Coronavirus Outbreak: What Is the U.S. Public Health Response?

The outbreak of a new coronavirus that originated in China has triggered alarm worldwide, leading to travel bans, border closings, trade controls, and other measures. The United States has declared a public health emergency, and federal agencies have ramped up their efforts to prevent the virus’s spread as the number of U.S. cases slowly rises. But experts warn the U.S. response could be hampered by funding issues.

Which agency leads the U.S. response?

The Centers for Disease Control and Prevention (CDC), part of the Department of Health and Human Services (HHS), has been the primary first responder to the coronavirus outbreak. Its actions have included:

• screening travelers at airports who recently visited the city of Wuhan, the epicenter of the virus, or the rest of mainland China, with help from Customs and Border Protection;
• operating quarantine stations for sick patients and tracking people they’ve been in contact with, a process known as contact tracing;
• deploying personnel and providing guidance to state and local health departments and hospitals;
• developing a test to diagnose the virus and seeking approval from the Food and Drug Administration to distribute it; and
• broadcasting best practices to the public and encouraging citizens to avoid nonessential travel to China.

The National Institutes of Health, also an HHS agency, has stepped up lab research, including developing a vaccine and antiviral drugs. Several U.S. companies are also working on a vaccine, though the process could take more than a year.

What are U.S. health authorities advising?

The State Department has evacuated U.S. citizens from Wuhan and warned against travel to China. The Defense Department has housed evacuees under quarantine at a military base. The Donald J. Trump administration’s coronavirus task force, led by HHS Secretary Alex Azar, temporarily banned Chinese travelers and non-U.S. citizens who recently visited China—though not Hong Kong, Macau, and Taiwan—from entering the United States.

The CDC has urged people to wash their hands frequently, avoid anyone who appears sick, cover their noses and mouths when sneezing, and disinfect surfaces that could be contaminated. It urges anyone with a fever, cough, or difficulty breathing who has traveled to China, or was in close contact with someone who has the coronavirus, to seek medical care.

How is the United States contributing to global efforts?

CDC experts have offered to join a team investigating the virus in China organized by the World Health Organization (WHO), which declared the coronavirus outbreak a public health emergency of international concern. The CDC also supports health ministries around the world to prepare for potential outbreaks, and it has spent years training health workers to investigate cases through its field epidemiology program. It plans to distribute diagnostic test kits for the coronavirus to international partners.

Is the United States equipped to respond if the outbreak worsens?

Experts say that while federal agencies have improved their capacities to respond, difficulties could arise if the outbreak worsens, which appears likely. The White House warned that “the public health system could be overwhelmed” if the virus spreads widely, given the CDC’s and local health departments’ limited resources. HHS has already requested additional funds from Congress to combat the virus.

Despite the creation of a task force, some experts have expressed concerns about low interagency coordination. In 2018, the Trump administration disbanded a global health team on the National Security Council that would have organized the federal response to the coronavirus outbreak. “I worry a little bit about coordination because responding to an epidemic or outbreak really does take a variety of agency inputs and coordination,” said CFR’s Thomas J. Bollyky.

As more is understood about the virus, the public health response could shift. If it is determined that the virus can be transmitted from people who don’t show symptoms, or that it is easily passed from person to person, then the U.S. response could move from a containment strategy to a mitigation strategy, including boosting vaccine development.