SALT LAKE CITY — World Health Organization officials say novel coronavirus spread is still not yet a pandemic, but it could “absolutely” become one. And much of the world is not ready to take on a significant public health crisis, they warn.
“For the moment, we are not witnessing the uncontained global spread of this virus and we are not witnessing large-scale severe disease or deaths,” said Dr. Tedros Adhanom Ghebreyesus, the WHO director-general, recently. “Does this virus have pandemic potential? Absolutely it has.”
The Centers for Disease Control and Prevention said the new illness, called COVID-19, will likely meet criteria to be called pandemic if there’s widespread infection worldwide. While COVID-19 has been diagnosed in at least 93 countries (new ones are added regularly), most of the countries do not have many diagnosed cases, although there are exceptions, including Italy, South Korea and Iran.
But WHO’s Tedros was blunt about the risks associated with any inaction to stem the spread of this coronavirus: “We are concerned that in some countries the level of political commitment and the actions that demonstrate that commitment do not match the level of the threat we all face,” he said Thursday in a media briefing. “This is not a drill. This is not the time to give up. This is not a time for excuses. This is a time for pulling out all the stops. Countries have been planning for scenarios like this for decades. Now is the time to act on those plans.”
Congress reached a deal to provide $8.3 billion in emergency funding related to the coronavirus in the United States and President Trump signed it Friday, March 6. He also visited the CDC Friday.
The numbers of confirmed cases and deaths have been changing rapidly, but as of Saturday, the official worldwide count was 101,927 lab-confirmed cases and 3,486 deaths. As of Friday noon, 164 cases in the United States had been reported to the CDC, but the health organization said state and local public health departments are now testing and local counts are presumed to be more current.
The New York Times reported Saturday that there are more than 100,000 confirmed COVID-19 cases worldwide and 312 cases in the United States, including 17 deaths. Others put the illness count higher.
The vast majority of both the cases and the deaths have been in China, where the disease broke out. But while numbers there are waning, more lab-confirmed cases are being detected in other countries, with concern especially high in South Korea, Iran and Italy, increasing talk about the potential of a pandemic.
WHO called global risk “high” and has already declared COVID-19 “a public health emergency of international concern.”
The international health group typically decides if something is a pandemic, and defines one as “worldwide spread of a new disease.” A pandemic is problematic not only because of the number of cases, but because most people do not have any immunity to a new illness, it said.
Risk low, but growing in U.S.
Friday night, Utah officials announced the first case of COVID-19 diagnosed in Utah, a person now in self-quarantine after traveling. It is still not considered community spread because exposure didn’t happen in Utah. But it’s a “Utah case” because diagnosis did. The governor had already declared a state of emergency, opening the door to federal resources to combat COVID-19.
Prior to the announcement, Utah Gov. Gary Herbert declared a state of emergency which will help free funds to prepare for the spread of COVID-19.
Utah health officials say the biggest risk factors for Americans so far is still having been to one of the outbreak areas recently or being in close contact with someone who was.
Unofficial counts say there are at least 79 cases in Washington state, more than 60 in California and New York reported 33. So far, labs have confirmed COVID-19 in at least 20 states.
The ability to test has improved greatly. Less than two weeks ago, only Nebraska, California and Illinois could test for COVID-19, the Association of Public Health Laboratories told Reuters. Now state labs have the capability and other test labs are coming online. And the criteria for testing has been loosened. Initially tests were only available to those who had traveled to areas with widespread disease, like Wuhan, China, or were symptomatic and in direct contact with someone who had traveled.
New CDC guidance allows testing for COVID-19 if a doctor orders the test, though there’s concern there aren’t enough tests to meet possible demand — an issue Vice President Mike Pence acknowledged this week while addressing a group of diagnostic laboratory CEOs. Pence heads the task force responsible for America’s response to this coronavirus.
The plan is to make at least 1.5 million tests available at hospitals that asked for them and in parts of the country “particularly impacted by the coronavirus,” he said, noting testing can be done, too, at state labs and university labs. But he said that more tests have to be made available to meet all the need in coming days.
“We do expect community spread at some point. We are ready and prepared for when that happens,” said Dr. Angela Dunn, state epidemiologist at the Utah Department of Health, in a news release Friday.
Like other states, Utah is gearing up “in case this goes sideways on us,” as Kevin M. McCulley, director of preparedness and response for the Utah Department of Health, put it. States are preparing, but not panicking.
McCulley said the health department is working with the health care system to determine what supplies might be needed and how many hospital beds would likely be available. Health officials are working with drug manufacturers to determine what issues might arise with the supply chain. Nondrug supplies like face masks are already more difficult to come by than they were a few weeks ago, for instance. Those conversations include whether an allocation system might be needed at some point for medication and other supplies so the first entity to order a needed item doesn’t get the entire available supply, and to prevent those with big pockets from buying needed supplies unfairly.
The fact that so many medical supplies are manufactured in China or elsewhere overseas can also impact availability if the United States gets hit hard by the illness, McCulley noted.
“As the situation evolves, we’ll be developing preparedness guidance to provide to health care communities,” he said, adding that much-needed information is already being provided by the CDC. Recently, public health and state officials unveiled a coronavirus.utah.gov website with current information.
Unlike earthquakes and other disasters that might hit one area, a pandemic is likely to hit at least whole regions, said McCulley. And that changes the response. In a pandemic, neighboring states might not be able to help out, as they would with a more localized disaster.
American health officials, like their counterparts worldwide, hope to contain the illness at least until the regular flu season has passed. That would allow more time to learn about the new coronavirus, decrease the number of hospital beds being taken up by those with influenza and give health care providers a better idea of what kind of illness they’re seeing.
This has been a very nasty flu season in America.
“At least 19 million people in the U.S. have experienced flu illnesses this season, the CDC estimates. About 180,000 people have been hospitalized so far, and an estimated 10,000 have died. Sixty-eight children have died from this flu season,” Marketwatch reported.
“Americans have simply gotten used to influenza despite the staggering number of people it affects,” Scott Weisenberg, a clinical associate professor of medicine and director of NYU Langone Health’s travel medicine program, told Marketwatch.
Learning and preparing
Officials are especially worried about the spread of the COVID-19 to poorer countries with less well-developed health infrastructure. “I’m not concerned about Japan or South Korea,” public health researcher Yanzhong Huang of the Council on Foreign Relations told CNBC. “I’m more concerned about Iran.”
In earlier briefing remarks, WHO’s Tedros listed three priorities: Protect the health workers who will deal with patients who have the virus. Protect those most at risk, especially the elderly and people who have underlying health conditions. And protect countries that don’t have capacity to deal with such an illness on a large scale. His goal is to make sure epidemics are “contained” in countries that have the resources and facilities to manage the disease.
WHO hosted a two-day forum of more than 300 health experts researchers who met in person and by video link to determine funding and research priorities in early February.
Meanwhile, the agency is providing broad educational materials about the illness, including a self-paced online course on the coronavirus. While it’s intended for health professionals, it’s been viewed tens of thousands of times already and anyone can watch it.
It’s hard to say what to expect, but CDC outlines what may happen:
“More cases are likely to be identified in the coming days, including more cases in the United States. It’s also likely that person-to-person spread will continue to occur, including in the United States. Widespread transmission of COVID-19 in the United States would translate into large numbers of people needing medical care at the same time.
“Schools, childcare centers, workplaces, and other places for mass gatherings may experience more absenteeism. Public health and health care systems may become overloaded, with elevated rates of hospitalizations and deaths. Other critical infrastructure, such as law enforcement, emergency medical services, and transportation industry may also be affected. Health care providers and hospitals may be overwhelmed. At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it. Nonpharmaceutical interventions would be the most important response strategy.”