President Trump and his team tasked with combating the spread of the coronavirus (COVID-19) in the United States should be commended for their efforts.  However, while they are taking important action, travel continues from South Korea, Italy, and other countries stricken with the disease.  To effectively prevent or significantly delay an uncontrolled outbreak in the U.S., President Trump must order a travel ban from all countries afflicted with uncontrolled outbreaks of the coronavirus, along with enforced quarantines of U.S. travelers who had recently been in any of those countries.

President Trump has taken important action towards preventing or significantly delaying an outbreak of the coronavirus in the United States.  Notably, in a presidential proclamation on January 31, he barred entry to foreign nationals who had been in China within the previous 14 days.  Residents of the U.S. who had been in China within the past 14 days are quarantined upon entry.

Despite criticism from political opponents and from China, President Trump's actions helped prevent a potential uncontrolled outbreak in the U.S. from individuals who would have traveled to the U.S. from China.  At the time of the proclamation on January 31, there were approximately 12,000 reported cases, which increased to 80,000 confirmed cases in China as of March 2.

The presidential proclamation provides the justifications for President Trump's unprecedented China travel ban:

The CDC, along with state and local health departments, has limited resources and the public health system could be overwhelmed if sustained human-to-human transmission of the virus occurred in the United States.  Sustained human-to-human transmission has the potential to have cascading public health, economic, national security, and societal consequences[.] ... The United States Government is unable to effectively evaluate and monitor all of the travelers continuing to arrive from China.

In addition to the outbreak of the coronavirus in China, other countries have experienced subsequent outbreaks, notably South Korea, Italy, and Iran.  As of March 3, South Korea had a total of at least 4,812 confirmed cases, with 477 new cases or a 9.9% increase over the previous day, while on March 1, Italy had 1,694 cases, with 566 new reported cases, or a rise of 50% in one day.  In fact, as of March 3, South Korea far surpassed China's rate of infection, with China at 56 cases per million people compared with South Korea at 94 cases per million people (Italy has 34 cases per million people).  Iran, which is assumed to be vastly downplaying the extent of the outbreak, as of March 2 had reported 1,501 cases, with 523 new cases, or a 34.8% jump in one day.  Indicative of Iran's cover-up is that as of February 28, Iran claimed that 34 people had died from the coronavirus, while according to sources in Iranian hospitals, at least 210 had died by then.

On February 29, in response to the outbreaks in South Korea and Italy, the Trump administration authorized a travel ban on foreign nationals who had been in Iran within the previous 14 days, while the State Department raised the travel advisory for the worst affected areas of South Korea and Italy to its highest level.  In addition, the State Department is working with the South Korean and Italian governments to enhance screenings of those traveling to the U.S.  In an interview on Fox News Sunday, HHS secretary Alex Azar explained why travel bans from South Korea and Italy have not yet been put in place:

The point is with Italy and South Korea we have highly developed public health and healthcare systems, we have transparent leadership and very aggressive action that's been on it from day one.  So, at this point we think advising people not to go is the right measure, but everything will always be on the table.

However, the recent stunning jumps in coronavirus cases in South Korea and Italy are fueled in part by the lack of proper preventive measures and deficient quarantines.  Notably, the South Korean government imposed a voluntary curfew over only the city of Daegu, at the heart of its coronavirus outbreak.  Stunningly, subsequent reports of "maximum" quarantine steps by the South Korean government did not amount to a lockdown such as China has imposed in the Hubei Province hotspot.

Continued travel from South Korea and Italy is disconcerting because it allows avenues for coronavirus to spread more rapidly in the U.S.  Even with screening of travelers to the United States, infected passengers who do not yet display measurable symptoms of coronavirus will pass these screenings and be permitted to travel to the U.S.  And since these passengers would not be quarantined, it is extremely likely that many new cases of coronavirus will spread in the U.S., mostly originating from these travelers from South Korea and Italy.  With an estimated transmission rate of coronavirus of 1.5 to 3.5 per carrier of the virus, making it more contagious than the flu, it is likely that continued travel from South Korea and Italy will allow for further spread of the coronavirus in the United States.

It's important to note that not only is the coronavirus more contagious than the flu, it's much more deadly; While the flu has a mortality rate estimated at below or about 0.1%, coronavirus so far has had a 6.1% mortality rate, with a reported 48,173 patients who have recovered and 3,119 who have died, although this may decline somewhat with increased preparedness.

Delta and American airlines have just suspended flights to Milan on account of the coronavirus, and 72 other airlines have suspended flights to locations with outbreaks outside of China.  It's worth noting that many other countries require quarantines or have outright bans on travel from South Korea and Italy, including 81 countries with bans or quarantines for travel from South Korea, which should serve as an example for the United States.

For instance, Israel banned South Korean travelers after 29 South Korean tourists to Israel, as well as a flight attendant who had subsequently been in Los Angeles, had tested positive for coronavirus.  Israel more recently banned travel from Italy and other affected countries.  Israel's strong measures, including the quarantine of 5,630 people enforced under penalty of serious criminal sanctions, are helping keep the spread of the virus limited.

In light of the rapid rise of coronavirus cases in South Korea and Italy, it is imperative that President Trump implement travel bans and quarantines for travel from South Korea, Italy, and any other country with an uncontrolled and rapidly spreading coronavirus outbreak.  Most importantly, people who have been in hotspots in affected countries, such as North Gyeongsang in South Korea (which includes the hotspots of` Daegu and Gyeongbuk) and Lombardy, Emilia-Romagna, and Veneto in Italy, should require forced quarantines, akin to the forced quarantines of those who arrived from Wuhan, China.

Continued travel from hotspots of the virus, particularly by travelers without symptoms of a disease they may be carrying, can threaten to allow uncontrolled outbreaks throughout the world and further exacerbate an already trying health situation.  If the Trump administration takes action to delay the spread of the coronavirus in the United States, it may allow enough time for vaccines to be readied and for medical institutions and medical professionals to have the tools at their disposal to much more effectively control any potential outbreaks on the horizon.

Taking the necessary steps to restrict travel from countries with coronavirus hotspots will be of great benefit and will avoid "cascading public health, economic, national security, and societal consequences."  It will also be of invaluable political benefit to the Trump administration and the Republican Party by preventing a potential political catastrophe in the 2020 election, as noted by Goldman Sachs, Mark Zandi of Moody's Analytics, and by Jason Miller, former senior communications advisor to President Trump's 2016 campaign.

Now is the time for President Trump to take advantage of the opportunity and take additional bold and decisive actions to prevent the spread of the coronavirus from South Korea, Italy, and other hotspots.  This may be the last and best opportunity and it must be fully and immediately utilized.

Image credit: Pixabay.