COVID-19 is spreading rapidly abroad while immediate threat to Americans remains low, says Alex Azar

HHS Secretary Alex Azar holds a press conference on COVID-19 with other health officials, including CDC Deputy Director Dr. Anne Schuchat.

As the coronavirus spreads abroad, Health and Human Services Secretary Alex Azar on Tuesday gave assurances that the immediate threat in the U.S. remains low, as other government health officials sent mixed messages about what to expect from the epidemic.

The Trump Administration said the situation is under control, while Dr. Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases said, "Ultimately, we expect we will see community spread in this country.

"It's not so much a question of if this will happen anymore but rather more a question of exactly when this will happen and how many people in this country will have severe illness," Messonnier said.

Speaking at a news conference with Azar on Tuesday afternoon, Dr. Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention, said the country would maintain a dual approach of aggressive containment and management in the home, "however current global circumstances suggest it's likely this virus will cause a pandemic."

Azar said the number of COVID-19 cases in this country remains steady, only jumping from 14, where it has stood since February 11, to 53 due to officials bringing home repatriated Americans infected from the Diamond Princess cruise line and Americans repatriated from Wuhan, China.

However, abroad, COVID-19 is spreading quite rapidly, Azar said, and the U.S. will likely see more cases.

"The immediate risk to the general American public remains low. But, as we have warned, that has the potential to change quickly," Azar said. "There is now community transmission in a number of countries, including outside of Asia. That is deeply concerning, and community spread in other countries will make successful containment at our borders harder and harder."

HHS will maintain a policy of "radical transparency," he said.

"We can't hermetically seal off the U.S.," Azar said. "Our efforts at containment so far have worked."

An emergency supplemental request of $2.5 billion to combat the virus will be spent between now and September 30, he said, and HHS is in the middle of looking at next year's appropriation as the coronavirus could well go into next season.

The money will be used in five key areas: surveillance, testing, funds for state and local partners in public health, lab testing and vaccine development.

Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases said he expected a vaccine to be in human trial in a month-and-a-half. Still this means that it will take at least a year to scale up to vaccine production.

Two major clinical trials are taking place in China, he said, which will tell officials worldwide what works and what doesn't.

In China, where the deadly virus began spreading eight weeks ago, the number of cases has peaked and is now on the downside of a bell curve, according to epidemiologist Dr. Bruce Aylward, Team Lead, World Health Organization, reporting Tuesday morning after his return from China.

The World Health Organization has not called the coronavirus a pandemic. The number of cases worldwide stands at more than 80,000, with 2,705 deaths. More than 2,500 of the deaths have been in the Hubei Province of China, the epicenter of the virus.

WHY THIS MATTERS

With more cases expected in the U.S., health officials and providers need to be prepared for a large scale response.

The epidemic has affected the stock market, though National Economic Council Director Larry Kudlow said on CNBC Tuesday morning that the U.S. is "holding up nicely."

The coronavirus will likely affect the the drug supply chain, said Steven Hahn, commissioner, U.S. Food and Drug Administration. The FDA is reaching out to hundreds of manufacturers and is not aware of shortages at this time.

U.S. Rep. Bill Pascrell, Jr., D-NJ and Sen. Robert Menendez, D-NJ wrote to Hahn requesting information and details on the federal government's plan to preserve the medical supply chain in light of the coronavirus outbreak. In 2018, the United States imported more than $13 billion of drugs, devices, and food from China.

THE LARGER TREND

On Tuesday morning, China Joint Mission Team Lead Bruce Aylward said China has been successful in limiting the spread of the virus to infecting more citizens through a systematic yet differentiated approach. There was a lockdown in Wuhan, but in other parts of the country, the level of response was different.

China's agile response was achieved only through the use of technology, big data and AI, he said. China has to manage massive amounts of data, 70,000 cases across vast areas.

Because of the sheer numbers, whole hospitals were taken out of general service and made into COVID-19 hospitals. Fifty percent of consultations with other patients for regular services are now done online.

"They've repurposed the machinery of government," Aylwood said. "It's a technology turbo-charged response."

People wonder if the downward trend in China is real, he said.

"Everywhere, we're hearing the same thing, we have open beds," he said. "The system is opening up because the number of cases is going down."

Where the epidemic goes from here depends on the ability of other countries  to apply the same rigor, he said.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com