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January 29, 2020 - Morning Update

EPI UPDATE China’s National Health Commission reported that a total of 5,974 confirmed cases and 132 deaths have been reported across 31 provinces as of January 28th. 9,239 suspected cases have also been reported. According to a WHO situation report published yesterday , 56 confirmed cases in 14 countries have been found outside of China. 

The UAE is reporting a case cluster in a family of four that had arrived from Wuhan in early January. All family members are reportedly in stable condition. These are the first confirmed cases reported in WHO’s Eastern Mediterranean Region. No new cases have been found in the US; the number of confirmed cases remains at 5.

STEPS TO PREVENT A US NCOV EPIDEMIC Former National Security Council Director Dr. Luciana Borio and former FDA Commissioner Dr. Scott Gottlieb have called for additional steps to prevent the transmission of nCoV within the United States. Drs. Borio and Gottlieb recommend : (1) the prompt identification and isolation of nCoV patients using a PCR assay; (2) increasing influenza vaccination rates to reduce the burden of respiratory disease on the healthcare system; (3) bolstering healthcare preparedness and infection control procedures. Stress on the supply chain for personal protective equipment should be anticipated; (4) supporting CEPI’s rapid vaccine research, development, and manufacturing efforts. 

TRAVEL RESTRICTIONS Growing case counts within China have prompted increasingly restrictive travel policies. Al Jazeera reports that several major airlines, including British Airways and United Airlines, have suspended flights to and from mainland China. Additionally, the United States is reportedly considering the possibility of a travel ban on all flights to and from China as a way to mitigate the spread of n-CoV. This would be a step beyond the Department of State’s current travel advisory which is currently at a ‘level 3’ for all of mainland China and ‘level 4’ for Hubei Province. 

EVACUATIONS Despite reassurances from WHO Director General Tedros that evacuations of foreign nationals from Wuhan, China are not needed at this time, multiple nations , including Japan , Russia, France, the United States, the United Kingdom, Australia, India , and South Korea are taking steps to repatriate their citizens. US evacuees will be transported to a military base in southern California and quarantined. 

PROTESTS IN HONG KONG More than 15,000 Hospital Authority employees have joined a new union, threatening to strike if the Hong Kong government does not close its border with mainland China. There are also reports of other protestors disrupting travel services in Hong Kong to encourage a border closure. Hong Kong has already announced a suspension of rail services to and from the mainland, and has reduced the number of flights.

WHO RESPONSE China has agreed to receive an international team of experts under WHO auspices. Reuters reported that “The two sides agreed that WHO will send international experts to visit China as soon as possible to work with Chinese counterparts on increasing understanding of the outbreak to guide global response efforts,”. No timeline was given. In other news, the WHO is also setting up a Global 2019-nCoV Clinical Data Platform to allow Member States to contribute anonymized clinical data to inform the public health clinical response. 

NCOV GROWN IN AN AUSTRALIAN LABORATORY A team of researchers at the Peter Doherty Institute for Infection and Immunity announced the successful culturing of the 2019-nCoV virus. The rapid availability of viral samples is important to understanding the virus and developing new vaccines and therapeutics.*

MODELING UPDATES Two infectious disease modeling groups have assessed the impact of travel screening procedures being put in place to reduce global nCoV transmission. Both found that travel screening is likely to miss at least half of infected travelers. One of the groups, based at the London School of Hygiene and Tropical Medicine, has released an interactive tool to allow decision-makers to explore the parameter space. Other modeling studies find that the incubation period is likely around 5-6 days.

NEPAL CLOSING BORDER WITH CHINA The border between Nepal and China will be closed for 15 days. This news comes after Nepal confirmed a case of nCoV on Jan. 24. Security and immigration authorities in China and Nepal decided to close the border in an attempt to “ strengthen vigil[ence] ” around the coronavirus outbreak.

*This post was updated at 5:21 EST on January 29th.