NEWS FROM THE SECOND DISTRICT
Dear Friend,
Congress was briefed Wednesday afternoon by Directors and leaders from the Center for Disease Control, National Institute of Health, Health and Human Services, State Department, and Department of Homeland Security (CDC, NIH, HHS, DoS and DHS respectively). Our front line of defense against any epidemic from a foreign nation will always include CDC, NIH, HHS, DoS, and DHS. These agencies are cooperating and constantly in contact. I have personally worked with medical authorities in all of these agencies at one time or another and am impressed with their proactive attitude, diligence, and willingness to work together.
The situation with the new virus in China was described to us in some detail including the numbers of cases and deaths China has confirmed. The virus has been designated 2019-nCoV in keeping with standard virology literature. The symptoms closely mimic those associated with the many various flu viral illnesses we have seen over the last century. This virus is structurally very similar to the SARS virus of 2002 and like that virus, is believed to have originated in bats which typically carry Coronavirus species asymptomatically. The intermediate host remains speculative although a great deal of attention has been focused on the wild game market in Wuhan.
The purpose of this message is to give you reliable information and some reassurance regarding risk levels in the US and specifically in Florida.
China has officially confirmed about 14,411 cases so far with 304 deaths. They have also confirmed human to human transmission, specifically in health care workers, family members, and household members.
So far, the US has confirmed just 8 cases of 2019-nC0V. All but one of these had traveled to China personally. The other was a household member of a traveler to China. All of these cases are being studied in detail including full genome sequencing and exhaustive contact tracing since their arrival in the US. Six of the eight cases that were discovered in the US were picked up by astute, community physicians. The CDC has screened over 100,000 targeted individuals with personal travel history to Wuhan or greater China and they discovered a single case of 2019-nCoV. All American patients have survived. It is worth saying here that the American medical community works well.
In the estimation of the CDC, confirmed by the NIH, the current risk in the US remains quite low, however the White House has been very proactively alert. The President stood up a Coronavirus Task Force dedicated to streamlining inter-agency efforts to prevent an American outbreak. This task force meets twice daily, 7 days a week. The goal is to keep the risk low.
When gauging the amount of risk to Americans at home, the CDC asked us to compare the statistics of 2019-nCoV to the risk posed by the common flu that is endemic to the US. There have been 140,000 hospitalizations and 8,400 deaths from the common flu in the US this Winter. This is a typical winter. Have you had your flu shot?
Our newest information suggests that the incubation period for the 2019-nCoV virus is not as long as was first reported. It is probably between 2-5 days rather than 10-14 days, as previously reported. This greatly enhances the possibility of stopping this disease by screening, early diagnosis, and diligent routine public health measures.
25 other countries have reported confirmed cases of 2019-nCoV patients – Japan has the highest number with 20 and the Republic of Korea has 15. There have been cases of confirmed person to person transmission outside of China. All these transmissions were to household members of victims who had personally traveled to China.
Currently, we have specific 2019-nVoC medical screening at 20 US entry points. The CDC and Border Patrol/TSA is already performing targeted screening on over 20,000 people a day coming into the US airports and ports. Foreign Citizens with travel to China in the last 14 days are not admitted to the US. The CBP made note that the inbound US travelers from China that concern them the most are not the ones arriving in airports or seaports, but those coming in illegally over our southern border. Those are the ones we likely will never have the opportunity to screen unless they are caught during crossing.
The USCG is also performing quarantines and screening of personnel arriving by sea that might not otherwise be picked up by CBP. We have been informed that outbound travel to China from the US has already dropped by over 50% in the last week and inbound travel to the US has dropped precipitously as well.
A few people have voiced concerns to our office over the 195 Americans that were repatriated from Wuhan, China. They arrived in California about at 1200 EST on Wednesday. Here, let me assure everyone, including Americans who travel abroad, our nation does not abandon US citizens who find themselves innocently in danger. This includes those at risk from epidemic diseases. It is a normal activity of our government to repatriate Americans who are at risk. There is a well-worn pathway for Americans exposed to infectious diseases abroad that includes layered screening, quarantines, and close monitoring after release. These people are also a source of scientific data for our efforts to characterize the risk of the disease. All will be held in quarantine for 14 days on an Air Force base. The Americans who were brought back to the United States on Wednesday will pose no danger at home.
*by answering this survey you are agreeing to future communications from the office of Congressman Neal Dunn* |
Countermeasures to epidemics in general surround early diagnoses, treatment and vaccination.
Early Diagnosis - Currently, the only way to confirm a diagnosis is viral sequencing for 2019-nCoV. This is an RNA virus and the only clinical laboratory performing the sequencing test is at the CDC in Atlanta. The turn-around time is 2-3 days. The CDC is working diligently on a rapid point-of-care diagnostic capability that can be widely disseminated. They hope to have that developed in two weeks and disseminated shortly thereafter. I remind healthcare experts reading this that both SARS and MERS were Coronaviruses as well. We have experience developing diagnostics for these.
Therapeutics - There is no specific proven anti-viral therapy for Coronavirus of any type, but innovative work is being done in this area.
Vaccines - NIH and others are already working to develop a vaccine based on a messenger RNA model very similar to that used in the instance of SARS. Producing a vaccine against SARS ready for Phase I trials required 20 months in 2002-3. The same model was used to develop a vaccine for ZIKA and it was ready for phase I trial in 4 months. NIH is expecting to beat that record with 2019-nCoV and hope to start trials on a new vaccine in 3 months. That does not mean that the vaccine will be provided to the public in that time frame. The very earliest we can hope to provide a publicly available vaccine would be at least 1 year. We must rely on good public health measures until then.
The US consulate in Wuhan is closed. The US Embassy has issued a Level IV Travel Advisory on travel to China. This means all non-mandatory and urgent travel to all of China should be cancelled. Properly, this should be interpreted as simply, DO NOT GO. As we write this, the American Embassy in Beijing is considering a decision to evacuate families and non-essential personnel.
As a precaution, plans for a US response are being finalized at this moment should an outbreak occur in the US. Our combined agencies have assessed the risk of that happening to be very unlikely at this time.
The CDC has sent personnel to Beijing. They have not yet been allowed to enter Wuhan to participate in the scientific gathering of information at this time. The Department of State and CDC believe that is imminent.
I will note that last year, Congress appropriated record funding ($85 million) for the CDC rapid response team for epidemic and pandemic threats. Their reserve funds now total over $100 million. That is looking like a good investment just now.
CDC also supports and participates in the mission of local public health clinics. The public health clinics are on the front line for point of care in general when faced with epidemics.
We have received questions about inbound travelers who have recently been in China, but did not come straight from China, referred to as “broken travel” – travelers. TSA and Border Patrol assure us that they can detect close to 100% of broken travel and have been very active about doing so. TSA and CBP agents are trained to look for all recent travel. Everyone who has a recent China travel history gets secondary screening.
Public Health response to a potential epidemic is a layered program. It involves screenings of several types – not just a cursory glance by a border agent. They have developed a number of targeted medical screens and the airlines are cooperating as well. The goal is early diagnoses and contact tracing. Retroactive travel tracing is also being done with the help of airlines. All risks are reassessed constantly and prioritized appropriately, most international airlines have very sharply curtailed flights to all of China.
We also enjoy assistance from multiple medically sophisticated nations actively screening all travels to/from China. These nations include Singapore, Australia, EU, UK, Canada, South Korea, Japan, and Taiwan to name a few.
In past Coronavirus epidemics, the word “mutation” became used as a buzzword that caused panic. Ill-informed reporting suggested that mutation events were per se, associated with more risk. The occurrence of a mutation by itself does not imply any increase in virulence. As this is an RNA virus it will naturally tend to mutate more quickly than a DNA virus would. The vast majority of mutations add no risk to the virus. Beware of people who are pandering panic.
The latest news and recommendations of the CDC can be found on their website, CDC.com or call 800-232-4636.
Sincerely,
Neal Dunn
Member of Congress
|
|
No comments:
Post a Comment