Last week I wrote about new research into when COVID-19 cases entered the country which led to massive spread of the virus. It isn’t the first case that matters. Many people don’t spread the virus at all, so it may enter and peter out. What matters is when a superspreader brings it in or catches it.
The research shows us that the ban on travel from China by non-U.S. residents didn’t work. I had thought it came too late because the virus was already here, but looking at details of the virus itself it appears that wasn’t true. The virus cases that actually spread came after the ban. So the ban didn’t work.
Many readers took that as a political point (“Trump bad”) but it actually isn’t. I wanted to understand the role of travel bans, and in this case a new New York Times investigation shows that it’s the CDC bureaucracy that failed.
Even after the ban was put into place U.S. residents were allowed to return, but were supposed to self-quarantine and the government was supposed to monitor this. That never happened.
Americans returning from China landed at U.S. airports by the thousands in early February, potential carriers of a deadly virus who had been diverted to a handful of cities for screening by the Centers for Disease Control and Prevention.
Their arrival prompted a frantic scramble by local and state officials to press the travelers to self-quarantine, and to monitor whether anyone fell ill. It was one of the earliest tests of whether the public health system in the United States could contain the contagion.
But the effort was frustrated as the C.D.C.’s decades-old notification system delivered information collected at the airports that was riddled with duplicative records, bad phone numbers and incomplete addresses. For weeks, officials tried to track passengers using lists sent by the C.D.C., scouring information about each flight in separate spreadsheets.
“It was insane,” said Dr. Sharon Balter, a director at the Los Angeles County Department of Public Health. When the system went offline in mid-February, briefly halting the flow of passenger data, local officials listened in disbelief on a conference call as the C.D.C. responded to the possibility that infected travelers might slip away.
“Just let them go,” two of the health officials recall being told.
It is possible that the virus entered the West Coast via Vancouver, British Columbia – suggesting that a China ban wouldn’t have kept it out if it had been managed properly. However the CDC wouldn’t have had the capability of managing a broader ban that included Canada either.
The research also shows that the virus which ultimately led to spread in New York entered on or about February 20 (95% likelihood between February 14 – 26) so the President’s March 11 ban on non-resident travel from Europe beginning March 13 did come too late. However the CDC failures suggest that even if the President had made this decision weeks earlier, it likely wouldn’t have mattered, just as it didn’t on the West Coast.
With each arriving China flight, the CDC “sent emails to state officials, one at a time, ..so they could download a list of targeted passengers.”
In California, state health officers received as many as 146 notification emails a day, forcing them to spend time forwarding them to the appropriate local health departments. In some cases, the information, collected for the C.D.C. by the Department of Homeland Security, listed incorrect dates or times; in other cases, passenger data was sent to the wrong state or came more than a week after the travelers had entered the United States.
“We got crappy data,” said Fran Phillips, Maryland’s deputy health secretary. “We would call them up and people would say, ‘Well, I was in China, but that was three years ago.’”
And then a week into the process the CDC “stopped sending notices entirely, even though flights kept coming.” They did this intentionally “to ‘improve data quality.'”
None of this should be surprising. The FDA only permitted use of the CDC test, which was faulty. We still don’t have good data that really tells us who is testing positive for the SARS-CoV-2 virus (rather than just how many and where). The CDC recommended against testing people who were exposed to the virus but who were asymptomatic. They’re keeping data backups of virus testing data on DVDs. The public health bureaucracy wasn’t up to this challenge and failed the country greatly.
And don’t blame this on the Trump administration, either. Real CDC funding did fall between 2010 and 2014 (during the Obama administration) but is back to prior levels during the Trump administration. The President’s budget, which is a political document never expected to become law, did recommend cuts to the agency. Those never happened.
Fascinating. Thank you for an interesting look behind the scenes.
Good analysis, especially about the CDC’s role. Of course, the root cause analysis leads back to the fact that, if China had treated this more seriously in the beginning, they could have contained the spread earlier and the travel bans would have been more effective due to fewer infected people in China.
I recall seeing persons with masks ( along with hacking and weezing ) last oct while on 2 Air China flights transiting via CTU.
Let’s not forget what happened throughout the EU beginning on Feb 1st, most notably in Italy. Hug a Chinese Person day! I recall seeing this and thought it was merely an Instagram joke/hoax, but, no it was real. Some of these were Americans that returned post holiday. At that time and thereafter there was no idea of quarantine from the EU, how do I know? My son, his best friend, and I returned from Spain on Mar 6th. We went through ATL and then onward home to SFO with no restrictions.
Just my $0.02
Amazing how quiet the comments are when the issue is not politicized. So the CDC could not get passenger data from DOT or Homeland, where all the post-911 money went. Or is everything this messed up everywhere?
The worst hit areas of the US mainly got the virus from Europe anyways.
I unequivocally disagree with your analysis. The CDC was highly regarded four years ago as the world governments always turned to for advice and support to combat diseases and viruses. Both WHO and CDC failed from the beginning when they both took China’s version at face value. A virus does not discriminate age, gender, ethnicity, geography, and religion. Humans do. Taiwan and other East Asian countries were skeptical because they all experienced previous endemic diseases. They rolled out their preventive measures on the spot. Vietnam, China’s southern neighbor, sustained no fatality. Taiwan recorded a single digit fatalities. Taiwan was sidelined by WHO, due to China’s pressure. We do not hear and read much about Taiwan’s success, but more about South Korea, HK and Singapore, because the media news cannot in conscience compare and explain US incompetence with Taiwan’s success. Americans are COVID idiots not because we are all imbecile, but half of the population is .We elected a government and indirectly appointed cabinet members and senior officials who have no credentials and merits to lead important agencies and departments. CDC staff are muzzled and retaliated against to speak out. Foreign governments did not receive prompt responses to confront and control the virus from CDC staff. CDC, NIH and HHS leaders are utterly incompetent in early critical times and the problems are compounded when Trump undermined and sidelined them every step of the way. China is the root cause of the pandemic but all other countries had sufficient time in a short time frame to combat it. China will come out stronger and more influential than US because the entire west still does not fully comprehend the serious threat that it imposes. China already control the raw materials that make technologies and medical necessities accessible and functional, including the G-5, banking, natural resources and dominance in developing countries. It is now engaging in border disputes with India, two nuclear powers in the world, and Bhutan. China has a history of border disputes with all of its neighbors.
Globetrotter,
Were you watching CNN while eating your meth laced breakfast cereal this morning…..
@David Szerlag
Nice, add a worthless comment to globetrotter’s well-thought out paragraph. Wow, does that make me change my mind? Hah!
people with low self esteem are brave making derogatory comments from the safety of their computers
Sorry to correct you but documentation shows that Obama asked for a 15% increase in Pandemic spending for the CDC but was denied by the Republican Senate. Likewise, allowing Americans to return home, en masse without established testing at the ports of entry falls on Trumps watch!
@Rob Carlin – you are neither correcting nor disagreeing with me. What he “asked for” isn’t my point and doesn’t contradict what I wrote.
If you have to keep explaining it you need help explaining it.
Post one positive Trump article and you may get me back.
does banning the entry of most Chinese originating passengers have a direct correlation with much better result California and the west coast were experiencing, compared to New York?
Yes, even banning China entirely won’t stop virus from coming in (because not everyone is banning China at the same time and US can’t afford to ban everyone in early Feb). But greatly reducing the number Chinese entry certainly helped the situation on west coast in my opinion.
I’m impressed that there was no Blame put on our President and that there were CDC issues-stemming from 2010 OBAMA RULE!!!! also with some many other issues like the WHO and the fact that Canada let flights from China in till much later
@Gary – I appreciate these articles. I myself love Trump, and I am guessing you don’t. I like these articles because even though critical, they tend to be well thought out and offer a different perspective. Although this is a travel blog, things do seem to go political sometimes, and increasingly so with the chaos happening lately. When that happens, I also appreciate that you don’t ban people for disagreeing, unlike some others…
The China travel ban worked. The Coronavirus genome sequence shows most of the cases came into the U.S. from Europe and Iran. The direct spread from China was isolated to California and Washington State. The number of infections and deaths in those two states are very low compared to the East Coast. NYC was the entry point of much of the Coronavirus into the U.S. If travel from Europe and Iran was shut down in late February, Coronavirus would have been well contained. I do blame people from this community because most criticized travel bans and were very upset with the March travel ban of non U.S. residents from Europe.
@ Globetrotter A good assessment that I agree with . You , like me are well travelled and probably in Asia .
Gary might as well polish up his resume for CNN. He can write all the anti-Trump, liberal, ANTIFA rocks posts all he wants and get paid good cash.
I think this analysis really needs to look at what happened in Australia. Australia stopped all non-citizens and non-permanent residents who had been in China in the previous 2 weeks from entering the country in January. That was enacted when the global source of infection was clearly from China. Had the U.S. erected that solid wall, then the outcome might have been very different. Australia then tried the self-isolation route for international arrivals, but found that going shopping / the beach / restaurants was too tempting. The U.S. found this too. Then Australia introduced a hard immigration stop so that only those residents / citizens could enter, and a hard quarantine (i.e. a Govt provided hotel including food for 2 weeks and these were guarded). It is now found that virtually all new infections detected are from those entering the country and found to be positive during testing in the hard quarantine hotels. There is effectively no community transmission because walls were erected to stop it spreading. Which country provided the most imported cases of Covid to Australia ? China? No. It was the U.S. Coronavirus was running rampant in the U.S. and it was being imported to Australia from there in Jan / Feb / March. The hard quarantine stopped it breaching the borders. It’s no good, as people mention above, to state that virus was coming from Europe – it had already come to the U.S from China and was spreading widely – and being exported to the world. Sorry to point that out those pointing fingers at Europe. If only the U.S. and the U.K. had acted swiftly and hard, their death tolls would probably be very small. Total deaths in Australia with a population of 25 million stands at 102. If you graph normal historical deaths vs 2020 deaths, those lines are the same. Do the same with the U.S. or U.K, and there is a huge difference, meaning deaths much larger than even the high death numbers being admitted by Governments. The last statistics I saw was that an American was 77 times more likely to die from Covid than an Australian, and a Brit 140 times more likely. Clearly given health, wealth, diet, advanced health care etc, nothing can explain those differences other than an inept responses by Governments (sorry Trump and Boris supporters – but its been a disgrace). Too little, too late, too disorganized and head-in-the-sand. I am no lover of the Aussie Prime Minister (PM), in fact I have little respect for him generally, however it seems he got things right – whether by design or accident. Across the ditch in New Zealand, a PM I do have respect for, did the same thing. Put it another way, if the U.S. had the same death rate as Australia, based on the fact the U.S. has 13 x the population of Australia, their total deaths should be approx. 1,300 not 100,000 and rapidly increasing. The UK would be 250 vs 40,000-50,000 and counting. Clearly something has gone very wrong. I don’t agree necessarily with the article, as its clear the virus exploded in the U.S. because it just wasn’t stopped from ever entering, and not properly traced after that point. Trump boasts about his border closure, but it was a half-hearted exercise and would never have worked. Too many were still coming from the initial source country, and then it was just too late. The same in the U.K, where some 18 million international arrivals came just in Jan-March, and only <300 of those were actually stopped and put into hospital / quarantine. Clearly its nonsense to be have been able to fly non-stop from Wuhan straight into London Heathrow, this entire year, and not even be given a simple leaflet let alone a temperature check / antibody test etc. Come off the plane, collect your luggage, and straight onto the tube / train / cab and disappear into London. It's absolute madness. A soft quarantine starts in the UK next week, but talk about closing the barn after the horse has bolted.