Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security.
The Center for Health Security will be analyzing and providing  update on  the emerging novel cor on avirus. If you would like to receive these daily  update s, please  sign up here  and select “ 2019-nCoV .” Additi on al resources are now available  on  our  website .

February 04, 2020 - Morning Update

Note: Beginning tomorrow, these updates will be published once per day.

EPI UPDATES The Chinese National Health Commission is reporting 3,235 new confirmed infections, bringing the total to 20,438. Of those, 2,788 (14%) are in serious condition. The NHC has also reported 425 deaths and 632 discharges. Hong Kong has reported 15 cases, Macao has 8 cases, and Taiwan has 10 cases. There are 171,329 individuals under medical observation. 

K o rea has confirmed its 16th case of 2019-nCoV in a person without travel history to China. The patient arrived in South Korea on Jan 19 following travel to Thailand and became symptomatic on Jan 25. 

Limited community transmission has also been reported in Singapore and Thailand . Four new cases in Singapore and at least two in Thailand and had no travel history to China and no contact with a specific confirmed case.

FIRST DEATH IN HONG KONG Multiple media outlets indicate that hospital officials in Hong Kong confirmed the country’s first death from 2019-nCoV ARD in a 39-year-old male identified as having previous comorbidities. This represents the second reported death outside of mainland China. We have not yet identified an official report or information on the patient’s comorbidities.

PROBABLE BAT ORIGIN An accelerated article preview published in Nature found nearly identical sequences between 2019-nCoV genomes in specimens taken from 5 patients infected early in the epidemic. In addition to finding 79.5% sequence identity to SARS-CoV, the sequences are 96% identical to bat coronavirus at the whole-genome level. The study also confirmed 2019-nCoV utilizes the the same ACE2 cell entry receptor that is used by SARS-CoV. Based on pairwise protein sequence analysis, the study found that 2019-nCoV belongs to the species that includes the virus that causes Severe Acute Respiratory Syndrome. 

NEW CORONAVIRUS KNOWLEDGE HUB Global Health Network has launched a website for sharing guidance, protocols, and research standards by responders to the 2019-nCoV outbreak. The goal of the open source platform is to support the generation of evidence to enable faster and standardized research. The platform includes a resources dashboard with links to protocols generated by WHO, CDC, Public Health England and other responding agencies. 

CRITICISM OF ASYMPTOMATIC TRANSMISSION STUDY In a study published on January 30 in The New England Journal of Medicine , the authors describe a case series in Germany that could indicate asymptomatic transmission of 2019-nCoV. The publication is receiving criticism for methodological flaws that may have led to inappropriate conclusions about transmission of 2019-nCoV. One potential flaw was that one of the asymptomatic individuals was actually showing symptoms of the disease but was self-medicating including an antipyretic. It is reported that the authors did not speak with the individual prior to publication. The authors have acknowledged the error, citing pressure to communicate quickly as a contributing factor.

NEW TREATMENT CENTER BEGINS ACCEPTING PATIENTS The 1,000-bed Huoshenshan treatment facility in Wuhan is now accepting nCoV patients. Construction of the facility began on January 24, less than 2 weeks ago. The hospital is staffed by military clinicians, including those with experience responding to SARS-CoV and Ebola. A second 1,600-bed treatment facility, Leishenshan, is expected to begin accepting patients on Thursday.

CRUISE SHIP QUARANTINE A Diamond Princess cruise ship is being quarantined off the coast of Yokohama, Japan, after a recent passenger tested positive for 2019-nCoV. The infected passenger is an 80-year-old man from Hong Kong who visited mainland China and Tokyo before boarding the cruise ship. He developed symptoms around January 19 and boarded the ship on January 20 in Yokohama. He departed the ship when it arrived in Hong Kong on January 25. He sought medical care on January 30 in Hong Kong and was subsequently diagnosed with 2019-nCoV acute respiratory disease. The 2,666 guests and 1,045 crew members are being held onboard while fever checks and medical exams are being conducted to identify any potentially ill passengers.