WASHINGTON - It is not a question of if, but when, the coronavirus becomes a pandemic in the US, a top health official said on Tuesday (Feb 25) as the government scrambled - late, experts say - to gear up.
Dr Nancy Messonnier, director of the National Centre for Immunisation and Respiratory Diseases at the Centres for Disease Control (CDC), told reporters: "Ultimately, we expect we will see community spread in the United States."
"It's not a question of if this will happen but when this will happen and how many people in this country will have severe illnesses.
"Disruption to everyday life may be severe," she added.
There is currently no known community spread in the US, where the number of confirmed cases of the disease - known as Covid-19 - has been steady at 14 for some days - 12 from travel to China and two from person-to-person transmission.
An additional 39 Americans repatriated from Wuhan in China, and from the Diamond Princess cruise ship, are also under quarantine.
The CDC tweeted: "Currently there are very few cases of #COVID19 in the US and no reported community spread. But as more countries see community spread, successful containment becomes harder and CDC is preparing for community spread in the US."
In another tweet, it said: "Now is the time for US businesses, hospitals, and communities to begin preparing for the possible spread of #COVID19."
On Monday (Feb 24) the White House asked Congress for US$1.25 billion (S$1.75 billion) in emergency funding to buy protective gear and fund treatment and research on a vaccine, which experts say is likely several months away.
House Speaker Nancy Pelosi called the effort "long overdue and completely inadequate to the scale of this emergency".
"I think they are going to need more money than this," Senator Richard Shelby, the Republican chair of the Senate Appropriations Committee, told reporters.
The Dow Jones sank 900 points on Tuesday afternoon after the CDC's warning, which came in the face of President Donald Trump, who was in India, downplaying the risk and saying the situation was "under control".
The S&P 500 closed down 3 per cent. The New York Times quoted Mr Yousef Abbasi, global market strategist at financial services and brokerage firm INTL FCStone, saying, "The market is resigning itself to the fact that the impact of the coronavirus is going to be well beyond China and the first quarter of 2020."
But there are serious shortcomings in the US, where the Trump administration has been cutting budgets for the CDC and pandemic preparedness, experts say.
At a testy Senate hearing on Tuesday, it became clear that the US does not have enough stockpiles of items like masks, for instance, to supply the potential number of patients.
Republican Senator John Kennedy snapped at Acting Homeland Security Secretary Chad Wolf when the latter could not provide certain details, saying: "You're supposed to keep us safe. And the American people deserve some straight answers on the coronavirus - and I'm not getting them from you."
The efficiency of CDC test kits is also a problem - as well as the low number of tests done.
According to reports, the US has tested only 426 people, not including those who returned from abroad on evacuation flights. And outside the CDC itself, only about a dozen state and local laboratories are running tests because CDC kits had a faulty component.
Democratic Senator Richard Blumenthal tweeted that he was "appalled and astonished" at the "inadequacy of preparedness and prevention".
At the Democratic candidate debate ahead of this Saturday's South Carolina primary, almost every candidate was critical of the Trump administration's readiness for a pandemic.
That prompted the President to take to Twitter to say: "CDC and my Administration are doing a GREAT job of handling coronavirus, including the very early closing of our borders to certain areas of the world."
"No matter how well we do, however, the Democrats talking point is that we are doing badly," he wrote. "If the virus disappeared tomorrow, they would say we did a really poor, and even incompetent, job. Not fair, but it is what it is."
"We're not prepared at all," charged Ms Laurie Garrett, an expert who has written books on public health and pandemics, on MSNBC. "There is a kind of inability to grasp the unimaginable - what will we do if we get this virus on the same scale as China."
In a phone call, Ms Garrett told The Straits Times: "Everything that's about to happen has been role-played in so many tabletop exercises I've been in.
"We anticipated all of this, including supply chain disruption, stock market difficulties, the loss of essential medical supplies, the run on masks; this was anticipated and nobody did anything.
"We had the beginning of preparedness under the Barack Obama administration - real programmes beginning to be rolled out. That was all eliminated by the Trump administration and now they are reinventing the wheel, in haste," she said.