OPINION

Can coronavirus be contained?

The latest strain of coronavirus continues to rage across China. Its death toll has eclipsed the body count from China's SARS outbreak in 2002 and 2003.

To get a better sense of the disease and the U.S. government's response to it, we spoke to Anthony Fauci, immunologist and director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. Below is a transcript of an interview with Fauci, edited for clarity and brevity.

What makes this virus different?

Well, we have to be concerned whenever there's a virus that has--and I'm going to use a big word here--pathogenic potential ... . [The coronavirus] is brand-new, and there's no real underlying experience with it, so the general population is naive with regard to protection. And it has serious potential, because it's already spreading rapidly. It's the unknown aspect of something that already tells you it's a serious problem. We don't know where it's going.

Are we past the point of containment for this coronavirus?

No, we're not. But it really does have the potential to turn into a global pandemic. What we have now is a very serious epidemic in China ... . [But outside of China] there is very little--but some--transmission from person to person. Once you get multiple countries that have sustained transmission from person to person, then it's beyond the situation where you can contain it. You can only mitigate it.

In the United States, we are clearly in the containment phase ... . And what we've done is we've identified. We've isolated. And we've done contact-tracing [identifying who might have come in contact with an infected person]. That seems to be successful. But once it it starts spreading all over the world ... then it's almost inevitable that it's going to start spreading here.

The Washington Post reported recently that China withheld information from the public, including silencing medical professionals, and that this made the spread of the virus worse. How does the United States work with a government that we can't even trust to tell the truth to its people?

That is an issue. And it's the reason why I have been saying that we need some of our people--CDC, NIH people--there on the ground, both helping and seeing with their own eyes exactly the extent of this. We want to be part of a [World Health Organization] convening group that goes there. But thus far, we've not been able to make that a reality.

Why is that?

I don't know. We have asked. We have colleagues--scientific colleagues--in China that we've dealt with for years, if not decades. Many of them have trained in the United States. And we know them as friends and as colleagues. They are the ones that are not holding back ... . But they're not the ones that make the official proclamations of what comes out.

The solution to the problem in the question you're posing is that we really do want people there, so that we can not only help them but also provide some expertise that might supplement or complement their own expertise.

What does the United States do if [the coronavirus] does become a pandemic in the developing world?

Well, obviously we will try to help them to contain as best as possible ... . Right now, by definition, it is not truly a global pandemic. It is a very serious outbreak and epidemic in China, but the amount of sustained transmission outside of China is still minimal ... . But there are some countries where it is going to be very difficult to stop the evolution into sustained transmission. The [World Health Organization] and the global security network that we put up over the years will try to help those countries, but there's no guarantee that we'll be successful.

On that point, the head of the WHO has criticized travel bans and restrictions around the world as not helpful to stopping the outbreak. He said it was potentially "increasing fear and stigma." What are your thoughts on that, given that the United States has issued travel bans from China and mandatory quarantines?

Everyone agrees that travel bans and restrictions are almost never successful in completely stopping something that is invariably going to turn into a pandemic ... . What we are trying to do is to pause temporarily and give China enough time to put the lid on [this virus] to prevent it from becoming global and to give us a little more time to prepare. There's no indication or imagination that if this becomes a global pandemic that travel restrictions are going to mean anything. But they can mean something, as a temporizing activity.

What should the average person be doing right now about coronavirus?

They should realize that at this point, it is a low risk. That risk can change, so pay attention to what's going on [and] to the ... announcements coming from the CDC ... . The things that you do for influenza--get vaccinated, wash your hands, avoid crowded places--are exactly the same things that you would do if we get coronavirus here. So the question is, should we do anything different from what we're already doing? No.

Should we all be wearing a mask?

Absolutely not.

Editorial on 02/16/2020

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