COVID-19: Global Implications and Responses

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Updated June 12, 2020
COVID-19: Global Implications and Responses
increases in COVID-19 cases, including Brazil, Chile,
Severe acute respiratory syndrome coronavirus 2 (SARS-
India, Russia, and Pakistan.
CoV-2) is believed to have emerged in Wuhan, China, in
No vaccines for COVID-19 exist, and current diagnostic
late 2019, and it has since spread around the globe.
supplies are insufficient to meet global demand. As a result,
Confirmed cases of Coronavirus Disease 2019 (COVID-19)
governments, philanthropies, international organizations,
are most numerous in the United States, Russia, and Brazil
scientists, and manufacturers have undertaken efforts to
(Figure 1). As of June 11, 2020, the World Health
expedite research and development (R&D) for COVID-19
Organization (WHO) estimated that over 7.4 million people
vaccines, as well as other medical products (e.g., diagnostic
had contracted COVID-19 worldwide, and that over
tests). Globally, at least 200 experimental COVID-19
400,000 people had died from it. WHO declared the
vaccine candidates are under development. Health experts
outbreak a Public Health Emergency of International
are also considering how to develop sufficient supply of
Concern (PHEIC) on January 30 and labeled it a
any vaccine created and bolster supply chain networks,
“pandemic” on March 11. For more information, see CRS
particularly in low-resource and conflict settings. Some
Report R46319, Novel Coronavirus 2019 (COVID-19):
experts believe that the best-case scenario for a vaccine
Q&A on Global Implications and Responses).
would be spring 2021; they caution that supplies of vaccine
The Virus
will not likely meet global need for several years.
Coronaviruses are a large family of zoonotic viruses—
China’s Experience
viruses transmissible between animals and humans—that
The Wuhan city government first publicly acknowledged
can cause illness ranging from the common cold to more
cases of pneumonia of an unknown cause on December 31,
severe diseases such as Middle-East Respiratory Syndrome
2019, linking cases to a local seafood market that sold live
(MERS) and Severe Acute Respiratory Syndrome (SARS).
animals. Chinese authorities did not confirm that the virus
According to the U.S. Centers for Disease Control and
was spreading from person-to-person until January 20,
Prevention (CDC), the most common symptoms among
2020, however, and before then reprimanded medical
confirmed COVID-19 patients include fever or chills,
workers who sought to warn colleagues about the dangers
shortness of breath, and a cough. Data suggest that older
of infection. The Trump Administration has been sharply
adults, those who live in nursing homes or long-term care
critical of China’s early response to the outbreak. On June
facilities, and those with preexisting medical conditions
1, 2020, Secretary of State Michael R. Pompeo alleged that
(such as heart and lung disease, cancer, and diabetes) are
China’s ruling Communist Party “continued to hide and
more likely to be severely sickened or die from COVID-19.
obfuscate and delay the global response to the pandemic.”
Many health experts suspect the true worldwide case count
After January 20, Chinese authorities began taking
is significantly higher than reported due to asymptomatic
aggressive actions to contain the epidemic, including
cases and insufficient diagnostic testing and contact tracing
painstaking efforts to find cases, isolate them, and trace
in some countries. Globally, nearly half of reported cases
their close contacts, plus applying broad restrictions on
and deaths have been in the Americas. The United States
movement. Reported infections peaked in late January.
accounted for 27% of both reported cases and reported
China says that it has now controlled spread of the virus. It
deaths worldwide. Several countries are seeing rapid
has reported a cumulative 84,641 confirmed cases and
4,645 deaths.

COVID-19: Global Implications and Responses
Figure 1. Number of Confirmed COVID-19 Cases Reported (June 3-10, 2020)

Source: WHO, COVID-19 Dashboard, June 10, 2020.
WHO Response
to support public health information campaigns; expand
PHEIC. On January 30, 2020, WHO Director-General
access to water, sanitation, and hygiene; and bolster
Tedros Adhanom Ghebreyesus declared the pandemic a
infection prevention and control in more than 100 countries.
Public Health Emergency of International Concern,
On March 6, 2020, the President signed into law the
prompting countries to take specific actions, including
Coronavirus Preparedness and Response Supplemental
heightening surveillance and reporting of the disease. A
Appropriations Act of 2020, P.L. 116-123, which provides
PHEIC declaration can prompt countries to provide
$8.3 billion for domestic and international COVID-19
additional resources for global and domestic response and
responses. The act includes $300 million to continue the
enable WHO to access certain emergency funding, such as
CDC’s global health security programs and a total of $1.25
from the WHO Contingency Fund for Emergencies (CFE).
billion for USAID and the Department of State. Of the
“Pandemic.” WHO defines a pandemic as “the worldwide
USAID and State funds, $985 million is designated for
spread of a new disease” for which most people do not have
foreign assistance accounts, including $435 million
immunity. WHO began calling COVID-19 a pandemic on
specifically for Global Health Programs. On March 27,
March 11, though the criteria were met earlier.
2020, President Trump signed the Coronavirus Aid, Relief,
and Economic Security Act (CARES Act), P.L. 116-136,
WHO COVID-19 Plan. On February 5, 2020, WHO
which contains emergency funding for U.S. international
announced a $675 million COVID-19 plan for February
COVID-19 responses, including $258 million to USAID
through April to provide international coordination and
through the International Disaster Assistance (IDA) account
operational support, bolster country readiness and response
and $350 million to the State Department through the
capacity—particularly in low-resource countries—and
Migration and Refugee Assistance (MRA) account (P.L.
accelerate relevant research and innovation. WHO issued an
updated plan in April, and in May estimated that it would
need $1.7 billion to respond to COVID-19 through
WHO Funding. On April 14, 2020, President Trump
December 2020. As of June 9, donors have provided $670
announced that the United States would suspend funding to
million, including $30 million by the United States. WHO
the WHO, pending a 60- to 90-day review of WHO’s
has used the funds to purchase and ship personal protective
COVID-19 response. The President and some world leaders
equipment (PPE) to 135 countries, supply over 2 million
assert that the WHO mishandled the early response to the
diagnostic kits to 126 countries, and deploy over 100
COVID-19 pandemic and have called for an investigation.
emergency medical teams to countries in need.
On May 30, 2020, President Trump announced that the
United States would be “terminating our relationship with
Access to COVID-19 (ACT) Tools Accelerator. On April
the World Health Organization and redirecting those funds
24, WHO, GAVI, the Vaccine Alliance, the Coalition for
[that the United States provides to WHO] to other
Epidemic Preparedness and Innovation (CEPI), and others
worldwide and deserving, urgent, global public health
announced the creation of the ACT Accelerator, a
needs.” The Administration has not provided additional
framework to ensure equitable global access to COVID-19
information, raising questions regarding U.S. global health
diagnostics, therapeutics, and vaccines. The global
engagement. Congressional responses have been mixed.
community, led by the European Union, raised $7.4 billion
Some Members have introduced bills calling for suspension
for the ACT Accelerator and other global COVID-19
of U.S. funding for WHO until it undertakes certain
responses. The United States did not participate in the
reforms. Other Members have raised concerns that
launch of or provide funding for the ACT Accelerator.
withholding funding during the outbreak might undermine
U.S. International Response
pandemic control efforts and have introduced legislation
Funds for Global COVID-19 Control. As of June 10,
supporting investigating WHO’s COVID-19 response while
2020, the State Department and the U.S. Agency for
maintaining U.S. financial support for global COVID-19
International Development (USAID) have pledged $1
containment efforts led by the WHO.
billion for COVID-19-related health and humanitarian
Travel Restrictions. Starting January 31, the President
assistance. USAID reports that these funds are being used
issued a series of proclamations suspending entry into the

COVID-19: Global Implications and Responses
United States of most foreign nationals who, within the 14
unavailable as the COVID-19 situation develops. Updated
days prior to arrival, had been in mainland China (effective
guidance reiterates that U.S. citizens who wish to return to
February 2), Iran (March 2), the Schengen Area of Europe
the United States should make arrangements to do so
(26 countries; March 13), the United Kingdom or the
without delay. As of June 10, the State Department reports
Republic of Ireland (March 16), and Brazil (May 26). On
coordinating the repatriation of over 100,000 American
March 21, the United States, Canada, and Mexico began
citizens on 1,140 flights from 136 countries or territories.
limiting nonessential travel across their borders. They have
On March 27, CDC issued a “Global COVID-19 Pandemic
since extended those restrictions until June 22, 2020.
Notice,” advising travelers to “avoid all non-essential travel
On March 19, the State Department issued a global Level 4
to all global destinations.”
(“Do Not Travel”) health advisory, advising Americans “to
Sara M. Tharakan, Coordinator, Analyst in Global
avoid all international travel due to the global impact of
COVID-19.” It advised U.S. citizens abroad to return home
Health and International Development
immediately, and it advised U.S. citizens living abroad to
Tiaji Salaam-Blyther, Specialist in Global Health
avoid all international travel. The State Department updated
Frank Gottron, Specialist in Science and Technology
this global health advisory on March 31, warning that its
ability to assist U.S. citizens overseas who wish to return to
Susan V. Lawrence, Specialist in Asian Affairs
the United States may become more limited or even

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