Updated February 27, 2020
COVID-2019: Global Implications and Responses
Overview
were in mainland China, and over 80% of cases in mainland
As of February 27, 2020, the novel coronavirus first
China were reported in Hubei Province, whose capital is
identified in patients in Wuhan, China, in early January
Wuhan. Of confirmed COVID-19 patients in China, about
2020 had spread to over 45 countries, including the United
80% experienced only mild symptoms, 13% experienced
States. Daily new cases reported outside China now exceed
severe symptoms, and 6% became critically ill. Outside
those reported in China. The World Health Organization
mainland China, the jurisdictions with the highest reported
(WHO) has declared the outbreak a Public Health
caseloads were South Korea, Italy, Japan, and Iran. More
Emergency of International Concern but has resisted
than 700 cases have been detected from the Diamond
labeling it a “pandemic.” WHO Director-General Tedros
Princess cruise ship, docked alongside Yokohama, Japan.
Adhanom Ghebreyesus stated on February 26 that using the
In addition to China, the United States and Germany have
word “pandemic” could “signal that we can no longer
confirmed community transmission of COVID-19,
contain the virus, which is not true.” WHO has named the
indicating the global response may need to move from a
new virus “severe acute respiratory syndrome coronavirus
containment strategy to one of mitigation.
2” (SARS-CoV-2) and the disease that it causes
“
Within days of Chinese scientists’ sequencing the virus,
coronavirus disease 2019” (COVID-19).
scientists around the globe developed lab tests to diagnose
The Virus
COVID-19. Current diagnostic supplies are insufficient to
Coronaviruses are a large family of zoonotic viruses
meet global demand, however. While trying to increase
(viruses transmissible between animals and humans) that
supply of these tests, developers are also trying to create
can cause illness ranging from the common cold to more
faster, cheaper, and more easily administered tests. No
severe diseases such as Middle-East Respiratory Syndrome
specific treatments or vaccines for COVID-19 exist. The
(MERS) and Severe Acute Respiratory Syndrome (SARS).
U.S. National Institutes of Health (NIH) indicated in late
The most common symptoms among confirmed COVID-19
January that a candidate vaccine for COVID-19 could be
patients include fever, dry cough, and shortness of breath.
ready for early-stage human testing within three months,
As of February 26, 2020, WHO reported more than 80,000
compared to the 20 months it took to begin early-state
confirmed COVID-19 cases globally, including more than
development of an investigational SARS vaccine.
2,700 deaths. All but 5% of the cases and 60 of the deaths
Figure 1. Locations with Confirmed COVID-19 Cases Globally, as of February 27, 2020
Source: World Health Organization and National Health Commission of the People’s Republic of China.
https://crsreports.congress.gov
COVID-2019: Global Implications and Responses
Developments in China
witnessing large-scale severe disease or death.” He
nonetheless urged countries to “prepare for a potential
China first reported cases of pneumonia of an unknown
pandemic,” stating, “Every country needs to be ready to
cause to the WHO on December 31, 2019. Chinese
detect cases early, to isolate patients, trace contacts, provide
scientists isolated the virus on January 7, 2020, and shared
quality clinical care, prevent hospital outbreaks, and
its genetic sequence with the world on January 12. China’s
prevent community transmission.”
government did not raise the alarm to its own people until
January 20, however. Before then, the government appears
WHO Funds. On February 5, WHO announced a $675
to have worked to suppress information about the outbreak.
million COVID-19 preparedness plan for February through
Observers have suggested that by withholding information,
April. It aims to provide international coordination and
the government may have squandered an early window of
operational support, bolster country readiness and response
opportunity to stem the virus’s spread.
capacity (particularly in low-resource countries), and
accelerate relevant research and innovation. As of February
After January 20, Chinese authorities began taking
26, six donors had pledged to provide $30.0 million in
aggressive actions to prevent the virus from spreading
support of the plan and WHO had received $1.4 million.
further. By February 20, they had imposed cordon
sanitaires, or restrictions on movement in and out of
U.S. Response
defined areas, on as many as 760 million people. Human
Leadership. On January 29, President Donald J. Trump
rights groups and others have questioned such measures.
announced the formation of the President’s Coronavirus
Bruce Aylward, the Canadian co-team leader of a WHO-
Task Force, led by HHS and coordinated by the National
China Joint Mission on COVID-19, praised China,
Security Council. On February 27, the President appointed
however, for a “bold approach” that “changed the course”
Vice President Mike Pence as the Administration’s
of the epidemic and prevented “probably hundreds of
COVID-19 task force leader, and the Vice President
thousands of cases of COVID-19 in China.”
subsequently appointed President’s Emergency Plan for
AIDS Relief (PEPFAR) Ambassador Deborah Birx as the
The WHO-China Joint Mission, which included
“White House Coronavirus Response Coordinator.”
representatives from the U.S. Centers for Disease Control
and Prevention (CDC) and NIH, carried out an on-the-
Funds for Global COVID-19 Control. On February 7, the
ground investigation of the outbreak in China from
Department of State and the U.S. Agency for International
February 16 to 24. The mission concluded that the epidemic
Development committed to use up to $100 million of
in China peaked and plateaued between January 23 and
existing funds to assist China and other affected countries
February 2, and has been waning since. Aylward
with COVID-19 responses. HHS has made available up to
acknowledged that the outbreak is not yet controlled in
$105 million from the Infectious Disease Rapid Response
Wuhan, and he warned of the risk that the epidemic could
“come back up again as people start to move again, the
Reserve Fund for domestic and international COVID-19
responses. In late February, the Administration stated those
shops start to open, restaurants open, schools open.” He
said that risk was “being managed very carefully.”
funds would be exhausted by the end of the month. On
February 24, the Administration asked Congress for an
WHO Response
emergency supplemental appropriation of $1.25 billion for
PHEIC. Following the emergence of a disease that might
COVID-19 response efforts. The Administration also asked
be deemed a Public Health Emergency of International
Congress to allow repurposing of another $1.25 billion in
Concern (PHEIC), WHO convenes an advisory group, the
existing funds from across the government, including HHS
IHR Emergency Committee, to review data and make
funds for current Ebola response activities.
recommendations to the WHO Director-General. At its
Travel Issues and Evacuations. On January 31, 2020, the
second meeting, on January 30, WHO’s 15-member IHR
President suspended the entry into the United States of any
Emergency Committee for Pneumonia due to the Novel
foreign national who has been in China within the prior 14
Coronavirus COVID-19 concluded the outbreak had
days. On February 2, the Department of Homeland Security
become a PHEIC. That day, WHO Director-General Tedros
issued instructions subjecting returning U.S. citizens with
issued a PHEIC declaration, prompting countries to take
recent travel to Hubei Province to mandatory quarantine of
specific actions, including heightening surveillance and
up to 14 days. The State Department has issued a Level 4
reporting of the disease. In the case of the United States,
(“Do Not Travel”) advisory for China and evacuated U.S.
Department of Health and Human Services (HHS)
citizens and others from Wuhan. The Department ordered
Secretary Alex Azar declared “a public health emergency
the mandatory departure of nonemergency U.S. personnel
for the entire United States.” A PHEIC declaration can
and their families from the U.S. consulate in Wuhan, and
prompt countries to provide additional resources for global
the voluntary departure of nonemergency U.S. personnel
and domestic response and enable WHO to access certain
and their families from other diplomatic posts in China. The
emergency funding, such as from the United Nations
U.S. government also repatriated U.S. citizens from the
Central Emergency Response Fund (CERF) and the World
Diamond Princess cruise ship in Japan.
Bank Pandemic Emergency Financing Facility (PEF).
Pandemic Designation Debate. Some observers have
Tiaji Salaam-Blyther, Specialist in Global Health
questioned why WHO has not labeled the global COVID-
Susan V. Lawrence, Specialist in Asian Affairs
19 outbreak a pandemic. On February 26, WHO Director-
Sara M. Tharakan, Analyst in Global Health and
General Tedros defended WHO’s caution, arguing, “For the
International Development
moment, we are not witnessing sustained and intensive
Frank Gottron, Specialist in Science and Technology
community transmission of this virus, and we are not
Policy
https://crsreports.congress.gov
COVID-2019: Global Implications and Responses
IF11421
Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan shared staff to
congressional committees and Members of Congress. It operates solely at the behest of and under the direction of Congress.
Information in a CRS Report should not be relied upon for purposes other than public understanding of information that has
been provided by CRS to Members of Congress in connection with CRS’s institutional role. CRS Reports, as a work of the
United States Government, are not subject to copyright protection in the United States. Any CRS Report may be
reproduced and distributed in its entirety without permission from CRS. However, as a CRS Report may include
copyrighted images or material from a third party, you may need to obtain the permission of the copyright holder if you
wish to copy or otherwise use copyrighted material.
https://crsreports.congress.gov | IF11421 · VERSION 9 · UPDATED