While U.S. President Donald Trump says that the risk the coronavirus poses to Americans is “very low,” an epidemiologist who has been watching the virus closely says there could already be a major outbreak in the country.
But there is no way to know for sure because of a lack of testing, says Harvard’s Eric Ding.
On Thursday, U.S. Centers for Disease Control (CDC) confirmed the first case of a patient getting the virus from an unknown origin. In other words, doctors can’t trace it directly back to travel abroad or contact with someone else who was infected.
The patient in California had to wait days to be tested because their symptoms did not fit federal criteria for testing. The CDC has restricted testing to patients who have recently travelled to China or have come in contact with an infected person.
Ding is an epidemiologist and health economist at the Harvard School of Public Health. Here is part of his conversation with As It Happens host Carol Off.
When you hear the president speak about the coronavirus in the United States, does that sound reassuring?
I am not fully reassured because America’s main problem is right now we have no testing almost whatsoever.
America’s basically in the dark completely about the epidemic. It’s like driving in the middle of night with no headlights.
But we’re hearing from the president of your country that the risk to the American people remains very low. He is saying there is nothing inevitable about a U.S. outbreak … What is any of that based on then?
It’s not based on anything because you can’t have an epidemic without any testing. And so right now … CDC’s kits were frozen and recalled because of a lab error.
And the U.S. for comparison has had less than 500 lab tests, with the entire country, while South Korea, which is the size of one or two American states, has over 40,000 tests already for a small country.
And that is what you need to truly capture if there really is an epidemic.
So why is the United States so, I guess, ill prepared for this?
We should have had more state labs authorized much faster. Now they have finally authorized different labs to skip a few steps and then develop their own tests, instead of relying on CDC’s kits. Which is a good sign because last week Hawaii was begging Japan for their kits because the CDC said we were not going to be able to send it to you until March.
And FDA has now approved these emergency kits used by these other states. So I think the tide will be changing, but it’s getting very frustrating with the defective kits.
You have the first case in the United States of someone getting it … of an unknown origin, which means they didn’t come from travelling, they got it in the United States. So what does that tell you?
It’s very worrisome. I think community transmission is likely already here in the United States. I think it’s more than just California.
This case right now is someone who is completely unrelated to any Chinese travel or the previous case.
For example, in Canada that ER doctor was very sharp and tested that woman who came back from Iran and discovered that she was positive.
Right now if a doctor in the United States wants to test someone who is not travelling from China, they could not. And that’s why we are totally in the dark and that’s why it’s so frustrating.
So I’m hoping we would get much more information about the epidemic in the coming weeks. But right now President Trump’s statement that everything’s fine, everything’s locked down … is completely not based on any evidence.
You mentioned that you can’t get tested if you didn’t come from travel. Is that what happened to this one patient who has it from an unknown origin? I understand [the patient] was not initially tested.
The person was not tested for many, many days. They had demanded it. Finally California provided the test. The test did not come from the CDC. California is one of the few states that actually has testing capability, limited albeit, at this time.
And they finally, after an extensive delay of CDC refusal, California tested it and, boom, discovered that person did have it. And 40 other states are hopefully going to have the same capability within next week. But again also these labs are also capacity limited to just 100 tests per lab per day. Which is not nearly the scale you need to fully capture this epidemic.
What’s the level of possibility of a major outbreak of the coronavirus in the United States?
I personally think it’s pretty high. I personally think it’s already here and we just don’t know about it. That’s the reality.
Just like in Iran and Italy, once they start testing they realized, “Oh my gosh, so many people have it.”
I think the U.S. is potentially going to get there as a certain stage once we have the testing because this virus is inevitable.
And right now any CDC and [National Institutes of Health] directors are gagged from speaking to the public after Trump’s announcement. So I think that’s very also very unfortunate.
What do you mean gagged?
They say because Trump has appointed Vice President Pence as the coordinating person, all these previous NIH directors and CDC directors who spoke to the public … are now prevented from speaking to the press.
All communications must now go through the vice president’s office, which, as you know, is a very political office, unlike a public health and scientific body like the NIH or CDC.
It’s just like China.
You cannot imagine how upset I am, but that is the world we live in right now.
And right now all I care about, first priority, is get the funding for more CDC resources and get the damn tests.
Written by Sarah Jackson with files from Associated Press. Produced by Alison Masemann. Q&A has been edited for length and clarity.