Home & Family
On 11 March, the United States announced it would restrict and suspend the entry into the United States of foreign nationals who were physically present in a number of European countries during the 14-day period preceding their entry or attempted entry into the United States. These countries include 26 European nations: Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, and Switzerland.
The restrictions apply only to foreign nationals, and not U.S. citizens, green card holders or the families of U.S. citizens. Those exempt from these restrictions, such as U.S. citizens, will be directed to limited airports where screening can take place.
This restriction becomes effective at 11:59 p.m. eastern daylight time on March 13, 2020. It does not apply to persons aboard a flight scheduled to arrive in the United States that departed prior to 11:59 p.m. EDT on March 13, 2020.
Additionally, on 11 March the COVID-19 outbreak was declared a pandemic by the WHO.
An outbreak of COVID-19, a respiratory disease which is caused by a coronavirus, was first detected in Wuhan City, Hubei Province and has spread throughout China. Infections in humans in other parts of the world, including the United States have also occurred. Increasingly there have been cases of person-to-person infections occurring around the globe. Most of these cases have involved individuals with prolonged and confined contact (e.g. passengers on a cruise ship) with infected individuals.
Early data on the genetic makeup of the Wuhan virus indicated the likelihood that this “novel” (meaning newly identified) virus is related to other coronaviruses found in bats and other mammals, as well as the coronavirus responsible for SARS (Severe acute Respiratory Syndrome), first identified in 2003. Currently Covid-19 has been determined to have mutated into so there are two strains of this virus circulating. Mutations in viruses are a natural and continuing occurrence. It is for that reason that vaccines, such as for Influenza are being updated annually.
Epidemiological data to-date indicates that human-to-human transmission remains the primary route of infection. Transmission occurs when infected individuals cough or sneeze, thereby releasing virus particles, which are contained in sputum and mucous secretions. These secretions can also be aerosolized and directly inhaled or ingested by others. These aerosols can also contaminate surfaces, infecting individuals who have touched the surfaces, then touched their eyes, nose or mouths. Clusters of cases are increasingly common, most frequently in families or large congregation of people like in a nursing home. This clustering of infections is common in other types of coronavirus infections, since under these settings people frequently have close contact with each other, increasing the likelihood of person-to-person transmissions.
Chinese infectious disease researchers have indicated that infection by fecal/oral route has also occurred. Previous data with other coronaviruses has indicated that as is the case with Influenza virus, infected individuals shed virus into their mucous secretions, which are then swallowed and passively transit the gastro-intestinal tract, mechanically contaminating feces. Infected individuals who do not practice good hygiene after using the toilet can then through direct contact, contaminate surfaces and food. Even though fecal/oral transmission can occur, the primary route of transmission for the current coronavirus epidemic remains respiratory.
The Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) are carefully monitoring the epidemic. Exact numbers for people infected and sick (morbidity) and deaths (mortality) are difficult to obtain, since large numbers of people may be infected, but be symptomless.
Infections with COVID-19 have increasingly occurred outside of China. The global spread of the outbreak was expected, but as of 10 March 2020 the infection rate outside of China has increased, while the number of new cases within China have decreased. On 11 March the COVID-19 outbreak was declared a pandemic by the WHO.
U.S. health officials reported on 30 January 2020, the first confirmed instance of person-to person infection in the U.S. That same day the WHO declared a Public Health Emergency of International Concern (PHEIC).
On 31 January 2020, President Trump signed a “Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus”, which restricts entry into the United States, by individuals coming from Wuhan or other affected regions of China.
Since the outbreak began, the U.S. State Department has issued travel advisories to reduce non-essential travel to impacted nations. For the latest advisories, visit the CDC website at https://wwwnc.cdc.gov/travel/notices
What Is a Coronavirus
Coronaviruses are a large group of viruses that cause a wide range of respiratory infections in mammals, humans, and birds. The virus group is responsible for other serious respiratory diseases, including SARS and MERS (Middle East Respiratory Syndrome). Coronaviruses of several varieties regularly circulate in human populations of both adults and children. As a group, coronaviruses are also responsible for a large percentage of common cold infections, which occur in the fall and spring of each year. These infections usually include symptoms such as fever, lethargy, lack of appetite, sore throats, and dry nonproductive coughs. Occasionally, more severe symptoms occur, including bronchitis, viral pneumonia, or bacterial pneumonia, which occurs as a secondary infection.
Although common colds usually resolve without complication in approximately 10 to 14 days in healthy adults and children, deaths do occasionally occur, primarily in the very young, the very old, or in individuals who have other underlying medical conditions.
Treatment and Prevention
Currently, there are no approved coronavirus vaccines or antiviral drugs. Best practices for prevention include staying away from people or animals experiencing respiratory infections and carefully practiced hygiene (washing hands and disinfecting potentially contaminated surfaces).
Interim guidance for care of patients not requiring hospitalization for respiratory infections that may be caused by COVID-19 is available from the CDC (Link: https://www.cdc.gov/coronavirus/2019-ncov/guidance-home-care.html).
Travel and Safety
In addition to the restrictions on travel from certain European nations, foreign nationals cannot enter the United States if they have been to China or Iran in the past 14 days.
U.S. citizens, residents and immediate family members who have visited China or Iran in the past 14 days can enter the U.S. but are subject to health monitoring and possible quarantine for up to 14 days.
On 8 March the CDC recommended that people at high risk of serious COVID-19 illness should avoid cruise travel and non-essential air travel. Travelers should carefully monitor travel health notices related to this outbreak, which are updated and available at the CDC (Link: https://wwwnc.cdc.gov/travel/destinations/list )
Until more is known about the transmission of the disease, persons traveling to affected areas should avoid consumption of cooked or uncooked exotic meats.
In areas where person-to-person transmission is occurring, it is important for potentially infected individuals (e.g. have been in or around affected areas, consumed raw or undercooked exotic meats, etc.), even including those who are currently symptomless, to avoid handling food materials, as food can mechanically transmit the virus, should the food handler inadvertently contaminate the food with mucus or sputum, from a sneeze or cough.