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Updated February 5, 2020
Novel Coronavirus (2019-nCoV): Developments in China and
International Response
Overview
nCoV patients include fever, cough, and shortness of
On December 31, 2019, China’s government notified the
breath. Of nearly 25,000 2019-nCoV cases identified
World Health Organization (WHO) of patients with
worldwide as of February 4, WHO reports 3,219 patients
pneumonia of unknown cause in Wuhan, China. On January
are severely sick and 492 patients have died, with all but
7, 2020, Chinese scientists isolated a previously unknown
two of the deaths being in mainland China. Health experts
coronavirus (2019-nCoV) in the patients, and on January 12
are still seeking to understand the origins of the disease and
made its genetic sequence available to WHO and
its epidemiology, including the intensity of human-to-
international partners. By February 5, the virus had spread
human transmission.
to every province in China and to 24 other countries (see
No specific treatments or vaccines are available for 2019-
Figure 1). The outbreak remains concentrated in China,
nCoV. Scientists from around the world, including the
with fewer than 200 of all cases having occurred outside of
United States, China, Russia, and Australia, are reportedly
the country. As required by the International Health
working to develop 2019-nCoV diagnostic tests, treatments,
Regulations (IHR), a binding international law on global
and vaccines. WHO has developed a disease commodity
health security, countries are closely monitoring and
package that lists essential biomedical equipment,
reporting emergent 2019-nCoV cases. WHO is coordinating
medicines, and supplies needed for 2019-nCoV care. The
the global response; the United States is aiding as a member
U.S. National Institutes of Health (NIH) indicated in late
of WHO and through its own agencies, such as the U.S.
January that a candidate vaccine for 2019-nCoV could be
Centers for Disease Control and Prevention (CDC). (See
ready for early-stage human testing within three months,
CRS In Focus IF10022, The Global Health Security Agenda
compared to the 20 months it took to begin early-state
and International Health Regulations, and CRS Insight
development of an investigational SARS vaccine.
IN11212, Another Coronavirus Emerges: U.S. Domestic
Response to 2019-nCoV.)
Developments in China
In 2002-2003, China’s government was widely criticized
The Virus: 2019-nCoV
for initially covering up the SARS outbreak. Critics have
Coronaviruses are a large family of zoonotic viruses
faulted China for suppressing critical information about the
(viruses transmissible between animals and humans) that
2019-nCoV outbreak in its early stages too. They suggest
can cause illness ranging from the common cold to more
China may have squandered a window of opportunity when
severe diseases such as Middle-East Respiratory Syndrome
an informed Wuhan populace could have potentially
(MERS) and Severe Acute Respiratory Syndrome (SARS).
changed its behavior to limit the virus’s spread. WHO
The most common symptoms among confirmed 2019-
Figure 1. Locations with Confirmed 2019-nCoV Cases Globally, as of February 5, 2020
Source: Centers for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/locations-confirmed-cases.html.
https://crsreports.congress.gov
Novel Coronavirus (2019-nCoV): Developments in China and International Response
Director-General Tedros Ghebreyesus has, however,
(PHEIC), WHO convenes an advisory group, known as the
praised “the speed with which China detected the outbreak,
IHR Emergency Committee, to review data and make
isolated the virus, sequenced the genome and shared it”
recommendations to the WHO Director-General related to
with the world.
the disease. On January 22, WHO convened a meeting of its
15-member IHR Emergency Committee for Pneumonia due
Wuhan authorities say the first patient later found to be
to the Novel Coronavirus 2019-nCoV, which includes a
suffering from “pneumonia of an unknown cause” was
CDC representative, Dr. Martin Cetron. The committee
hospitalized on December 12, 2019. Wuhan’s Health
agreed on the “urgency of the situation” and said it would
Commission first acknowledged the outbreak publicly on
reconvene on January 30, at which time the committee
December 30, and Chinese authorities alerted WHO of the
concluded the outbreak had become a PHEIC. The same
cases the next day. From January 1 to January 19, 2020,
day, WHO Director-General Tedros issued a PHEIC
however, Wuhan authorities publicly downplayed the
declaration, prompting countries to take specific actions,
outbreak. They asserted “no clear evidence of person-to-
including heightening surveillance and reporting of the
person transmission,” and from January 11-16 reported a
disease. In the case of the United States, Department of
constant 41 known 2019-nCoV infections. On January 1,
Health and Human Services (HHS) Secretary Alex Azar
Wuhan authorities announced they were investigating eight
declared “a public health emergency for the entire United
individuals for spreading “inaccurate information.” Those
States to aid the nation’s healthcare community in
individuals were later revealed to be medical workers who
responding to 2019 novel coronavirus.” He also announced
had sought to warn others about the outbreak.
the department would make available up to $105 million
On January 20, China's leaders pivoted, abruptly elevating
from the Infectious Disease Rapid Response Reserve Fund
containment of the virus to an urgent national priority. That
for domestic and international 2019-nCoV responses. A
day, state media quoted a renowned doctor as saying for the
PHEIC declaration can also prompt countries to provide
first time that the virus could be transmitted from person-to-
additional resources for global and domestic response and
person. China’s National Health Commission declared
enable WHO to access certain emergency funding, such as
“novel coronavirus-caused pneumonia” a statutory
from the United Nations (U.N.) Central Emergency
infectious disease under China’s Law on the Prevention and
Response Fund (CERF) and the World Bank Pandemic
Treatment of Infectious Diseases, triggering prevention and
Emergency Financing Facility (PEF).
control measures.
Following a January 28, 2020, meeting in Beijing between
On January 23, the day before Lunar New Year’s Eve,
Chinese President Xi Jinping and the WHO Director-
Wuhan, a city of 11 million people and a major national
General, China accepted WHO’s offer to send an
transport hub, abruptly announced it was suspending public
international expert team to China to work with Chinese
transportation and sealing off the city. Other cities across
counterparts on control of the 2019-nCoV outbreak. China
Hubei Province rapidly instituted their own travel
says it is working with WHO on “the relevant
restrictions, putting much of the province of 59 million
arrangements” for the China-WHO joint expert group.
people in a de facto lockdown. Both the scale and the speed
of the lockdown are unprecedented globally. On January
U.S. Response
27, Wuhan Mayor Zhou Xianwang acknowledged that
On January 29, President Donald Trump announced the
approximately 5 million residents left his city before the
formation of the President’s Coronavirus Task Force, led by
travel restrictions went into place. The disclosure raised
HHS and coordinated by the National Security Council.
questions about how effective the later move to seal off the
The Department of Homeland Security has issued
city would be in stemming spread of the virus. The mayor
instructions for quarantining U.S. citizens and permanent
also acknowledged that he had not disclosed information
residents returning to the United States after stays in China,
“in a timely manner” and implicitly blamed China’s central
and barring the entry of other foreigners with recent travel
government. He said Chinese law restricted Wuhan from
to China. China has criticized those measures and called on
sharing information without permission from higher-ups.
the United States to “react in an objective, fair, calm and
China’s Premier Li Keqiang is leading a new Communist
evidence-based manner, rather than excessively.” CDC
Party committee on controlling the virus. Hubei hospitals
experts will be part of the China-WHO joint expert group
are struggling with shortages of staff and supplies; they are
on 2019-nCoV.
reportedly unable to screen everyone seeking care. Across
China, schools and workplaces have delayed reopening
The State Department has evacuated nonemergency U.S.
after the holiday to limit person-to-person transmission.
personnel and their family members and private U.S.
China has suspended all outbound overseas group tourism.
citizens from Wuhan. It has also authorized the voluntary
Hong Kong, a Special Administrative Region of China, has
departure of nonemergency personnel and family members
announced a compulsory 14-day quarantine for all arrivals
of U.S. government employees from other posts in China,
from mainland China. Several of China’s neighbors,
and ordered the mandatory evacuation of family members
including Mongolia, Nepal, North Korea, Russia,
under age 21. The Department has issued a Level 4 (“Do
Tajikistan, and Vietnam, have ordered partial closure of
Not Travel”) advisory for China.
their land borders with China. Many international airlines
have reduced or suspended service to China.
Sara M. Tharakan, Analyst in Global Health and
Global Cases and WHO Response
International Development
Susan V. Lawrence, Specialist in Asian Affairs
Following the emergence of a disease that might be deemed
Tiaji Salaam-Blyther, Specialist in Global Health
a Public Health Emergency of International Concern
https://crsreports.congress.gov
Novel Coronavirus (2019-nCoV): Developments in China and International Response
IF11421
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https://crsreports.congress.gov | IF11421 · VERSION 2 · UPDATED