Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security.
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February 06, 2020

EPI UPDATES The National Health Commission of China has reported 3,694 new confirmed cases and 5,328 suspected cases of 2019-nCoV, bringing the totals to 28,018 confirmed and 24,702 suspected cases. There have now been 563 deaths, up from 490 yesterday.

The Philippines has reported its third 2019-nCoV case in 60 year old Chinese woman in Cebu City. The woman arrived from Wuhan on January 20th and originally tested negative. She returned to China, but the Philippines Department of Health was subsequently notified that an earlier sample tested positive.Contact tracing is being conducted on close contacts.

Reports of local transmission are growing. Both South Korea and Malaysia are each reporting cases among travelers returning from a Singapore business meeting. In its statement, Singapore noted that while multiple cases were close contacts of earlier cases, there is no evidence yet of widespread community transmission in the country. Singapore recently confirmed four more cases of 2019-nCoV. While Japan has continued to quarantine the Diamond Princess cruise ship; 10 more people tested positive for 2019-nCoV, bringing the total to 20. Hong Kong is conducting fever screening and symptom monitoring on the World Dream cruise ship after 8 travelers subsequently tested positive. Test results of 32 crew members are currently negative and one is pending.

NEW CASE IN NORTH AMERICA The United States has confirmed its 12th case of 2019-nCoV in Wisconsin, in an adult with previous travel history of Beijing, China and known exposure to confirmed cases of 2019-nCoV. The confirmed case presented to the emergency department and was safely isolated with appropriate infection control procedures. Officials report that the individual is doing well and is being isolated at home, emphasizing that the risk to the American public is low. On February 05th, Canada reported a second case of 2019-nCoV in British Columbia.

VERTICAL TRANSMISSION Reports of transmission from mother to fetus are emerging out of China. Hubei province has confirmed two newborn infants are infected, both of which had mothers also infected with 2019-nCoV. One of the infants, delivered via Cesarean section, was tested shortly after delivery and found to be positive. The other tested positive in the third week of life. Both babies have symptoms. Medical experts from China are emphasizing that attention should be paid to the potential for infection in newborn infants.

WHO COURSE CRITICAL CARE SEVERE ACUTE RESPIRATORY TRAINING The World Health Organization has launched an online free training course on the clinical management of patients with severe acute respiratory infections. The course which aims to provide resources for clinicians in low-middle income countries. The course will include modules on the clinical management of 2019-nCoV and recommendations for infection prevention and control.

RESPONSE EFFORTS IN MAINLAND CHINA China’s Vice Premier Hu Chunhua called for greater focus on controlling the epidemic in rural communities to protect the supply of agricultural products. This follows reports indicating poultry farmers culling chickens because of the ban of movement of live poultry to reduce possible risk of coronavirus transmission. 

China’s National Health Commission has reported that the first modular treatment center in Wuhan, converted from a former exhibition hall, is accepting patients. The treatment center provides approximately 1,600 beds. Leishenshan Hospital , another new treatment center, is scheduled to start seeing patients today (February 6th), and holds 1,500 patients in prefabricated units. Most of the rooms are depressurized and have ventilation systems. To meet high patient volume, the National Health Commission also reported that certain hotels and “other venues” will be repurposed for receiving and treating with mild symptoms and for observation of close contacts of cases. 

RESPONSES OUTSIDE MAINLAND CHINA Hong Kong announced that it is instituting a mandatory 14-day quarantine on all people entering Hong Kong from mainland China. The government also increased the number of suspended checkpoints from six to 10. Freight services between the two regions will not be affected. 

The Philippines also recommended the voluntary repatriation of all Filipino citizens located in Hubei Province, who will be quarantined upon returning to the Philippines. Additionally, India has begun temperature screening of passengers coming in from Singapore and Thailand, expanding its screening beyond just passengers from mainland China and Hong Kong. As of Tuesday, February 4, nearly 90,000 passengers from over 700 flights were screened across 21 airports. India has also invalidated existing visas (including e-visas) from foreign nationals coming from China. To support China’s response, Brunei has committed to donating approximately 150,000 masks to the country, with the first batch of 50,000 arriving today.

REMDESIVIR CLINICAL TRIAL A clinical trial using the antiviral drug remdesivir to treat 2019-nCoV has been approved and is set to begin today at several hospitals in Wuhan in Hubei Province, China. The drug, which is manufactured by Gilead, has previously shown activity against SARS and MERS. Currently there are 761 patients enrolled in the double blind placebo controlled trial.

WUHAN INSTITUTE APPLIES FOR REMDESIVIR PATENT South China Morning Post reports that the Institute of Virology in Wuhan recently filed a patent for the antiviral remdesivir. The developers of remedisivir, US-based company Gilead Sciences, said that they filed patent applications in 2016 for global use against all coronaviruses, though currently the drug is not approved for use in any countries. The potential dispute raises concerns about China’s commitment to adhering to intellectual property rights, and whether such actions could disincentivize pharmaceutical companies from pursuing drugs to combat emerging infectious diseases. While China’s application is not a move to fully claim rights to the drug, it may reduce Gilead’s return on investment if the country decides to manufacture the medication.