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 updates on the emerging novel coronavirus. If you would like to receive these daily updates, please sign up here and select “2019-nCoV.” Additional resources are now available on our website .

January 28, 2020 - Morning Update

EPI UPDATE China’s National Health Commission reported a total of 4,515 cases of 2019-nCoV through January 27, including nearly 1,000 severe cases and 106 deaths. Hong Kong has reported 8 cases, Macau has reported 7 cases, and Taiwan has reported 5 cases. There are an additional 6,973 suspect cases, and more than 44,000 individuals are currently being monitored.
Reports are emerging about the first case of 2019-nCoV in Germany. According to media reports , the 33-year-old man from Bavaria has not recently traveled to China. The man attended training in Bavaria that was conducted by a colleague who had recently returned from China. The colleague, now also a confirmed case, had recently traveled to Wuhan to visit family. This is believed to be the first transmission of 2019-nCoV infection in Europe. Health officials in Germany are monitoring 40 contacts of these 2 cases. We have been unable to confirm this report with official statements from the German or Bavarian governments, but comments in the media reports about the patient are attributed to Andreas Zapf, head of the Bavarian food and safety office.
At the time of this writing, early details are emerging of human-to-human transmission in Japan as well.
The latest WHO Situation Report cites 37 cases across 11 countries, but this does not include the new case in Germany.
UPDATED PREVENTION, DIAGNOSIS & TREATMENT PLANS China’s National Health Commission published the 4th version of the diagnosis and treatment plan for 2019-nCoV patients. The document is in PDF form and can be translated via Google Translate or other services. The National Health Commission also published guidance regarding the prevention and control of the disease in elderly individuals , a group that is believed to be at higher risk for severe disease and death. The guidance emphasizes the importance of mitigating the risk of transmission in multiple settings: at home, in the community, and in assisted living and long-term care facilities. Recommendations focus on limiting potential exposures, including reducing unnecessary outings in public, improving hygiene and disinfection standards, supporting anxiety and mental health, and implementing effective disease surveillance and patient isolation programs. The guidance also appears to include provisions for limiting visitors and new patients at long-term care facilities.
MENTAL HEALTH RESPONSE On January 26, China published “ Guiding Principles for Emergency Psychological Crisis Intervention for Pneumonia Epidemic of New Coronavirus Infection ," which aims to support the mental health challenges that accompany the epidemic. On January 28, China’s National Health Commission published some clarifying information on the purpose and associated interventions. They note that both patients and healthcare workers can experience fear, anxiety, and loneliness as well as stress, fatigue, and exhaustion. The guidance was published to reduce the impact of mental health challenges in the public on response operations.
The guidance includes real-time research to identify high-risk groups and individuals in order to proactively address these challenges and prevent negative outcomes. The priority population for these efforts includes patients, frontline healthcare workers, and other responders, and this aims to gradually expand to include those under home quarantine/isolation and family members. The guidance recommends establishing a central expert group to direct activities, as well as rapid response teams, hotlines, and online mechanisms to facilitate communication with the public. The mental health response aims to leverage local resources, but cities that do not have sufficient resources available can request support from provincial governments.
RETURN OF MIGRANT WORKERS China’s Ministry of Human Resources and Social Security, the National Health Council, and the Ministry of Agriculture and Rural Affairs jointly issued guidance regarding the anticipated return of Chinese migrant workers who have been working overseas and return during the Lunar New Year holiday, particularly in rural areas. The document notes that many Chinese citizens living and working overseas return home during the holiday, and it provides recommendations to mitigate the risk of transmitting 2019-nCoV. The primary recommendation is to immediately report any individuals experiencing symptoms associated with the disease, including fever, cough, and chest tightness. It also recommends routine precautions such as wearing a mask and using proper hand hygiene. Notably, the guidance includes several recommendations to avoid gatherings, including holiday parties. It advises against holiday parties, encourages sending holiday greetings by video or phone, and recommends not meeting up with friends in crowded areas.
SUPPLY CHAIN FUNDING China published guidance to financial institutions , designed to simplify and facilitate foreign payments for imported materials necessary for the coronavirus response. The guidance appears to implement policies that reduce delays in submitting payments and alleviates foreign borrowing limits on funds needed to purchase required materiel.

HONG KONG Hong Kong continues to implement stringent travel restrictions to limit the influx of travelers from mainland China. At a press conference on January 27 , Chief Executive Carrie Lam noted that the government is attempting to “drastically limit” travel between Hong Kong and the mainland. Hong Kong has stopped issuing certain permits to cross the border with mainland China, including for tour groups, which has reduced the number of visitors by half. Additionally, Hong Kong has closed 6 border crossing points in an attempt to funnel all travelers through a limited number of border control points to facilitate the necessary screening measures. Hong Kong also announced additional travel-related measures , all starting January 30, aimed at curbing transmission. Several rail service lines will be suspended, and cross-border bus services using certain border crossings will have reduced operations. Additionally, several airlines will be reducing the frequency of flights between Hong Kong and mainland China, including Cathay Pacific, Hong Kong Airlines, Cathay Dragon, and Hong Kong Express. Ferry service between China Ferry Terminal at Tsim Sha Tsui and Tuen Mun Ferry Terminal in Hong Kong will be suspended, and ferry service between Hong Kong and Macau will be reduced.
The Hong Kong government is also investigating production and supply issues for face masks , which are in high demand in Hong Kong and around the world. Both the central Hong Kong government and staff at overseas offices have contacted manufacturers and retailers in order to secure a sufficient supply for the public and the healthcare system.