WASHINGTON -- The U.S. Department of Health and Human Services has notified Congress that it might need to transfer up to $136 million to help combat the coronavirus epidemic, while federal and state officials are struggling with how to carry out stringent new travel restrictions ordered by the Trump administration.
Elsewhere, the Centers for Disease Control and Prevention is quickly burning through $105 million that was set aside for emergency public-health responses that now include the coronavirus, which infectious-disease experts say is likely to become a pandemic -- an ongoing epidemic on two or more continents.
The global death toll from the disease topped 400 on Monday, while the number of confirmed cases passed 20,000. Hong Kong reported early today its first death from the virus -- a 39-year-old man who traveled from mainland China. He was the second person to succumb to the illness outside mainland China.
In the U.S., officials are trying to determine where to quarantine passengers arriving from China, where the epidemic began. The restrictions bar non-U.S. citizens from entering the country if they recently visited China, and they quarantine Americans who visited Hubei province, the epicenter of the outbreak, within the 14 days before the order.
The administration is also requiring screening and self-monitoring of symptoms for Americans who recently visited other parts of China. All flights from China as of Sunday evening are being funneled to 11 airports: in New York; Chicago; San Francisco; Los Angeles; Seattle; Atlanta; Honolulu; Newark, N.J.; Detroit; Dallas; and Dulles, just outside the District of Columbia.
Four of those airports, including Dallas-Fort Worth, were added Sunday. Health officials in Dallas said they were caught off-guard and spent Sunday trying to develop protocols for screening travelers. As of Monday afternoon, they said, they were still waiting for CDC to issue final guidances for assessing and monitoring travelers.
Transportation officials said airlines have already canceled most flights out of China, and U.S. carriers will stop all direct service out of China starting Wednesday, giving airports some time to work out the logistics. The three airports still getting flights out of China are in Los Angeles, San Francisco and Chicago.
Under quarantine in the United States are 195 people who were evacuated from Wuhan in Hubei province last week and are staying at a military base in California. It is not yet clear how many new people have been placed in quarantine or how many have been denied entry to the United States.
Top U.S. officials have repeatedly warned that the number of cases in the country will likely climb, and reported the first case of person-to-person transmission in the United States last week.
'AGGRESSIVE MEASURES'
Nancy Messonnier, the top official overseeing the CDC response, said Monday that there are 11 confirmed cases of the virus in the United States, and 82 people are being monitored.
Testing of suspected cases is expected to accelerate by the end of this week. A diagnostic test developed by CDC scientists was sent Monday to the U.S. Food and Drug Administration to be approved for emergency use by state labs.
Currently, all specimens must be sent to CDC headquarters in Atlanta for the virus testing.
"This is an unprecedented situation and we have taken aggressive measures," Messonnier said. "The goal is to slow this thing down before it gets into the United States."
Hawaii Lt. Gov. Josh Green said the rollout of the U.S. measures against the coronavirus has been "concerning."
"This is not the kind of thing you want to do on the fly, because that creates chaos," Green said. "When you rush, you make mistakes, and this isn't a case where we can afford mistakes."
On Monday, Green said, Hawaii officials were waiting on the Defense Department to tell them whether they had a location to house people under quarantine.
"We are an island state that is 80% dependent on tourism. This isn't a case where we can just put people up in hotels without great collateral risk," Green said.
HOSPITAL BEDS ADDED
China sent medical workers and equipment Monday to its just-completed, 1,000-bed hospital for treating victims of the new coronavirus.
The reopening of schools was also delayed to keep the virus from spreading further in hardest-hit central Hubei province, where the specialized hospital in Wuhan was completed in just 10 days. A second hospital with 1,500 beds is under construction. Restrictions were tightened still further in one city by allowing only one family member to venture out to buy supplies every other day.
Leading Chinese epidemiologist Zhong Nanshan said additional hospital space was crucial to stopping the spread of new infections.
"The lack of hospital rooms forced sick people to return home, which is extremely dangerous. So having additional [beds] available is a great improvement," Zhong told CCTV's 24-hour news channel.
Zhong played a major role in overcoming China's 2002-2003 outbreak of SARS -- severe acute respiratory syndrome -- a coronavirus from the same family as the current pathogen.
However, the new coronavirus has spread more widely and caused more deaths. The Chinese government said this morning that mainland China has 425 deaths from the virus and 20,438 confirmed cases. During the SARS outbreak, China had 349 deaths and 5,327 cases, according to the World Health Organization.
More than 160 cases have been diagnosed in two dozen other countries, including the 11 in the United States.
Hong Kong leader Carrie Lam on Monday said she would close more border crossings with mainland China, leaving only three open, but stopped short of fully closing the door.
Her announcement on Monday came as thousands of medical workers in the city started the first wave of a strike designed to pressure the government into a full border closure. Medical workers are also demanding sufficient protective supplies like masks, which are in very short supply in the semi-autonomous territory.
Lam said she hoped the closure would discourage people from crossing between the two territories. Hong Kong has its own immigration system, but Beijing has ultimate sovereignty over the territory.
The decision, Lam said, has "absolutely nothing to do" with the five-day strike launched by health care workers on Monday.
"If anyone thinks that by resorting to such extreme measures, the government will be made to do something that is not rational or will harm the public good, they will not get anywhere," she said.
XI WARNS OFFICIALS
President Xi Jinping of China called Monday for all Communist Party officials to make reducing the number of infections and deaths a top priority.
Xi presided over a meeting of senior Communist Party leaders at which they acknowledged shortcomings in policies on public health and emergency management, according to a report by China's official Xinhua News Agency. The leaders called the coronavirus epidemic "a major test of China's system and capacity for governance."
Xinhua quoted Xi as saying that officials who resist orders and "lack boldness" could be punished.
That appeared to be the case behind the firings of six officials in the city of Huanggang, next to Wuhan in Hubei province. Xinhua reported that the officials were fired over "poor performance" in handling the outbreak, citing the mayor as saying Huanggang has "a severe shortage in medical supplies such as protective suits and medical masks."
Elsewhere, Chinese scientists said they have more evidence that the virus likely originated in bats. In a study published in the journal Nature, Shi Zhen-Li and colleagues at the Wuhan Institute of Virology reported that genome sequences from seven patients were 96% identical to a bat coronavirus.
Scientists suspect the latest outbreak began at a seafood market in Wuhan where wild animals were on sale and in contact with people.
In a sign of the economic toll of the outbreak, China's Shanghai composite index plunged 8.7% when it reopened Monday after the long Lunar New Year holiday. The fall was a reflection of 10 days of unrelenting bad news since the Chinese markets were last open on Jan. 23.
Authorities in Hubei and elsewhere have extended the Lunar New Year holiday break well into this month to try to keep people at home. All Hubei schools are postponing the start of the new semester until further notice.
Many Chinese cities have also postponed the reopening of nonessential businesses and offices, while a drop-off in Chinese tourists is also affecting the economies of nearby countries in Asia.
Information for this article was contributed by Lena H. Sun, Lori Aratani, William Wan, Antonio Olivo, Simon Denyer, Yasmeen Abutaleb, Erica Werner, Lenny Bernstein, Shibani Mahtani, Min Joo Kim, Anna Fifield and Isabelle Khurshudyan of The Washington Post; by Sui-Lee Wee of The New York Times; and by Ken Moritsugu, Bharatha Malawaraarachchi, Maria Cheng, Mari Yamaguchi, Jamey Keaten, Joe McDonald, Yu Bing, Chen Si and staff members of The Associated Press.
A Section on 02/04/2020