Updated March 5, 2020
COVID-2019: Global Implications and Responses
Overview
confirmed COVID-19 cases globally, including more than
As of March 4, 2020, the novel coronavirus that began
3,200 deaths. Nearly 85% of cases and more than 90% of
sickening patients in Wuhan, China, in early December
deaths have been in mainland China, overwhelmingly in
2019 had spread to over 75 countries, including the United
Hubei Province, whose capital is Wuhan. About 80% of
States. Daily new cases and deaths related to the virus
cases outside China are in three countries: South Korea,
outside China now exceed those reported in China, where
Italy, and Iran.
the epidemic appears to be coming under control. The
According to WHO, current data suggest that COVID-19 is
World Health Organization (WHO) has named the new
less transmissible than seasonal influenza but causes more
virus “severe acute respiratory syndrome coronavirus 2”
severe illness, with deaths in 3.4% of reported cases
(SARS-CoV-2) and the disease that it causes “coronavirus
globally. Of confirmed COVID-19 patients in China, about
disease 2019” (COVID-19). WHO has declared the
80% experienced mild to moderate illness, 14% had severe
outbreak a Public Health Emergency of International
illness, and 6% became critically ill. More than 30 countries
Concern and raised its global risk assessment to “Very
High.” It
have confirmed community transmission of COVID-19, but
has refrained from labeling the outbreak a
“pandemic,”
WHO Director-General Tedros observed on March 4 that
however. Doing so, WHO Director-General
“most cases can still be traced to known contacts or clusters
Tedros Adhanom Ghebreyesus has said, could “signal that
we can no longer contain the virus, which is not true.”
of cases,” such as within families.
On
March 5, Tedros told countries, “This is not the time to give
Within days of Chinese scientists’ sharing the genetic
up.” Rather, “This is a time for pulling out all the stops.”
sequence of the virus on January 11, 2020, scientists around
The Virus
the globe developed lab tests to diagnose COVID-19.
Current diagnostic supplies are insufficient to meet global
Coronaviruses are a large family of zoonotic viruses—
demand, however. While trying to increase supply of these
viruses transmissible between animals and humans—that
tests, developers are also trying to create faster, cheaper,
can cause illness ranging from the common cold to more
and more easily administered tests. No specific treatments
severe diseases such as Middle-East Respiratory Syndrome
or vaccines for COVID-19 exist. The U.S. National
(MERS) and Severe Acute Respiratory Syndrome (SARS).
Institutes of Health (NIH) indicated in late January that a
The most common symptoms among confirmed COVID-19
candidate vaccine for COVID-19 could be ready for early-
patients include fever, dry cough, and shortness of breath.
stage human testing in spring 2020.
As of March 5, 2020, WHO reported more than 95,000
Figure 1. Locations with Confirmed COVID-19 Cases Globally, as of March 4, 2020

Source: World Health Organization.
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COVID-2019: Global Implications and Responses
China’s Experience
U.S. Response
Leadership.
On January 29, President Donald J. Trump
China’s government first reported cases of pneumonia of an
announced the formation of the President’s Coronavirus
unknown cause to WHO on December 31, 2019, but did not
Task Force, led by HHS and coordinated by the National
raise the alarm to its own people until January 20.
Security Council. On February 27, the President appointed
Observers have suggested that by withholding information,
Vice President Mike Pence as the Administration’s
the government may have squandered an early window of
opportunity to stem the virus’
COVID-19 task force leader, and the Vice President
s spread. After January 20,
subsequently appointed President’s Emergency Plan for
Chinese authorities began taking aggressive actions to
AIDS Relief (PEPFAR) Ambassador Deborah Birx as the
prevent the virus from spreading further, including
“White House Coronavirus Response Coordinator.”
imposing controversial cordons sanitaires, or restrictions
on movement in and out of defined areas, on as many as
Funds for Global COVID-19 Control. The Department of
760 million people. Reported infections “peaked and
plateaued” in China between January 23 and January 27,
State and the U.S. Agency for International Development
(USAID) have committed to use up to $100 million of
and have been declining since then, except for a spike on
existing funds to assist China and other affected countries
February 1, according to the report of a WHO-China Joint
“to contain and combat” COVID-19. HHS has made
Mission that investigated the outbreak in China. The
available up to $105 million from the Infectious Disease
mission included representatives from NIH and the U.S.
Rapid Response Reserve Fund for domestic and
Centers for Disease Control and Prevention (CDC). Bruce
international COVID-19 responses. In late February, the
Aylward, the mission’s Canadian co-team leader, told Vox
Administration announced the committed funds would be
that key to China’s apparent success in changing the course
exhausted by the end of the month. On February 24, the
of the epidemic was not the lockdowns. Instead, it was
Administration asked Congress for an emergency
painstaking implementation of traditional public health
supplemental appropriation of $1.25 billion for COVID-19
measures: finding cases, isolating them, and tracing their
response efforts, and to allow repurposing of another $1.25
close contacts, plus suspension of public gatherings.
billion in existing funds from across the government,
WHO Response
including HHS funds for current Ebola response activities.
PHEIC. On January 30, 2020, WHO Director-General
On March 4, the House passed H.R. 6074, which would
Tedros declared a Public Health Emergency of International
provide $8.3 billion in emergency supplemental
Concern (PHEIC), prompting countries to take specific
appropriations for COVID-19 preparedness and response.
actions, including heightening surveillance and reporting of
This includes $300 million to continue CDC’s global health
the disease. In the case of the United States, Department of
security programs (global disease detection and emergency
Health and Human Services (HHS) Secretary Alex Azar
response) and $1.25 billion for various Department of State
declared “a public health emergency for the entire United
and USAID accounts. USAID’s bilateral global health
States.” A PHEIC declaration can prompt countries to
programs would receive $435 million—including at least
provide additional resources for global and domestic
$200 million for the Emergency Reserve Fund—to prevent,
response and enable WHO to access certain emergency
prepare for, and respond to COVID-19. The Senate is
funding, such as from the United Nations Central
expected to pass the bill on March 5.
Emergency Response Fund (CERF) and the World Bank
Pandemic Emergency Financing Facility (PEF).
Travel Issues and Evacuations. The President has issued
two proclamations suspending the entry into the United
Pandemic Designation Debate. Some observers have
States of most foreign nationals who have been in mainland
questioned why WHO has not labeled the global COVID-
China (effective February 2) or Iran (effective March 2)
19 outbreak a pandemic. On February 26, Tedros defended
WHO’s caution, arguing, “For the moment, we are not
within the prior 14 days. On February 2, the Department of
Homeland Security issued instructions subjecting returning
witnessing sustained and intensive community transmission
U.S. citizens with travel to China’s Hubei Province in the
of this virus, and we are not witnessing large-scale severe
prior 14 days to mandatory quarantine of up to 14 days.
disease or death.”
The U.S. government arranged charter flights to repatriate
WHO Funds. On February 5, WHO announced a $675
U.S. citizens and permanent residents from Wuhan and the
million COVID-19 preparedness plan for February through
Diamond Princess cruise ship off Japan. CDC has elevated
April. It aims to provide international coordination and
its travel warning for China, Iran, Italy, and South Korea to
operational support, bolster country readiness and response
the highest level (Level 3, “Avoid nonessential travel”).
capacity—particularly in low-resource countries—and
The State Department has raised its travel advisory for
accelerate relevant research and innovation. As of March 4,
China to the highest level (Level 4, “Do not travel”), added
donors had pledged to provide $289 million.
a COVID-19 caution to its existing Level 4 advisory for
Appeal on Personal Protective Equipment. WHO has
Iran, and raised its advisories for Italy and South Korea to
highlighted a global shortage of personal protective
Level 3 (“Reconsider travel”).
equipment for health care workers, estimating a 40%
production surge is necessary to meet demand. Tedros has
Sara M. Tharakan, Analyst in Global Health and
urged industry and governments to “act quickly to boost
International Development
supply, ease export restrictions and put measures in place to
Frank Gottron, Specialist in Science and Technology
stop speculation and hoarding.”
Policy
Susan V. Lawrence, Specialist in Asian Affairs
Tiaji Salaam-Blyther, Specialist in Global Health
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COVID-2019: Global Implications and Responses

IF11421


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