Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security.
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February 02, 2020

EPI UPDATES China’s National Health Commission reported 14,380 cases of 2019-nCoV acute respiratory disease, including 2,110 severe cases, 304 deaths, and 328 patients discharged in China. Another 19,544 suspect cases have also been identified, and 137,594 individuals remain under monitoring. Additionally, the NHC reported 14 cases in Hong Kong, 7 in Macau, and 10 in Taiwan.

The WHO Situation Report for February 2 reports 146 confirmed cases outside of China in 23 countries, including 1 death reported in the Philippines. Notably, no new countries have reported a case to the WHO in the past 24 hours.

FIRST DEATH OUTSIDE MAINLAND CHINA The Department of Health of the Philippines announced the first death associated with 2019-nCoV acute respiratory disease outside of mainland China. The patient was a 44-year-old male Chinese national from Wuhan. The Department of Health reports that he was coinfected with S. pneumoniae and influenza B. The official reports have not indicated whether the man had any other underlying health conditions. The Philippines has banned travelers coming from China, Macau, and Hong Kong.

FECAL-ORAL TRANSMISSION Hubei Province has confirmed that viral nucleic acids were found in stool specimens from infected patients, suggesting that fecal-oral transmission of 2019-nCoV is possible. It was also reported that diarrhea is sometimes the first symptom, as opposed to fever or respiratory symptoms.

GUIDELINES FOR MANAGING TRANSMISSION RISK IN PUBLIC SPACES China CDC published guidance on recommended infection control practices in public spaces , including “hotels, shopping malls, cinemas, swimming pools, museums, waiting rooms..., office buildings and other places where people often gather.” The guidance specifically addresses cleaning and disinfection after incidents of vomiting and after meals as well as washing clothing and linens, including the use of chlorine bleach solution. The guidance also includes recommendations to increase ventilation and air circulation for indoor spaces, ensure the availability of hand washing stations, and implement appropriate waste collection and handling procedures. Workers are directed to wear masks in densely populated areas, practice enhanced hand hygiene, and remain vigilant for symptoms associated with 2019-nCoV acute respiratory disease.

HUBEI RESPONSE The Wuhan Municipal Health Commission published data on bed capacity at local hospitals. Many of the hospitals listed appear to be operating at or above capacity. Media reports indicate that the emergency hospitals under construction in Wuhan are nearing completion and may be operational in the coming week, which would add bed space to support the response. Hubei provincial authorities have also issued guidance that all suspect cases and their close contacts must be placed in isolation or quarantine. “Hotels, guest houses, idle factory buildings” are to be requisitioned to house cases and their contacts.

TRANSPORTATION OF SUPPLIES China’s Ministry of Transport published guidance that vehicles carrying basic “living supplies” or “living materials” are able to continue moving goods, despite movement restrictions. The guidance does not define “living supplies/materials,” but we understand that to refer to food and other supplies that are necessary for the public while travel restrictions and cordon sanitaire are in place. These supplies may not be directly designated for response operations, like personal protective equipment or medical supplies would be, but they are critical to supporting the public during the response.

US DEPARTMENT OF DEFENSE RESPONSE The US Department of Defense is supporting the US Department of Health and Human Services coronavirus response by providing housing for quarantined individuals . The DOD will provide several facilities capable of “housing at least 250 people in individual rooms,” and HHS will be responsible for transportation and care for the affected individuals. Four military bases have been identified as suitable locations: Fort Carson in Colorado, Travis Air Force Base and Marine Corps Air Station Miramar in California, and Lackland Air Force Base in Texas. March Air Reserve Base in California is being used to quarantine evacuated US government personnel and their families.

Additionally, DOD announced a policy requiring 14-day self-quarantine for military personnel returning from China to South Korea, where the US military has a significant presence. The quarantine is mandated for all military personnel, but DOD is also recommending voluntary self-quarantine for civilian employees, family members, contractors, and others with recent travel to China.

PSYCHOLOGICAL SUPPORT Provinces in China have been directed to establish “ psychological hotlines ” to provide mental health support to the public during the 2019-nCoV epidemic. These services will be provided by a variety of governmental organizations and local partners—including health, education, and civil affairs agencies—and will provide 24-hour support. Provincial governments are directed to identify local mental health and psychologists with relevant expertise and experience to support the hotlines. Relevant guidance for providing mental health support during the epidemic is available on China’s National Health Commission website.

Additionally, China’s National Health Commission reported that a number of recovered patients from the ongoing epidemic have been communicating with healthcare workers to thank them and send well wishes. Many clinicians have been responding to the Wuhan outbreak for more than a month, devoting long hours to caring for patients in isolation.

ECONOMIC IMPACT As the 2019-nCoV epidemic continues to grow, economists are initiating efforts to forecast its economic impact. The White House reported that the National Economic Council and Council of Economic Advisors are evaluating the impact that the ongoing 2019-nCoV epidemic could have on the US economy over the coming months. White House economists indicate that there has been relatively minimal impact from the epidemic so far, but they are analyzing the potential for longer-term effects. The Organization for Petroleum Exporting Countries is expected to meet this week to discuss the epidemic’s potential to impact demand for oil around the world.