Transcript for CDC Telebriefing: Update on COVID-19 | CDC Online Newsroom

>>> Good afternoon and thank you all for standing by.  For the duration of today’s conference, all listeners are on silence mode until the question and answer section.  After that time, press star one.  Today’s call is recorded.  If you have objections, disconnect at this time.  It is my pleasure to introduce Mr. Paul Fulton.  Thank you, sir.  You may begin.

>> Thank you for joining us on the briefing of the COVID-19 response.  We’re joined by secretary for consular affairs for the department of state, Ian G. Brownlee, and Nancy Messonnier, the Director for the National Center for Immunization and Respiratory Diseases, who will give opening remarks before taking your questions.  At this time, i will turn the call over to acting assistant secretary for counselor affairs Brownlee.

>> Good morning.  I’d like to say a word about the cruise ship travel alert that the State Department posted yesterday afternoon.  U.S. Department of State has no higher priority than the safety and welfare of U.S. citizens overseas.  February 20th, the department advised all U.S. citizens to reconsider travel by cruise ship to or within Asia.  Many countries implemented strict screening procedures to prevent the spread of the COVID-19 virus.  This is a dynamic situation, and U.S. citizens traveling by ship may be impacted by travel restrictions affecting their itineraries or may be subject to quarantine procedures implemented by local authorities.  While the U.S. 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 U.S. citizens under potential risk of quarantine by local authorities.  We urge U.S. citizens to evaluate the risks associated with choosing to remain in an area that may be subject to quarantine and to take all appropriate proactive measures.  People who plan to travel by cruise ship should contact their cruise ship line companies for further information on the current rules and restrictions, and should continue to monitor the travel.state.gov website for updated information.  We encourage all U.S. citizens traveling overseas to enroll their travel plans in the smart traveler enrollment program, step.state.gov.  They can receive important messages about their destination, including timely alerts and updates to travel advisories.  Finally, you can find the text of the travel alert on that same website, travel.state.gov.  Thank you very much.

>> Thank you, acting assistant secretary Brownlee.  Thank you all for joining us today.  This is Nancy Messonnier.  I want to start with how we will be reporting our cases of COVID-19 beginning today and going forward.  We are making our case counts in two tables.  One only tracks people who were repatriated by the state department, and the second tracks all other cases picked up through U.S. public health network.  CDC will continue to update these numbers every Monday, Wednesday, and Friday.  We are keeping track of cases resulting from repatriation efforts separately because we don’t believe those numbers accurately represent the picture of what is happening in the community in the united states at this time.  As of this morning, when you break things up this way, we have 13 U.S. cases versus 21 cases among people who were repatriated.  The repatriated cases include 18 passengers from the “diamond princess” and three from the wuhan repatriation flights.  I want to update you on the status of the repatriation efforts.  Yesterday, nearly all of the remaining people who returned from Wuhan, China, via state department chartered flights, who have been quarantined at four department of defense installations across the U.S.  have completed their 14-day quarantine.  We are truly thankful to those released from quarantine for their cooperation and patience and wish them well as they return to home, work, and school.  I want to be clear that someone who has been released from quarantine is not at risk for spreading the virus to others.  Specifically, they are not infected.  Additionally, i want to extend my thanks to the men and women on all of the dod bases and their families for their graciousness while hosting these guests.  We are also thankful that Travis Air Force Base and Joint Base San Antonio-lackland opened their doors to the recently returned passengers from the “Diamond Princess” cruise ship.  Now, the “Diamond Princess.”  329 U.S. citizens earlier this week returned to the united states aboard two state department chartered flights.  So far, 18 have tested positive at CDC.  Another 10 were reportedly positive in Japan.  11 are receiving care at the university of Nebraska medical center.  Five are receiving care around Travis.  Two are receiving care around Lackland.  Because the passengers on the “Diamond Princess” were in a close setting, where there has been a significant spread of COVID-19, they are considered at high risk for infection.  We do expect to see additional confirmed cases of COVID-19 among the passengers.  Additionally, since many of these people are over the age of 60, we are also prepared for other medical issues to arise that will require hospitalization.  We’re going to do everything we can to make their quarantine as easy as possible while monitoring them to see if they develop illness.  Our goal for these people who have been repatriated is to be sure that each and every person is properly cared for and that those who are in need of medical care receive it.  To ensure this, we are working closely with local hospitals as well as other facilities across the country who are prepared to provide this care.  I want to take a minute to extend my condolences to the families who have lost loved ones who were infected on the “Diamond Princess.”  we heard yesterday that two Japanese passengers of the “Diamond Princess” died.  There are several Americans with COVID-19 who are hospitalized in japan and who are seriously ill.  Sadly, we may see poor outcomes in others, not just people who were on board the “diamond princess,” but among others who become sick with this virus.  Despite the increasing cases in china and around the world, we believe our aggressive travel precautions are working.  As I said, the number of cases detected through the recent U.S.  surveillance systems has increased to 13.  The most recent patient was announced last night by Humboldt county in California.  This patient had traveled to mainland china.  The fact we have been able to keep this number low is good news, especially given what we are seeing among some countries in Asia that are beginning to experience community spread.  This is when cases are detected in a community but it is not known what the source of the infection was.  This is being reported in Singapore, South Korea, Taiwan, Thailand, and Vietnam, as well as Hong Kong and Japan.  The last two countries we issued level one travel notices for earlier this week.  We are working in close coordination with the state department to keep travelers informed with up-to-the-minute guidance, including on cruise ship travel, as discussed by Mr. Brownlee.  We never expected we’d catch every traveler with novel coronavirus from China.  It would be impossible.  We’re not seeing spread here in the United States yet, but it is possible, even likely, that it may eventually happen.  Our goal continues to be slowing the introduction of the virus into the U.S.  This buys us more time to prepare our communities for more cases and possibly sustained spread.  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 medicine to treat it specifically.  We are taking and will continue to take aggressive action to reduce the impact of this virus, that it will have on the communities in the U.S.  we are working with state, local, and territorial health departments to ready our public health work force to respond to local cases and the possibility this outbreak could become a pandemic.  We are working closely with health care systems across the country to reinforce infection control principles and plans for surges of people seeking and requiring care.  We’re collaborating with supply chain partners to understand what medical supplies are needed and available.  This will help CDC understand when we may need to take more aggressive measures to ensure that health care workers on the front lines have access to the supplies they need.  We’re working with businesses, hospitals, pharmacies, clinicians, manufacturers, and distributors to communicate about these measures and what they can do to get ready.  I want to direct everyone to a document that will be very informative in terms of what people can expect in the coming weeks if the virus starts spreading in our community.  This is an MMWR recommendations and report titled “community mitigation guidelines to prevent pandemic influenza, united states–2017.”  we are reviewing the materials and adapting them to COVID-19.  These materials will serve as a blueprint for the community interventions we will use here in the U.S.  if you’re watching the news, you may be hearing about schools shutting down and businesses closing in countries in Asia to reduce the potential spread of this virus.  The day may come where we need to implement such measures in the U.S. communities.  By next week, we expect to be posting a new web page focused on what CDC is already doing to mitigate transmission in communities.  We recognize the uncertainty of the current situation.  As always, CDC public health experts strive to make the best recommendations based on the most up to date data.  Our guidance will change as we learn more about this virus.  When that happens, we will share it with you.  We’d be happy to take questions now.

>> Thank you.  If you would like to ask a question, please unmute your phone.  Press star 1, and when prompted, record your first and last name clearly so i may introduce you.  To withdraw your question, press star 2.  Again, to ask a question, press star 1.  Our first question comes from Jason Gale with Bloomberg news.  Your line is open.

>> Thanks for taking my question.  It has two parts.  We’ve heard something like 40% of COVID-19 patients hospitalized in China have received corticosteroids.  Could this be worsening the disease or helping patients by calming the damaging immune response?  The second bit is, what is the worst threat, the virus or the body’s response to it?

>> This is CDC.  I would say, in general, that CDC clinical guidance does not recommend the use of steroids for this virus based on the information we have now.  I’ve also seen the reports out of China, but i would consider it to be unverified at this point.  As we’ve talked about before, folks are rushing appropriately to get information out.  Sometimes, it is difficult to know which of those have been fully reviewed.  I wouldn’t want to comment more directly on what clinical practice is or is not in china.  As many of you know, there is a team on the field now in china working specifically on this outbreak.  We, like everyone else, are waiting for the reports to come out so we can learn more about what they’re finding in china.  Also point out that there is also a WHO overseeing clinical group that is involving not just the U.S. but all the countries that are treating patients with this, so that we can be sharing experiences and using best practices that are available across the globe.  In terms of your second question, and i really do think it is premature to hypothesize why some patients are having poorer outcomes than others, but i would remind us that emergent data still says that the people who have the worst outcomes are those who are older and with underlying illnesses.  That seems to be true, continue to be true.  Next question?

>> Our next question is from Lisa Krieger with “San Jose Mercury News.”  your line is open.

>> Thank you very much.  Ten Americans tested positive in Japan, and 18 tested positive here with the CDC test upon their arrival.  Does that suggest that they were infected en route, or might be there some other explanation?

>>  This is CDC again.  What i would say is, as we said when this started, these group of people we judge to be at high risk for COVID-19 based on what the attack rates were on the cruise ship.  Therefore, it is possible that some of these people were already incubating the disease when they left japan. That is similar to, for example, what we’ve seen in just some of the travelers in the U.S.  I’ll remind you that some of the U.S. cases were asymptomatic when they came back in the U.S., and then developed symptoms several days later.  It is entirely possible that that’s what’s going on here.  I think that more information will become available over the next couple days, as we fully evaluate these repatriated travelers and as we line up the lab results from japan, as well as the testing in the united states.  So more than that, i think it is really premature to say.  Next question.

>> Actually, for state, just one clarification to that.  The positive results that you saw in folks that were repatriated either before they were transported, becoming positive or immediately upon arrival, it is important to note that those test samples were obtained 48 to 72 hours prior to the evacuation and repatriation flight.  So the results that you’re seeing don’t represent infection en route.  They actually represent infection that existed prior to the evacuation that is only now coming to light.

>> Our next question is from Lenny Bernstein with the “Washington Post.”  your line is open.

>> Thank you very much for taking my call.  Dr. Messonnier, you say you expect to see more infections from “diamond princess”  passengers.  Is that based on preliminary testing?  Is that just a prediction?  If you can say, how many more?  Is this going to be a very large number?

>> As i think you know if you’ve been listening to me give these telebriefings for weeks, i’m never going to make predictions that way.  I guess what we would say is that this was a high-risk situation.  Based on what we know about the attack rates and the exposures, we should expect to see additional cases.  Some of these passengers are still in what we would consider the incubation period, which we know to be 10 to 14 days.  Until we’re through that period, we won’t have a good feel for how many additional cases there are.  But i’m — we do think, based on epidemiology and risk assessment, that there may be additional cases.  Next question?

>> Our next question is from Luke Simmons from San Antonio.  Your line is open.

>> Thank you for taking my call.  I was wondering if you could clarify on the group that is over at Lackland.  Is that two more patients that have tested positive, not including the one that had originally come here?  Also, we had some elected officials that were concerned with them being taken, you know, for testing at the local hospitals.  It seems like you may have changed course a little bit with the Texas center for infectious disease.  I’m just wondering if you can kind of clarify what that process is once you guys, you know, start testing in this type of incident.

>> I’m going to maybe answer the second question first.  So as we’ve said with these…


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