Coronavirus in the US

Parent Cafe
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CNN:

After the Trump administration’s coronavirus travel restrictions came into effect this week, local and state officials say they were left scrambling to figure out the new rules. An East Coast official told CNN that planes were arriving “within hours” with no federal protocols in place – the quarantine locations were still to be determined, and authorities were “scrambling to see who had hospital beds available.” “The federal government basically said, we’re going to bring these planes in, and when they land, you guys figure it out,” the government official said…they were left to devise solutions to how to execute the federal order on their own.

Similar complaints came from a state official on the West Coast. “It’s a high level order without a lot details filled in. We are working really hard to understand the conditions,” the West Coast official told CNN. This official says he worked throughout the weekend to coordinate efforts, and was on the phone with the White House several times.

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I thought about this today. Hope they have event insurance ?

Seriously though, this could be a real threat to not only completing all of the venues (if many raw materials, supplies are coming from China, or would otherwise be impacted by all the travel restrictions), to countries pulling out, to travelers unable to get there. On the one hand six months seems far away, OTOH for a huge event like the Olympics six months is a short time.

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Newborn tests positive 30 hours after birth

An infant in Wuhan has reportedly tested positive for the coronavirus just 30 hours after birth, raising concerns that the infection could be contracted in the womb.
Citing sources from the city’s children’s hospital, state broadcaster CCTV reported that two infants were infected with the virus, the youngest just 30 hours old.
“The mother of the newborn was a confirmed patient of the coronavirus. At present, the infant’s vital signs are stable,” the report said. (SCMP)

Capacity to diagnose the coronavirus has been boosted in Wuhan

"31 institutions in Wuhan were equipped to carry out testing, and that their capacity had been increased from 200 tests a day to 4,000. Tongji Hospital could now perform 1,000 tests a day, and had 27 staff – up from 12 – who were able to conduct them in a 24-hour operation, the report stated.

The ability of health authorities in Wuhan to quantify the scale of the outbreak has been hampered by a short supply of testing kits, a member of the NHC’s expert panel said earlier this week." (SCMP)

Second Cruise Ship In Quarantine

The second ship, the World Dream, is docked at Hong Kong’s Kai Tak Cruise Terminal with 1,800 people on board, the city’s Department of Health said Wednesday…

Three former passengers who took a World Dream cruise from January 19 to 24 to Vietnam tested positive for the coronavirus after they’d left the ship…The company said 4,482 passengers and 1,814 crew members were on board for that voyage.

The crew stayed on and the World Dream then picked up a different set of passengers before arriving in Hong Kong Wednesday morning…

Dream Cruises said it was attempting to contact all the passengers who had been on the January 19 to 24 cruise “to inform them of the situation…”

Read for more…
https://www.cnn.com/2020/02/05/asia/coronavirus-cruise-quarantines-intl-hnk/index.html

Fear In South Korea

"South Korea has confirmed 18 cases of infection…and there are fears of a broader local spread.

Anxiety abounds. Movie theaters, shopping malls and restaurants have closed. A large church in Seoul skipped Sunday services because a virus patient had attended earlier. Parents have kept schoolchildren at home. Stores are running out of face masks and hand sanitizers.

Residents of central South Korea threw eggs and other objects at government officials over plans to quarantine about 700 evacuees from Wuhan at government facilities in their neighborhoods." (Global News)

More Americans Evacuated From Wuhan Area

" Two planes carrying about 350 people were headed for Travis Air Force Base in Northern California. One of them was to stay there, while the other was to refuel before continuing on to Miramar Marine Corps Air Station in Southern California."

“A State Department official told CBS News on Tuesday that it would charter an additional flight or flights out of the city at the heart of the coronavius outbreak on Thursday, but that those would likely be the final evacuation planes organized by the U.S. government.” (CBS)

Seats will be offered on a reimbursable basis. March AFB reporting full. Four other military air bases will be used including “Camp Ashland in Nebraska, near a national quarantine center and biocontainment unit.”

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@BunsenBurner wrote: „Here we go. German doctors question the NEJM report“

I was suspicious about that story from the start (you may recall my careful wording in my first post about it: “if we accept that…etc”.). The account that the woman from Shanghai was supposed to have felt fine when she got on the plane home and only developed symptoms during the journey was just too pat. Now that doctors were finally able to reach her in China, it turns out her symptoms merely weren’t visible and she didn’t tell anyone. In fact, she had been feeling achy and fatigued during her stay in Germany and taken paracetamol for it. However, rather than seeking healthcare she got on that plane, probably leery of going into hospital in a foreign country and afraid of being quarantined - which she should have been.

Equally, the co worker who reportedly wasn’t showing symptoms when he went into work to infect more colleagues, had had plenty of them, but that had been over the weekend, and he’d gone back to work as soon as he felt “better”, as people do, probably still not feeling super well. Should he have been more careful, having recently met a person from China? Probably, though he couldn’t have known she was already ill and most probably couldn’t have known that despite being from Shanghai, she’d been in close contact with her family from Wuhan recently. But he would have had plenty of contact with people who’d had seasonal flus and colds, so having been infected through them would have been the reasonable assumption.

So asymptomatic transmission is still a known unknown, but it still means that any containment measures based on noticeable or self reported symptoms, as opposed to “having been to Wuhan or having been in contact with someone who has been” were useless from the start, because people WILL have reasons to take their chances with the virus rather than with hospitalisation and quarantine.

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Is the United States equipped to respond if the outbreak worsens?

“Experts say that while federal agencies have improved their capacities to respond, difficulties could arise if the outbreak worsens, which appears likely. The White House warned that “the public health system could be overwhelmed” if the virus spreads widely, given the CDC’s and local health departments’ limited resources…
Despite the creation of a task force, some experts have expressed concerns about low interagency coordination. In 2018, the Trump administration disbanded a global health team on the National Security Council that would have organized the federal response to the coronavirus outbreak. “I worry a little bit about coordination because responding to an epidemic or outbreak really does take a variety of agency inputs and coordination,” said CFR’s Thomas J. Bollyky.”

https://www.cfr.org/in-brief/coronavirus-outbreak-what-us-public-health-response?

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Well it’s going to be sad if the coronavirus gets politicized. Personally, I think the best approach would be to shut down all flights to and from China and Hong Kong with no exceptions and anyone coming from these areas needs to be quarantined for 13 days ( 12 plus 1 for extra safety). That way if someone needs to fly in/out for emergency/family purposes, the onus is on them. They’ll think longer and harder before traveling. Lots of people want to do what is good for them and their families, often without thinking about society at large. Think about people who have babies or family members with health issues, they should have a say also.
They can’t stop the disease but slowing it down by restricting travel gives the CDC and others time to create a possible solution. Time means less deaths. I know it is already out in the world, but it’s not at a crisis level outside China. Also, at this point they don’t know enough about the transmission process.

What reason does one possibly have to go to China now other than family visits ( emergency) and help with the crisis?
I wonder what are considered best practices to slow down the virus. IMHO, economics should take a back seat to health. (health, wealth and fun in that order).

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Am I missing some news? I thought all flights from China were halted. Are there airlines still flying into and out of China to the US? And aren’t foreign nationals who have been in China recently banned from entering and U S citizens put into quarantine.

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@TatinG No, exactly. Not all flights to China are halted. If you wanted to fly there, you still can. Though several airlines have halted flights not all have. And you can fly via various other stops. Yes, foreign nationals who have visited China (affected areas or all) cannot enter the US. And people ( US citizens included) who have visited the affected provinces cannot enter without undergoing quarantine.

What is missing: If you were in China ( not Wuhan) and you are American, you can fly back home ( no quarantine). This is how the disease has spread to several US cities. Also, if you want to go to China for “important” business you can. Then fly on to other nations and come home. No one will be able to track this. People who travel a lot internationally are going to be exposed more than others.

As long as the onus is on people to self-report and self-quarantine, cases will spread. I’m not sure what the answer is, but I don’t think, wait and see is a best practice type scenario. Then again, I was against bringing Ebola patients to the US and that ended up being fine.

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A look at day to day life in quarantine for American evacuees.

https://www.cnn.com/2020/02/05/us/coronavirus-quarantine-day-in-life-california-trnd/index.html

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Fwiw, Ebola was different than this. I never had a problem with bringing Ebola patients here and didn’t believe in cutting off travel but that’s because ebola is only contagious if you have symptoms. And with Ebola you don’t just have mild symptoms you can pass by with.

nCoV is contagious in asymptomatic people.

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Not a fact yet. The accuracy of the NEJM report of asymptomatic transmission is being heavily questioned. See above.

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When the customs officers scan a passport on entry to the US, there is a lot of information there. China requires a visa for Americans traveling there. I don’t know if they require one for citizens of other countries traveling to China. So, either on the scanned chip on the passport or a visa stamp, the customs officers should be able to flag anyone who has traveled in China recently before entering the US.

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@BunsenBurner my mistake. Hadn’t caught that tidbit yet.

Even still though, with symptoms you can still travel without arousing much notice, unlike Ebola.

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If the Chinese woman who infected germans is any indication, it looks like you could take a pill and symptom-less while infecting others. Do we know people will NOT do that? They don’t need to be intentionally deceptive. They could have thought it was a common cold/flu. Besides, we don’t know for sure asymptomatic transmission is not happening. Just that the chinese-german transmission was not asymptomatic.

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^^Containment of rumors is just as important as containment of the virus.

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Plus Ebola is contagious via direct contact with bodily fluids, so less likely to be contracted via limited contact.

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"The WHO called for $675 million in donations for a plan to fight the novel coronavirus, mainly through investment in countries considered particularly “at risk.

The Bill and Melinda Gates Foundation pledged to commit up to $100 million." (Japan Times)

"Tedros said Wednesday WHO has tapped $9 million of funding from its contingency fund for emergencies. The organization has also sent medical supplies and diagnostic tests around the globe. " (The Hill)

3 new cases in Hong Kong again today - all locally transmitted.

"As the coronavirus spreads, the union that represents UPS pilots has struck a deal with shipping giant to make flying to China “voluntary.”

“This joint effort addresses crewmember concerns over safety during the coronavirus health crisis,” the union said in a statement." (CNBC)

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Don’t they still stamp passports when one comes into and leaves a country? It will be pretty clear for international travelers that they have been to China if anyone scans their passport upon re-entry into the United States.

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Twelfth case confirmed in the US - this time in Wisconsin.

https://wkow.com/2020/02/05/first-case-of-coronavirus-in-wisconsin-confirmed/

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@thumper1 when I flew to Australia and Canada last, they didn’t stamp. You had to specifically ask for it.

It was instead scanned and stamped electronically if that makes sense.