Benjamin Haynes: Thank you all joining us for this briefing. We’re joined today by the director of CDC’s National Center for Immunization and Respiratory Disease, Dr. Nancy Messonnier.  At this time Ii will turn the call over.

Dr. Nancy Messonnier: Good afternoon, thank you for joining us today.  Since I last briefed you, there has been one new case of COVID-19 detected through the U.S. public health system. As has been widely reported, at this time we don’t know how or where this person became infected. This brings the number of confirmed cases of person-to-person spread in the United States to 3.

We also have confirmed 2 more people who have tested positive for the virus that causes COVID-19 among U.S. citizens repatriated from the Diamond Princess cruise ship. That brings the total number of people with COVID-19 to 44 among this group of people.

I’d like to share with you some additional information about the U.S. case CDC confirmed on Wednesday. CDC officials first heard from public health colleagues in California about this patient last Sunday, February 23rd. California reported a severely ill person who had not recently traveled abroad or had contact with a known case of COVID-19.  CDC recommended testing for COVID-19 that day. We received samples on February 25th and confirmed the results with public health officials in California the day they were finalized, on February 26th. As I said, the patient’s exposure is unknown.  It’s possible this could be the first instance of community spread – meaning the illness was acquired through an unknown exposure in the community. It’s also possible, however, that a thorough investigation may show that the patient had exposure through contact to a returned traveler who was infected.

CDC has sent a team to support the California Department of Health and the local health departments in investigating this case.  We are working hard to find and identify how the patient was exposed as well as tracing back people who were exposed or might have been exposed to this patient.  Like you, we are thinking about the wellbeing of this patient, this family, and this community. People who were exposed to this person during their infection are at some level of risk depending on their exposure. Based on what we know about how this virus behaves, we expect that we will find additional people who have had contact with this patient, especially those who have had close, prolonged contact. This of course includes family members and potentially among healthcare workers who cared for the patient.

There has been some confusion about whether this person met CDC’s criteria for testing of COVID-19.

Let me comment briefly on how we have set our PUI criteria, which has been evolving as all of our guidance has to meet the needs of this rapidly evolving situation. You can look for these updates online at www.cdc.gov/covid19.

Editor's Note: PUI means 'person under investigation' ...

CDC’s definition of a person under investigation, or PUI, from the beginning has been broad, for travelers especially, because this was a disease that was being introduced from another part of the world. We have been looking for people with fever, cough, or trouble breathing. Fever and cough are pretty broad parameters, especially during flu season, and we’ve had to rule out many people who had other respiratory illnesses.  At this point in our investigation, we are most focused on symptomatic people who are closely linked to confirmed cases or had travel history. But our criteria also allows for clinical discretion.

As public health professionals, we know that there is no substitute for the astute clinician on the frontlines of patient care. Our clinical team working with state and local health departments to assess PUIs has not said no to any request for testing.

So, on the topic of PUIs, I want to say that as we’ve been watching the increased spread of this virus across the world, we have been working with our partners on an updated PUI definition. That was posted online yesterday. The updated PUI definition takes into account the new geographic spread of the virus and includes a list of affected areas with widespread or sustained community spread. This list is dynamic and will change as our travel guidance is revised. I would now like to share an update on our progress to get all state and local public health labs the capacity to test for this virus. That is CDC’s role in testing for this illness. As I’ve said before, this has not gone as smoothly as we would have liked.

We have been working simultaneously on a couple of possible solutions and I’m happy to say today that both have delivered.

Right now, labs can start testing with existing CDC test kits. States that were able to validate their kits should continue to test in this manner. States that were able to validate only the two components specific to novel coronavirus can test using only these two using revised instructions developed at CDC. We have established that the third component, which was the cause of the inconclusive results, can be excluded from testing without affecting accuracy. We have been working with FDA and they agree with our approach. While we’re working to amend the existing EUA, we have discretionary authority from FDA to proceed in this manner. This will increase testing capacity at state and local health departments. All positive test results will continue to be confirmed by CDC for some time.

Additionally, CDC has manufactured brand new test kits that will only include the two components that are specific to novel coronavirus.  Those test kits are at the International Reagent Resource, where orders can be placed. We are working as quickly as we can to get CDC test kits to state and local public health authorities. However, during any infectious disease response there is a great need for test manufacturers to rapidly make testing available in clinics, in hospitals, and at the bedside.  This is part of a huge effort within the US government led by HHS.

States will now start testing for this virus. You may start hearing from states directly. As always, their case counts will be the most up-to-date. CDC will continue to report case counts on Mondays, Wednesdays and Fridays. Our priority continues to be getting accurate diagnostic capacity—and doing so quickly—because we know public health surveillance is critical to our fight against this novel coronavirus. To date, our strategies have been largely successful.  As a result, we have very few cases in the United States.  And while we may be confronting the first instance of community spread, we are working very hard with our state and local public health partners to find out more.

I want to recognize that people are concerned about this situation. We appreciate that Americans are taking this threat seriously and continuing to seek information about how to be prepared. As always, President Trump’s and our number one priority is the health and safety of the American people. Our mission includes providing you with clear information that allows you to make decisions about how best to protect yourself and your family.

While the immediate risk to the general American public remains low, and the U.S. government is doing everything we can to keep it low. CDC is constantly monitoring what is happening abroad. Our guidelines and advice are likely to be interim and subject to change as we learn more. We will continue to keep you updated.

I would be happy to take questions now.