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U.S. Declares Public Health Emergency for Coronavirus

— Dramatic steps taken for quarantining some travelers and blocking entry by others, based on "unknown" nature of virus

Last Updated February 1, 2020
MedpageToday

Citing the U.S. cases of novel coronavirus, including one case of human-to-human transmission and several unknown factors, the U.S. Department of Health and Human Services declared a public health emergency in the U.S. on Friday.

Beginning on February 2, 2020 at 5 p.m. Eastern time, the U.S. government will be enacting several temporary measures involving U.S. citizens returning from China back to this country, HHS Secretary Alex Azar announced at a press conference of President Trump's Novel Coronavirus Task Force:

  • U.S. citizens returning from Hubei province within 14 days, the epicenter of the outbreak in China, will be medically quarantined for up to 14 days
  • All U.S. citizens returning from China within 14 days, once medically cleared in airport screening, will be asked undergo mandatory self-isolation for up to 14 days once medically cleared
  • Foreign nationals who have been in China in the past 14 days will be barred from entry to the U.S., with certain exceptions including lawful permanent U.S. residents and immediate family of U.S. citizens or permanent residents

These actions, , were described by officials as “prudent, targeted and temporary,” and mainly designed to reduce the burden of screening on public health officials screening for novel coronavirus.

Azar reiterated the government's position that risks to the U.S. from the coronavirus remain low. "Our job is to keep it that way," he added.

"Safety of the American people" was repeated over and over during the briefing, but Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, cited the "unknown aspects of this particular outbreak" as the chief reasons why this was necessary from a medical standpoint.

While the novel coronavirus has killed far fewer people than seasonal flu, the difference, Fauci said, was "unknown" versus "certainty." Whereas with novel coronavirus, he cited asymptomatic transmission, and the inability to detect the illness when patients are asymptomatic, as a major factor.

"One of the problems is when a virus is transmitted in an asymptomatic way, it puts a terrible burden on the screening process," Fauci said. "We still have a low risk to the American public, but we want to keep it at a low risk ... because there are so many unknowns here."

CDC Director Robert Redfield, MD, also emphasized the limitations of current novel coronavirus testing, adding that of the six cases we have seen in the U.S., a number were asymptomatic, but only one was picked up by airport screening, while the rest were "picked up by astute doctors."

Fauci also cited the "unknown accuracy" of current diagnostic testing.

"If we absolutely had an accurate test that was very sensitive and very specific, we could test people and we're good to go," he said, adding "it's not a test that's absolute," unlike, for example, an HIV test -- which can determine with 100% accuracy if a person has HIV in their blood.

Fauci gave another example: "Ebola doesn't get actively transmitted unless you're very ill," he said.

Redfield added that the self-isolation for U.S. citizens returning from China was the standard for the 2014 Ebola outbreak in West Africa, and "98% of the American public voluntarily accepted the importance of this."

Officials stressed that this is not a "travel ban," as all U.S. carriers to China have been taking down passenger flights, such that it has been a "market response by airlines and voluntary decisions taken by travelers."

So far, there are 12 cases of human-to-human transmission outside China, and Redfield said they are most concerned with "expansion of sustained community human-to-human transmission," such as the type occurring inside China.

"This is a precautionary message and action put out today," he said, adding that it is "intended to keep this virus from causing significant consequences to the American public."

A was confirmed by the CDC late Friday in Santa Clara County, California. This was a travel-associated case, with the man reporting travel history to Wuhan, according to NBC Bay Area. He is currently “self-isolated,” never having become sick enough to be hospitalized, the report said.

Senior Editor Crystal Phend contributed to this report. It was updated at 10:20 a.m. Feb. 1 to clarify which foreign nationals are barred from entry to the U.S.