Preparing for a Coronavirus Pandemic

Health officials from the Centers for Disease Control and Prevention (CDC) warned Americans to prepare for the likelihood of a coronavirus outbreak in the United States. The organization was previously not worried about the disease, officially referred to as COVID-19, spreading in the United States. But the continued global spread of coronavirus has led to the CDC’s concern that the world will experience a pandemic and U.S. will not be exempt. (1)

On Tuesday, February 25, 2020, the CDC held a telebriefing for the press led by Nancy Messonnier, the Director of the National Center for Immunization and Respiratory Diseases. Messonnier explained that there are three criteria for a pandemic. COVID-19 already meets the first two: it spreads between people and causes an illness that can result in death. The third criterion for a pandemic is that the disease spreads worldwide. (1)

The CDC has been acting to contain known cases of coronavirus and prevent further introduction of the disease to the United States. Messonnier described “an aggressive containment strategy that requires detecting, tracking, and isolating all cases.” And their efforts have been effective so far. There have been very few cases of coronavirus reported in the U.S., and the country has not experienced community spread. (1) But, because COVID-19 is spreading to more and more countries, health officials are concerned about how long containment in the U.S. will last. As that happens, it will be difficult to keep the disease from spreading further into the United States. And, it is likely that there will be community spread. (1)

“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. (1)

The Spread of Coronavirus

Believed to have originated in a seafood market in Wuhan, China, COVID-19 spreads from person to person. The virus causes respiratory symptoms including fever, cough, shortness of breath, and pneumonia-like symptoms. The virus can worsen to cause severe illness and even death. (2, 3, 4)

Despite quarantines and travel restrictions enforced by China, the U.S., and other countries, the novel coronavirus continues to spread across the globe. The New York Times reported that, as of February 27th, cases had been reported in 48 countries. Most cases outside of China involved people who had traveled from there. (1, 2)

In spite of countries’ efforts to contain COVID-19, it had infected more than 82,600 people and killed at least 2,809 people as of February 27, 2020. There are 60 confirmed cases in the United States. All but one had recently traveled from Asia. (1, 2)

Community Interventions for Coronavirus

During the telebriefing, Messonnier assured the public that the CDC would continue to try to contain the disease and keep it from impacting American communities for as long as possible. But, in the case that coronavirus does spread through the U.S., she outlined non-pharmaceutical interventions (NPIs) as the best way to respond to COVID-19.

“This parallel, proactive approach of containment and mitigation will delay the emergence of community spread in the United States while simultaneously reducing its ultimate impact,” Messonnier said in the telebriefing. (1)  

Messonnier said that NPIs will differ depending on the conditions in each community. Interventions for a community that hasn’t seen the spread of coronavirus will be different than one that has. (1)

She shared guidelines from a document called ‘Community Mitigation Guidelines to Prevent Pandemic Influenza United States 2017’. This document outlines three types of community NPIs to undertake in the case of a pandemic: (1)

1. Personal NPIs

Personal NPIs refer to personal protective measures for avoiding diseases such as washing your hands and getting enough sleep. In the case of a pandemic, this could also include voluntary home quarantine for sick household members.

2. Community NPIs

Community NPIs are social-distancing measures to avoid the spread of disease from person to person. These include school closures and dismissals. Messonnier suggested that, in the case of a pandemic, students could continue their education from home through internet-based teleschooling. And businesses could offer alternatives to in-home meetings like video or telephone conferences. Increasing teleworking options would also help to limit the spread of disease.

3. Environmental NPIs

Environmental NPIs refer to consistently cleaning surfaces that are touched frequently at home, work, school, and large gatherings. However, most evidence points to person-to-person transmission rather than a great risk of picking up the disease from contaminated surfaces.

While Messonnier was confident that implementing community NPIs will be the best way to respond to coronavirus, she remained realistic. “In general we are asking the American public to work with us to prepare in the expectation that this could be bad,” Messonnier said. (1)