As authorities in China scrambled to handle a coronavirus that has killed at least 81 people, the U.S. Centers for Disease Control and Prevention on Monday described a surging potential crisis even as they pushed back on the latest thinking from Beijing about just how easily it spreads.
Dr. Nancy Messonnier, director of the CDCs National Center for Immunization and Respiratory Diseases, confirmed to reporters that the total number of cases stateside had reached fiveand that there were 110 additional persons under investigation for the virus in 26 states.
The confirmed cases in the U.S. include patients in Orange County, California; a man in his 30s in Washington state; a woman in her 60s in Chicago; a passenger who felt ill after flying into Los Angeles International Airport; and a student at Arizona State University who does not live in university housing, the CDC said on Sunday. All of the U.S. cases appeared to involve patients who had recently traveled from Wuhan, Chinathe epicenter of the deadly virus.
An additional 32 people in the U.S. were at one point suspected to have the virus, but tested negative, and there have been no confirmed person-to-person transmissions inside the country, Messonnier said on Monday.
We understand that many people in the United States are worried about this virus and how it will affect Americans, Messonnier said, adding that risk depends on exposure, which for Americans remained low on Monday.
In each U.S. case, health officials have said they will trace the patients contacts and identify anyone who may have had prolonged exposure, then monitor those individuals for symptoms. In the U.S., anyone who has had close contact with confirmed patients has not been quarantined unless and until they display symptoms.
That policy came into question over the weekend, when Chinas health minister Ma Xiaowei said the ability of the virus to spread is getting stronger and that authorities in that country now believe the virus can spread during the incubation periodeven before infected patients become symptomatic.A study published last week in the journal Lancet appeared to bolster that contention.
But Messonnier said the CDC had not seen any clear evidence of patients being infectious before symptom onset as of Monday, even if authorities in the U.S. are being very aggressive and very cautious in tracking close contacts of infected individuals.
This outbreak is unfolding rapidly, and we are rapidly looking at how that impacts our posture at the border, said Messonnier. I expect that in the coming days, our travel recommendations will change.
Experts said that even as statements from Chinese health officials had to be viewed through a political lens, outright dismissal of asymptomatic transmission was premature.
Eric Toner, a senior scientist with the Johns Hopkins Center for Health Security and the Universitys School of Public Health, called the question nuanced.
Its hard to know why the [Chinese] minister was so sure, said Toner. The evidence we have seen is quite suggestive of pre-symptomatic transmission, at least in some people, but not conclusive. He may have information that we do not.
For now, officials were still screening passengers at five American airports: Los Angeles International Airport, San Francisco International Airport, John F. Kennedy International Airport in New York, Hartsfield-Jackson Atlanta International Airport, and Chicago's O'Hare International Airport. Of course, fewer travelers are coming out of Wuhan in the wake of a travel lockdown late last week; Messonnier said the CDC had screened approximately 2,400 people in those airports so far but that the number of people coming from Wuhan is declining.
Though Chinese authorities halted travel from Wuhan to stop the spread of the virus, the U.S. is among several countriesincluding France and Russiathat were given special permission to evacuate diplomats and private citizens.
In addition to the 81 dead in China76 of whom reportedly lived in Wuhannearly 3,000 people across the world, including a 9-month-old baby girl in Beijing, had confirmed cases of the virus as of Monday morning. Aside from the five cases in the U.S., more have been reported in Thailand, Taiwan, Australia, Macau, Singapore, Japan, South Korea, Malaysia, France, Canada, Vietnam, and Nepal.
There had been no deaths from the virus reported outside of China as of Monday morning. But the new fatalities in that country over the weekend, including an 88-year-old man in Shanghai, stoked fears that the government had failed to contain the infections spread. Beijing announced Monday morning that it would push back the official end of the Lunar New Year holiday to Thursday from Sunday in order to reduce mass gatherings and block the spread of the epidemic, according to a statement from Chinas cabinet.
Meanwhile, Wuhans mayor, Zhou Xianwang, on Monday offered to step down, along with the citys party secretary, Ma Guoqiang, in order to appease public indignation. He said the pair were prepared to take responsibility for the crisis after days of public outcries from citizens, on social media and elsewhere.
Our names will live in infamy, but as long as it is conducive to the control of the disease and to the peoples lives and safety, Comrade Ma Guoqiang and I will bear any responsibility, Zhou reportedly said Monday.
Dr. Adrian Hyzler, chief medical officer for Healix International, which provides medical information to travelers, told The Daily Beast the CDC will know much more about how easily the virus spreads once the incubation periodestimated at a maximum of 14 dayshas passed in the five U.S. cases.
If, as the Chinese are saying, patients are contagious before symptoms develop, then it is much harder to control, he said.