Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security.

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April 13, 2020

EPI UPDATE The WHO COVID-19 Situation Report for April 12 reports 1,696,588 confirmed cases with 85,679 cases in the past 24 hours. In total, there have been 105,952 deaths, with 6,262 deaths. 

The Russian Ministry of Health reported a total of 18,328 cases and 148 deaths. After several days of increased COVID-19 incidence, Pakistan reported 122 new cases on April 13, compared to 336 new cases on April 12, its highest daily incidence outside the large spike on April 5-6 (577 cases), bringing the national total to 5,496 cases and 93 deaths. India has reported 8,048 active cases and 324 deaths. The Johns Hopkins CSSE Dashboard has reported 9,240 cases in India, with 759 cases reported since April 12. 

Spain reported 3,477 new cases in the last 24 hours, totaling 169,496 cases and  17,489 deaths, continuing a very recent trend in the decline of new cases there.

Italy has reported 4,092 new cases in the past 24 hours, a decrease from 4,694 new cases the previous day. Daily incidence continues to fluctuate but could indicate a gradual decline over time. In total, Italy has reported 20,465 deaths and 159,516 total cases. 

Indonesia has reported a total of 4,557 confirmed cases and 399 deaths. Daily incidence has fluctuated, with a total of 316 new confirmed cases reported today, compared to 399 cases reported on April 12 and 330 cases on April 11. Overall, recent daily incidence has been higher than that reported since April 4 (106 new cases). 

The US CDC reported 525,704 cases and 20,486 deaths on April 12. Currently there are 49 states or territories that have reported community transmission. The Johns Hopkins CSSE dashboard is reporting 557,590 US cases and 22,109 deaths as of 9:00 AM US EDT on April 13. In addition to states and territories, the Indian Health Service (IHS) is publishing COVID-19 data reported by tribal partners. The IHS reported 985 total cases, among 11,818 individuals tested. The largest number of cases were found in the Navajo Nation (536 cases). 

JHU CENTER FOR HEALTH SECURITY PLAN ON CONTACT TRACING   The Johns Hopkins Center for Health Security published a National Plan aimed at increasing capacity to conduct contact tracing and case finding in the US. The report found that in order to 1) conduct contact tracing, 2) safely isolate those who are sick and 3) quarantine exposed contacts, the US would need an approximately 100,000 additional paid or volunteer contact tracers as well as $3.6 billion in funding to state and territorial health departments. 

RACIAL DISPARITIES IN US CASES The US CDC published a report that found that 33% of 580 individuals hospitalized with COVID-19 were black and 8% were Hispanic, suggesting that black populations could be disproportionately affected by COVID-19. Maryland has published COVID-19 case counts and data by zipcode, and areas with high prevalence of minorities were found to be particularly affected

US RESPONSE A US sailor from the Theodore Roosevelt aircraft carrier has died from COVID-19. The ship is the site of the largest COVID-19 outbreak in the military. The crew member was first diagnosed on March 30. An additional four other crew members have also been hospitalized. In other news, employees at meat processing plants are reportedly falling ill and protesting working conditions that make them vulnerable to COVID-19. Union leaders and others have raised concerns about lack of available personal protective equipment and the tight working conditions in meat processing plants. Some facilities have closed or reduced production due to the pandemic, which has affected supply chains amid high demand for meat.

GLOBAL RESPONSE Earlier this weekend, India’s State Minister announced that they would extend their national lockdown. The lockdown was planned to end tomorrow, April 14, but has now been extended for at least another 2 weeks. The strict nature of India’s lockdown has raised a number of concerns from the public, especially as members of the country’s most vulnerable groups face the brunt of the economic impacts. The country has announced changes to the lockdown that would help mitigate the damage to their economy. This includes a proposal to mark districts on a scale based on their severity of disease transmission, that would allow 400 districts largely unaffected to continue key economic services including farming and manufacturing. 

There have been calls from many countries and organizations to provide debt relief for some of the most economically vulnerable countries in Africa. As countries across the continent allocate resources to prevent and respond to the spread of COVID-19, some of the largest lenders have been called upon to reduce or eliminate long-standing debt. China has been an increasingly present source of funding across the continent, and will have the largest impact on any final decision to reduce outstanding debt. 

Russia has seen a steady increase in the number of confirmed COVID-19 cases, and China has seen its highest numbers in several weeks. An article from Reuters has outlined that Russia’s eastern border with China has become a key focus of China’s current response, with travelers returned from Russia making up a high proportion of the country’s recent incidence. The border was already closed for anyone who was not a Chinese citizen, and reports suggest that the country will be increasing its response efforts in that area. 

Sweden has resisted more aggressive lockdown and quarantine measures and has opted instead for a “low scale” approach that still involves some levels of teleworking, avoiding mass gatherings, and remaining at home but to a lesser degree than other countries. Case and death counts have continued to rise in Sweden. Sweden has 10,948 cases and 919 deaths in a population of approximately 10 million, according to the JHU CSSE dashboard. It remains uncertain to what extent the measures will slow disease transmission, or whether the less aggressive social distancing measures could still lead to substantial health and economic consequences. 

Spain has begun to loosen its lockdown restrictions approximately one month after they were put in place. Recent slowing in the number of new cases and deaths prompted the easing of certain measures. Some businesses, such as construction and manufacturing, have been allowed to re-open. However, most of the population must still remain at home and avoid shops, bars, and other public areas until April 26th, or longer. 

IMPACT ASSESSMENT OF COVID-19 IN MAINLAND CHINA OUTSIDE HUBEI A new paper in The Lancet examines the transmissibility and severity of COVID-19 cases in regions of mainland China outside of the outbreak epicenter in Hubei province. The research team estimated the reproduction number and case-fatality risk for 31 Chinese provinces and looked to model the implications of rolling back public health distancing measures. The analysis found that in regions outside of Hubei province, mainland China experienced a case-fatality risk of 0.98%, a number roughly one-fifth of that in Hubei province. They also noted that aggressive social distancing was impactful in reducing the reproductive number of the virus.