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An infectious disease specialist on what we do and don’t know about COVID-19

After infecting tens of thousands in China, the novel coronavirus has reached dozens of other countries -- at least 48 in total. Public health officials say it’s almost inevitable the illness will spread more extensively within the U.S. So what do we know about COVID-19, and how can we prepare for a broader outbreak? Amna Nawaz reports and talks to Dr. Peter Hotez of Baylor College of Medicine.

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  • Judy Woodruff:

    Emergency measures are spreading across the world tonight, in a race with the viral outbreak that began in China.

    That comes as infections and deaths surged again across Asia and the Middle East and as economic fears fueled an almost-1,200-point loss in the Dow Jones industrials average, underscoring worries about the larger global economy.

    After the markets closed, there were reports of a whistle-blower at the Department of Health and Human Services raising concerns a dozen government workers were sent to meet the first infected patients coming to the U.S. from China without proper training or protective gear.

    First, Amna Nawaz reports on public health efforts here and abroad.

  • Amna Nawaz:

    Across the world, governments and citizens are taking steps to contain the spread of coronavirus, known officially as COVID-19.

    In Iraq, health worker sprayed disinfectant on the Kufa Mosque, a major destination for Muslim pilgrims. Japan said it will close all schools until late March. And, in Italy, the military is stopping vehicles from entering quarantined towns like Turano, after more than 300 people were infected with the virus this week.

  • Roberto Speranza (through translator):

    Italy is the country that is making the most checks. We have isolated all the positive cases, tracked all the people who have had contact with these positive cases, and we are following how the outbreak develops with the utmost attention.

  • Amna Nawaz:

    COVID-19 has now spread from its epicenter in Wuhan, China, to six continents.

    Outside of China, South Korea has the highest number of cases, more than 1,500 so far. The government there has launched roadside testing units, but amid long lines for masks, officials are under fire for their response.

  • Lee Yong-Duk (through translator):

    When it comes to disinfection, we would like the government to do it more often, but it has been done only twice.

    I started seeing officials disinfecting the market only after the virus started spreading, and it feels like they are always one step behind.

  • Amna Nawaz:

    In Iran, 26 people have died so far, the most reported deaths outside of China. Some import restrictions have been eased, like hand sanitizer and masks.

    But one Tehran resident accused the government of downplaying the threat.

  • Mohammed Rezi Khani:

    The Internet says it's very dangerous, but television says it's nothing serious, it's just a simple cold. As a citizen, I haven't been able to tell which one is telling the truth.

  • Amna Nawaz:

    The head of the World Health Organization warned at a press conference today in Geneva that the outbreak is at a decisive point.

  • Tedros Adhanom Ghebreyesus:

    Our message continues to be that this virus has pandemic potential. And WHO is providing the tools to help every country to prepare accordingly. This is not a time for fear. This is a time for taking action now to prevent infections and save lives.

  • Amna Nawaz:

    Back in this country, President Trump continued to reassure Americans of the government's response, tapping Vice President Mike Pence to lead the administration's coronavirus task force.

    But during a press conference last night., the president contradicted the message from top federal health officials.

  • President Donald Trump:

    No, I don't think it's inevitable. It probably will. It possibly will. It could be at a very small level or could be at a larger level. Whatever happens, we're totally prepared.

  • Amna Nawaz:

    At least 60 people in the U.S. have been infected so far, including one person in California, who officials say had no travel to China, nor contact with an infected person.

    House speaker Nancy Pelosi today criticized the administration for slashing its public health budget, but said Congress will appropriate more money.

  • Rep. Nancy Pelosi, D-Calif.:

    We're coming close to a bipartisan agreement in the Congress as to how we can go forward with a number. That is a good start, but we don't know how much we will need.

  • Amna Nawaz:

    Senate Majority Leader Mitch McConnell said today the Senate will vote on that funding in the next two weeks.

    With the virus now reaching at least 48 countries, and mounting concerns about whether it will eventually spread wider in the U.S., we wanted to focus on some important and key information about COVID-19.

    Dr. Peter Hotez is an infectious disease specialist at the Baylor College of Medicine. He's in Houston to help us with some of those questions.

    Dr. Hotez, welcome back to the "NewsHour."

    One of the biggest questions we hear again and again from people is, we know it's a respiratory illness. We know it's highly contagious, but how is it spreading? How does it move from person to person?

  • Peter Hotez:

    Well, thanks for having me on.

    Unfortunately, because this is a new virus agent, there's more we don't know than we do know. We think it's highly likely that this virus is transmitted by what we call droplet contact. By that, somebody sneezes or coughs and releases micro -droplets into the air that either land on surfaces that people will touch with their hands and bring to their face, or the droplets will directly contact to the face, and they will rub that into their mucous membranes of their eyes and nose.

    That's probably a highly likely mode of transmission that we see with other respiratory viruses.

    Is it also airborne? So many people are surprised to learn that most respiratory viruses are not airborne, by that, being on small particles in the air that can travel for several feet or meters. It turns out that not many viruses do that. We know measles does it. That's one of the reasons why it's so highly contagious, why chicken pox virus does it, why that's so contagious.

    We think there's a possibility this may also be true of this coronavirus, in part because so many people are getting infected so quickly. It has a very high what we call reproductive number of up to four. That means up to four people get infected if a single individual has it.

  • Amna Nawaz:

    So here's the other thing we're hearing again and again from people is, they really want to better understand how dangerous the virus is, if you become infected.

    We have heard the president and others compare it to the flu. Is that a fair comparison?

  • Peter Hotez:

    There are some similarities to the flu, certainly, but there's some important differences as well.

    From the studies in Wuhan, the case fatality rate, the number of people who get — who died because they become infected is around 2 percent, or one in 50.

    Now, that number has been somewhat questioned in the last few weeks, because we know there are people with low-grade symptoms maybe we're not fully accounting for.

    However, the World Health Organization, Dr. Bruce Aylward, came out a couple of days ago, and he says he thinks that 2 percent number is real. And that's a pretty significant mortality rate, because a typical seasonal flu, for instance, which still kills a lot of people in the United States, as the president pointed out last night, will kill around 0.1 to 0.2.

    So we're talking about something that is maybe 10 to 20 times more lethal than typical seasonal influenza. So, that's really concerning, the fact that it's so highly transmissible, and it has that high case fatality rate.

    So I think we're going to be — have to be — watch this very closely, especially in the United States in the coming weeks.

  • Amna Nawaz:

    So, people are out there hearing public health officials, not just in the United States, across the world, basically saying, you need to prepare for a pandemic. This is not a question of if. It's a question of when.

    And we hear about, OK, wash your hands all the time, cover your mouth when you cough. What else should people be doing? Should they be buying masks? Should they be canceling international travel? Should they be stockpiling medications? What do you recommend they do right now?

  • Peter Hotez:

    Well, so that's the big question.

    The good news is, right now, we're not seeing a significant level of transmission in the U.S. So we still have time. And, remember, it's not as if we're going to be going no transmission, no transmission, then one day there's going to be half the country infected. It's not going to work like that.

    If we're going to start seeing an uptick, we're going to hear about focal areas of transmission in a few selected cities. And, gradually, that will increase.

    So I think we still have a little bit of time. At this point, I'm not canceling any of my domestic trips. I do recommend that, if you're on prescription medicines, you might want to start stockpiling those prescription medicines. Don't go raiding stores at this point.

    I wouldn't even cancel major events at this point. Now, having said that, a week from now or 10 days from now, I may be telling you a different story. So that's really important that you're mindful and keep in touch with the news about what's happening, because this is a rapidly changing situation.

  • Amna Nawaz:

    Good to stay on top of it.

    Thank you for helping us with that.

    That's Dr. Peter Hotez of the Baylor College of Medicine.

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