Issue: February 2020
Disclosures: Adalja, Azar, Rasmussen, Redfield and Tedros report no relevant financial disclosures.
February 21, 2020
3 min read

Novel coronavirus emerges in China, prompting emergency declarations

Issue: February 2020
Disclosures: Adalja, Azar, Rasmussen, Redfield and Tedros report no relevant financial disclosures.
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The emergence of a novel coronavirus in China and its rapid spread to dozens of other countries, including the United States, prompted WHO and the U.S. to declare public health emergencies.

The WHO declaration was not a vote of “no confidence” in China, explained Director-General Tedros Adhanom Ghebreyesus, PhD, MSc. Tedros praised the country’s response to the outbreak, which grew quickly to include thousands of patients in China.

“The main reason is not because of what is happening in China but because of what is happening in other countries. Our greatest concern is the potential of the virus to spread to countries with weaker health systems, ill prepared to deal with it,” Tedros said during a press conference. “In many ways, China is setting a new standard for outbreak response.”

Amesh A. Adalja, MD
Amesh A. Adalja

Early on, the 2019-nCoV outbreak was traced to a wholesale seafood and animal market in Wuhan, Hubei province, which was closed for disinfecting. Research published in The New England Journal of Medicine examined the first 425 laboratory-confirmed cases of the virus from Wuhan and revealed that human-to-human transmission of the virus had been occurring since mid-December among close contacts in China. Most of the illnesses that began before Jan. 1 were linked to the Wuhan seafood and animal market, according to the findings.

U.S. officials increased health screenings of travelers who arrived on direct and connecting flights from Wuhan. The first U.S. case was reported in a 35-year-old male U.S. citizen who had recently returned from visiting family in Wuhan. He was not detected through screening. Instead, the man was aware of the outbreak and reported his symptoms as soon as they began, presenting at an urgent care clinic outside of Seattle with mild symptoms indistinguishable from common respiratory illnesses. He eventually developed signs of atypical pneumonia and was treated, under compassionate use, with remdesivir (Gilead Sciences), an investigational antiviral that has been tested against Ebola.

The first U.S. case of human-to-human transmission of the virus was reported in a man in his 60s with underlying health issues who contracted the virus from his wife, a Chicago woman who had traveled to China.

CDC Director Robert R. Redfield, MD, said the report of human-to-human transmission in the U.S. was “not unexpected.”

“Our goal in the ongoing U.S. public health response is to contain the outbreak and prevent sustained spread,” he said. “This is why our response has been aggressive.”

The early U.S. response included expanded health screenings at designated airports, a recommendation that travelers avoid all travel to China, the 14-day quarantine of nearly 200 U.S. citizens who had arrived on a plane from Wuhan and the declaration of a national public health emergency.


As part of the emergency declaration, foreign nationals — other than immediate family of U.S. citizens and permanent residents — who had traveled in China within the previous 14 days were denied entry into the U.S.

“These prudent, targeted and temporary actions will decrease the pressure on public health officials screening incoming travelers, expedite the processing of U.S. citizens and permanent residents returning from China and ensure resources are focused on the health and safety of the American people,” HHS Secretary Alex Azar said in a briefing.

The outbreak has led to an “impressive and unprecedented” global effort to share data and research, Angela Rasmussen, PhD, an associate research scientist at the Columbia University Mailman School of Public Health Center for Infection and Immunity, told Infectious Disease News.

Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security, also emphasized the importance of sharing information.

“In an outbreak situation, there is always a need for more information,” Adalja told Infectious Disease News. “This outbreak will best be managed through full transparency and the sharing of information throughout the global public health community.” – by Caitlyn Stulpin, Julia Ernst, MS, and Gerard Gallagher

Disclosures: Adalja, Azar, Rasmussen, Redfield and Tedros report no relevant financial disclosures.