listen to health authorities, and protect themselves, their families, and their communities. Reducing the spread of the disease will also reduce the burden the health care system could face.

“There are personal responsibilities that we’re asking everyone in the United States to take,” she said.

  • The panic buying during the coronavirus pandemic is breath taking. Today I saw a cartoon that depicted two dinosaurs looking up at the sky with a huge meteorite with a long flaming fireball tail barreling down on the hapless dinosaurs. One dinosaur turned to the other and said, “quick, run buy some toilet paper!”. That cartoon says it all.

  • So if we’re mostly going to catch this in the next 1-2 years, and herd immunity doesnt kick in til we hit 60-70% infected, what’s the point in trying to run from this thing? I dont feel like there is a long term strategy unless its to just slow the burn- same number of infections but spread out over time.

    • Jeff…you make valid points. I think they are trying to prevent a large increase all at once, like Italy has had…because our hospitals are not ready and not equipped for very many cases all at once. Clearly, our govt has not prepared for a highly contagious virus like this one,

    • ‘Slowing the burn’ is the plan in most areas, as there is currently no vaccine in a 6-9 month timeline (and possibly longer). The degree of infection is interesting; currently, Italy, the ‘crisis point’ of the infection, is en route to 30,000 proven cases out of 60 million population, or about 0.05%. About 20% of those cases should prove to be serious, and half of those severe. Spreading those out more will lessen the impact on ICU/critical care resources, improving the level of care possible for those severe cases. It should also reduce the impact of those cases on the medical professionals faced with treating them, an aspect of this situation not to be dismissed. A big issue in China was the localized impact of the disease, swamping the medical resources in the area and wearing out the medical professionals.

  • About time some one can explain all the different ways (mouth eyes, hands) and methods of transmission (close contact, touching) and who all (people) is affected. Good Job. It’s been my observation that a lot of people are careless and do not wash their hands, especially food handlers, people traveling and stopping at Rest Points, Grocery Store Staff, even some medical personnel at various hospitals. I’m just saying.

    • Donypu wash your hands for 3 to 30 minutes when you “sanitize yourself”? Because that is how long it tskes to kill bacteria…germs….virus. So let me get this straight….every time a fast food worker gives someone thwre food at the fast food window they are going to tske atleast a 3 minute break to wash? Hand sanitizers are a lie so that doesnt wirk either.

  • Thank you for your online updated covid2019 about the expected length of time the covid2019 virus could possibly last into next year please keep me informed if those statistics change. Sincerely Pat Ray

  • Exceptional reporting; article.

    As a former hospital epidemiologist, and medical risk management consultant and healthcare analyst, there are several factors that cause me concern: much is unknown about this virus, particularly its route(s) of tranmission. Nearly all infectious and communicable diseases are spread by not one but two routes. Influenza, for example, is spread by both contact (contaminated surfaces are touched, which contaminates the hands; and the hands then used to touch a mucous membrane such as the mouth or eyes, or used to hold a food, etc) & airborne (viral particles exhaled simply by breathing, talking, singing, or via coughing; these minute size particles readily carried by ventilation systems, which in essense exposes everyone who breathes in this same air, such as in stores, fitness centers, hospital and medical clinic waiting areas, churches, schools, concerts, buses, airports, airplanes, and so on. Well, given this is a similar virus, it might be spread similar to influenza, thus an airborne rather than droplet transmission, which is what is being reported! In other words, droplet transmission occurs from large particle respiratory secretions — so large, the particles only carry at most six (6) feet from its source/ host. And so, barrier masks — the kind sold in stores and supplied by hospitals, which are used by medical staff to help prevent infected people from exposing all others in a given setting — would NOT be effective in preventing nor even mitigating risk of exposure. Because viral agents that are spread this way (airborne transmission) permeate the material these masks are made of. A special type of mask is needed for prevention of airborne infectious agents, and it requires something known as “fit testing” in order to even wear it with an assurance of protection. Different sizes and shapes of one’s face, and the other applicable factors (e.g., beard growth), affects a mask’s fit; and “fit” is not so much about if or how it fits, but rather the efficacy of its air-tight seal, which is what makes this sort of mask essential for airborne transmission. No other mask will be effective. Thus, if this virus is spread by airborne — not via droplet — transmission, then all of these measures being taken to mitigate an advancement of the spread of this virus will be mute/ ineffective. And same for what’s advised for infected and/or symptomatic people in the community; generic masks worn will have offered no prevention for others who have had close contact interactions with them. This is a MAJOR problem.

    Secondly, I don’t like the lack of specificity as regards who falls into these high risk groups. People need to know which group they are in — high risk or low to negligible risk. Lay persons (those who lack medical training) need more info in order to understand their level of risk for transmission and severity of illness if indeed exposed and affected physiologically. The info provided by officials is just too generic. What I am getting to is simple:

    There are many underlying medical conditions that suppress immune system functionality — these conditions are not limited to the conditions indicated by authorities (i.e., diabetes, heart or lung diseases). Dozens of conditions as well as post-operative recovery, certain medical treatment procedures and various treatments — such as bone marrow transplant and chemotherapy, respectively — and pregnancy to post-partum status, as well as hundreds of medications — over-the-counter and prescription medications both — not to mention severe physical and physiological deconditioning such as obesity, all have a profound negative impact on immune systems; suppressing the immune system enough to create moderate to markedly increased susceptibility to all viral, bacterial and pathogenic ailments. Not to mention others at high risk such as those in crisis and undergoing intense stress, which impairs sleep and in turn, immune functioning. Youth and seniors over age 55, especially those of older age with medical conditions. Thus, the point is, a great many people, not just those of older age and with cardiopulmonary conditions, are in the high risk group.

    And need to know. But officials are under reporting who is at risk, which is a very serious error and of concern as to why they are not being specific, rather than putting people in a situation where they must guess or figure out things for themselves.

    Another issue is the fact there are key contradictions in certain articles and reports. Not in this article, however it is important to make note of because a majority of persons seek info from multiple sources. For example, a sole focus on droplet transmission, as the presumed mode of transmission, which is not evidence-based, in concert with dismissing contact precautions for contact transmission, which is thought of as less important than droplet precautions. Then, later in the same article, emphasizing how important it is to wash the hands and avoid touching potentially contaminated surfaces, etc — all of which indicates contact tranmission is a key mode of entry!

    I could go on and on.

    • This is spot on. This disease is proving to be far too contagious to be simply spread by coughs and sneezes. People who are infected will also be exhaling sub micron sized particles on every breath.Face masks will not block these particles Sneezes tend to produce heavier droplets which will indeed travel on average 6 feet before gravity does its thing and they fall onto any available surface. Its pretty much a nightmare scenario where exhaled breath from infected people is the main transmission. It also sounds like the virus will hang around in the human body even after ‘recovery’, possibly reactivting itself at times of stress. This is not going to end any time soon. Anti viral meds will need to be developed and available to everyone…

    • Thanks Max. It seems as of now (3/15) they’re ‘saying’ this isn’t truly airborne. Not to be a total pessimist, but what if it becomes truly airborne?

    • Flu is indeed droplet (not airborne) transmissible and therefore risk of catching it is mitigated by a plain old surgical mask. These masks are what are worn by healthcare workers entering flu-infected patient rooms. Airborne transmission, on the other hand, requires the N95 particulate respirator and typically the patient is placed in a negative pressure ventilation room (think TB). Having actually cared for such patients in the ICU for the past 15 years, I am well-versed in infection control policy. According to the CDC website, flu have never been found to be airborne transmissible: https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm

    • What if this virus has already been around and they just renamed it. Suppose its a virus that the elderly had at one time in their lifes. But, this new virus just like the chickenpox virus came back as shingles in most elderly. In other words, some viruses that have always been here are double whammy for dorment viruses in the elderly.

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