Transcript of 2019 Novel Coronavirus (2019-nCoV) Response

Operator: Welcome and thank you for standing by.  Today’s conference is being recorded.  If you have any objections you may disconnect at this time.  All participants are in a listen-only mode and to the question and answer session of today’s presentation.  To ask a question at that time, please press star bun.  I would like to turn the call over to your host, Benjamin Haynes, thank you.

Haynes: Thank you, Michelle, and thank you for joining us for today’s briefing, I am joined by Dr. Nancy Messonnier, director of CDC’s national center for immunization and respiratory diseases, who will provide opening remarks before taking your questions. I would now like to turn the call over to Dr. Messonnier.

Messonnier: Thank you for joining us today. I’m pleased to give an update on the ongoing 2019 novel coronavirus situation in the united states. As promised, we updated our web site earlier today with our lab results.  This morning, we have 165 persons under investigation or PUIS with 68 persons testing negative and only 5 confirmed positive.  The remainder are samples in transit or being processed at CDC for testing.  We have uploaded the full genetic sequence for all five viruses detected in the united states to date, and we’re working quickly through the process to get the CDC -developed test into the hands of public health partners in the united states and internationally.  CDC is expanding entry screening to 20 U.S. Ports of Entry where CDC have quarantine stations.  Also, in collaboration with customs and border protection, CDC is expanding distribution of travel health education materials to all travelers from china.  350,000 travel education cards are ready for distribution.  The good news here is that despite an aggressive public health investigation to find new cases, we have not.  The situation in china is concerning.  However, we are looking hard here in the united states.  We will continue to be proactive.  I still expect that we will find additional cases.  Another development today, the federal government was able to successfully return a plane full of U.S. Citizens living in Wuhan, china to this country.  We have taken every precaution to ensure their safety while also continuing to protect the health of our nation and the people around them.  195 passengers have been screened, monitored and evaluated by medical personnel every step of the way, including before takeoff, during the flight, during a refueling in Anchorage, Alaska, and again in California.  Twenty CDC staff are present to help manage this process.  All of the 195 passengers are without the symptoms associated with novel coronavirus.  And all have been given assigned living quarters at the air force base.  All of the 195 have agreed to remain on base voluntarily.  CDC has now begun a second stage of further screening and information gathering from the passengers.  The passengers will be offered testing as part of this thorough risk assessment.  And samples will be sent to CDC.  We will be processing them with the appropriate speed.  I want to thank everyone who worked so hard over these past few days to bring these Americans home.  I heard that the people on board cheered loudly when the plane touched down safely in anchorage.  I want to thank those now safely returned from Wuhan for their cooperation and patience as we safeguard their health and the health of all Americans.  I understand that many people in the united states are worried about this virus and whether it will affect them.  Outbreaks like this are always concerning.  Particularly when a new virus is emerging, but we are well prepared and working closely with federal, state and local partners to protect our communities and others nationwide from this new public health threat.  At this time, we continue to believe that the immediate health risk from this new virus and the general American public is low.

Haynes: Thank you, Dr. Messonnier, Michelle, we are ready to take questions.

Operator: Our first question will come from mike stobbe with ap, your line is now open.

Stobbe: Hi, thank you for taking my call.  Yeah, thank you, doctor.  I wanted to ask you, there was a press event from Riverside, and it was a little confusing.  First of all, you used the number 195.  The number 201 has been used earlier.  Are you saying it was actually 195 people on the flight?  And the people who — from the flight, could you tell us exactly what the restrictions are for those folks at the base?  You have already said that they’ve all agreed, but there was supposed to be a three-day period, and there was some confusion about whether if someone decided they wanted to leave before three days even if there isn’t a federal quarantine order, are they allowed to do that.  And why three days?  How did you all arrive at three days if the incubation period is up to 14 days according to a paper in the “new England journal today” is five days, and the flight was supposed to go to the Ontario airport.  Whose decision was it to divert it to the air force base and why was that decision made?  Thank you.

Messonnier: Sure.  So, I know that the numbers have been confusing and as you know, we pride ourselves on precision.  Some of this is the desire to communicate quickly.  So, the correct number is 195 passengers.  It’s 195 passengers who have been screened.  Thanks also for the opportunity to clarify around what the status of the travelers are.  You know, quarantine is a regulatory authority.  It’s used to isolate someone because they pose a threat to the health of their family or their community.  In this instance, we have 195 travelers who are willingly undergoing isolation for the purpose of medical evaluation and investigation of their risk.  These passengers are happy to be back in the united states.  We at CDC are happy to help them return to their communities at the completion of their risk assessment.  All of the parties are committed to reducing the spread of this illness, so the 72 hours, you know, we hope that we will be able to assess their risk more quickly than that, get these patients through the process, after giving them perhaps a little time to rest and recuperate and we’re trying hard to make sure that we can get them on their way as quickly as possible, knowing that it may take a little while to let them rest and fully assess their risk, which is something we’re doing jointly with these passengers, so we’re hoping that you give them and us a little time to make sure that we take our time to do this risk assessment fully, but also mindful of the stress that these passengers have been under.  We also want to give them a little time to recuperate before we ask them the detailed set of questions that we think will help us help them make the appropriate risk assessment.

Haynes: Next question, please.

Operator: Next question will come from Eden David with ABC news medical unit; your line is now open.

David: Hi, thank you for taking the time to update us, so I understand that you are isolating these particular 195 passengers but what about the commercial flights that are still coming in from china?  You’re not isolating them or why the extra precautions for this specific — this specific subset of passengers and what would be your comment on why you’re not taking the same initiative or interventions for the commercial flights coming in?

Messonnier: Thanks for the opportunity to clarify.  These are passengers from Wuhan, and the number of travelers coming from commercial airlines from Wuhan has drastically dropped in the past days since the airport at Wuhan was closed.  So, the numbers of passengers directly coming from Wuhan drastically dropped.  We are still doing active screening of any passenger who was coming from Wuhan in the five airports where we initially set that up, and the kind of screening that we’re doing is in the same category as this screening.  It is a similar risk assessment where we’re understanding where they’ve been, who they’ve been in contact with.  Of course, looking for any medical illness and quantifying their risk into the set of categories that help us define the next steps.  These passengers are undergoing something similar.  It is more detailed, partly because of what’s been going on in Wuhan the past few days.  And because of their situation, we thought that out of the desire to make sure that they have time to rest and recuperate before they’re getting asked those questions, we wanted to make sure that they had a place where they could safely do that.  And this offers us that place.  It is in the same kind of setting that we’re offering risk assessment for other passengers coming back from Wuhan as well as anybody in the united states.  For example, the individuals who have been identified as close contacts of the confirmed patients we’re also stratifying their risk as well, and our guidance for those individuals differs based on their risk.  For example, somebody who was directly in close contact of a coughing patient with Wuhan would have a higher risk of somebody for example who passed them on the street a week before they became ill.  But all of those people are at risk, but the risk is different, and in these returning travelers, these 195 people, we want to take our time to make sure we fully assess their risk, and that we have worked with the people to do it.  Again, I want to compliment them.  I also want to thank the folks from Alaska as well as California who have been with us every step of the way.  We appreciate their patience.  As we said before, the cooperation of the patients with this novel coronavirus as well as their close contacts, as well as their — these other travelers are essential for us to be able to protect the health of these people, the health of their families and the health of the communities.

Haynes: Next question, please.

Operator: Next question will come from eben brown with FOX News, your line is now open.

Brown: Thank you, Dr. Messonnier, for doing the call this afternoon.  It’s been mentioned that the screening is being done at 20 airports or at 20 metro areas where the CDC has their standing quarantine stations but is it just only airports or will there or are there screening stations underway at sea ports or land-based border crossings?  I mean, it’s always possible someone could have flown from china to Cancun, got on a cruise ship and came to Miami.  Is that something that’s being addressed or what would be the criteria to start addressing those types of scenarios?

Messonnier: Sure.  Thank you.  So, I actually think it’s a great opportunity to differentiate the active enhanced screening that we were doing at the five airports for folks coming out from Wuhan from what we’re doing to enhance the screening at these 20 quarantine stations.  So as part of our regular business at those 20 quarantine stations, we look and work with customs and border protection to identify people who are returning to the united states with illness.  That is part of our regular business and at these 20 quarantine stations, what we’re actually doing is enhancing the staffing at those airports so that we can do more of that illness detection.  It’s called a standard illness protocol.  Part of our normal business, but we’re enhancing those activities.  There are two of the 18 airports actually include two land borders that are also quarantine stations and also searching those for illness response.  Detecting people that come into the united states ill is part of our normal business, and it’s relevant here, but we should remember that some of our five cases weren’t ill when they crossed back into the united states.  They became ill later.  So it’s equally important to use that opportunity and for CDC to work with cbp to provide all of these returning passengers educational materials, those educational materials specifically point out what the signs and symptoms of novel coronavirus are and we tell them if they have a fever and they have respiratory symptoms, specifically a cough, they need to contact their health care provider.  This is part of the method we use in a layered approach to try to protect all of us from any such illness that comes into the united states.

Haynes: Next question, please.

Operator: Our next question will come from Richard Harris from npr.  Your line is now open.

Harris: Thanks, I’ve got two quick questions, one of which is, if these folks get screened with the CDC’s pcr test, and they call come back negative is there any biological reason to continue the 14-day surveillance of them or is that just, is that belts and suspenders up because it would seem like if everyone’s negative for carrying the virus, that would be end of story.  And the second question is about w.h.o. Which today said CDC would not be part of their new scientific efforts to go into china and learn more, and I was wondering if the CDC has any progress to report on getting a CDC team into china.  Thanks.

Messonnier: Sure.  The answer to the first question is we’re being appropriately cautious as one should be when there is a new virus with which we only have limited experience, and so we really will continue to work with these individuals to make sure that there’s appropriate monitoring.  As we’re doing for all of the — as we’re doing for all of the close contacts of the confirmed cases in the united states, and so I think it’s — I wouldn’t call it belts and suspender, I would call it an appropriate degree of caution for a new disease.  As we learn more about the disease from investigations here in CDC, as well as around the world, our procedures may change but right now we’re taking what we consider to be an appropriately proactive and cautious approach around potential contacts as well as around travelers.  In terms of the — in terms of the w.h.o., I don’t know that that’s a confirmed report, and actually, we expect that we will be invited to be part of the this w.h.o. Expert group, so we actually will, as I understand it, we are working with w.h.o.  To put together a team to go to china as soon as possible and we’ll provide an update on the team’s departure as well as activities when more information becomes available.

Haynes: Next question, please.

Operator: Next question will come from Erica Edwards from NBC, your line is now open.

Edwards: Hey, thank you.  I have two quick things.  One is just to clarify something that was said earlier.  I know that the number of passengers changed from 201, now to 195.  Can we assume that the other six were crew members?  And also, I’m wondering if you can say anything more about the close contacts in the confirmed cases here in the U.S., particularly that patient in Washington state?  I believe we’re at or near the end of the 14 days since he arrived back in the U.S.  Is that person still hospitalized and if so, why?

Messonnier: Yeah, so the 195 is the correct number.  The other people on the plane were state department employees, medical officers and pilots.  In terms of the clinical status of the patient in Washington state, as I said before, you would really need to direct that question to the state health department, but just know that we are actively engaged with these patients and their clinical care making recommendations to their clinicians and the health department as to how long they need to stay in hospital.  I think that as you can imagine, with a new disease, we are being cautious and I think their clinicians in their health departments are being cautious as we learn more, but those decisions will be coming from the state health department, local decisions, not from CDC, over.

Haynes: Next question, please.

Operator: Our next question will come from Nathan Weixel from the hill, your line is now open.

Weixel: Thanks for taking my question.  I just wanted to clarify, just about whether CDC is actually going to be part of this w.h.o.  Group, you don’t know that you’re a part of it yet or you don’t know that you’re going to china, you just expect that?

Messonnier: So, the information that I have right now is that we are invited to be part of this W.H.O. mission and that we are working with W.H.O. through the particulars of that team.  I think there are logistic questions and such about this, but again, my understanding is that there has been preliminary outreach and that CDC at this point, the plans are to include CDC as part of that team.

Haynes: Michelle, we have time for two more questions.

Operator: Our next question will come from Lisa Krieger from san Jose mercury news, your line is now open.

Krieger: Yes, hi, thank you very much.  Granted that the travel to Wuhan is the single greatest risk factor, I wonder if you could answer a reader’s questions about how do I tell the difference between, you know, symptomatically between a cold, the flu and a new coronavirus?

Messonnier: I actually think that’s a really important question for the American public because the symptoms of this disease early are fever and cough and respiratory disease, and as I think your readers astutely pointed out, that is similar to what we say as the early symptoms of influenza as well as other viral respiratory diseases.  That’s why it’s really important for Americans to know right now that the risk factors that we have identified in the united states are travel to Wuhan, but the second group of people that we’re especially concerned about are people who are close contacts of people who are traveling to — who have traveled to Wuhan, and that’s why the health department is working with CDC, have been — I’m sorry, it’s Hubei province.  You said Wuhan so I said Wuhan, but the answer is people who have recently traveled to Hubei province, and that’s all of our five cases have had that recent travel history but the second group that we’re concerned about is people who have had close contact with people who have traveled to Hubei province, and other countries that already identified cases among those groups that have had close contact with people who have traveled and that’s why we have been working with our state health departments to be very proactive and aggressive in identifying potential contact of confirmed patients and monitoring them closely.  That is, you know, we expect to see additional cases in the united states.  We think there could be in travelers returning from Hubei province but we also think that it’s likely we may have cases among close contacts of patients who have returned, that would be human-to-human transmission, so we’re expecting that, but right now, there is no sign in the united states that we have broader community transmission, and that’s why people who are not in one of those groups either traveling themselves or having close contact with a confirmed case, we don’t think those Americans need to be especially concerned, because we judged the risk in the general American public to be low.

Haynes: Last question, please.

Operator: and our last question will come from Issam Ahmed from AFP, your line is now open.

Ahmed: Hi, Nancy, just another clarifying question, so it’s the volunteer isolation period is 72 hours, and then what was the 14 days for, and I’m sorry, and will everybody have to submit a specimen or is that also voluntary, which will be tested at the CDC?

Messonnier: I’m sorry if some of this got confusing as we tried to work quickly through a complex problem.  We said it might take up to three days because we thought it might take up to that long for us to do a full risk assessment with these returning travelers and built in there some time to make sure that they also had enough time to rest and recuperate after what sounds like a difficult ordeal.  So, we said up to three days because we thought that gave us a little room to make sure that we had enough time to do all the things that we needed to do.  It’s not a specific time line.  It is just a period of time for our medical officers who evaluate each patient.  Each passenger in giving the passengers time to work things through with us as quickly as possible.  What I can say in general is that we are working with — we at CDC are working as quickly as we can to return our fellow Americans to their lives but we also want to make sure we’re doing it in a way that no one represents a risk to themselves or their families or their communities and right now, all 195 of these travelers are willing and eager to cooperate because they also want to make sure that they’re taking care of their own health, the health of their families and the health of their communities.  So, they are voluntarily cooperating with us, and in these kind of situations, that’s in general how our fellow Americans react.  They want to make sure that they’re protecting themselves and their communities and we want to compliment them on their eagerness to help, and we have full expectation that we’ll continue to have that kind of cooperation.

Haynes: Thank you, Dr. Messonnier, and thank you all for joining us for today’s update.  Please visit the 2019 novel coronavirus web page for continued updates and if you have further questions, please contact the main media line at 404-639-3286 or by e-mail at media@cdc.gov, thank you.

Operator: This conclude’s today’s conference, all participants may disconnect at this time.  Please disconnect at this time.  Thank you.

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