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As the coronavirus outbreak unsettles the global economy, the Centers for Disease Control is warning that Americans should prepare for significant disruptions to daily life as well if it begins to spread locally in the U.S.

That could include school closings, cancellations of sporting events, concerts and business meetings. The United States is preparing as if the virus will become a pandemic, with spread in the U.S., Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, said on a Tuesday call with reporters.

“We expect we will see community spread in this country,” Messonnier said, referring to person-to-person transmission of the virus. “It is not a matter of if, but a question of when, this will exactly happen.”

Exactly what measures health authorities put into place, and how broadly they’re implemented, would depend on how wide transmission is, Principal Deputy Director of CDC Anne Schuchat said later Tuesday at a separate press conference.

New clusters of cases in Italy, Iran, South Korea and countries outside China appear to have confirmed health officials’ predictions that efforts to contain the virus in China would slow the infection’s spread, not stop it.

The CDC is the primary federal agency responsible for tracking and responding to outbreaks of disease. While officials there have warned for weeks that the virus was likely to spread to the U.S., Tuesday’s call was a notable escalation in describing what that would mean.

The outbreak is “rapidly evolving and expanding,” Messonnier said. While there have only a small number of cases diagnosed in the U.S. so far, she said it was necessary for health workers and governments to prepare now as if there will be a significant American outbreak. The measures taken could be significant, and Messonnier said she told her own children on Tuesday morning to get ready for disruptions in their lives.

How Michigan is preparing

Michigan health officials have been preparing for a possible spread of coronavirus to communities in the state, said Lynn Sutfin, spokeswoman for the Michigan Department of Health and Human Services.

The state health department already has infrastructure in place to deal with outbreaks of diseases such as chicken pox and flu, but has taken specific steps to prepare providers for COVID-19, she said.

"(W)e have been holding weekly calls with local health departments since the outbreak began. We also have a weekly call with hospitals and health care providers," Sutfin noted in a Tuesday email to The Detroit News. 

"In routine calls with local health departments and health care partners, MDHHS has been working to transition our preparedness and response toward community mitigation."

State health officials began working with local health departments, health care coalitions, hospitals and health care partners when the novel coronavirus outbreak began in Wuhan, China, Sutfin said.

"Our initial focus was working with federal partners to ensure that Michigan’s public health system could support traveler screening and monitoring to limit the entry of coronavirus cases into the US.," she said. 

"Hospitals and health care partners were also engaged to establish screening procedures for any patients presenting for care with a travel history and symptoms that could be indicative of a possible coronavirus case."

The Michigan health department has tested five people for coronavirus and all came back negative. Three of those tested were from Washtenaw County, one from Oakland County and one from Macomb County. 

Detroit Metro is among 11 airports nationwide designated to receive flights from China, where the outbreak originated. As of Tuesday, no travelers routed to the airport had been quarantined or required testing for COVID-19, said Michael McElrath, spokesman for the Wayne County Department of Health, Human and Veteran Services.

"Our epidemiologists are in front of all monitoring efforts in Wayne County and our preparedness team has ongoing collaboration and communication with local officials, other first responder agencies and Wayne County community partners should the incident expand further," McElrath said in an email.

Urging calm

U.S. stocks plunged to an 11-week low and bond yields fell to records on rising concern the coronavirus will upend global supply chains critical to economic growth. The S&P 500’s four-day rout topped 7.6%, with losses accelerating Tuesday after the CDC call. The Dow Jones Industrial Average dropped 879 points, for a two-day loss of 1,911 points.

The CDC’s warnings are in contrast to remarks by President Donald Trump and other senior administration officials, who have portrayed the coronavirus as a problem largely contained outside the U.S.

The virus is “very well under control in our country,” Trump said Tuesday at a news conference in New Delhi, where he’s concluding a two-day visit to India.

“I think people should be as calm as possible in assessing this,” Trump administration economic adviser Larry Kudlow said at the White House Tuesday, after Trump’s remarks. “Emergency plans don’t necessarily mean they’ll have to be put into place.”

Kudlow said that steps by the administration, such as screening travelers from China, have reduced the risk. “We have contained this, I won’t say airtight, but pretty close to airtight,” Kudlow said.

Health officials have plans in place for infectious disease outbreaks, and Messonnier pointed to 2017 report on recommendations for community mitigation measures for pandemic influenza as a blueprint for steps the U.S. could take when coronavirus starts spreading the U.S.

One major tool is what’s known as social distancing – finding ways to limit personal interactions where the virus could transmit. Measures could include school closings, or dividing classes into smaller groups and rearranging desks so they are further apart. For workers, U.S. businesses could offer telecommuting and replace in-person meetings with conference calls. Mass gatherings of all sorts, including concerts, festivals and sporting events, might be postponed. Another important component is routine cleaning of frequently touched surfaces.

“The maximum benefit occurs when the measures are layered on each other,” Messonnier said on the call.

U.S. preparations

Despite the steps being put into place, there have been a handful of worrying signs about the U.S. readiness.

A test for the virus developed in part by the CDC and shared with states has been turning up inconclusive results, limiting the ability of local health departments to conduct broad surveillance for the disease and raise the alarm if it’s silently spreading already. That’s crucially important, given that mild cases tend to resemble the flu.

“I am frustrated that we have had issues with the test,” Messonnier said. The agency is working on a modified test kit it hopes to send out to state and local health departments as soon a possible. Twelve states and localities are now able to perform testing on their own, she said.

Through Feb. 23, the CDC has conducted 2,620 coronavirus tests on 1,007 patients. While it has no backlog, getting the test done at CDC involves sending to sample to the agency, which potentially delays the results.

The U.S. also has far fewer protective masks than it would need in the case of a major outbreak of the coronavirus in the country, Health and Human Services Secretary Alex Azar told Congress Tuesday.

The U.S. has about 30 million stockpiled N95 masks that can help stop a person from inhaling infective particles, Azar said, but would need as much as 300 million for health workers in an outbreak. U.S. health officials have said they’re preparing for the coronavirus to eventually begin spreading locally.

The rise is cases outside China will also make the virus harder to contain – especially in countries with weaker health systems.

China situation

The world outside China is “simply not ready” for the spread of coronavirus and needs to step up its preparations for the disease, a World Health Organization official who led a fact-finding team in China told reporters.

The data the WHO team collected in China showed transmission of the virus is slowing there, Bruce Aylward, the head of the joint China-World Health Organization team, told reporters in Geneva in his first briefing after returning from a fact-finding mission to China, the epicenter of the outbreak.

China’s rapid response probably prevented hundreds of thousands of more cases, Aylward said. Even as the number of new cases drops, government authorities are building more hospitals based on the assumption that the disease could remain for “some time,” he said.

“You can actually affect the course of the disease, but it takes a very aggressive and very tough program,” he said. “There has to be a shift in mindset.”

The Trump administration asked for an additional $2.5 billion to help fight the looming outbreak, money that would be used to help expand disease surveillance in the U.S.; bolster state and local health agencies that will fight it on the front lines; fund work on vaccines and drug treatments; and help fortify the strategic national stockpile with protective gear including masks and respirators.

“We cannot hermetically seal off the United States to a virus,” Azar said at a congressional hearing in Washington Tuesday. “We need to be realistic about that. This virus, we will have more cases in the United States. We have been very transparent about that. Then we will work to mitigate the impact of those.”

Detroit News Staff Writer Karen Bouffard contributed.

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