Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security.
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January 27, 2020 - AM Update
EPI UPDATE China’s National Health Commission reports 2,744 confirmed cases, of which 461 (17%) are severe. There are nearly 5,800 suspected cases and 80 deaths.
The United States is reporting 5 confirmed cases, all of whom had a connection to Wuhan; the current CDC criteria for evaluating a suspected case of nCoV requires a travel history to Wuhan. Canada is reporting a second presumptive case, the wife of the case diagnosed in Toronto over the weekend.
ENVIRONMENTAL SAMPLING nCoV has been detected in 33 of 585 samples taken from the Huanan Seafood Market in Wuhan. The positive samples were reportedly found in an area of the market that sold wild game rather than seafood. It has been hypothesized that the outbreak began after an infected animal was sold at the market; these findings support that idea. However, a new article in Science suggests an alternative hypothesis: that the outbreak began earlier than suspected and has been circulating unrecognized.
CHINA’S RESPONSE Beijing is extending their holiday break until Feb 2, keeping universities, primary schools, and kindergartens closed. Students will continue with lessons remotely. The Mayor of Wuhan said that 5 million people left the city for the Lunar New Year before the cordon sanitaire took effect. Guangdong Province now requires that people wear face masks in public. Media reports continue to describe overcrowded hospitals, with some patients turned away; meanwhile, work continues to expand capacity to 10,000 beds. This article provides a clear overview of the extensive containment measures that Chinese officials have implemented.
A press conference (permanent link, post 108) with officials from the Hubei provincial government contained a number of insights. Approximately 45% of suspected cases are eventually confirmed, but the diagnostic process “takes a long time for confirmatory tests and gene sequencing.” The number of discharges from hospitalizations is slow, because patients who are “cured” remain in the hospital an additional 12 days.
FINANCIAL SUPPORT The Bill and Melinda Gates Foundation announced $10M in awards to fight the epidemic. Half is to go to China and half to Africa. Reuters has reported that the Chinese government is dedicating almost US$9 billion toward efforts to quell the spread of the outbreak. However, News China has reported totals closer to US$1.5 billion.
WHO SITREP The World Health Organization has released a sixth situation report. Notably, among the 3 cases with no known travel history to China, 2 had direct contact with a confirmed case. The travel history of the third is unknown.
HKU MODELING ASSESSMENT HKU Medicine has released [pdf] new nowcasting and forecasting estimates for the 2019-nCoV outbreak. They estimate that the current R0 is between 1.9 and 2.3, and that current case counts may be in the range of 20,000 to 78,000. Additional forecasts and estimates of the effectiveness of interventions are also available in the slides linked above.
COUNTRIES LIMIT TRAVELERSMongolia announced that they are closing the border they share with China. Mongolia is also canceling school until March 2; there are no confirmed cases in Mongolia. Kyrgyzstan closed the border with China effective January 23. Hong Kong is restricting entry of people who reside in or have traveled to Hubei Province in the past 14 days; this restriction relies on self-reporting.