— CDC says preparations for domestic transmission should begin
by Molly Walker, Associate Editor, MedPage Today February 25, 2020
The U.S. should prepare for community transmission of the COVID-19 coronavirus, CDC officials said on Tuesday.
"We expect to see community spread [of COVID-19] in this country. It's not a question of 'if' anymore," said Nancy Messonnier, MD, director of the CDC's National Center for Immunization and Respiratory Diseases, on a media call.
Currently, the U.S. has 14 COVID-19 cases that are travel-associated or in close contacts of travelers, and 43 cases from citizens brought home from the Diamond Princess cruise ship and Wuhan, China. But she cited the "rapidly evolving and expanding" situation, including the explosion of sustained person-to-person community spread in a variety of countries, including South Korea, Italy, Iran, Japan, Taiwan, Thailand, and Singapore.
As the world inches closer to worldwide spread, and the final criterion of a pandemic, Messonnier acknowledged the previous strategy of containing the disease at the borders may no longer be enough to stop it. The strategy would then shift from a containment strategy to mitigation, she said.
"I had this conversation at the breakfast table," she said. "I told my children I didn't think we were at risk right now, but we as a family need to start preparing for significant disruptions to our lives." Messonnier added that she'd contacted her local school superintendent to ask what they were doing to prepare for potential community spread of COVID-19.
In the vein of "when, not if" the U.S. will experience community spread, she advised people to ask whether their providers have telemedicine capability, and said parents should consider "what to do about childcare" if schools are closed.
Messonnier outlined community mitigation guidelines, based on those outlined for pandemic influenza a decade ago. These non-pharmaceutical interventions include personal practices, including covering coughs and washing hands, as well as community and environmental measures such as surface cleaning.
Community measures are the most dire, and include social distancing, or limiting contact in face-to-face settings, employing such options as closing schools, telework or teleschool for children, and recommending that cities potentially "modify, postpone, or cancel mass gatherings."
This included a special advisory for the healthcare system: triaging patients, conducting patient visits via telemedicine, and delaying elective surgeries.
Obviously, this would be based on the outbreak's severity and breadth, but CDC called on a variety of industries, including the healthcare, education, and business sectors, to start preparing now because when the virus hits the community, it hits quite rapidly.
"The disruption to everyday life may be severe, but these are things we need to start thinking about right now," Messonnier noted.
She added that 12 state and local health departments currently have the diagnostic test for COVID-19, but the tests still come to CDC for confirmation. She anticipated commercial laboratories would be coming online with their own tests, as it becomes "more and more important clinicians have a full toolkit."
"We are working as fast as we can, and we understand the frustration of our partners within the healthcare sector," Messonnier said.
While the case definition of COVID-19 is still travel-associated, Messonnier said that may change based on information in other countries and when they had new information about case definitions, they would "publicize it broadly."
She ended with the caveat that she's not sure if community spread of COVID-19 will be mild or severe, but told a reporter it was better to be overprepared than underprepared.
"People are concerned about the situation. I would say rightfully so," Messonnier said. "I'm concerned about the situation. CDC is concerned about the situation."
Preparing for a pandemic: World Health Organization officials say it's still too early to declare the novel coronavirus a pandemic — but now is the time to prepare. Meanwhile in the US, President Trump has remained publicly optimistic about the virus, even as Democrats criticize his administration. Uh-Oh but there's no valid link here.
All | iran | italy | united states | china 77 Posts Sort by Latest 17 min ago UK warns against "all but essential" travel to 11 Italian towns
The United Kingdom’s Foreign and Commonwealth Office advised against “all but essential travel” to 11 Italian towns undergoing isolation measures due to coronavirus.
The towns included in the advisory are:
Codogno, Castiglione d’Adda, Casalpusterlengo, Fombio, Maleo, Somaglia, Bertonico, Terranova dei Passerini, Castelgerundo, San Fiorano and Vo’ Euganeo
22 min ago Public health labs ask to create their own tests for coronavirus
From CNN’s Nadia Kounang
With only 12 state and local health laboratories able to test for the novel coronavirus, public health labs are asking the US Food and Drug Administration for permission to create their own tests for the virus.
“We are now many weeks into the response with still no diagnostic or surveillance test available outside of CDC for the vast majority of our member laboratories,” the Association of Public Health Laboratories wrote in a letter to FDA Commissioner Stephen Hahn on Monday.
The association represents the 150 largest public health labs across the country and is asking the FDA for a special exemption to create its own diagnostics.
“We find ourselves in a situation that requires a quicker local response,” the association wrote.
While the CDC currently has no backlog or delay in testing, the lab association’s CEO, Scott Becker, told CNN that its concern is not about the current situation, but for when community spread of the virus increases.
“We want to encourage and ensure that we have the test closest to the population,” Becker said.
The CDC announced on Feb. 6 that 200 test kits would be distributed to labs across the United States. The kits needed to be verified by the local health laboratories to ensure they were working. Less than a week later, Dr. Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases, said some labs that had received the tests were getting inconclusive results, and components of the tests would need to be remade.
The CDC has been working to resolve the testing kit issue but has yet to provide a timeline about when labs will receive new tests.
Trump spent the past 2 years slashing the government agencies responsible for handling the coronavirus outbreak
Sonam Sheth and Gina Heeb 2 hours ago
* President Donald Trump insisted on Tuesday that the coronavirus, known as COVID-19, is under control because China is "working very hard" to contain its spread.
* The president's comments are at odds with reality.The same day, the CDC announced that it expects the virus to spread enough within the US to cause a "disruption to everyday life."
* The Trump administration has also spent the last several years dismantling the very government programs responsible for combatting a global health crisis.
President Donald Trump spent much of Tuesday reassuring the public that the coronavirus is under control.
"China is working very, very hard," Trump told reporters at a business roundtable at the US embassy in New Delhi, India. "I have spoken to President Xi [Jinping of China], and they are working very hard. If you know anything about him, I think he will be in pretty good shape. They have had a rough patch, but now it looks like they are getting it more and more under control. I think that is a problem that is going to go away."
Trump's comments are at odds with reality.
The coronavirus, or COVID-19, originated in Wuhan, China and has killed 2,700 people globally and spread to 30 countries. There are at least 36 confirmed cases in the US, including repatriated citizens.
On Tuesday, the Centers for Disease Control and Prevention announced that it expects the virus to spread further within the US.
"It's not so much of a question of if this will happen in this country any more, but a question of when this will happen," Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases, said during a press call on Tuesday. "We are asking the American public to prepare for the expectation that this might be bad."
Messonnier also warned that the agency is "preparing as if we are going to see community spread in the near term," adding that the outbreak could soon lead to a "disruption to everyday life."
Fears of a pandemic come after the Trump administration spent the past several years gutting the very government programs that are tasked with combatting such a crisis.
Here are some other actions the Trump administration undertook to dismantle government spending programs related to fighting the spread of global diseases, according to Foreign Policy: "Trump Has Sabotaged America’s Coronavirus Response" https://foreignpolicy.com/2020/01/31/coronavirus-china-trump-united-states-public-health-emergency-response/ * Shutting down the entire global health security unit of the National Security Council. * Eliminating the US government's $30-million Complex Crises Fund. * Reducing national health spending by $15 billion. * Consistently attacking Mark Green, the director of the US Agency for International Development (USAID).
The CDC is working on a new test to screen for the coronavirus, but according to New York Magazine, problems with the test's development resulted in only three out of 100 public-health labs being equipped to screen for the virus. Moreover, each test costs as much as $250, and the Health and Human Services department is already running out of money to finance an adequate response to the outbreak.
The Trump administration recently requested $2.5 billion in emergency funds — $1.25 billion in new funding and $1.25 billion to be diverted from other federal programs — to aid in preparing and responding to coronavirus cases in the US.
But Democratic lawmakers and health experts skewered the administration for not going far enough to combat the crisis.
The economic consequences of an unaddressed outbreak would dwarf US spending on efforts to control it, Marc Lipsitch, an epidemiologist and the director of the Center for Communicable Disease Dynamics at the Harvard T.H. Chan School of Public Health, told Insider.
"It seems quite inadequate and absurd to divert funds from one serious epidemic to another," Lipsitch said of the emergency funding package. "Money to control it is a very important investment."
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