Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security.
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February 10, 2020

EPI UPDATES Per China's National Health Commission , a total of 40,171 confirmed cases of 2019-nCoV have been identified in China, including 36 in Hong Kong, 10 in Macao, and 18 in Taiwan. 97 new deaths were reported across the country, bringing the total deaths to 908, which exceeds the global mortality caused by the SARS outbreak in 2003.

Earlier today, the World Health Organization shared its 20th 2019-nCoV situation report. The report, which cites data as of February 9th, listed lower case numbers in mainland China and 307 confirmed cases across 24 other countries. No new countries have reported cases over the past 24 hours. 

65 more people aboard the Diamond Princess, the cruise ship currently under quarantine in Japan’s Yokohama harbor, have tested positive for 2019-nCoV, bringing the total to 135 passengers infected. It is not clear whether the newly diagnosed cases will influence the quarantine’s end-date, currently scheduled for Feb 19. 

RESPONSE FUNDING China’s finance ministry reported that it has allocated a total of $10.26 billion in order to fund the national response to the ongoing 2019-nCoV epidemic. 

In the United States, HHS Secretary Alex Azar is pushing back against lawmakers who are urging the administration to submit a request for an emergency appropriation to the Congress. He was quoted by The Hill as saying, ”it’s premature to be talking about any additional needs for money at this point. There are still so many unknowns about the situation … We won’t let resources be any kind of barrier to response activities here but let’s not put the cart before the horse.” 

INTERNATIONAL MISSION EN ROUTE An advance team of the WHO’s international mission left for China on Sunday evening. The team, lead by Dr. Bruce Aylward, will work with Chinese scientists and clinicians to better understand the virus and its epidemiology. 

MODELLING UPDATES Several groups have published new models regarding the 2019-nCoV outbreak. Earlier today Imperial College London published estimates of severity of 2019-nCoV. The report builds upon a number of underlying factors to present new estimates for case fatality ratios within Hubei Province (18% with a large confidence interval), travelers from mainland China (95% CI: 1.2% - 5.6%), and an overall estimate for infections as a whole (95% CI: 0.5% - 4%). 

Separately, modelers at the LSHTM published a preprint of an investigation into the feasibility of outbreak control via the isolation of patients and contact tracing of contacts. The authors concluded that “[w]e found that in most scenarios contact tracing and case isolation alone is unlikely to control a new outbreak of 2019-nCov within three months.”

CLINICAL OBSERVATIONS FROM 1,099 NCOV PATIENTS Chinese clinicians have reported on the clinical course of over a thousand confirmed 2019-nCoV cases drawn from over 500 healthcare facilities in all Chinese provinces, the largest such series to date. Of note, 30% had been to Wuhan and 71.80% had contact with people from Wuhan. 55 patients (5.00%) were admitted to an ICU and 15 (1.36%) died. The authors also reported a median incubation period of 3 days, with a range of 0-24 days.

CRASH VACCINE PROGRAM PROFILED The Economist recently published an article on the Coalition for Epidemic Preparedness Innovation’s (CEPI) rapid research and development program for an 2019-nCoV vaccine. No licensed vaccines exist against any coronaviruses, but several investigational products and programs have been announced in recent days. The article’s authors noted that “ [e]ven if a vaccine were ready within a year, it would be too late to stem the current epidemic in China. But it could help other countries.”