Office of Emergency Coordination (OEC) OEC Update: March 2020 (1) Coronavirus Disease 2019 (COVID-19): An Evolving Situation – Part-1 Past issues of the OEC Update are available at https://clphs.health.mo.gov/oec/updates.php. Coronavirus Disease 2019 (COVID-19): An Evolving Situation Public health officials worldwide are responding to an expanding outbreak of respiratory illness caused by a novel (new) coronavirus now named SARS-CoV-2. The disease caused by SARS-CoV-2 has been named coronavirus disease 2019 (COVID-19). Cases of COVID-19, which were first identified in China, are now occurring in many other parts of the world, including the U.S. In some individuals, infection has resulted in severe illness and death. Sustained person-to-person transmission of SARS-CoV-2 is occurring in China, and community spread is also being reported in a number of countries outside China. CDC has called the COVID- 19 outbreak a concerning and serious public health threat. In the U.S. as of March 5, a total of 99 confirmed and presumptive COVID-19 cases* have been reported from 13 states. Ten individuals have died. These numbers will continue to increase, Recently in the U.S., several instances of infection with SARS-CoV- 2 have occurred in persons in multiple states with no travel history and no known source of exposure. These situations are potentially indicative of community spread of the virus. (See below for links to up-to-date information on what is a rapidly evolving situation.) Public health officials have stated that there will be community spread of SARS-CoV-2 in the U.S., although it is presently unclear how significant the long-term impact of COVID-19 will be in this country, including how many people will develop severe illness. CDC believes the current risk to persons in this country from the virus is low, but everyone should be prepared for the possibility that a COVID-19 outbreak might occur in their community in the future. CDC, multiple other federal agencies, state and local health departments, and other partners are currently implementing aggressive measures to slow transmission of SARS-CoV-2. These measures include identification of potential cases and their contacts, and ensuring that appropriate precautions are put in place to help prevent further transmission of the virus. Although these measures might not prevent the eventual establish- ment of ongoing, widespread transmission of SARS-CoV-2 in the U.S., slowing the spread of illness can be beneficial because it provides time to: 1. prepare health care systems and the general public to be ready if widespread transmission with substantial associated illness occurs, and 2. obtain a better understanding of SARS-CoV-2 infection to guide public health recommendations and the development of medical countermeasures including diagnostics, therapeutics, and vaccines. *These are cases of COVID-19 reported to CDC or tested at CDC since January 21, 2020, with the exception of testing results for persons repatriated to the U.S. from Wuhan, China and Japan. SARS-CoV-2 is a respiratory virus that can be transmitted from an infected person to close contacts. Transmission appears to be mainly through respira- tory droplets produced when an infect- ed person coughs or sneezes, similar to how other respiratory viruses spread. __________________________ Clinical manifestations of SARS-CoV-2 infection have ranged from mild symptoms to severe illness and death. Asymptomatic infection has also been reported. Signs/symptoms can include fever, cough, and shortness of breath. Currently there is no specific antiviral treatment recommended for SARS-CoV- 2 infection; those who are ill receive supportive care. There is also, at present, no vaccine to prevent infection. __________________________ Interim recommendations have been provided to health care providers for evaluation of persons under investiga- tion (PUI) for COVID-19, as well as guidance for infection control and the collection of specimens for laboratory testing. Providers are instructed to immediately notify both infection control personnel at their health care facility and public health officials in the event of a PUI for COVID-19. Illustration of a Coronavirus