Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security.
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February 16, 2020

EPI UPDATES China’s National Health Commission reports 2,009 new confirmed cases and 142 deaths across 31 provinces. In total, 68,500 confirmed cases and 1,665 deaths have been reported in China. Taiwan also reported two more cases - which brings the total there to 20 - and the first death due to COVID-19.  

Per the WHO’s latest situation report , Egypt has reported its first confirmed case of COVID-19, making it the first new country to report a case in several days and also the first to be reported in Africa. Dr. John Nkengasong, director of Africa CDC, relayed in a reporte d that “...the patient is male, 33 years old, of foreign origin and is currently receiving treatment at an isolation centre in Egypt. The 17 contacts of the patient have tested negative, and all of them are under home isolation for 14 days.” Further efforts to prepare African nations to detect and manage COVID-19 are being undertaken by Africa CDC, WHO, and other partners. 

The US CDC is reporting 15 confirmed cases. Hawaiian public health authorities are conducting investigations after a couple visiting from Japan were confirmed to have COVID-19. It is currently unclear whether the man contracted the virus during his time in Hawaii or elsewhere in his travels.

CRUISE SHIP OUTBREAKS The Diamond Princess cruise ship has reported an additional 70 cases of COVID-19. The ship, which has been docked off the shore of Japan since February 5, has now reported 355 cases, a total that exceeds every country’s confirmed case total except China. There are a number of international missions to transport quarantined passengers from the ship to quarantine locations, including separate efforts from the United States and Canada. 

Additionally, there are reports that an American passenger on the MS Westerdam has been diagnosed with COVID-19. The MS Westerdam had been denied port access from five separate countries until late last week when Cambodia allowed them to dock. The passenger was diagnosed with the disease after disembarking the vessel. 

CHINESE CLINICAL TRIALS DETAILED An overview of the over 80 clinical trials currently underway in China was published by Nature . The trials range in size and are being conducted to evaluate a range of products for the treatment of COVID-19, from repurposed HIV therapies to traditional Chinese medicine. The WHO is providing scientific and technical support. WHO Chief Scientist Soumya Swaminathan was quoted as saying, “[g]etting the clinical trials straight is a priority, since if we get information on what is working and not working, we can benefit patients now.” 

CREDIT EXTENDED China’s Banking & Insurance Regulatory Commission said at a press conference on Saturday that small and medium enterprises (SMEs) would be able to access 537 billion yuan ($77 billion) of credit intended to ease the financial impact of the COVID-19 outbreak. This intervention is critical as, according to researchers at Peking and Tsinghua universities, 85% of SME’s would fail within three months without the additional support. 

TEDROS ADDRESSES THE MUNICH SECURITY CONFERENCE On Saturday, WHO Director General Tedros Adhanom Ghebreyesus gave a speech at the Munich Security Conference in which he laid out three scenarios that require the collaboration of the health and security sectors: (1) in the setting of a high-consequence outbreak in an area of active conflict or instability; (2) the emergence of a pathogen with pandemic potential; (3) during the accidental or intentional release of a pathogen. He also outlined areas of optimism and concern regarding the ongoing COVID-19 epidemic from the WHO’s perspective. [ Editor’s comment - interested readers should review the DG’s remarks in full.

MODELING UPDATES A new analysis from researchers at the Harvard T.H. Chan School of Public Health attempted to estimate the spread of COVID-19 cases outside of China. The research team compared external country’s surveillance systems with Singapore, a country that is known for its open and expansive disease surveillance program. From this baseline, the team concluded that the estimates of case numbers internationally are most likely much lower than the number of actual cases, with the largest risk to countries with poor surveillance and multiple connections to disease hot spots. 

The MRC Centre for Global Infectious Disease Analysis at Imperial College London published their fifth modeling report relating to the COVID-19 outbreak. The group explored the phylogenetic diversity of SARS-COV-2, the pathogen associated with COVID-19. The report builds off of data collected from over 50 genome sequences collected through February 3, 2020. Their findings suggest that the virus undergoes greater genetic diversity in its subsequent generations, that the crossover event that introduced the virus to humans occurred in the beginning of December, and that the epidemic doubling size is around 7 days.