An international effort is underway to halt the spread of a novel coronavirus, known as 2019-nCoV. The World Health Organization, Chinese health authorities, and the U.S. Centers for Disease Control and Prevention are all critical to this effort. However, CNA’s Center for Public Health Preparedness and Resilience has also learned from 20 years of experience evaluating responses to public health emergencies that in addition to thinking globally, it is essential to coordinate locally.
First detected last month in Wuhan, China, the virus has sickened hundreds of people and killed more than two dozen. The number of confirmed cases jumped significantly over the past week as public health officials in China ramped up surveillance. Additional cases have been identified in several other countries, including the United States. While much still needs to be learned about the virus, it appears capable of spreading from person to person. This has heightened concerns in the U.S. and global health communities about the potential for 2019-nCoV to cause a large-scale epidemic.
U.S. health authorities are closely monitoring the situation and have implemented certain precautions, including screening passengers coming from Wuhan at five major U.S. airports: JFK in New York, San Francisco International, Los Angeles International, Chicago-O’Hare, and Atlanta’s Hartsfield International Airport. Similar enhanced screenings were a critical component of the U.S. response to the 2014–2016 Ebola epidemic, though it’s important to emphasize that the two viruses are vastly different. During the response to Ebola, entry screenings proved to be an effective method to establish a risk profile for people entering the country from areas where the disease was occurring. The screenings also helped to mollify those calling for stricter disease containment measures, such as travel bans or border closures. Such extreme measures have no proven public health benefit and are fraught with potential unintended consequences that can adversely affect our nation’s health security.
The efficacy of enhanced entry screenings in response to the 2019-nCoV outbreak remains to be seen. Health authorities will undoubtedly revisit these and other protective measures as we learn more about this particular virus. What we do know is that close coordination between federal, state and local public health and health care authorities is critical to any response in a scenario like this. This will help ensure that all parties have the information they need to rapidly detect and respond to emerging threats and address the public’s concerns. Coordination is also vital for monitoring the impact that federal guidance and interventions can have on local, frontline resources, which are already stretched thin in many areas of the country. For example, federal guidance for personal protective equipment should accurately reflect capacity within supply chains for that equipment.
The 2019-nCoV outbreak is rapidly evolving and warrants our attention. We must ensure that in addition to the best available science, a practical understanding of state and local public health capabilities and resources informs our national response.