HHS Secretary Azar urges healthcare providers to watch for patients who have traveled to China

• In response to the novel coronavirus, providers should screen patients who recently have traveled to the affected area of China.
• It remains unclear whether asymptomatic patients can transmit the virus.
• A rapid test to confirm the virus will be distributed to local public health departments within two weeks.

As part of the federal response to the novel coronavirus, the Trump administration is urging providers to check whether patients have traveled to China, where the outbreak started.

At a Jan. 28 news conference, Alex Azar, secretary of the Department of Health and Human Services (HHS), outlined various steps the administration is taking in response to the first five U.S. cases of the virus (2019-nCoV) and urged vigilance by the provider community.

“Healthcare providers should be on the lookout for patients with travel history to China, especially Hubei Province, and relevant symptoms,” Azar said.

Azar revealed the administration expanded airport screenings from five to 20 airports with incoming flights from China, where the virus has spread beyond quarantine zones. But he also downplayed concerns about the impact of the virus on the United States.

“This is potentially a very serious health issue, but there is nothing that individual Americans should be worried about,” Azar said.

What’s the latest

Administration officials outlined their latest understanding of the virus, how to contain it and what China should do to help, including:

• Planning to release a “rapid test” within two weeks for confirming cases in local communities
• Establishing the need for repeat testing in some cases to identify the virus
• Requesting that China allow virologists from the Centers for Disease Control and Prevention (CDC) into the country to help analyze data
• Requesting data from China to help confirm whether the virus is spreading through person-to-person contact
• Requesting data from China to confirm whether asymptomatic transmission is occurring
• Providing $105 million for “preparedness and response activities”

Federal officials emphasized that all five U.S. cases contracted the virus in the outbreak areas of China, and no transmission appears to have happened in the United States.

What providers should know

The CDC has urged healthcare providers to follow its interim guidance for evaluating patients,  recommendations for infection control and preparedness checklists. The agency plans to host a call for clinicians Jan. 31 at 2 p.m. ET to provide additional information.

U.S. patients should be evaluated as a patient under investigation (PUI) in association with the 2019-nCoV outbreak if:

• They display fever and symptoms of lower respiratory illness, plus have either traveled to Wuhan City, China, within 14 days of symptom onset or had close contact with a person under investigation for the virus.
• They display fever or symptoms of lower respiratory illness and have had contact within 14 days with a laboratory-confirmed case of the virus.

The CDC noted that fever may not be present in some patients, such as those who are very young, elderly, immunosuppressed or taking certain fever-lowering medications.

Patient samples should be provided to the local health department, which should coordinate getting the samples to the CDC for testing.

“Clinical judgment should be used to guide testing of patients in such situations,” the agency’s website states.

The American Hospital Association also has recommended steps hospitals should take to respond to the virus.

CDC-recommended steps when a PUI is identified include:

• Directing such patients to wear a surgical mask
• Evaluating patients in a private room with the door closed, ideally an airborne-infection isolation room
• Using standard precautions for the healthcare personnel entering the room, including contact precautions, airborne precautions and eye protection
• Notifying immediately the healthcare facility’s infection control personnel and the local health department