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January 31, 2020
Novel Coronavirus (2019-nCoV): Developments in China and
International Response
Overview
breath. Of nearly 10,000 2019-nCoV cases identified in
On December 31, 2019, China’s government notified the
China as of January 30, China’s National Health
World Health Organization (WHO) of patients with
Commission said just over 15% of patients are severely ill
pneumonia of unknown cause in the central Chinese city of
and 2% have died. Health experts are still seeking to
Wuhan. On January 7, 2020, Chinese scientists isolated a
understand the origins of the disease and its epidemiology,
previously unknown coronavirus (2019-nCoV) in the
including the intensity of human-to-human transmission.
patients. On January 12, China’s government shared the
Chinese Health Minister Ma Xiaowei has stated the virus
genetic sequence of the virus with WHO and international
can be infectious even before patients show symptoms, but
partners. By January 30, the virus had spread across China
CDC has not verified this claim. If confirmed, such
and to four continents (see Figure 1). As required by the
transmission could increase the challenge of controlling the
International Health Regulations (IHR), a legally binding
virus’s spread.
instrument of international law under which countries work
No specific treatments or vaccines are available for 2019-
together for global health security, the global health
nCoV. Researchers are studying whether antivirals, such as
community is closely monitoring 2019-nCoV and seeking
those that effectively treated HIV and MERS cases, can be
to limit its spread. WHO is coordinating the global
used to treat 2019-nCoV. The U.S. National Institutes of
response; the United States is aiding as a member of WHO
Health, China CDC (CCDC), and others have said they are
and through its own agencies, such as the U.S. Centers for
working on vaccines.
Disease Control and Prevention (CDC). (See also CRS
Insight IN11212, Another Coronavirus Emerges: U.S.
Developments in China
Domestic Response to 2019-nCoV.)
Reviews of China’s response to the outbreak are mixed.
WHO Director-General Tedros Adhanom Ghebreyesus has
The Virus: 2019-nCoV
praised China’s leaders for “the transparency they have
Coronaviruses are a large family of zoonotic viruses
demonstrated, including sharing data and [the] genetic
(viruses transmissible between animals and humans) that
sequence of the virus.” In contrast, Secretary of Health and
can cause illness ranging from the common cold to more
Human Services Alex Azar has urged China to embrace
severe diseases such as Middle-East Respiratory Syndrome
“more cooperation and transparency.” Some have
(MERS) and Severe Acute Respiratory Syndrome (SARS).
questioned the efficacy of China’s containment efforts,
The most common symptoms among confirmed 2019-
including city lockdowns.
nCoV patients include fever, cough, and shortness of
Figure 1. Locations with Confirmed 2019-nCoV Cases Globally as of January 30, 2020
Source: Centers for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/locations-confirmed-cases.html.
Note: The 2019-nCoV virus was first identified in patients in Wuhan, capital of China’s Hubei Province.
https://crsreports.congress.gov
Novel Coronavirus (2019-nCoV): Developments in China and International Response
The first known cases of 2019-nCoV emerged in Wuhan,
Global Cases and WHO Response
capital of China’s Hubei Province. According to a paper by
According to WHO, as of January 30, 2020, nearly 20
Chinese scientists in the medical journal The Lancet, the
countries have reported 2019-nCoV cases. Many countries
first of 41 confirmed 2019-nCoV patients in their dataset
are seeking to help their nationals leave China and are
began displaying symptoms on December 1, 2019. Wuhan
screening visitors arriving from China. Several of China’s
authorities say the first hospitalization of a patient with
neighbors, including Mongolia, Nepal, Russia, and
unknown pneumonia was on December 12, 2019. On
Tajikistan, have ordered the partial closure of their borders
December 30, 2019, Wuhan’s Health Commission released
with the country. International airlines have reduced or
two “urgent notices” to the local medical community with
suspended service to China.
instructions for responding to cases of “pneumonia of
unknown cause.” The next day, Chinese authorities alerted
On January 30, the WHO convened a second meeting of its
the WHO office in China of the cases. On January 1, 2020,
IHR Emergency Committee for Pneumonia due to the
Wuhan authorities closed a local wildlife market, a
Novel Coronavirus 2019-nCoV and declared that the novel
suspected source of the infection. Although the first three
coronavirus constitutes a Public Health Emergency of
patients in The Lancet authors’ dataset had no contact with
International Concern (PHEIC). WHO defines a PHEIC as
the market, it was a common link among 27 later cases in
an extraordinary event that constitutes a risk to other
the dataset. Chinese experts believe the virus may have
countries and requires a coordinated international response.
originated in bats and jumped to humans via another
Declaring a PHEIC may release emergency funding and
animal, but no source has been confirmed.
trigger more restrictive protocols, as well as affect trade,
travel, and other international commerce activities. The 15-
With a meeting of China’s cabinet, the State Council, on
person committee, which includes a CDC expert, plans to
January 20, 2020, China’s leaders appeared to pivot from
reconvene regularly. (See also CRS In Focus IF10022, The
publicly downplaying the outbreak to elevating its
Global Health Security Agenda and International Health
containment to an urgent national priority. The same day,
China’s National Health Commission declared “novel
Regulations, by Tiaji Salaam-Blyther.) Following a January
28, 2020 meeting in Beijing between Chinese President Xi
coronavirus-caused pneumonia” a “Class B” infectious
disease, to be handled as a “
Jinping and WHO Director-General Tedros, China accepted
Class A” disease, triggering
WHO’s offer to send an international expert team to China
prevention and control measures including mandatory
to work with China’s National Health Commission on
quarantine of patients. On January 23, 2020, the day before
outbreak control.
families around the country were due to gather for Lunar
New Year’s Eve feasts, Wuhan, a city of 11 million people
U.S. Global Funding and Response
and a major national transport hub, abruptly announced it
CDC is leading the U.S. government response to 2019-
was suspending public transportation and sealing off the
nCoV, in collaboration with the Department of State and
city. Other cities across the province rapidly instituted their
international partners. CDC is currently using funds made
own travel restrictions, putting much of the province of 59
available through the Infectious Disease Rapid Response
million people under forms of quarantine. Both the scale
Reserve Fund (IDRRRF), first established in FY2019
and the speed of the lockdown appear to be unprecedented
appropriations (P.L. 115-245). Secretary of Health and
globally. Wuhan Mayor Zhou Xianwang later
Human Services Azar has issued a determination making
acknowledged that approximately 5 million residents left
available $105 million from the IDRRRF for the 2019-
his city before the travel restrictions went into place. The
nCoV response.
disclosure raised questions about how effective the later
move to seal off the city would be in stemming
CDC has staff based in China who work with CCDC on
transmission of the virus.
disease control and prevention, developing lab capacity,
On January 27, 2020, Mayor Zhou told China’s state
and disease surveillance. CDC expects to participate in the
broadcaster that because of the sudden lockdown, “many
WHO team that is preparing to go to China to work on
people in this closed city despise us.” Unusual for an
2019-nCoV. On January 27, 2020, CDC raised its China
official in China’s authoritarian political system, the mayor
travel warning to Level 3 (“avoid nonessential travel”). On
also acknowledged he had not disclosed information “in a
January 30, 2020, the State Department elevated its travel
timely manner” and implicitly blamed China’s central
advisory for China to Level 4 (“do not travel”). The State
government. He said China’s Law on Prevention and
Department’s advisory advised that those currently in China
Control of Infectious Diseases restricted Wuhan from
“consider departing using commercial means.” A week
sharing information without permission from higher-ups.
earlier, on January 23, 2020, the State Department ordered
the mandatory departure of nonemergency U.S. personnel
China’s Premier Li Keqiang is leading a new Communist
and family members from the U.S. consulate in Wuhan. On
Party “leading group” on controlling the virus, and visited
January 29, 2020, it authorized the voluntary departure of
Wuhan on January 27, 2020. Hubei hospitals are struggling
nonemergency personnel and family members of U.S.
with shortages of staff and supplies. China has deployed
government employees from other posts in China.
military medics to Wuhan and begun the rapid construction
of dedicated 2019-nCoV hospitals. Local governments
Sara M. Tharakan, Analyst in Global Health and
across China have banned large public gatherings. Many
International Development
schools and workplaces have delayed reopening after the
Susan V. Lawrence, Specialist in Asian Affairs
Lunar New Year holiday in a bid to limit person-to-person
contact. In a blow to the global tourism industry, China has
IF11421
suspended all outbound overseas group tourism.
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Novel Coronavirus (2019-nCoV): Developments in China and International Response
Disclaimer
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