Stephenson J. Coronavirus Outbreak—an Evolving Global Health Emergency. JAMA Health Forum. Published online February 4, 2020. doi:10.1001/jamahealthforum.2020.0114
Events of the past week have made it clear that the novel coronavirus 2019-nCoV emergence in Wuhan, China, and its spread beyond that country’s borders is a rapidly evolving situation in terms of the growing number of cases, the virus’s continuing spread across the globe, and the responses of countries attempting to curb its spread. Here is a brief recap of some of the most recent developments of the epidemic as well as resources to consult for perspectives and updates.
On Thursday, January 30, with reports of thousands of new cases of 2019-nCoV infection in China and evidence of person-to-person transmission in the United States and other countries, the World Health Organization (WHO) declared the outbreak a global health emergency. At that point, there were 9826 confirmed cases globally, with 213 deaths. Of these, 9720 cases were in China; outside of China, health authorities reported 106 confirmed cases in 19 countries. As of Sunday, February 2, the WHO updated the count, reporting 14 557 confirmed cases from 24 countries—14 411 of them in China.
“While we still don’t have the full picture and we can’t predict how this situation will play out in the US, the current situation…is a cause for concern,” said Nancy Messonnier, MD, director of the National Center for Immunization and Respiratory Diseases at the US Centers for Disease Control and Prevention (CDC), at a press briefing on Friday. In addition to the rapid spread of the virus throughout China and in new locations outside of China, she called attention to the increasing number of reports of person-to-person transmission and evidence of asymptomatic spread.
Also on Friday, US Health and Human Services Secretary Alex Azar declared that the 2019-nCoV outbreak constitutes a public health emergency in the United States and that international citizens who have traveled anywhere in China during the previous 14 days would be denied entry to the United States. In addition, any US citizen who had been in China’s Hubei province during that period would be subject to quarantine for up to 14 days for medical observation.
At the CDC press briefing, Messonnier said that the agency, under statutory authority of the Health and Human Services secretary, had issued federal quarantine orders for all 195 repatriated individuals who were evacuated on January 29 from Wuhan, China, to a California military base. “While we recognize this is an unprecedented action, we are facing an unprecedented public health threat,” she said.
The action marks the first time in 50 years that the United States has issued a mandatory quarantine order. Isolation is a tool used to restrict the movement of people who are already sick with a specific illness, as opposed to quarantine, which restricts the movement of people who have been exposed to infection but are not yet sick. “While there have been several isolation orders over the last many years, the last time the quarantine was used for a suspect case was in the 1960s for a smallpox evaluation,” Marty Cetron, MD, director of CDC’s Division of Global Migration and Quarantine, said at the briefing.
The WHO is issuing frequent situation reports with updates on cases, deaths, and countries, territories, or areas with reported confirmed 2019-nCoV cases.
Using artificial intelligence to analyze data from government reports, news sites, social media, and other sources, the public health surveillance site HealthMap provides near-real-time information tracking the spread of 2019-nCoV.
The CDC’s 2019 Novel Coronavirus site contains regularly updated information for the public, health care professionals, public health professionals, and laboratories. Included are updates released on Mondays, Wednesdays, and Fridays indicating the number and location of US cases under investigation.
The Coronavirus Resource Center offers information and thoughtful analysis about the 2019-nCoV outbreak, information about the outbreaks caused by the Middle East respiratory syndrome coronavirus (MERS-CoV) and the severe acute respiratory syndrome coronavirus (SARS-CoV), recent articles reviewing new technologies for rapid vaccine development for emerging viral diseases, effectiveness of various types of masks for preventing infections in health care settings, global preparedness for health care emergencies, and other topics. Recent offerings include:
The Novel Coronavirus Originating in Wuhan, China: Challenges for Global Health Governance, from Alexandra L. Phelan, SJD, LLM, Rebecca Katz, PhD, MPH, and JAMA Health Forum contributor Lawrence O. Gostin, JD (@LawrenceGostin). This JAMA Viewpoint provides an overview of the early events in the 2019-nCoV epidemic, including the control measures in China and by governments worldwide, the role of the WHO, and the need for a coordinated international response to contain it.
Coronavirus Infections—More Than Just the Common Cold, from Catharine I. Paules, MD, Hilary D. Marston, MD, MPH, and Anthony S. Fauci, MD. This JAMA Viewpoint, along with a related video and audio interview with Dr Fauci, director of the National Institute of Allergy and Infectious Diseases, discusses the biology of coronaviruses, similarities and differences between the current 2019-nCoV epidemic and previous SARS and MERS coronavirus outbreaks, and the status of medications and vaccination development for 2019-nCoV.
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Joan Stephenson, PhD Joan Stephenson, PhD, is Consulting Editor for the Forum and JAMA and an award-winning independent writer and editor based in Chicago. She joined JAMA as a writer and editor for JAMA's Medical News & Perspectives department and subsequently served...