Editor's note:For the latest news on coronavirus disease 2019, visit https://www.aappublications.org/news/2020/01/28/coronavirus.
As the number of countries reporting community spread of coronavirus disease 2019 (COVID-19) rises, federal health officials are operationalizing preparedness and response plans in anticipation of more cases in the United States.
“Ultimately, we expect we will see community spread in this country,” said Nancy Messonnier, M.D., director of the Centers for Disease Control and Prevention’s (CDC’s) National Center for Immunization and Respiratory Diseases. “It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen and how many people in this country will have severe illness.”
Dr. Messonnier emphasized the CDC’s containment strategies have been “largely successful” in slowing the introduction of COVID-19 to the U.S. and allowing more time to prepare. “These containment strategies include: detecting, tracking and isolating all cases preventing introduction of disease at points of entry; restricting travel into the U.S.; and issuing extensive travel advisories.
“We have very few cases in the United States and no spread in the community. But as more countries experience community spread, successful containment at our borders becomes harder and harder,” she said during a Feb. 25 media telebriefing.
At press time, there are 14 confirmed cases in the U.S.; 12 are travelers from where disease is circulating; 2 are close contacts of other cases. There also are 40 positive cases among those repatriated from the Diamond Princess cruise ship, Dr. Messonnier reported.
Containment and mitigation
The CDC will maintain a dual approach to tackling spread of the disease by using containment measures, while also employing strategies to minimize impact on communities, Dr. Messonnier said.
With no vaccine to prevent the disease and no medication to treat it, nonpharmaceutical interventions (NPIs) will be the “tools” used at the community level, but to varying degrees based on whether local transmission has occurred. The document “Community Mitigation Guidelines to Prevent Pandemic Influenza — United States, 2017” provided the framework for the NPIs, which will be implemented in an “aggressive, proactive way,” she said.
The NPI categories include:
- Personal—Daily personal protective measures
- Community—Social distancing measures, designed to keep the sick away from others
- Environmental—Surface cleaning measures
Local communities will need to exercise flexibility and adaptation in deciding what NPIs to implement and when.
“Right now, CDC is operationalizing all of its preparedness and response plans, working on multiple fronts, including specific measures to prepare communities to respond to local transmission of the virus that causes COVID-19.
“I understand this whole situation may seem overwhelming and this disruption to everyday life may be severe, but these are things people need to start thinking about now,” Dr. Messonnier urged.
She stressed that CDC is busy preparing, and urged businesses, hospitals, schools and everyone to begin preparing as well.
