Coronaviruses: Outbreak Preparedness and Response, Infection Control, and Public Health Policy

A New Novel Coronavirus

In December 2019, astute clinicians in Wuhan, China, notified public health authorities of a cluster of asymptomatic pneumonia cases, some with ties to a seafood market in the city. Within days, additional cases were discovered, and a sophisticated epidemiologic investigation was launched. Within weeks, a novel coronavirus, now known as 2019-nCoV, was identified and sequenced, with the sequence published online for use by other scientists and public health authorities globally.

Although the full significance of this outbreak is not yet known, it calls to mind previous experiences with Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), 2 coronaviruses responsible for significant morbidity and mortality. Fortunately, current known evidence suggests that this new virus is neither as severe nor as transmissible as SARS-CoV or MERS-CoV. However, the Health Security editorial staff see this outbreak as an opportunity to reflect on the progress made in the past 2 decades and on the work yet to be done.

Infectious disease surveillance systems have evolved dramatically from the emergence of SARS, when delays in recognizing the outbreak hampered the response effort. The International Health Regulations (2005), which provided for expanded surveillance, reporting, and capacity building, have facilitated communication of health threats. There have also been substantial advances in both basic science and public health capabilities in countries around the world. For instance, improved diagnostic technologies have enabled the rapid detection and identification of emerging infectious diseases. Infection control has also improved, with a number of countries having developed biocontainment units to improve the ability to safely treat patients with highly infectious diseases.

Nonetheless, this new novel coronavirus outbreak serves as a reminder to the global public health community that we must be relentless in our efforts to prevent, detect, and respond to biological threats. There is more that governments need to do to prepare for and respond to biological threats. Efforts to develop the capabilities to rapidly develop and manufacture new medical countermeasures are more important now than ever, given the speed with which pathogens can travel the globe. Healthcare systems should be strengthened to ensure they are robust enough to treat a large number of patients in an epidemic. And the global community must continue to support and strengthen the IHR to ensure that outbreaks are identified and stopped at their source.

The rapid detection and identification of the 2019-nCoV underscores how much progress has been made since the early days of SARS, but gaps remain. We have selected 10 relevant articles from Health Security on coronaviruses, outbreak preparedness and response, infection control, and public health policy; these articles will be freely available through the pandemic to facilitate the conversation around health security. We hope these pieces will serve as resources for the community as it works to ensure that the 2019-nCoV outbreak is fully understood and contained.