Last week, Republican members of Congress heard a sober warning in a closed-door briefing on Capitol Hill: Thereâs a good chance most people in the United States will eventually be exposed to the novel coronavirus, according to one former official.
The assessment, from a former White House public-health official who now works in the pharmaceutical industry, did not suggest that most people will become infected or illârather, just that most will encounter the virus, which has killed at least 31 Americans and infected hundreds more.
Not all public-health experts share that view. And not everyone exposed to the virus will become infected. Still, the briefing highlighted the potential gravity of the growing crisis.
Two sourcesâa member of Congress who attended the briefing and a second person with knowledge of itâdescribed the remarks, made last week, to The Daily Beast. They were delivered by Rajeev Venkayya, the president of the Global Vaccine Business Unit at Tokyo-based pharmaceutical giant Takeda. The member of Congress said the comment was âsobering,â while the second person noted it came during a discussion about how to manage the costs of medical care related to the coronavirus. Venkayya pointed out that widespread access to medical care will be vital, given the likely breadth of the exposure, that source said.
Venkayya confirmed to The Daily Beast through a spokesperson that he made the remark about the broad scope of likely exposure, and did not provide further comment on the briefing. He was previously director of vaccine delivery for the Bill & Melinda Gates Foundationâs Global Health Program, according to his bio on Takedaâs website. Before that, he worked in the George W. Bush White House as special assistant to the president for biodefense, where he led efforts to develop and implement the national strategy for pandemic influenza. (A Takeda spokesperson told The Daily Beast on Wednesday that the same group of executives also briefed Democrats.)
The remarks came in a briefing to House Republicans. Executives from multiple pharmaceutical companies spoke to the members, as did Vice President Mike Pence. The comment on most Americansâ likely potential exposure to the virus came after Pence left the briefing, the sources noted. Spokespersons for House Minority Leader Kevin McCarthy did not respond to requests for comment on this story. Neither did the Centers for Disease Control and Prevention (CDC).
The comment appeared to go further than the most recent public warnings from the CDC. Nancy Messonnier, director of the the National Center for Immunization and Respiratory Diseases at the CDC, said in a press call Monday that âas the trajectory of the outbreak continues, many people in the United States will at some point in time either this year or next be exposed to this virus and thereâs a good chance many will become sick.â
In that call, Messonnierâwho has not shied away from issuing dire warnings about the public health risks posed by the outbreakâtook a comparatively reassuring tone.
âRight now in the United States, most communities, by far the vast majority of communities, are not having community transmission,â she said. âThis is a time for people to prepare for what they might need to do, but not a time for people to clear out the shelves.â
In a statement to The Daily Beast, Venkayya gave more detail about his concerns regarding the spread of the virus, which appears to be particularly dangerous to the elderly.
âIn my view, we have been past the point of containment since late January,â he said, noting Takeda asked its employees on Feb. 9 to cancel all non-essential international travelâmore than a week before the first deaths in Iran and before news broke of the cluster of cases in Italy.
âWe havenât done a good job of explaining that case reports donât reflect the global spread of the virus, because: (1) diagnostic testing hasnât been widely available; and (2) clinicians and public health officials havenât appreciated the speed and stealth of this outbreak,â he continued. âThis has led to a dangerous sense of complacency in many places.â
âWe can look at South Korea and Italy as possible glimpses into the future in parts of the U.S.,â he added. âThose are developed countries with well-functioning health systems, so there is no reason to believe this couldnât happen here. We canât expect everywhere to be like Singapore.â
Cases have boomed over the past few weeks in both South Korea and Italy, where more than 9,000 people had confirmed cases as of Tuesday evening and officials implemented an unprecedented lockdown. Singapore, meanwhile, has won praise from the head of the World Health Organization for its aggressive action to contain the virus. The city-state with a population of 5.6 million people has confirmed 166 cases as of March 10, according to The Straits Times, and no deaths.
Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University and an expert on U.S. readiness for pandemics, told The Daily Beast it was unlikely a significant majority of people in the United States would be exposed to the virus.
âBased on what we know now, it is not likely that 80 percent of Americans will be exposed,â he said, âthough it is likely that 30 percent could be exposed.â
âWe seem to have an overabundance of guessworkânot based on evidence or scienceâthat has permeated the discussions about coronavirus, and this is a problem,â he cautioned. âItâs a problem that really began with our inability to get information that would have come from a robust testing program.â
He added that the disease was spreading very rapidly in the U.S., which could face a situation similar to that in Italy.
Dr. Timothy Brewer, a professor of epidemiology and medicine at UCLA who has served as an adviser for the World Health Organization, CDC, and National Institutes of Health, questioned how health authorities could monitor the likelihood of exposure to the American public.
âThere is no good way to measure exposure in the absence of infection,â said Brewer. ââExposureâ without infection would not have any health consequences.â
Officials can measure infections, though, and âthere is no reason at this time to assumeâ that âa majority of all Americans are likely to get the novel coronavirus,â he said.
And Dr. Jeffrey Klausner, an adjunct professor of epidemiology at the University of California Los Angeles who previously worked for the CDC, said the outbreaks in China and South Korea show spread of the virus is âhighly localizedâ to individual cities or areas. âItâs just not demonstrating that itâs spread that easily,â he said. âWe havenât seen waves and waves of transmission anywhere in the world. Weâve seen highly localized, geographically specific areas.â
He said the virus has not spread all over China, South Korea, or Washington State. And he said an outbreak of 100,000 cases in the United States would be âour wildest estimate.â