COVID-19
Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security.
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February 12, 2020

EPI UPDATES Incidence has continued to decline in China, with the National Health Commission reporting 2,015 new confirmed cases and 97 deaths of COVID-19. Hubei Province continues to be the hardest hit, with 81% of new cases. In total, 44,563 cases of COVID-19 and 1,113 deaths have been reported in China.  

According to the latest WHO situation report , no no new countries reporting cases in the last 24 hours. Globally, the largest proportion of newly identified cases are tied to the passengers and crew of the quarantined “Diamond Princess” cruise ship; 174 confirmed cases have been found out of the 492 passengers and crew tested.

OUTBREAK RESPONSE CHALLENGES Science Magazine reports that some Chinese laboratories have insufficient diagnostic testing capacity, which has made diagnosing and confirming cases difficult. However, Caixin reports that there is no longer a backlog of specimens in Huanggang City. 

In other news, the Hong Kong Ministry of Health reports that two residents living on different floors of the same apartment building contracted the virus, recalling a superspreading event in an apartment building during the 2003 SARS outbreak that was later linked to faulty plumbing. The Hong Kong government has successfully is following up with other households within the building and has found no additional cases. Finally, the Wall Street Journal is reporting that two officials from Hubei province’s health committee have been relieved of their duties.

INTERNATIONAL PREPAREDNESS EFFORTS Mongolia, which shut its land border to China over a week ago, announced that they will be closing all public schools and canceling mass gatherings from now until March 2. There are no confirmed cases in Mongolia. In other news, CDC released an updated strategy to minimize the number of healthcare professionals needing to wear N95 respirators in healthcare settings. The guidance recommends a hierarchy of controls, including a combination of engineering and administrative controls.

ECONOMIC IMPACT OPEC reduced estimates of global oil demand for 2020, citing the ongoing coronavirus epidemic’s economic implications. Travel restrictions are also impacting other major economic markets . Supply chains that would normally deliver commodities throughout China have been disrupted, slowing production and damaging economic productivity. The United States Postal Service announced that it can no longer guarantee priority delivery of some items destined for China and Hong Kong. A major Singapore bank, United Overseas Bank, announced that they will be setting aside roughly USD$2.2 bn for companies that need relief following economic turmoil during the coronavirus outbreak. 

QUESTIONS TO BE ANSWERED Investigators at Hong Kong University published an article in Eurosurveillance recommending epidemiological research priorities relating to transmission dynamics, severity, susceptibility and control measures. Specific priorities include: (1) clarifying the importance of symptomatic and asymptomatic transmission; (2) estimating serial interval and generation time; (3) estimating robust estimates of the case and infection fatality risks; and (4) clarifying age-varying risks.

RESEARCH UPDATES The Lancet published a paper describing lessons learned from 25 years of responding to emerging zoonotic viruses. Using 6 case studies, the authors suggest the following four lessons to improve preparedness for future spillover events: (1) develop new causal criteria that takes rapid sequence availability into account; (2) stress the importance of clinicians and scientists in response; (3) practice a one health approach; (4) and the importance of virus naming as an element of good communication.