Tony's Diary Package — page 8

Jan. 25, 2020 - now more than1400 cases and 42 deaths. President Xi Jinping essentially sutting down the entire country. Schools closing in Beijing. Suspicion that the Chinese are telling us everything that is going on in China. Why are the Chinese reacting so dramatically by essentially shutting down the entire country? State Department evacuating all USA personnel from consulate in WUHAN New York Times interview; CNN International Jan. 26, 2020 - GAME ON!!! Things are changing rapidly. Dr. Ma Xiaowei, the Chinese Minister of Health gave a press statement saying that the incubationperiod of nCoV is 1 to 14 days and that the virus is being transmitted when people are asymptomatic! This has enormous implications for how we handle people from Wuhan (like our diplomats who are now on the way back from WUHAN, having been ordered to evaculate). Should we quarantine them. I am very skeptical about the Chinese interprepation of their data. I spoke with Mike Ryan (WHO) from Geneva and he and Tedros are going to Wuhan soon. Mike is very skeptical that aymptomatic spread is present or at worst is a major driver of spread. Mike Osterholm also feels this way. I spoke with Nancy Messonnier and Bob Redfield this AM to coordinate our responses. Bob and I feel (and I told Elizabeth Cohen this) that we should be allowed to send our CDC epidemiologists to China to work with them so that we see the data first hand since we will base important response activities and strategies based on whether this is true. It would require our quarantining for a period of time even asymptomatic people who arrive from Wuhan. It now appears using epi data and genomic data that the first infection was in early December and was not connected to the market. The infections spread among people weeks before the Chinese reported that they were dealing with a new infection and that gave the virus time to establish itself in multigenerational (sustained) spread. Remember, early on the Chinese were saying that there is no human to human transmission and all the original 27 cases were from the market. Now we know the market was not the source, it was the amplifier. Having said that, somewhere the virus jumped from animals to humans. There is complete chaos in China now with president Xi Jinping declaring an emergency situation. The Chinese are building within days 1000 and 1300 bed hospitals and flying in hundreds of medical personnel from military. They have shut down travel within most of the country and have called off many Lunar New Year events. Schools closed at least until mid-February. Running out of supplies such as PPE. Had 8:00 PM call with Anthony Ruggiero, Phil Ferro, and Bob Redfield about the evolving situation. The deputiers and White House are pushing to close the borders for any traffic from China. Bob and I are against that. Anthony said that he heard that I wa in favor of that. Will have 11:00 AM meeting tomorrow from SCIF with Deputy National Security Advisor Matthew Pottinger regarding possibly closing borders from China entry.