2019-nCoV
Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security.
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February 01, 2020

EPI UPDATES China’s National Health Commission reports 11,791 confirmed cases, of which 1,795 (15%) are severe. There have been 259 deaths and 243 cured and discharged patients; 17,988 suspected cases are under investigation. Cases have been recognized in 23 countries outside of mainland China according to the latest World Health Organization situation report

The 7th and 8th cases detected in the US have been announced in the last 24 hours. The cases, diagnosed in Santa Clara , California and Boston , Massachusetts, were both men with a travel history to Wuhan, China.

New cases continue to be reported elsewhere in Asia. Hong Kong has reported 14 confirmed cases; 188 others are hospitalized for investigation. One recently-confirmed case found in Hong Kong spent only a few hours on the mainland of China on January 10. South Korea CDC has confirmed 12 cases ; Singapore has reported 18 cases. Japan has reported a total of 12 cases as of January 31. A full list of countries reporting cases can be found in each WHO situation report .

Outside of Asia, news media has reported a new case in Germany, bringing the total to 6. The case is the child of an employee at a Bavarian company where 5 other workers also tested positive. More than 100 Germans have been evacuated from Wuhan City on 1 February; the plane will also bring aid support China’s response, including 10,000 protective suits. Canada has reported its third case in Toronto, and Sweden has also announced its first case of a woman with a travel history to Wuhan. The woman returned to Sweden on 24 January and did not exhibit symptoms until after returning.

SURVEILLANCE IN JAPAN FINDS ASYMPTOMATIC CASES Of the 210 Japanese nationals who were evacuated from Wuhan City on a chartered flight, two individuals were rtPCR positive but asymptomatic. Neither reported contact with previous cases and they had no connection to the Wuhan seafood market where cases were first reported. This finding adds further evidence to the growing understanding that asymptomatic infection is possible; efforts to understand to what degree asymptomatic carriers are infectious is ongoing.

GUIDANCE ON HANDLING REMAINS China’s National Health Commission released guidance for managing the remains of patients who have died of nCoV infection. Notably, relatives will be required to hand over remains to funeral parlors and to have the body cremated. Remains must be cremated immediately; interment is not permitted, nor are ceremonies prior to cremation. These regulations will also apply to foreigners who die in China; cremated remains of foreigners can be transported out of the country based on the wishes of the relatives of the deceased.

SUPPLY CHAIN Shanghai launched a mask registration program: “After receiving notification from a committee, residents can go to designated pharmacies to buy the masks. Currently, one household is allowed to make only one registration and buy five masks. Those who register first can get their masks first.” There have been many reports of a shortage of personal protective equipment in China.

US PUBLIC HEALTH EMERGENCY DECLARED The US Department of Health and Human Services officially declared a public health emergency yesterday. The declaration enables state, tribal, and local health departments to reassign personnel roles in response to 2019-nCoV if they are funded by Public Health Service Act programs. A public health emergency declaration can also make certain funds readily available for use, including the Public Health Emergency fund, used to strengthen stakeholder coordination, medical countermeasure development, laboratory capacity, and biosurveillance. The declaration also enables the government to modify or waive certain rules and requirements under HIPAA, Medicare, Medicaid, and CHIP to facilitate rapid response.

PRESIDENTIAL PROCLAMATION The White House issued a Presidential Proclamation that imposes additional travel restrictions on non-US citizens seeking to enter the United States. The proclamation found that “...the unrestricted entry into the United States of persons [...] would, except as provided for in section 2 of this proclamation, be detrimental to the interests of the United States, and that their entry should be subject to certain restrictions, limitations, and exceptions.”   

CHINA DEPLOYS ECONOMIC COUNTERMEASURES At least 21 jurisdictions in China have told businesses not to resume work before Feb. 10 at the earliest. The People’s Bank of China announced Saturday that new measures, including cuts to lending rates and an increase in liquidity, would be implemented as part of a larger bid to protect its economy from a slowdown. In addition, per the Finance Ministry, China will implement tax exemptions for imports of products that will be needed to respond to the nCoV outbreak. 

BACKLASH AGAINST SOCIAL MEDIA CENSORSHIP China's People's Court News and Media Corporation published a rebuke of the detainment of 8 individuals accused of spreading false information about 2019-nCoV early in the outbreak. Multiple people were detained in early January after sharing on social media that cases of SARS had reemerged in the South China Fruit and Seafood Market in Wuhan. While the information was technically not correct and therefore broke laws on false information during epidemics, the article asserts that authorities should have been more lenient , as the spread of that information could have benefited awareness and response efforts. Misinformation outside of China has also been a challenge for response efforts internationally.

WHO SITUATION REPORT Notable findings from the World Health Organization’s 12th situation report include: (1) 60.5% of confirmed cases are in Hubei Province; (2) a healthcare worker has been diagnosed in France; (3) a third-generation case has been identified in Bavaria; (4) of the 132 cases reported outside of China, 7 were asymptomatic at detection and 14 were due to secondary transmission.

HONG KONG STRIKE Thousands of hospital workers in Hong Kong have voted to strike in order to urge the government to close borders with mainland China. Hong Kong has currently not closed all borders with China, citing World Health Organization recommendations.