The Centers for Disease Control and Prevention (CDC) is preparing for potential community spread of the novel coronavirus in the United States — which has 34 confirmed cases as of today — and is not ruling out the future need for school and business closures such as those implemented in China.
“This new virus represents a tremendous public health threat. We don’t yet have a vaccine for this novel virus, nor do we have a medication to treat it specifically,” Nancy Messonnier, MD, director, National Center for Immunization and Respiratory Diseases, CDC, said during a telephone news briefing today.
On February 20, the US Department of State issued a travel alert advising citizens to “reconsider travel by cruise ship to or within Asia,” Ian Brownlee, principal deputy assistant secretary, Bureau of Consular Affairs, Department of State, said during the news briefing.
“While the US government has successfully evacuated hundreds of our citizens in recent weeks, such repatriation flights do not reflect our standard practice and should not be relied upon as an option for US citizens under potential risk for quarantine by local authorities,” Brownlee said.
“We urge US citizens to evaluate the risks of choosing to remain in an area that may be subject to quarantine and to take all appropriate proactive measures.”
Brownlee encouraged travelers to enroll their trips on the US Department of State’s Smart Traveler Enrollment Program.
The CDC is working with the state department to provide “up-to-the-minute” information for travelers, Messonnier explained.
Earlier this week, 329 passengers from the Diamond Princess returned to the United States on two state department-chartered flights. Of those, 18 have tested positive for virus by the CDC and 10 were reported positive in Japan. Of the 18 cases here in the United States, 11 are being cared for at the University of Nebraska Medical Center, five are being cared for at Travis Air Force Base, and two are being cared for at Joint Base San Antonio-Lackland.
These individuals are considered at high risk for infection and the CDC expects to see additional confirmed cases of COVID-19 among them.
Changes Made to Case Tracking
The CDC has changed the way it is tracking cases to separate infection in individuals who were repatriated to the United States from other cases.
“We are keeping track of cases resulting from repatriation efforts separately because we don’t believe those numbers accurately represent the nature of what is happening in the community in the United States at this time,” Messonnier explained.
Separating cases out in this way, there are 13 US cases versus 21 cases among individuals who were repatriated as of February 21, for a total of 34. Repatriated cases include 18 passengers from the Diamond Princess and three from the Wuhan repatriation flights.
Almost all remaining individuals who have returned to the United States from Wuhan, China, on state department-chartered flights and who have been quarantined at Department of Defense installations have completed their 14-day quarantine and are not at risk of spreading the virus to others, Messonnier said.
Many of these individuals are older than 60 years; therefore, the CDC is preparing for these patients to develop additional issues that will require hospitalization.
Several US citizens are currently hospitalized with COVID-19 in Japan and are seriously ill.
Community Spread: “Very Possible, Even Likely”
Messonnier said the CDC believes their aggressive approach is effective.
The fact that the number of cases in the United States is still low is “good news given what we are seeing among some countries in Asia that are beginning to experience community spread,” she said.
Community spread, when cases are detected in the community but the source of the infection is unknown, is being reported in Hong Kong, Japan, Singapore, South Korea, Taiwan, Thailand, and Vietnam. The United States issued Level 1 travel notices for Hong Kong and Japan earlier this week.
“We never expected that we would catch every single traveler with novel coronavirus returning from China, given the nature of this virus and how it’s spreading,” Messonnier said, emphasizing that community spread of the virus is not being seen in the United States yet but it is “very possible, even likely, that it may eventually happen.”
“The day may come” when the United States implements school and business closures such as those currently being enforced in Asia, Messonnier warned.
The CDC’s goal continues to be slowing the spread of the virus in the United States, which will “buy us more time to prepare our communities for more cases and possibly sustained spread.”
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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