Infectious disease experts discuss Wuhan coronavirus

Infectious disease experts from UNMC and Nebraska Medicine met with members of the media Tuesday to discuss the Centers for Disease Control and Prevention’s announcement of the first confirmed case of the Wuhan coronavirus in the U.S.

Their message: Don’t panic.

“Right now, the risk in the United States and in most countries outside of China is very low,” said James Lawler, M.D., of the Global Center for Health Security. “The outbreak really seems to be concentrated in the city of Wuhan, which is in central eastern China. In the U.S., we should probably be much more worried about influenza and respiratory diseases that we know cause significant morbidity and mortality every year.”

In an average year, Dr. Lawler noted, 30,000 Americans die of influenza.

“We’ve had one detected case of this new coronavirus in the U.S.,” he said.

Mark Rupp, M.D., chief of the UNMC Division of Infectious Diseases, noted that coronaviruses are a broad family of viruses, named because they resemble a crown.

“There are a few that are known to infect humans that largely cause relatively mild upper respiratory disease, or common cold,” Dr. Rupp said. “More recently, we’ve had outbreaks of coronaviruses that can cause severe lower respiratory tract disease, or pneumonia.”

Dr. Rupp pointed to the SARS and MERS epidemics, calling the Wuhan coronavirus the third novel coronavirus that can cause severe lower respiratory tract disease.

“It appears to be less transmissible and less severe, perhaps, than SARS or even MERS,” he said.

Dr. Lawler said the nation and world’s reaction to the Wuhan coronavirus showed how the world’s response to public health crises has evolved.

“We’ve become much better at detecting these types of events,” he said. “Our surveillance is much better than it was even in 2003 with SARS . . . Just a couple of weeks into the outbreak, we have a much better idea of what the pathogen is, we have systems already in place that are doing surveillance, detection and tracking, so we’re well ahead of where we have been with previous outbreaks.

“We seem to have done a much better job of identifying cases and implementing the appropriate public health measures to prevent spread,” he said. “The Chinese government has actually been very transparent and open about sharing the status of the outbreak and identifying and notifying partners in the World Health Organization very quickly.”
Most experts predict the virus will not be declared an international public health emergency.

“This does demonstrate that the world has made significant progress in combatting these types of emerging disease threats,” Dr. Lawler said.

Still, he sounded a cautious note.

“This is unfortunately something that is going to continue to happen,” he said. “New and emerging diseases are not going to stop anytime soon.”

Angela Hewlett, M.D., medical director of the Nebraska Biocontainment Unit, said the unit was closely monitoring the outbreak, as it does any outbreak in the world.

“In our role as a biocontainment unit, and one of the leaders in the United States in biocontainment, we should not only be monitoring this closely but serving as an example for others,” she said, pointing to the importance of appropriate travel screening at health care institutions such as Nebraska Medicine.

“We should serve in that leadership role and provide that guidance for others in their infection control management,” she said.

Dr. Rupp noted that the CDC has issued a low-level alert for people travelling to the Wuhan area of China, with what he called “common-sense precautions.”

Still, all agreed that the United States should focus on influenza and other, more common, viruses.

“We need to be making sure that we’re taking appropriate precautions to prevent the spread of those viruses, while being on the lookout for this novel coronavirus at the same time,” Dr. Rupp said.