Excerpts of Press Briefing on Coronavirus
AZAR: Part of the risk we face right now is that we don’t yet know everything we need to know about this virus. But I want to emphasize that does not prevent us from preparing and responding. We have the experience of responding to two earlier coronaviruses that emerged to cause serious illness in people, SARS and MERS. And we have experience responding to bird flu outbreaks in Asia.
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The playbook for responding to an infectious disease outbreak is relatively simple and multi- tiered. You identify cases, isolate people, diagnose them and treat them. Then you track down all the contacts of the infected person, and you do the same with those people and the same with contacts of contacts, if necessary. That approach is how public health departments and healthcare providers, working with the CDC, are handling the cases here in the United States, and I am very grateful the hard work that they are all doing together.
This kind of work, coupled with studies and analysis, is also how we answer the questions I described earlier. On January 6 we offered to send a CDC team to China that could assist with these public health efforts. I reiterated that offer when I spoke to China’s Minister of health on Monday, and it was reiterated again via the World Health Organization’s leadership today in Beijing. We are urging China; more cooperation and transparency are the most important steps you can take toward a more effective response.
Beyond that, all options for dealing with infectious disease spread have to be on the table, including travel restrictions. But diseases are not terribly good at respecting borders, so we would have to assess carefully whether the evidence recommends any steps beyond the thoroughly tested methods I just described.
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The president and I have been speaking regularly about this outbreak, and I have been speaking with the senior officials at HHS and the White House multiple times each day since the outbreak began to represent an international threat. The president is highly engaged in this response and closely monitoring the work we’re doing to keep Americans safe.
REDFIELD: Thank you, Mr. Secretary, and thank all of you for joining us here today as we discuss the latest developments that are involved in this situation. It is a rapidly changing situation in the United States and throughout the global community. Right now we know of 18 international locations that have identified cases of this new virus, including the United States. To better protect the health of the American public during the emergence of this novel coronavirus, and based on the evolving situation information from China, CDC has reassessed its entry strategy and decided to expand to screening travelers from the five airports originally to 20 airports in the United States.
It’s currently the lu season, and respiratory disease season, and there’s a lot of respiratory disease out in our nation. We recommend washing of the hands, covering your mouth when you cough, staying at home if you’re sick. For healthcare providers, we ask them to be on the lookout for people with a travel history from China, especially Hubei Province, if they develop fever and respiratory symptoms. And if you’re a healthcare provider that’s caring for a confirmed patient, we ask you to follow the recommended infection control procedures.
For all people that may have this infection, we ask you to follow the CDC guidance in how to reduce the risk of spreading your illness to others. And for people who may have had close contact with someone who is a confirmed patient, we ask them also to follow that guidance and if you have symptoms, to contact your healthcare provider.
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FAUCI: I’m going to give you a brief snapshot of the countermeasures in the form of diagnostics and therapeutics and vaccines that are being investigated and pursued by the NIH, by our grantees contractors, and by our collaborators in industry. First, with regard to diagnosis diagnostics, the CDC has rapidly developed at diagnostic based on the published sequence of the virus. The NIH, together with the CDC, will be working on next generation diagnostics that are more point-of-care so that we can get them more distributed to people throughout the country in the world.
Next is therapeutics. There is no proven therapy for coronavirus infection. Yet, there are now ongoing studies that have been initiated with the previous experience we had with SARS and with MERS. For example, back then and between those outbreaks and the current one, that number of antiviral drugs have been tested in vitro and some animal models and even in the field anecdotally with historic controls. One of them is the antiviral Remdesivir, which some of you may remember was used as one of the elements and the clinical trial against Ebola. And the other one that is now being used on a compassionate basis by some in China is KALETRA, which is a combination of two antiretroviral drugs.
Again, I must emphasize there’s no proven efficacy of these, but they are being pursued together with the screening of a number of other agents. I might point out that is why it is so important that we get isolates of the virus, which we will soon have both particularly from the individuals in this country who have now been infected, the ive individuals that you’ve heard of.
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And then finally, and most importantly, vaccines. We have already started at the NIH and with many of our collaborators on the developing of a vaccine…
When the Chinese isolated the virus, they put on a public database that sequence. Given the technology of the 21st century, we were able to use that sequence, pull out the gene for the glycoproteins spike of the particular coronavirus and make that the immunogenicity to be used in a vaccine. Right now, that’s being prepared. I anticipate with some cautious act optimism that we will be in a phase 1 trial within the next three months.
I want to emphasize because it’s sometimes confused, going into a phase 1 trial does not mean that you have a vaccine that’s ready for deployment. It will take three months to get into the trial, three months to get safety and immunogenicity data, and then you move into phase 2. What we do from that point on will be determined by what has happened with the outbreak over those months. Remember, we made a phase 1 trial with SARS and we never had to use the vaccine. But nonetheless, we are proceeding as if we will have to deploy a vaccine.
In other words, we’re looking at the worst scenario that this becomes a bigger outbreak. So in summary, there are three types of interventions that we’re working on. Diagnostics, therapeutics and vaccines, then we will keep you posted as we make progress in each of these. Thank you.
QUESTION: Thank you. Robert Delaney (SP) with the South China Morning Post. I just wanted to follow up on media reports that the White House is considering travel restrictions from China to the U.S. And the other question I had was about the offer to–for the CDC team to– to support a solution by working with the health authorities in China. Can you give us more information about what the response from China has been to that and who has been involved in that interaction? Thank you.
AZAR: -in terms of travel restrictions… it’s important to not take anything off the table with a rapidly emerging novel infectious disease. We will be constantly assessing the appropriate public health measures to be taken based on that science, evidence, and epidemiology that we learn, including some important information… that we hope to learn by working on the ground in China as quickly as possible so we can see raw data, raw evidence, and help design the types of studies and analytics that really are needed.
… the offer that we have made, which we do hope that the Chinese government will take us up on that CDC experts are standing by, ready, willing, able to go immediately to China either on a bilateral basis or under the auspices of the world health organization. So I have been directly engaged in those discussions with Minister Ma, the Chinese Minister of health, as well as with the Director General Tedros of the World Health Organization, and he had– Director General Tedros just add meetings this morning in China, so what would be Tuesday morning in China with senior most officials.
I found my interactions with the Chinese government to be very productive and cooperative and I am hopeful that will have a positive resolution and be able to deploy, especially under the auspices of the World Health Organization.
REDFIELD: Currently we do have a CDC office in China that’s embedded in the China CDC. We would add our personal there to help them really define the epidemiology and answer some of the critical questions that were asked about asymptomatic transmission, for example in particular and what is the incubation period since there’s been such a wide range. We also can assist them to begin to understand really the spectrum of infection.
We’ve developed a diagnostic test that we can use to actually tell after the fact when somebody hit has actually recovered were they actually infected or not. So this is the critical thing we do. We augment laboratory support, but most importantly, we augment the epidemiology capacity to answer these critical questions that are so necessary to understand for future public health action.
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AZAR: with regard to the light of individuals who are connected to that U.S. Embassy consulate in Wuhan returning with family members, we will be heavily engaged with that light and the transport of those individuals. Will be screened, evaluated constantly. There will be physicians on the light and we’ll take whatever the appropriate evidence-based public health measures are with them as we would in any other situation. So will–that will all be dependent on what we learn as we screen, speak to people as we do the type of evaluation, we would do in any type of infectious disease contact tracing type activity.