The NCSL Blog


By Haley Nicholson, Margaret Wile, Kate Bradford and Noah Cruz

In the midst of flu season, the news over the past few weeks has been dominated by a new virus known as the coronavirus. The outbreak of the virus originated in the city of Wuhan in the Hubei province of China. The virus also known as COVID-19, has been compared to as a less severe pathogen than severe acute respiratory syndrome (SARS). Scientists and medical stakeholders continue to study the disease to best understand how it is contracted and its full impacts

People wait at Wuhan Red Cross Hospital in Wuhan, China, on Jan. 24. HECTOR RETAMAL/AFP VIA GETTY IMAGESTo date there have been more than 823,000  reported cases of coronavirus and more than 40,000 deaths globally. In the United States, 213,144 cases have been diagnosed with 4,513 deaths, according to the Centers for Disease Control.

The World Health Organization has agreed to work with China and international partners to help scientists study the virus—its incubation period, symptoms and other aspects—to better understand the outbreak and how to best implement a global response. 

The Trump administration has declared a public health emergency and several federal agencies have been involved in the U.S. response to the outbreak. The public health emergency prompted the quarantine of 195 U.S. citizens who returned from Wuhan; they will be monitored over the next few weeks.

The president also signed an order temporarily barring entry to foreign nationals who have visited China and who could pose a risk of spreading the illness, unless they are immediate relatives of permanent residents. All flights from China will be funneled through several designated U.S. airports. After recent outbreaks in several other countries the CDC has also advised: no travel to, South Korea, Iran and Italy; practicing pre-cautions for travel to Japan and an advisory warning for Hong Kong.

Any U.S. citizens returning from the Hubei Province will be required to do a mandatory quarantine while Americans returning from other parts of mainland China will have to undergo screening and monitored self-quarantine. Self-quarantine requires individuals to stay at home for up to two weeks upon return to the U.S. and monitor any symptoms they may have. The U.S. State Department also issued its highest level do-not-travel advisory for China and has advised those currently in the country to leave, as American citizens could be subject to travel restrictions with little advance notice.

Health and Human Services (HHS) Secretary Alex Azar announced he will use $105 million of the agency’s Infectious Disease Rapid Response Fund to respond to the coronavirus outbreak. Since this announcement, Secretary Azar has requested additional funding. This includes $1.25 billion in new dollars through emergency supplemental appropriations and other funding made available by enhancing the administration’s authority to move federal funds around within the HHS budget. The latter will require congressional action.  While U.S. health officials say the risk of Americans contracting the virus remains low, there is much unknown about the virus, and they want to ensure a safe response as the situation evolves.

Scientists are working to create a vaccine against the coronavirus. Stakeholders have cautioned while developments are more rapid than other outbreaks in the past, there are many factors to consider whenever developing a new vaccine.

In Congress, the House Energy and Commerce Committee members received a briefing on coronavirus with officials from: Centers for Disease Control and Prevention (CDC), National Institutes of Health, HHS and the Food and Drug Administration. HHS Secretary Azar notified Congress the department may need to transfer $136 million to address the virus and the response needed because the initial $105 million set aside is being spent down. The funding would help fulfill the needs of several federal agencies that are dealing with addressing the virus.

State Response

As the federal government leads the national response to COVID-19, state and local health departments stand on the front lines.

State health officials continue to work with the CDC, federal authorities and other health agencies to ensure proactive and collaborative measures. State lawmakers may direct constituents to local, state and federal health resources to keep everyone informed. Meanwhile, some states are taking extra steps to respond to or anticipate the spread of this virus, especially those with confirmed cases of community or unknown spread.

Following several deaths from and a rising number of confirmed cases of COVID-19, the Washington State Department of Health (DOH) is working to contain a local outbreak. On Feb. 29, Gov. Jay Inslee declared a state of emergency and directed state agencies to use all necessary resources to respond to the coronavirus, including the use of the Washington National Guard, if necessary. Lawmakers included $8.6 million for activities related to coronavirus in an appropriations bill, awaiting the governor’s signature. King County, where most of the state's deaths have occurred, declared a state of emergency on March 2, which is meant to allow “extraordinary measures” to help contain the spread of the virus, including overtime pay for county employees. Washington State DOH has established a call center to address questions from the public.

With a growing number of confirmed cases, California activated the Department of Public Health’s Emergency Response Operations Center in January to coordinate efforts across the state and continues to monitor over 9,000 residents who have recently returned to the state from abroad. On Feb. 25, the San Francisco Department of Public Health joined Santa Clara and San Diego counties in issuing a declaration of a local emergency to help the city better prepare for the coronavirus response. Governor Gavin Newsom is calling on legislators to make $20 million from the state’s disaster relief fund available to respond to the virus.

Massachusetts enacted legislation to appropriate $95,000 for the surveillance, treatment, containment or prevention of coronavirus. Illinois introduced a bill to require a study of the state’s disease response preparedness, particularly against the coronavirus. Minnesota, Hawaii and Utah have introduced legislation appropriating funds or encouraging precautions in preparation for a public health response.

On Feb. 3, the Michigan Department of Health and Human Services activated its Community Health Emergency Coordination Center to support public health agencies and health care providers. Additionally, Governor Phil Murphy of New Jersey and Governor Roy Cooper of North Carolina established coronavirus task forces to better prepare state responses to the outbreak.

This is a rapidly evolving situation. NCSL regularly updates state responses on our webpage, State Action on Coronavirus (COVID-19). Stay up to date using the CDC’s Coronavirus Disease 2019 (COVID-19) webpage that includes national, state and local resources. For current information in your state, check your state health department webpage.

Haley Nicholson is senior policy director and Margaret Wile is policy director in NCSL's Health and Human Service Program in NCSL's State-Federal Relations Division. Kate Bradford and Noah Cruz are research analysts in NCSL's Health Program.

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.