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While the trajectory of this outbreak is impossible to predict, effective response requires prompt action from the standpoint of classic public health strategies to the timely development and implementation of effective countermeasures. The emergence of yet another outbreak of human disease caused by a pathogen from a viral family formerly thought to be relatively benign underscores the perpetual challenge of emerging infectious diseases and the importance of sustained preparedness.
It is too early to predict how widespread and pathogenic 2019-nCoV will become. It is better to act decisively now rather than wait to see how the outbreak unfolds globally. Beyond all, this global health threat teaches, once again, that it is far better to invest in preparedness to prevent, rapidly identify, and contain outbreaks at their source. Reacting after a novel infection has spread widely (perhaps overreacting with travel bans and quarantines) costs lives, economic resources, and the well-being of millions of people currently cordoned off in a zone of contagion.
Emerging viral diseases with pandemic potential are a perpetual challenge to global health. The time-honored approach to vaccinology, which depends predominantly on isolating and growing the pathogen, has not adequately met this challenge. To effectively prepare for and respond to these continually emerging threats, it will be critical to exploit modern-day technological advances, preemptively establish detailed information on each family of viral pathogens, and invest in more infrastructure for surveillance in developing countries to expedite pathogen identification and jump-start the process of vaccine development using these new technologies. Failure to do so will result in the untenable situation of not optimally using vaccinology in the response to newly emerging infectious disease threats.
Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.
Hardening the border and restricting travel and immigration will not stop pathogenic threats. The best protection of US residents is to stop threats at their origin, while supporting the WHO.
The United States must reassert its global leadership. Now is a pivotal moment to strengthen health security, from providing robust support for the GHSA and the Rapid Response Fund, to funding new vaccines and antimicrobials. The path ahead is clear, but the political will is very much in question.
The Johns Hopkins Center for Systems Science and Engineering has developed an online dashboard to visualize and track reported COVID-19 cases on a daily timescale; the complete set of data is downloadable as a google sheet.
The CDC maintains website posting the latest information regarding infectious diseases. The following are links to selected webpages along with summaries of information that clinicians and patients need to know about COVID-19.
Like many flu viruses, SARS-CoV-2 virus causes an illness characterized by fever, cough and shortness of breath. Given that we are currently in the peak of flu season, many patients with present with these symptoms and most will not have SARS-CoV-2. However, if a patient has traveled from Wuhan, China the possibility of COVID-19 should be seriously considered. Physicians treating patients with upper respiratory flu symptoms who have either traveled to China or have been exposed to people suspected of having COVID-19 flu within the past 2 to 14 days should immediately contact the their local health officials or the CDC to receive advice for how to manage these patients. (Contact CDC-INFO) 800-CDC-INFO | (800-232-4636)
The greatest risk for becoming infected with SARS-CoV-2 is in people who have recently been in Wuhan, China. The US-based population is not considered to have a risk for developing COVID-19 unless they are healthcare workers who are providing care for patients known to be infected with this virus or other people who have come in close contact with patients who have the infection.
Prevention is the best approach. General preventative measures include hand washing with soap and water for at least 20 seconds, avoiding touching your eyes, nose and mouth with unwashed hands, avoiding contact with people who are sick, staying at home when you are sick, covering your face when coughing or sneezing, throwing any used facial tissues in the trash and frequently disinfecting surfaces you may touch.
If you come in close contact with someone who has COVID-19, watch for the signs and symptoms of the infection: fever, cough and shortness of breath. You may also experience chills, body aches, sore throat, headache, diarrhea, nausea/vomiting, and a runny nose. If any of these develop, immediately call your health care provider or go to an emergency room and let the clinicians know about your risk of exposure and concern for having COVID-19 infection. Let the health care team know about your concerns by phone before presenting to them if possible. If you are seeing health care providers, the very first thing to do is to tell them about your concerns for having COVID-19 infection. If presenting to a health care provider is not possible, immediately contact the CDC (Contact CDC-INFO) 800-CDC-INFO | (800-232-4636) to obtain advice for what to do.
CDC currently recommends that travelers avoid all nonessential travel to China.
Health care providers should obtain a detailed travel history for patients being evaluated with fever and acute respiratory illness. Patients with lower respiratory infection symptoms (fever, cough, shortness of breath) who have traveled to Wuhan, China in the last 14 days or have been in close contact with someone being investigated for possible COVID-19 or was in close contact within 14 days with someone with laboratory-confirmed COVID-19 infection should be classified as a Person Under Investigation (PUI). When a PUI has been identified, local infection control and health department officials should immediately be contacted to seek further guidance.
What is a coronavirus, and how dangerous is it? Can I catch it from my pet? Frequently asked questions are answered here.
Updated advice for international traffic
Is it safe to handle packages from China? How can I protect myself? Common myths about virus transmission are debunked here.
Daily updates on the spread of infection, with assessment of regional and global risk.
Patient management, surveillance and case definitions, infection control in health care facilities, and more.
(Photo credit: NIAID)
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