Coronavirus Update

 

President Trump’s team has come out with an initial briefing on the coronavirus outbreak, offering facts, cautions, and pushing back against panic. Johns Hopkins University has an excellent data visualization tool, constantly updating data on maps: “2019-nC0V Global Cases (by Johns Hopkins CSSE). CNET has a fact-based story, with lots of links, that is being regularly updated; it is now titled: “Coronavirus cases pass 11,000, US declares emergency: Everything we know.”

This was a display of competent communication to the American public, treated as adults. Dr. Redfield gave the numbers. Dr. Fauci then explained the question posed by people on Ricochet, including me: why is this different from the well-known annual deaths from the seasonal flu?* With the numbers and the differentiation in place, the briefers laid out a series of screening and quarantine steps that will go into full effect Sunday. Anyone who has been in the province where the outbreak started will be quarantined for 14 days, while those coming from other areas with known infections would be screened and then go into “self-quarantine.” They were also careful to speak of sympathy and compassion for the Chinese people who have been affected, directly or with family losses.

Here is the video and the whole transcript, of the press briefing, followed by the text of the presidential proclamation. Both the transcript and the proclamation are posted on the White House website.

Press Briefing by Members of the President’s Coronavirus Task Force

Issued on: January 31, 2020

James S. Brady Press Briefing Room

3:42 P.M. EST

SECRETARY AZAR: Well, good afternoon, everyone. I’m Alex Azar, Secretary of Health and Human Services, and Chairman of the President’s Task Force on the Novel Coronavirus.

I’m going to start by turning things over to Dr. Robert Redfield, the Director of the Centers for Disease Control and Prevention, to discuss the current situation on the novel coronavirus. Dr. Redfield.

DR. REDFIELD: Thank you, Mr. Secretary. Let me give you an update on the current situation of the novel coronavirus. First though, I want to emphasize that this is a serious health situation in China, but I want to emphasize that the risk to the American public currently is low. Our goal is do all we can do to keep it that way.

Second, I want to recognize the concern that the American public may have. And I want to reiterate what I just said: Currently, the risk of the American public is low.

As of today, there are nearly 9,700 cases in China, with more than 200 deaths. Additionally, currently there are another 23 countries that have confirmed, totally, 132 cases. This also includes 12 individuals who have been confirmed in six countries who did not travel to China.

CDC has launched an aggressive public health response focused on early case recognition, isolation of those cases identified, and contact tracing around those individuals. This response is a layered response, which includes both targeted airport screening, as well as heightened education and awareness of the American healthcare community to be vigilant in ascertaining the possibility of recent travel to China when they are evaluating patients with upper respiratory tract infection.

To date, we have confirmed six cases of this novel virus in the United States. The most recent case had no travel history to China, but was a close personal contact of one of the previous cases that we had identified through our aggressive contact tracing. In addition, there are currently 191 individuals that are under investigation.

Once again, I want to emphasize that this is a significant global situation, and it continues to evolve. But I also want to emphasize again that the risk at this time to the American public is low.

Mr. Secretary.

SECRETARY AZAR: Thank you, Dr. Redfield. I would now like to invite Dr. Anthony Fauci, the Director of the National Institute of Allergy and Infectious Disease, to discuss the underlying rationale for the actions that I will be discussing after he concludes. Dr. Fauci.

DR. FAUCI: Thank you very much, Mr. Secretary. The concept that’s underlying the action that you’ll hear about shortly is the issue of the unknown aspects of this particular outbreak. So let me enumerate just a few of these.

I can start off by putting it into perspective by telling you I often get asked — we have an influenza outbreak here. We have about 8,000 deaths already. We have about 100,000 hospitalizations. Why are we paying such attention? And why are we doing the kinds of things we’re doing here right now?

Well, the reason is, despite the morbidity and mortality with influenza, there’s a certainty, for example, of seasonal flu. I can tell you all, guaranteed, that as we get into March and April, the flu cases are going to go down. You could predict pretty accurately what the range of the mortality is and the hospitalizations, as we’ve done over the years.

The issue now with this is that there’s a lot of unknowns. As you can see just from the media, the number of cases have steeply inclined each and every day. You know that, in the beginning, we were not sure if there were asymptomatic infection, which would make it a much broader outbreak than what we’re seeing. Now we know for sure that there are.

It was not clear whether an asymptomatic person could transmit it to someone while they were asymptomatic. Now we know from a recent report from Germany that that is absolutely the case.

There are a number of countries outside of China that have travel-related cases. And now what we’re seeing is that there are secondary cases from them, and, as Bob mentioned, we also have that in this country. The WHO has issued, as you know, a Public Health Emergency of International Concern declaration.

If you put all these things together, I underscore what Bob said: We still have a low risk to the American public, but we want to keep it at a low risk. And because there are so many unknowns here, we’re going to take the action that the Secretary will describe, in a temporary way, to make sure we mitigate, as best as we possibly can, this risk. Thank you.

SECRETARY AZAR: Thank you, Dr. Fauci. Today, President Trump took decisive action to minimize the risk of the spread of novel coronavirus in the United States. Since taking office, President Trump has been clear: His top priority is the safety of the American people. In addition to the steps that the doctors have outlined, we continue to operationalize a multi-layered, cross-agency, public health response.

Following the World Health Organization’s decision to declare the 2019 novel coronavirus a Public Health Emergency of International Concern, I have today declared that the coronavirus presents a public health emergency in the United States. The actions we have taken and continue to take complement — complement the work of China and the World Health Organization to contain the outbreak within China.

In accordance with the declaration, beginning at 5:00 p.m., Eastern Standard Time; Sunday, February the 2nd, the United States government will implement temporary measures to increase our abilities to detect and contain the coronavirus proactively and aggressively. Any U.S. citizen returning to the United States who has been in Hubei Province in the previous 14 days will be subject to up to 14 days of mandatory quarantine to ensure they are they are provided proper medical care and health screening.

To be clear, this applies only to U.S. citizens who have been in Hubei Province in the past 14 days prior to their attempted entry into the United States.

Any U.S. citizen returning to the United States who has been in the rest of Mainland China within the previous 14 days will undergo proactive entry health screening at a select number of ports of entry and up to 14 days of monitored self-quarantine to ensure they’ve not contracted the virus and do not pose a public health risk.

Additionally, the President has signed a presidential proclamation, using his authority pursuant to Section 212(f) of the Immigration and Nationality Act, temporarily suspending the entry into the United States of foreign nationals who pose a risk of transmitting the 2019 novel coronavirus.

As a result, foreign nationals, other than immediate family of U.S. citizens and permanent residents, who have traveled in China within the last 14 days will be denied entry into the United States for this time.

Once again, these actions will become effective at 5:00 p.m., Eastern Standard Time; Sunday, February 2nd. These prudent, targeted, and temporary actions will decrease the pressure on public health officials screening incoming travelers, expedite the processing of U.S. citizens and permanent residents returning from China, and ensure resources are focused on the health and safety of the American people.

I want to stress: The risk of infection for Americans remains low. And with these and our previous actions, we are working to keep the risk low. All agencies are working aggressively to monitor this continually evolving situation and to keep the public informed in a constantly transparent way.

The United States appreciates China’s efforts and coordination with public health officials across the globe, and continues to encourage the highest levels of transparency.

It is likely that we will continue to see more cases in the United States in the coming days and weeks, including some limited person-to-person transmission. The American public can be assured the full weight of the U.S. government is working to safeguard the health and safety of the American people.

I’d now like to invite Deputy Secretary of State Steve Biegun for an update.

DEPUTY SECRETARY BEIGUN:  Good afternoon. And thank you, Secretary Azar. My name is Steve Biegun, and I am the Deputy Secretary of State, and I represent the State Department on the President’s Novel Coronavirus Task Force.

Let me describe briefly the role of the Department of State in the proceedings of this task force and our contributions. Our first responsibility is to monitor events on the ground in China where we have the presence of U.S. diplomats, and to give clear and accurate advice to American citizens and, in particular, American travelers considering visiting or staying in China.

In this particular case, this includes identifying any health or safety risks to which they may be subjected, but also, very importantly, identifying their access to essential services such as healthcare in parts of China that are affected by this coronavirus.

China has an excellent healthcare system, but, in parts of the country, it is simply overwhelmed and the accessibility to that healthcare for any reason — including potential infection, but also any other type of accident in need of medical care — may be compromised during the Chinese government’s own treatment of the consequences of this virus.

Finally, we also make our judgments based upon any obstacles, particularly obstacles to movement that American citizens might face in the country. And in China, we have seen barriers to travel, both within and without China, as well as between the United States and China. And so we’ve given prudent advice, over the course of the week, to American citizens in order for them — to allow them to make the best possible choices for themselves.

Our second responsibility is to assist U.S. citizens in the affected areas as much as possible. Because we have a presence on the ground, we can provide advice and, in some cases, we can make other arrangements. But I want to emphasize this is “as possible,” and we will continue to review what we can do in certain circumstances.

Finally, and very importantly, the core mission of the Department of State is to work closely with our international partners. And in this case, we are working very closely with the Chinese government in order to address a number of related matters.

But let me start, on behalf of the President and the Secretary of State, by extending our deepest compassion to the people of China. This has been a very difficult time for the Chinese people. It came at a point of their peak holiday season. Many are affected. Many have lost loved ones or are enduring the illness of loved ones. And I want the Chinese people to know that they have the deepest sympathies of the United States of America.

Let me also say and echo what Secretary Azar said, which is we are deeply appreciative of the close cooperation we have with the Chinese government as we work together to try to find appropriate ways to address any risks and challenges from this virus.

And finally, the United States will continue to cooperate with China in ways that we could potentially provide assistance, including technical assistance, and also, to the extent possible, any critical supplies that the Chinese need in order to address this virus. And we are working very hard to find donors and make arrangements so that we can — we can undertake a robust effort to help the Chinese people get their arms around this outbreak.

Thank you.

SECRETARY AZAR: Thank you, Secretary Biegun. Let me — let me next invite the Acting Deputy Secretary of the Department of Homeland Security Ken Cuccinelli to take the podium for some comments.

ACTING DEPUTY SECRETARY CUCCINELLI: Thank you, Mr. Secretary. I am Ken Cuccinelli. I’m the Acting Deputy Secretary at the Department of Homeland Security, and I’m the Department’s representative on the task force led by Secretary Azar.

Several elements of the Department of Homeland Security are engaged in implementing the medical strategy you heard described here, including Customs and Border Protection, which stands at our land ports, seaports, and airports — and I’ll come back to the airports in a moment — particularly the Office of Field Operations personnel who you see when you come back into the country from your travels. They’re the first line of defense when you land and come to the country.

Additionally engaged is TSA — the security and the engagement with the airlines. Our chief medical officer in the department is in CWMD and they’re — we were providing medical support at the airports.

So we’re using contract authority that we have to backfill the CDC personnel, so they can be freed up for other missions at the airports where medical screening is being focused.

FEMA continues to prepare and support HHS preparations themselves. And then the United States Coast Guard, of course, commands the ports of the United States and deals with incoming shipping, which is obviously slower than the airplanes but coming nonetheless, and we are prepared to deal with each of those.

The President’s proclamation will have Customs and Border Protection ensuring that United States citizens, legal permanent residents, and their immediate families continue to enter the United States, though they — those coming from Hubei Province, as you heard from the Secretary, will be subject to quarantine and the others from China to screening.

We will be implementing a funneling effort at the airports. This is done under the authority of the Customs and Border Protection, and it will include seven airports. So starting five o’clock on Sunday, Eastern Time, incoming flights from China will be funneled through seven airports. Those airports are JFK, Chicago’s O’Hare, in San Francisco, Seattle, Atlanta, Honolulu, and LAX.

This is done under CBP’s authority. It will be executed by the Secretary the Department of Homeland Security, consistent with the President’s proclamation and in support of that effort — again, so we can focus the expertise of the medical professionals that will do the screening to implement this.

We’ll continue to support the medical efforts across the country both at our ports — our land, sea, and air — as well as with personnel standing up some of the resiliency measures that HHS has been working on for some time. Thank you.

SECRETARY AZAR: Thank you, Secretary Cuccinelli. At this point, we’d be happy to take some of your questions. Kevin, would you like to get started?

Q Thank you, Mr. Secretary. If the risk is really low, could you talk about why go to such an extreme as a public health emergency? If the risk is that low, why are we taking such measures?

SECRETARY AZAR: So these are actually fairly incremental, measured steps, on top the steps we’ve already progressively been taking.  You’ll notice that many airlines have already stopped direct flights from China. They have pulled that down. We’re seeing a significant — and the Department of Transportation could comment on the numbers we’re seeing or Homeland Security. We’ve seen a significant reduction in people from the U.S. going to China, people from China coming to the U.S., already.

This just helps us focus our efforts so that we — as we’re dealing with the unknowns that Dr. Fauci spoke about earlier — unknowns around incubation period, unknowns about the speed of transmissibility, unknowns about asymptomatic transmission, unknowns about severity — that we take appropriate, measured, prudential steps so we can focus our resources. Because it’s the bread and butter — I’ve talked to you before about — the bread and butter of public health is: identify people who might be symptomatic or might have the disease, diagnose, isolate, treat, contact trace.

That’s a significant undertaking, as we have already done with the six individuals in the United States who’ve been positively identified. We have to focus those resources.

John.

Q Mr. Secretary, the mandatory quarantine for people coming in Hubei Province — will that be home quarantine or will that be in an institutional setting?

SECRETARY AZAR: That would be at an appropriate quarantine facility of some kind for those individuals. For the U.S. citizens returning to the United States from having been in China within the previous 14 days, they would be funneled, as Secretary Cuccinelli spoke of; they would be screened appropriately to see if they present any type of symptoms of the disease; and then they would be asked to self-isolate at home over the 14 days.

But for individuals from Hubei — because that is the epicenter of this, with such high immediate transmission — we feel that these additional measures of quarantine for up to 14 days are appropriate.

Q And can I just follow that: Have you selected specific quarantine centers?

SECRETARY AZAR: We have selected them. We’re — we will announce those as DHS implements, with the airlines, that funneling activity.

Q To follow up on John, what does self-quarantine look like for the people who are self-quarantining? How do you enforce that? What are the mechanisms surrounding that?

And if you could you also speak to — you just described this as sort of an incremental step, I believe. This is obviously significant: the quarantine of citizens in this country.

What is your message to Americans who are watching this on the news, who are seeing this, who are feeling really alarmed by the steps that this administration is taking and by the spread of coronavirus in general? They hear you say the risk is low, but then they see this action being taken, and I think some people might be freaked out by that.

SECRETARY AZAR: I hope not. I hope that people will see that their government is taking responsible steps to protect them. These are — these are preventive steps. The risk is low in the United States. The risk is low of transmissibility, the risk of contracting the disease is low, but our job is to keep that risk low, as much as we can, by taking appropriate preventative steps.

So that’s — that’s the approach we’re taking.

Let me ask Dr. Redfield if he can talk a bit about — we — this is — we do this type of quarantine and self-isolation work basically every day, working very closely — I want to stress something that we’ve not mentioned enough — working very closely with our state and local public health partners. They’re — just as we do with emergency response, we serve as a backup and expertise and a border-type force, but the state and local authorities are the backbone of our public health infrastructure and we work with them to daily to help with our quarantine stations and activities.

So, Dr. Redfield, could you talk a bit about self-isolation?

DR. REDFIELD: Thank you, Mr. Secretary. Clearly, we’ve stratified the risk groups here, as it was already alluded to, from Hubei Province, where there really is aggressive transmission. Those individuals are going to come and be required to have 14 days of — up to 14 days of (inaudible) transmission.

Then, there’s a large category of individuals coming back to China. As we stand here today, over half of the reported cases in China now are not in Hubei, but when you look at their history it’s — they got infected — probably over 80, 85 percent of them got infected from Hubei.

Those individuals will then be actively screened when they come into one of the seven airports, for significant risk, as well as any evidence of any symptoms. In the absence of any reason to advance them into a clinical evaluation at that port of entry, they will be allowed to complete their travel back to their home, where they then will be monitored by the local health departments in a self-monitoring situation their home.

We did this in the West Africa Ebola outbreak.

Q That sounds Ebola. Right.

DR. REDFIELD: We did it in the — but I want to emphasize: At that time, over 98 percent of the American public voluntarily accepted the importance of this. And we think and we continue to believe the American public will see this as something to their benefit, to their family’s benefit, obviously their community’s benefit. So that’s the current situation.

DR. FAUCI: There’s one other aspect of this that I think is important. Very recently, there was a case of a woman who was in China, and came to Germany, and had an interaction — professional interaction — with a professional partner.

She had no symptoms at the time. She went back to China and got sick. This individual, with whom she had an interaction, contracted the coronavirus at a time that she had no symptoms. He then transmitted it to two of his colleagues, so they now have four cases. One of the problems with when the virus is transmitted in an asymptomatic way and has its implications — it puts a terrible burden on the screening process. How do you screen somebody?

You know, remember back with Ebola? Ebola doesn’t get transmitted unless you’re actively very ill, and you know that. It’s very, very clear. When you can transmit a virus at a time when you’re asymptomatic, that just puts that extra burden on screening. And as a lot of people come in, it’s going to be very difficult.

Q Dr. Fauci, can I follow up on that? I — just what he was just saying. Given that Germany data that you just cited, are the 195 people being quarantined right now — are they getting tested every day for coronavirus?

SECRETARY AZAR: Let’s ask Dr. Redfield to describe their care.

DR. REDFIELD: Clearly, they’re all isolated and will be for the 14 days. We have done virus isolation, but I want to be clear: The current tests that we developed at CDC is not — we’re not sure of the natural history of how the virus is isolated. Can you isolate it one day, then three days later you can’t? And we are seeing — in the cases that are in the hospital, we’ve seen people who had detectable virus, then they didn’t have detectable virus, and then three days later they had detectable virus.

We’re using the virus cultures right now in these individuals more to help us learn about this virus. How much asymptomatic carriage, in fact, is there? So I want people to understand that distinction. We’re not using it as a release criteria because we don’t know the natural history of how this virus is secreted, and this is what we’re continuing to learn.

Q And are you comfortable that the thousands of people that pass through the U.S. screening so far are not car- — that they don’t have coronavirus?

DR. REDFIELD: So this is why it’s such a layered approach. We are going to see additional cases in this country. We’ve already seen, in the six cases we’ve defined: A number of them came in asymptomatic. So this is why we have that multi-layered approach and have really worked hard to engage the medical community in the United States.

Of the six cases that we diagnosed so far, one was picked up by hospi- — airport screening. Four were picked up by astute doctors. And the most recent one was picked up by CDC doing aggressive contact tracing.

Q Thank you, Mr. Secretary. Jeff Mason from Reuters. Can you — you referenced airlines earlier. Can you or your colleague from the Department of Transportation give us an update on the administration’s thinking about a travel ban on airlines, in general, being prohibitive for flying to and from China?

ASSISTANT SECRETARY SZABAT: There is no travel ban — Joel Szabat, Assistant Secretary of Department of Transportation. I think many of you who’ve been following this are aware: All of the three U.S. carriers who’ve flying between the U.S. and China have announced that they are taking down all of their passenger flights, and they announced that before any action by the administration.

So we are working closely with our counterparts in the — our Chinese aviation counterparts. And we’ll be working, going forward, with both the U.S. and the Chinese passenger airlines about their flight plans going forward.

Q Are you considering more drastic action beyond the voluntary measures that the airlines have taken so far?

ASSISTANT SECRETARY SZABAT: As Secretary Azar mentioned earlier, this is an evolving situation — but, at the moment, no.

SECRETARY AZAR: Would you mind giving some numbers on — I don’t know if you or Ken can talk a bit about what we’re seeing on air traffic numbers, perhaps.

ASSISTANT SECRETARY SZABAT: So I’ll start it off and then turn over to Acting Deputy Secretary Cuccinelli.

So, in terms of passengers traveling between United States and China, as you might expect, over the course of the last couple of weeks, the passengers loading in the U.S. to fly to China have dropped to almost none. Passengers continue to have a high, what we call, “load factor” — a high rate of passengers coming from China to United States. However — so the U.S. carriers, though, as they’re (inaudible) they represent just under 40 percent of the passenger capability.

So with that, we have been seeing already, in the course of the last week to 10 days, a significant decrease in the number of passengers that have been going between United States and China. And the Department of Homeland Security does an excellent job of tracking those numbers day to day.

ACTING DEPUTY SECRETARY CUCCINELLI: So, just to speak to the numbers: Since the Chinese have locked down Wuhan and the Hubei Province — which was eight days ago, if memory serves — travel from China to the United States, as of yesterday, had dropped by close to 20 percent
Travel from the United States to China had dropped by well more than 50 percent, and this is with the sort of market response that Joel referenced by the airlines and the voluntary actions taken by travelers.

I would note for you all that it’s not a lot of data, but over the last five days, the number of American citizens traveling from China back to the United States has been rising. So even while the total number is going down, it does look to us, initially, like Americans, at least some of them, are returning back home.

Q Dr. Fauci, how confident are you in the accuracy of these tests? If somebody is testing negative and then they later test positive, can you have confidence, if you’re testing negative for something, that you don’t have it?

DR. FAUCI: So, you mean — I think the question you ask is really one of the fundamental bases of why this decision was made. If we had an absolutely accurate test that was very sensitive and very specific, then we could just test people and say, “Okay, we’re good to go.”

I want to get back to that broad concept that I mentioned when I made my brief introduction about the unknowns. We don’t know the accuracy of this test. We haven’t done enough — people who came in with negative, then all sudden they were positive. You could have virus in your nasal secretions or you couldn’t and still be infected. I mean, it isn’t like it’s a horrible test, but it is not a test that’s absolute.

I spoke to a reporter the other day, talking about tests. So when you’re talking about HIV, if a person has HIV and I draw their blood, I can tell you 100 percent whether they have HIV or not — 100 percent. That’s not even near where we are with this.

Q You talk about a gradual approach, Mr. Secretary, in terms of what you’re doing right now. What measures do you have, sort of, in the toolkit if this gets worse?

SECRETARY AZAR: Well, let me ask, perhaps, Dr. Kadlec to talk a bit about our approach. Obviously, at this point, as I’ve said, the risk here in the United States is quite low for any individual. The risk is low. Our job is to work to keep that that way.

But we have public health tools that we use, we exercise constantly in the event of larger-scale infectious disease outbreaks. And that’s what we would — that what we would rely on should we end up seeing more cases in the United States. But it’s exactly these measures that help make any additional cases more manageable to use the tools Dr. Kadlec will talk about.

DR. KADLEC: Well, thank you very much, Mr. Secretary. And my role in this is really precautionary at this stage. And everything that’s been done at this point has been incremental, proportionate, and precautionary. And so my responsibilities are to work across the federal government, as well as within HHS, to ensure that we’re postured should this virus, kind of, continue to expand.

And so, domestically, we’re working on — working with our private sector healthcare preparedness. We’re working specifically around supply chain resilience because much of our healthcare products come from overseas. And we’re also working actively with NIH and our DOD colleagues, as well as our DARPA colleagues and the private industry to develop better diagnostics, possible therapeutics, as well as vaccines, which Dr. Fauci can speak more about.

So we’re really taking a very — I wouldn’t say cautious — but deliberate and methodical approach to ensure that, come what may, we’re prepared. Thank you.

SECRETARY AZAR: Kristen.

AIDE: I’m going to call the last question so that we can ensure we get you guys out for departure. So last question.

SECRETARY AZAR: Kristen.

Q Any concerns about legal challenges, international travel, in general, to the region? What’s the message to people who need to travel to the region, and what benchmark will you have for when this gets lifted?

SECRETARY AZAR: So let me ask Dr. Redfield if he could talk a bit about — just giving your assessment as a health professional about international travel generally. And then the types of factors — maybe for Dr. Fauci — that we’ll be looking at as we, again, temp- — hopefully, temporary measures, titrated, try to just keep a pause on the situation.

DR. REDFIELD: Thank you, Mr. Secretary. I think, as Dr. Fauci said, right now there’s a lot of unknowns. Obviously, almost every other day, we’re learning something we didn’t the day before about this. And we’ll continue to do that.

Probably the most important thing, from our perspective, is whether or not there’s expansion of what I call “sustained community human-to-human transmission.” Right now, that is limited, in large part, to Hubei area and the broader China.

We’ve had some isolated human-to-human transmission in some of the cases that have gone internationally. I mentioned we’ve had 12 so far that have been defined in the whole world. So that’s going to be important to see if there’s broadening of sustained human-to-human transmission. I think that’s going to really be the major — the major thing that we’re going to be looking.

And, as the Secretary said, these precautionary messages and actions that have been put out today, it really is intended to keep this virus from causing significant consequences to the American public.

SECRETARY AZAR: Thank you all very much. And again, I just want to stress: First, the most important thing that we can be doing is what we are doing, which is offering to help the Chinese government and assist them in helping them to control the spread of the novel coronavirus in China — working with them as closely as possible, as well as with the World Health Organization.

Second, the risk to Americans is low. You have a team here. You have an experienced, first-class — the world’s best public healthcare system, infrastructure, and professionals looking out for you, making judgments like this, scaling them up, as appropriate, to work to keep this from becoming an issue that would be of concern for you — to keep that risk low.
So thank you all very much.

END

The presidential proclamation is quite detailed, providing both background to the public and the rationale, to stand up in court, for actions under specific provisions of law. Emphasis added.

Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus

HEALTHCARE

Issued on: January 31, 2020

The United States has confirmed cases of individuals who have a severe acute respiratory illness caused by a novel (new) coronavirus (“2019-nCoV”) (“the virus”) first detected in Wuhan, Hubei Province, People’s Republic of China (“China”). The virus was discovered in China in December 2019. As of January 31, 2020, Chinese health officials have reported approximately 10,000 confirmed cases of 2019-nCoV in China, more than the number of confirmed cases of Severe Acute Respiratory Syndrome (SARS) during its 2003 outbreak. An additional 114 cases have been confirmed across 22 other countries; in several of these cases, the infected individuals had not visited China. More than 200 people have died from the virus, all in China.

Coronaviruses are a large family of viruses. Some cause illness in people and others circulate among animals, including camels, cats, and bats. Animal coronaviruses are capable of evolving to infect people and subsequently spreading through human-to-human transmission. This occurred with both Middle East Respiratory Syndrome and SARS. Many of the individuals with the earliest confirmed cases of 2019-nCoV in Wuhan, China had some link to a large seafood and live animal market, suggesting animal-to-human transmission. Later, a growing number of infected individuals reportedly did not have exposure to animal markets, indicating human-to-human transmission. Chinese officials now report that sustained human-to-human transmission of the virus is occurring in China. Manifestations of severe disease have included severe pneumonia, acute respiratory distress syndrome, septic shock, and multi-organ failure.

Neighboring jurisdictions have taken swift action to protect their citizens by closing off travel between their territories and China. On January 30, 2020, the World Health Organization declared the 2019-nCoV outbreak a public health emergency of international concern.

Outbreaks of novel viral infections among people are always of public health concern, and older adults and people with underlying health conditions may be at increased risk. Public health experts are still learning about the severity of 2019-nCoV. An understanding of the key attributes of this novel virus, including its transmission dynamics, incubation period, and severity, is critical to assessing the risk it poses to the American public. Nonetheless, the Centers for Disease Control and Prevention (CDC) has determined that the virus presents a serious public health threat.

The CDC is closely monitoring the situation in the United States, is conducting enhanced entry screening at 5 United States airports where the majority of travelers from Wuhan arrive, and is enhancing illness response capacity at the 20 ports of entry where CDC medical screening stations are located. The CDC is also supporting States in conducting contact investigations of confirmed 2019-nCoV cases identified within the United States.  The CDC has confirmed that the virus has spread between two people in the United States, representing the first instance of person-to-person transmission of the virus within the United States. The CDC, along with state and local health departments, has limited resources and the public health system could be overwhelmed if sustained human-to-human transmission of the virus occurred in the United States. Sustained human-to-human transmission has the potential to have cascading public health, economic, national security, and societal consequences.

During Fiscal Year 2019, an average of more than 14,000 people traveled to the United States from China each day, via both direct and indirect flights. The United States Government is unable to effectively evaluate and monitor all of the travelers continuing to arrive from China. The potential for widespread transmission of the virus by infected individuals seeking to enter the United States threatens the security of our transportation system and infrastructure and the national security. Given the importance of protecting persons within the United States from the threat of this harmful communicable disease, I have determined that it is in the interests of the United States to take action to restrict and suspend the entry into the United States, as immigrants or nonimmigrants, of all aliens who were physically present within the People’s Republic of China, excluding the Special Autonomous Regions of Hong Kong and Macau, during the 14-day period preceding their entry or attempted entry into the United States. I have also determined that the United States should take all necessary and appropriate measures to facilitate orderly medical screening and, where appropriate, quarantine of persons allowed to enter the United States who may have been exposed to this virus.

NOW, THEREFORE, I, DONALD J. TRUMP, President of the United States, by the authority vested in me by the Constitution and the laws of the United States of America, including sections 212(f) and 215(a) of the Immigration and Nationality Act (INA), 8 U.S.C. 1182(f) and 1185(a), and section 301 of title 3, United States Code, hereby find that the unrestricted entry into the United States of persons described in section 1 of this proclamation would, except as provided for in section 2 of this proclamation, be detrimental to the interests of the United States, and that their entry should be subject to certain restrictions, limitations, and exceptions. I therefore hereby proclaim the following:

Section 1. Suspension and Limitation on Entry. The entry into the United States, as immigrants or nonimmigrants, of all aliens who were physically present within the People’s Republic of China, excluding the Special Autonomous Regions of Hong Kong and Macau, during the 14-day period preceding their entry or attempted entry into the United States is hereby suspended and limited subject to section 2 of this proclamation.

Sec. 2. Scope of Suspension and Limitation on Entry.

(a) Section 1 of this proclamation shall not apply to:

(i) any lawful permanent resident of the United States;

(ii) any alien who is the spouse of a U.S. citizen or lawful permanent resident;

(iii) any alien who is the parent or legal guardian of a U.S. citizen or lawful permanent resident, provided that the U.S. citizen or lawful permanent resident is unmarried and under the age of 21;

(iv) any alien who is the sibling of a U.S. citizen or lawful permanent resident, provided that both are unmarried and under the age of 21;

(v) any alien who is the child, foster child, or ward of a U.S. citizen or lawful permanent resident, or who is a prospective adoptee seeking to enter the United States pursuant to the IR-4 or IH-4 visa classifications;

(vi) any alien traveling at the invitation of the United States Government for a purpose related to containment or mitigation of the virus;

(vii) any alien traveling as a nonimmigrant under section 101(a)(15)(C) or (D) of the INA, 8 U.S.C. 1101(a)(15)(C) or (D), as a crewmember or any alien otherwise traveling to the United States as air or sea crew;

(viii) any alien seeking entry into or transiting the United States pursuant to an A-1, A-2, C-2, C-3 (as a foreign government official or immediate family member of an official), G-1, G-2, G-3, G-4, NATO-1 through NATO-4, or NATO-6 visa;

(ix) any alien whose entry would not pose a significant risk of introducing, transmitting, or spreading the virus, as determined by the CDC Director, or his designee;

(x) any alien whose entry would further important United States law enforcement objectives, as determined by the Secretary of State, the Secretary of Homeland Security, or their respective designees based on a recommendation of the Attorney General or his designee; or

(xi) any alien whose entry would be in the national interest, as determined by the Secretary of State, the Secretary of Homeland Security, or their designees.

(b) Nothing in this proclamation shall be construed to affect any individual’s eligibility for asylum, withholding of removal, or protection under the regulations issued pursuant to the legislation implementing the Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, consistent with the laws and regulations of the United States.

Sec. 3. Implementation and Enforcement. (a) The Secretary of State shall implement this proclamation as it applies to visas pursuant to such procedures as the Secretary of State, in consultation with the Secretary of Homeland Security, may establish. The Secretary of Homeland Security shall implement this proclamation as it applies to the entry of aliens pursuant to such procedures as the Secretary of Homeland Security, in consultation with the Secretary of State, may establish.

(b) Consistent with applicable law, the Secretary of State, the Secretary of Transportation, and the Secretary of Homeland Security shall ensure that any alien subject to this proclamation does not board an aircraft traveling to the United States.

(c) The Secretary of Homeland Security may establish standards and procedures to ensure the application and implementation of this proclamation at United States seaports and in between all ports of entry.

(d) An alien who circumvents the application of this proclamation through fraud, willful misrepresentation of a material fact, or illegal entry shall be a priority for removal by the Department of Homeland Security.

Sec. 4. Orderly Medical Screening and Quarantine. The Secretary of Homeland Security shall take all necessary and appropriate steps to regulate the travel of persons and aircraft to the United States to facilitate the orderly medical screening and, where appropriate, quarantine of persons who enter the United States and who may have been exposed to the virus. Such steps may include directing air carriers to restrict and regulate the boarding of such passengers on flights to the United States.

Sec. 5. Termination. This proclamation shall remain in effect until terminated by the President. The Secretary of Health and Human Services shall, as circumstances warrant and no more than 15 days after the date of this order and every 15 days thereafter, recommend that the President continue, modify, or terminate this proclamation.

Sec. 6. Effective Date. This proclamation is effective at 5:00 p.m. eastern standard time on February 2, 2020.

Sec. 7. Severability. It is the policy of the United States to enforce this proclamation to the maximum extent possible to advance the national security, public safety, and foreign policy interests of the United States. Accordingly:

(a) if any provision of this proclamation, or the application of any provision to any person or circumstance, is held to be invalid, the remainder of this proclamation and the application of its provisions to any other persons or circumstances shall not be affected thereby; and

(b) if any provision of this proclamation, or the application of any provision to any person or circumstance, is held to be invalid because of the lack of certain procedural requirements, the relevant executive branch officials shall implement those procedural requirements to conform with existing law and with any applicable court orders.

Sec. 8. General Provisions. (a) Nothing in this proclamation shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b) This proclamation shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c) This proclamation is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

IN WITNESS WHEREOF, I have hereunto set my hand this thirty-first day of January, in the year of our Lord two thousand twenty, and of the Independence of the United States of America the two hundred and forty-fourth.

DONALD J. TRUMP


* See “Why all the panic about the latest Chinese Flu?” for a good discussion in the comments by medical professionals and those of us who read stuff and are just trying to make sense of it all.

There are 23 comments.

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  1. RightAngles Member
    RightAngles
    @RightAngles

    Thanks for this!

    • #1
  2. Norm McDonald Member
    Norm McDonald
    @Pseudodionysius

    This is an engineered virus.

    • #2
  3. The Reticulator Member
    The Reticulator
    @TheReticulator

    Isn’t there a judge who could issue an injunction bringing these travel restrictions to a halt on the grounds that Trump’s motives are bad? 

    • #3
  4. Norm McDonald Member
    Norm McDonald
    @Pseudodionysius

    The Reticulator (View Comment):

    Isn’t there a judge who could issue an injunction bringing these travel restrictions to a halt on the grounds that Trump’s motives are bad?

    I heard a rumour that the virus might affect the frontal cortex in such a way that people would watch endless episodes of the View. If true, this would be a very clever way of creating a virus that would give Hillary the victory in 2020 when she emerges from the cave she’s hanging upside down in at night.

    • #4
  5. DonG (skeptic) Coolidge
    DonG (skeptic)
    @DonG

    The Reticulator (View Comment):

    Isn’t there a judge who could issue an injunction bringing these travel restrictions to a halt on the grounds that Trump’s motives are bad?

    I could see some Obama judge issuing a global ban on all travels bans just to annoy Trump.

    • #5
  6. JosePluma Thatcher
    JosePluma
    @JosePluma

    Norm McDonald (View Comment):

    This is an engineered virus.

    Evidence?

    • #6
  7. Norm McDonald Member
    Norm McDonald
    @Pseudodionysius

    JosePluma (View Comment):

    Norm McDonald (View Comment):

    This is an engineered virus.

    Evidence?

    Women’s intuition.

    • #7
  8. OmegaPaladin Moderator
    OmegaPaladin
    @OmegaPaladin

    They seem to be doing a better job of communicating than the Ebola task force under Obama.  For my point of view as someone who took classes on public health communications, they are doing a good job of getting the message out.

    • #8
  9. Clifford A. Brown Contributor
    Clifford A. Brown
    @CliffordBrown

    OmegaPaladin (View Comment):

    They seem to be doing a better job of communicating than the Ebola task force under Obama. For my point of view as someone who took classes on public health communications, they are doing a good job of getting the message out.

    That was my impression, appreciate the informed eye on this.

    • #9
  10. Goddess of Discord Member
    Goddess of Discord
    @GoddessofDiscord

     But no minority representation, so anything they say is illegitimate;) I work for a local health department in Tennessee and I can assure you this plan trickles down to the local level. 

    • #10
  11. LibertyDefender Member
    LibertyDefender
    @LibertyDefender

    OmegaPaladin (View Comment):

    They seem to be doing a better job of communicating than the Ebola task force under Obama. For my point of view as someone who took classes on public health communications, they are doing a good job of getting the message out.

    But the honest message – which gets completely obscured in all the messaging – is that the risk to Americans is so low as to be nearly undetectable.

    But since we can’t detect or invent an actual risk, we’ll overreact.

    • #11
  12. OmegaPaladin Moderator
    OmegaPaladin
    @OmegaPaladin

    LibertyDefender (View Comment):

    OmegaPaladin (View Comment):

    They seem to be doing a better job of communicating than the Ebola task force under Obama. For my point of view as someone who took classes on public health communications, they are doing a good job of getting the message out.

    But the honest message – which gets completely obscured in all the messaging – is that the risk to Americans is so low as to be nearly undetectable.

    But since we can’t detect or invent an actual risk, we’ll overreact.

    No.  That is incorrect.

    There is not significant risk to Americans at present, so let’s keep it that way.

    This is proper quarantine procedure.  Infection Control at the hospital I work with is implementing pretty intense controls.   What kept SARS from getting out of hand was quarantine and good old fashioned epidemiology.  This is one of the few cases where you really need the government involved, like national defense and law enforcement.

    • #12
  13. Old Bathos Moderator
    Old Bathos
    @OldBathos

    The hostile approach rather than trying to meet the virus halfway with more conciliatory approaches will just provoke other viruses and cause a health crisis.

    Profiling persons because of their point of travel origin is overtly racist. A true diversity of infectious agents is what America was all about—before Trump.

    This needless hype to keep persons at home out of fear of infection is the beginning of a systematic voter suppression campaign.

    Lastly, a whistleblower has stepped forward to reveal that President Trump directed Dr. Fauci et al. To keep Americans alive solely to enhance his election chances and to dampen demands for socialized medicine types of policies.

    • #13
  14. Clifford A. Brown Contributor
    Clifford A. Brown
    @CliffordBrown

    Goddess of Discord (View Comment):

    But no minority representation, so anything they say is illegitimate;) I work for a local health department in Tennessee and I can assure you this plan trickles down to the local level.

    Via PowerLine Blog, how right you are!

    • #14
  15. James Gawron Thatcher
    James Gawron
    @JamesGawron

    Old Bathos (View Comment):

    The hostile approach rather than trying to meet the virus halfway with more conciliatory approaches will just provoke other viruses and cause a health crisis.

    Profiling persons because of their point of travel origin is overtly racist. A true diversity of infectious agents is what America was all about—before Trump.

    This needless hype to keep persons at home out of fear of infection is the beginning of a systematic voter suppression campaign.

    Lastly, a whistleblower has stepped forward to reveal that President Trump directed Dr. Fauci et al. To keep Americans alive solely to enhance his election chances and to dampen demands for socialized medicine types of policies.

    OldB,

    Yes, the woketard analysis marches on. Gd help us.

    Regards,

    Jim

    • #15
  16. Danny Alexander Member
    Danny Alexander
    @DannyAlexander

    Woketard approaches to border non-control, to the resultant undermining of public health protection, and to Newspeak-style “coverage” of same are anything but comedy fodder for me personally.

    My mom, a Massachusetts denizen, has a chronic form of pulmonary hypertension (not induced by any smoking — we still don’t understand the cause), and it is dangerously easy for her to go from catching a cold to developing bronchitis to slipping into life-threatening pneumonia.

    And yet the no-borders mania that has gripped so many in positions of ostensible public responsibility in Boston and elsewhere in the Bay State apparently takes precedence over the right to life of actual Americans even in the face of a highly contagious various capable of reducing the state’s tax rolls and filling its cemeteries instead.

     I say this because just now come news reports that a “young man” studying at UMass-Boston has — after unspecified travel in Wuhan — checked himself into an isolation unit in one of the downtown Boston hospitals with a positive diagnosis for the virus.

    Who the hell in the Logan Airport CBP/DHS contingent allowed this guy past the first point of Immigration Control, and why?

    I will note that local online “news” source Boston.com characterized this virus-carrier as “A Boston man…” with the putative status of one who was returning from travel to/in Wuhan — no particular national identifier attached, though.

    In contrast, the eminently more responsible writers/editors at The Daily Caller described the virus-carrier as a college student, albeit still not adding much in the way of national identity information.

    Still, at least somewhat better than the “no-borders” mentality surely gripping not only the Boston.com newsroom but also the ranks of locally-staffed CBP officers supposedly “on duty” at Logan.

    Hashem/God help us all.     

    • #16
  17. Keith SF Member
    Keith SF
    @KeithSF

    Norm McDonald (View Comment):

    JosePluma (View Comment):

    Norm McDonald (View Comment):

    This is an engineered virus.

    Evidence?

    Women’s intuition.

    All circumstantial at the moment. But a study in The Lancet determined that many of the earliest cases, including patient zero, had no connection to the food market currently assumed to be the source of the virus:

    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext

    That food market however, is in close proximity to China’s National Biosafety Laboratory.

    (This is where I have to add the perfunctory “I’m not into conspiracy theories, but…”)

    I’m not entirely convinced of the “shoddy protocols at the bio-weapons lab” theory, but it isn’t implausible.

    • #17
  18. MarciN Member
    MarciN
    @MarciN

    From Harvard’s web page on its international students:

    An analysis of student visa data suggests that in 2018 as many as 368,073 Chinese students came to the U.S. to study at American colleges and universities. From this pool of 368,073, Harvard was home to approximately 1,301 Chinese students.

    I am concerned about the number of students from China who go to school in the United States. I hope the NIH and CDC will come up with a definitive test soon.

    • #18
  19. Kozak Member
    Kozak
    @Kozak

    Keith SF (View Comment):

    Norm McDonald (View Comment):

    JosePluma (View Comment):

    Norm McDonald (View Comment):

    This is an engineered virus.

    Evidence?

    Women’s intuition.

    All circumstantial at the moment. But a study in The Lancet determined that many of the earliest cases, including patient zero, had no connection to the food market currently assumed to be the source of the virus:

    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext

    That food market however, is in close proximity to China’s National Biosafety Laboratory.

    (This is where I have to add the perfunctory “I’m not into conspiracy theories, but…”)

    I’m not entirely convinced of the “shoddy protocols at the bio-weapons lab” theory, but it isn’t implausible.

     

    🤔

     

    • #19
  20. Danny Alexander Member
    Danny Alexander
    @DannyAlexander

    Kozak thanks indeed for posting the Tom Cotton video.

    I’m usually ashamed of my undergrad alma mater and the majority of her alumni/ae, but fortunately Cotton is pretty consistent in his capacity to demonstrate sterling character and intellect notwithstanding Harvard’s anything-but-Puritan embrace.

    As a Tokyo denizen, this whole situation has me very much on edge.

    I will say, in any event, that I’m with Cotton in pointing to the biowarfare center’s likely role, even if that role is down to broken lab protocols and dumb mistakes (very likely).

    My own guess is that the lab was working on coronavirus weaponization for application against Hong Kong’s anti-CCP/anti-PLA protest movement leaders — perhaps even against Uighyurs as well.

    • #20
  21. James Gawron Thatcher
    James Gawron
    @JamesGawron

    Kozak (View Comment):

    Keith SF (View Comment):

    Norm McDonald (View Comment):

    JosePluma (View Comment):

    Norm McDonald (View Comment):

    This is an engineered virus.

    Evidence?

    Women’s intuition.

    All circumstantial at the moment. But a study in The Lancet determined that many of the earliest cases, including patient zero, had no connection to the food market currently assumed to be the source of the virus:

    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext

    That food market however, is in close proximity to China’s National Biosafety Laboratory.

    (This is where I have to add the perfunctory “I’m not into conspiracy theories, but…”)

    I’m not entirely convinced of the “shoddy protocols at the bio-weapons lab” theory, but it isn’t implausible.

     

    🤔

     

    Kozak,

    Senator Cotton is not a man who has a history of believing in conspiracy theories or end of the world scenarios. His statements are measured and backed by facts. Everything he presents should be taken seriously.

    He is the adult in the room.

    Regards,

    Jim

    • #21
  22. The Reticulator Member
    The Reticulator
    @TheReticulator

    Danny Alexander (View Comment):
    My own guess is that the lab was working on coronavirus weaponization for application against Hong Kong’s anti-CCP/anti-PLA protest movement leaders — perhaps even against Uighyurs as well.

    If I were the ruthless dictator of a country in which people lived crowded together, I wouldn’t pick a contagious disease as my biowarfare weapon. Epidemiology 101. And I wouldn’t pick that as a weapon to use against targeted individuals, as it is likely to get the wrong targets.

    • #22
  23. LibertyDefender Member
    LibertyDefender
    @LibertyDefender

    OmegaPaladin (View Comment):

    LibertyDefender (View Comment):

    OmegaPaladin (View Comment):

    They seem to be doing a better job of communicating than the Ebola task force under Obama. For my point of view as someone who took classes on public health communications, they are doing a good job of getting the message out.

    But the honest message – which gets completely obscured in all the messaging – is that the risk to Americans is so low as to be nearly undetectable.

    But since we can’t detect or invent an actual risk, we’ll overreact.

    No. That is incorrect.

    There is not significant risk to Americans at present, so let’s keep it that way.

    Perhaps my concern is “merely” about messaging.  “Zero risk” to Americans at present is closer to the truth than “significant risk,” and closer to the truth than “not significant risk to Americans at present.”

    But the response of the government is “the coronavirus presents a public health emergency in the United States.”

    Perhaps the government could come up with a different phrase than “public health emergency” to describe something that is of so little risk.

    • #23

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