NEW YORK FOREIGN PRESS CENTER, 799 UNITED NATIONS PLAZA, 10TH FLOOR
MODERATOR: Good morning, everyone, and thank you for joining us. Just to remind, this will be an on-the-record briefing. We will post the transcript to the Foreign Press Center website, which is fpc.state.gov, as soon as we have it ready.
This morning, I’m happy to be joined by Dr. Nancy Messonnier, the Director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control, and Dr. Barbara Marston, the Deputy Director for Science at the U.S. Centers for Disease Control and Prevention’s Division of Parasitic Diseases and Malaria.
Dr. Messonnier will begin with making some brief remarks, followed by Dr. Marston, and then we’ll have time for your questions. And with that, over to you, Dr. Messonnier.
DR MESSONNIER: Great, and thank you for joining us this morning. As you heard, I’m going to be providing a few brief updates on our domestic response and then my colleague, Dr. Barb Marston, who is acting as the International Task Force lead for the response, will speak to our longstanding, fundamental global health work.
As of this morning, CDC has confirmed one new infection with the novel coronavirus in Wisconsin. The total number of confirmed positives in the United States is now 12. Two cases were close household contacts with people who had traveled to Wuhan, in one case had traveled to Beijing and was exposed to a known case while in China. The other cases all had direct contact themselves with Wuhan.
Almost all of the confirmed cases of this novel coronavirus are in China and the majority of those are still in Hubei province. But there have been more than 200 infections detected in 28 locations outside of China, including the United States.
As WHO Director-General Dr. Tedros said yesterday, we have a window of opportunity. Now is the time to act both globally and within the United States to slow the introduction and the impact of this virus. The U.S. Government and its public health systems have been preparing for an outbreak like this for years. All of the pandemic planning that we’ve done for influenza is the foundation for our response to this new virus, and we believe this is the beginning of what could be a long response.
Right now, we’re aggressively working to contain introduction in the United States. If community spread is established here in the U.S., we will implement broader measures to mitigate the impact of the virus on our communities.
Yesterday – actually, the night before, I guess – we announced that there is now a signed emergency use authorization, or EUA, for the diagnostic kits developed at CDC. Initially, 200 test kits will be distributed to U.S. domestic laboratories, and another 200 will be distributed to selected international laboratories. Each test kit can preform 700 to 800 patient samples. Additional test kits are now in production, will be made available for ordering in the future from CDC’s International Reagent Resource, a capacity that our international laboratory partners are well experienced with. Distribution of these tests will improve the global capacity to detect and respond to this new virus, as well as greatly enhance our national capacity. Availability of this test is also a starting place for greater commercial availability of these tests.
In addition, the CDC has grown the virus in cell culture, which is necessary for further studies, including for additional genetic characterization. The cell-grown virus has been sent to the NIH’s BEI Resources Repository, where it can be accessed by the broader scientific community. Both of these efforts will increase the international capacity to diagnose and hopefully treat this new virus.
Here at CDC, there are more than 800 people working on this response. This includes nearly 200 people working at airports to screen passengers coming into the U.S. from China, assisting with medical assessments, and monitoring of individuals returning from Wuhan and helping the health departments – state health departments conduct contact tracing around confirmed cases. CDC’s full expertise in infectious disease and preparedness is being brought to bear for this response. CDC established an incident management structure in early January and fully activated our Emergency Operations Center to better provide ongoing support during this response.
Effective this past weekend, the U.S. Government suspended entry of foreign nationals who have been in China within the past 14 days in an attempt to slow the spread of this virus into the United States. Any U.S. citizen, resident, and their immediate family member who have been in Hubei province and other parts of the mainland China are allowed to enter the U.S., but they are subject to health monitoring and possible quarantine for up to 14 days.
CDC is helping prepare healthcare systems and clinicians by providing them with guidance and resources on the clinical management of patients, as well as how to protect themselves and others. We’re working with healthcare and industry partners to understand the supply chains for personal protective equipment, and we’re putting tools in place to help reduce the burden public health and healthcare facilities face when monitoring individuals at risk for this new virus.
Despite years of planning, we need to remain humble and understand that we may not have planned for everything. We expect to see additional cases of novel coronavirus infection globally and in the United States among returning travelers, as well as their close contacts.
The world is watching this outbreak unfold, and we recognize the uncertainty this situation poses. As always, CDC’s public health experts strive to make the best recommendations based on the most up-to-date data, which will continue to inform our guidance.
I’d like to turn the call over to Dr. Barb Marston, who again is leading CDC’s International Task Force as part of the novel coronavirus response. Dr. Marston.
MS MARSTON: Thank you, Dr. Messonnier, and thank you to everyone for joining the call. The U.S. Government works closely with international partners and host governments around the world to support countries to prepare for, prevent, identify, and respond to health threats. For this outbreak in particular, CDC is working closely with the World Health Organization, our ministry of health colleagues, and other partners to respond to requests to assist countries to prepare for and respond to the novel coronavirus.
CDC has staff stationed in more than 60 countries around the globe. We have offices in China, in a number of the countries that are currently reporting cases, and in countries that have not yet reported cases but are busy with planning and preparedness efforts. For instance, CDC and the Government of China have collaborated for the past 30 years addressing public health priorities affecting the U.S., China, and the world. In China, CDC is an important technical partner for China’s field epidemiology training program. Using classroom and hands-on experience, this program has graduated 279 epidemiologists who conducted more than 2,000 outbreak investigations as part of their training. Many graduates are applying their training to investigate this outbreak.
CDC has identified experts that are prepared to join a planned WHO mission to support efforts to better understand the severity and transmissibility of the virus. We look forward to the chance to work together with our colleagues in China as we both confront this public health challenge in our respective countries.
In other countries, CDC is working in collaboration with WHO to support ministries of health to prepare and respond to the epidemic. We are helping to support countries to implement recommendations provided by WHO related to the identification of people who might have the new infection, diagnosis and care of patients, and tracking of the epidemic.
CDC staff are also starting to work together with country colleagues to conduct investigations that will help inform response efforts going forward. We at CDC are committed to stopping the spread of this outbreak. While it is unclear how the situation will evolve, we are preparing as if it were the next pandemic, while hoping that it is not.
I’ll stop there, and Dr. Messonnier and I are happy to take your questions.
OPERATOR: Ladies and gentlemen, if you wish to ask a question, please press 1 then 0 on your touchtone phone. You may remove yourself from queue at any time by pressing 1-0 again. If you are using a speaker phone, please pick up the handset before pressing the numbers. Once again, if you have a question, please press 1 then 0 on your phone at this time.
Our first question comes from Nikhila Natarajan. Please, go ahead – from Indo-Asian News Service.
QUESTION: Good morning, Drs. Messonnier and Marston. Thank you for doing this. My question is very simple. In the 12 cases that you have confirmed in the U.S., what are the symptoms you are seeing and what is your general guidance to at-risk populations, whether it’s the very old or immunocompromised, whatever those may be? Thank you.
DR MESSONNIER: This is Dr. Messonnier. I’ll start. The patients we’re seeing in the United States have a spectrum of illness, but in general are characterized by fever and respiratory symptoms. As you say, the data from China suggests that patients that are older and have underlying illness are more at risk for severe disease and severe outcomes including death, but we’re being cautious with all the U.S. patients. I’m happy to report that they’re clinically, at this point, all improving, but of course we’re watching them closely and doing everything we can to support their care.
OPERATOR: Our next question comes from Kevin Kelley from Nation Media Group in Kenya. Please, go ahead.
QUESTION: Yeah, hi. Good morning. Thanks for doing this; this is very valuable. So I have questions regarding Africa, where many observers think that the coronavirus could really prove devastating because of the underdeveloped nature of many of the healthcare systems on the continent. Specifically, there’s been criticisms of Ethiopia Airlines’ decision to keep flying to China, despite the intensity of the outbreak there. I’d like you to comment, please, generally about preparedness in Africa for the onset of this disease, which has not yet been confirmed in Africa, and also about the Ethiopian Airlines decision to keep flying. Thank you.
MS MARSTON: This is Dr. Marston. Happily, over the past several years, countries in Africa have been working very hard to prepare for this sort of situation through global health security efforts. There has been training in every aspect of disease response, so in surveillance, in laboratory capacity, in workforce capacity, and the capacity to manage the responses to these types of situations.
So far, I’m not aware of any cases that have been confirmed in Africa, but I’m aware of numerous legitimate suspect cases that have been managed well and tested, and so we’re happy to start seeing the improvements in surveillance and the extension of laboratory capacity. There are now several laboratories that can do laboratory testing, and there have – there has been very good cooperation among countries to ensure that laboratory tests can be done. If a suspect is identified in a country that doesn’t have the capacity, they have been able to refer samples to other locations for testing.
The countries are at different stages in their preparedness efforts, but we have been in discussion with quite a number of our country offices and heard that the ministries of health are doing things like establishing surveillance at border crossings; they are identifying health facilities that will be the place where patients are being housed; they are ensuring that they have plans for diagnostics, whether that be building up the capacity in their own country or having a plan to send the samples elsewhere.
So you’re right to be concerned. The resources are more limited in Africa and a response would be more challenging, but there has been excellent progress in many settings.
MESSONNIER: Next question.
OPERATOR: Our next question comes from Carter Rice with Asahi Shimbun. Please, go ahead.
QUESTION: Good morning. Thank you for this call. I wanted to ask about travel restrictions for foreign tourists. I wondered if you had more information about how these restrictions are implemented. Is this usually by TSA officers or CBP in the U.S., or if this is up to individual airlines? Additionally, I wanted to know if – how many tourists from abroad have been rejected from entering the U.S. due to their history of traveling to China? Thank you.
DR MESSONNIER: Those are questions that you’d really have to ask DHS. It’s not information that CDC has. That being said, certainly the goal is to make that differentiation before people get on a plane to the United States, not once they arrive here. But in terms of numbers and specific details, that would be something to ask DHS.
OPERATOR: Our next question comes from Robert Delaney from South China Morning Post. Please, go ahead.
QUESTION: Hi, thanks again for doing the call. I just wanted to ask, can you review for us again the details about the 12th case in Wisconsin? I didn’t get all the details about the travel history of that case and that person’s contacts.
Also, I wanted to know – we’ve been covering reports out of China that health authorities there are experimenting with antiretrovirals and antivirals and combinations thereof, and I was wondering if the CDC, in conjunction with the NIH or any other health authorities, are experimenting with these therapies with the cases that we have in the U.S.
And then my third question was just regarding the CDC experts that you’ve identified to go to China along with the larger WHO group. If you could just let us know exactly what do they hope to accomplish when they are – assuming that they do make it to China, will they be in outbreak infection areas? And what – will they be obtaining isolates, or if you could explain to us exactly what they’ll be doing? Thank you.
MS MESSONNIER: Yes, it’s Dr. Messonnier. Let me start with the case in Wisconsin. This woman traveled to Beijing, China, but when she was in Beijing, she interacted with family members from Wuhan who had novel coronavirus. And so while she wasn’t in Wuhan herself, she is clearly a close contact of a patient from Wuhan, and therefore her risk is a direct link back to the large ongoing outbreak of Wuhan – in Wuhan.
In terms of treatment, there is a large intergovernmental conversation in the United States as well as among the global community convened with WHO about potential treatment. I guess I wouldn’t use the word “experiment” because that sounds something different than what we’re doing, but in the United States, we’re evaluating potential treatments that could be useful for cases of novel coronavirus in the United States, and making sure that those are in the toolbox that our clinicians would be able to use if we have patients who – for whom it was clinically indicated.
Dr. Marston, do you want to talk about the WHO mission?
MS MARSTON: We don’t know the full details of what the activities of that mission will be. The main purpose of the mission is to gather additional information about the severity and transmissibility of the virus because that sort of information is critical to informing control efforts. We don’t know yet exactly where the mission will be going.
MS MESSONNIER: But we at CDC stand ready to assist the Chinese Government in any way that we can inside of that mission or outside. We have, obviously, a large amount of expertise at CDC among a broad array of disciplines, and we are hoping to be able to bring it to bear more broadly on the problem in China.
OPERATOR: Our next question comes from Xiaojuan Miao from Xinhua News Agency. Please, go ahead.
QUESTION: Hi, good morning, everyone. So reportedly there are some extreme cases across the United States right now that Asian-looking people who wore face masks for self-protection got bullied or discriminated against by others in the subway or on the streets. So CDC – CDC actually suggested earlier that there’s no need for the public to wear masks right now, but some say it’s a cultural difference. So I wonder what’s your take on this potentially dangerous discrimination or even racism?
And another related one: So considering the widespread influenza flu in the country right now, would CDC say that it’s a more alarming situation or a threat to the public, actually? And would CDC advise those with the flu to wear face masks to protect the others? Thank you.
MS MESSONNIER: This is Dr. Messonnier. Let me start at the end and say that we continue to believe that the immediate risk for novel coronavirus in the United States is low, but as Dr. Tedros says, we have a window of opportunity. And so our actions are directly to try to slow the spread of the virus and to give ourselves time for additional preparation. Because the current risk to the American public is low, we do not recommend the use of face masks for the general American public as they go about their day-to-day lives.
Let me also say that I am very concerned about the kind of stigma that you are describing. We have also seen it in the news. It is unfortunate. The group of individuals who are at high risk, based on the U.S. data, are narrowly those folks who are returning from the most impacted areas, and they are being treated cautiously to keep them safe and their families and communities, but generally, there’s no reason for the American public to fear Asians in our community, and it really saddens me to hear these stories. Our sympathies go out with folks – to folks, and I would certainly again encourage everyone in our communities to be careful not to send those messages to people who really aren’t at – posing a risk to the communities and their families.
PARTICIPANT: And influenza —
DR MESSONNIER: In terms of influenza, influenza is a threat that we’re used to. Seasonal influenza causes significant cases and hospitalizations and deaths every year in the United States. We still are in flu season. We recommend the things that we normally recommend at this time of year. People should wash their hands, cover their coughs, and stay home when they’re sick to protect themselves, and not spread this illness. But we do not recommend generally, for influenza, that people wear facemasks. We just don’t think it’s indicated in that situation, so we don’t, and we certainly aren’t recommending it now. Next.
OPERATOR: Our next question comes from Delin Ma from China News Service. Please, go ahead.
QUESTION: Morning. Thank you have this call. I have one question about China’s current work. So since you are going to send a team to China, what do you think of China’s current work to contain the virus? And are they doing enough to – at this moment – to control this disease? Thank you.
MS MESSONIER: Yeah, this is Dr. Messonier. I’ll start. I just want to be clear that WHO – there’s an agreement that WHO will send a team, and we are hopeful that there will be CDC staff on that team, but we are still waiting for confirmation of that.
What I would say about China’s response is that it – our focus is on what we’re doing now with the Chinese and in the United States to protect American citizens, and if our staff is on the ground in China, their focus will be looking forward what needs to get done. There’ll be plenty of time when we’re through this crisis to look back and judge what we wish we had or hadn’t done, but our focus right now needs to be on the current situation and how we move forward. China has certainly taken aggressive actions to try to mitigate the spread of this virus, but I wouldn’t want to be judging their overall actions now. Let’s focus on what we need to do together to control this thing. Next.
OPERATOR: Our next question comes from Tamar Kahn from Business Day newspaper. Please, go ahead.
QUESTION: Hi. Thanks very much for holding this call. I’m working for a South African newspaper. This is a country at the epicenter of the world’s AIDS epidemic. I just wondered at this stage if there’s any information available about whether people with HIV might be more vulnerable to the novel coronavirus. And secondly, is there information available or what is your assessment of whether climate might prove some protection? It’s summer in Sub-Saharan Africa. Might that offer people in this part of the world some protection? Thanks.
MS MARSTON: This is Dr. Marston. From the perspective on the HIV question, I think we are concerned that it may be that people that have vulnerabilities – age or underlying conditions – may have an increased risk, but we really don’t have solid information about that at this time. I’m not aware of any specific information about the association between this virus and HIV. That’s part of the – part of the thing that we need to continue to gather information about the severity and transmutability and risk factors.
MS MESSONIER: This is Dr. Messonier. About the seasonality, I mean, in – those of you who are familiar with influenza know that it’s seasonal in the United States as well as in Sub-Saharan Africa, and we definitely see those seasonal declines in disease, for example, in summertime. Given that we’ve really only had six weeks since this pathogen was discovered, it’s premature to hypothesize about seasonality. It’s certainly something that we’re interested in learning more about, but until we hit more of these summer months and have a little perspective, I don’t – we certainly are not relying on seasonality to protect, for example, Africa from this disease. We need to behave as if it’s not, and then obviously we’ll learn more as this progresses.
STAFF: Listen, Tiffany (ph), this is Dave (ph). I think we have time for two more questions on our end.
OPERATOR: Okay, thank you. Our next question comes from Dennis Hirata from Fuji TV. Please, go ahead.
QUESTION: Yes, thank you for taking my question. My question is regarding the confirmed cases and all the cases that are still being tested and those who are being quarantined. Have there been any foreign citizens or nationals or are they all U.S. citizens? And if there has been, are any of them Japanese citizens? And for these foreign nationals that are being tested, are the protocols taken by CDC the same as U.S. citizens? Are you screening, for example, foreign nationals who enter the U.S. as well?
MS MESSONIER: Yeah, let me start with the first. I’m not going to release any information about the nationality of the 12 confirmed cases in the United States. However, I can assure you that our protocols for testing for – laboratory evaluations for patients under investigation as well for quarantined don’t differentiate based on nationality. Last question.
STAFF: And our last question, please.
OPERATOR: Our last question comes from Werner Beukes from Media 24. Please, go ahead.
QUESTION: Good morning. I’m interested in the distribution of those test kits. How would that be done? And also, you mentioned people – between 700 and 800 can be tested by using those kits. Is that correct? I just need more information on those test kits.
MS MESSONIER: Yeah, so the kits are distributed (inaudible) in the United States as well as globally through something called the International Reagent Resource. If you Google it, you’ll find a lovely online ordering system that almost looks a little like Amazon. But note, it isn’t that any person can order the kits. It has to be a laboratory that has already been registered in the system. So we really want to make sure that these test kits, both in the United States and globally, are going out to public health labs that can make the best use of them.
Each test kit does allow testing for 700 to 800, as you said, but we’re working on making more – on manufacturing more test kits here in the United States so that we can be providing them globally. But our first priority was to get at least one kit out to every one of these labs so that everybody would be able to take advantage of this capacity.
STAFF: Liz and Tiffany, I’m afraid that’s all the time we have. Thank you so much.
MODERATOR: Okay. Thank you, everyone, for participating in the call. We will post the transcript to fpc.state.gov as soon as it’s available. And thank you again to both of our experts for your time and your incredible commitment to this effort. Thank you.