Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security.
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February 21, 2020

EPI UPDATES The Chinese National Health Commission reported 889 new cases of COVID-19, bringing the total to 75,465 cases. There have been 2,236 deaths and 18,264 people discharged. Of the 48,730 confirmed cases in Wuhan, 10,997 cases are in serious condition. There are 5,206 suspected cases and 120,302 contacts of confirmed cases are under medical observation. 

There 258 confirmed cases connected to two Chinese prisons , one in Shandong and the other in Zhejiang. In response, 7 prison officials have been removed from their duties due to their lack of implementation of infection control measures.

The WHO’s latest situation report reports a total of 1,073 cases outside of China in 26 countries; 149 new cases have been reported to WHO over the last 24 hours. The WHO report also included a description of the Global Surveillance System that is being used to collect and organize data related to the COVID-19 outbreak. Per the WHO, “[t]he goals of global surveillance are to: 1) Monitor the global extent of the epidemic; 2) Provide early epidemiological information to support risk assessment at the national, regional and global levels; 3) Rapidly detect new cases in countries where the virus was not previously circulating; 4) Monitor trends of the disease after a first case is imported and; 5) Provide epidemiological information to guide response measures.”

CANADA The Ministry of Health in British Columbia has confirmed a case of COVID-19 with no travel history to China, but with recent travel to Iran. In a statement from the Ministry of Health, the patient is identified as a female in her 30’s who is currently isolated at home. Her close contacts are being followed by ministry officials. 

LOCAL TRANSMISSION IN SOUTH KOREA, ITALY, IRAN Following initial reports of 5 cases and 2 deaths, Iran is reporting 13 additional cases and 2 deaths bringing the total to 18 cases and 4 deaths. In an effort to reduce transmission, the Ministry of Health in Iran is proposing temporary restrictions on visits to national shrines and pilgrimage to Qom where one of the initial cases was detected. Neighboring Iraq is closing the border between Iran and Iraq preventing border crossing by Iranian nationals. Iraqi Airways and Kuwait Airways are also suspending flights to Iran. In addition, the Lebanese Ministry of Health is reporting one confirmed case who had recently arrived from Iran. Two suspected cases were also reported. The South Korean CDC is reporting 100 new cases, bringing their national total to 204. Of the 53 cases reported yesterday afternoon, 30 had an epidemiological link to a church in the city of Daegu . Six cases of COVID-19 have been identified in northern Italy, none of whom had recently visited China. 

DIAMOND PRINCESS The Japanese Ministry of Health has reported 2 confirmed cases in government officials participating in the response on the Diamond Princess cruise ship, both of whom are hospitalized and receiving treatment. In total, 621 cases and two deaths have been linked to the Diamond Princess, making it the second largest epicenter of COVID-19. Japanese authorities have said that the two week quarantine of the ship has ended, and uninfected passengers are being allowed to disembark. 

Yesterday, the Washington Post reported on the evacuation of 328 Americans who had been quarantined on the Diamond Princess and repatriated to the United States. During that evacuation, a disagreement between the CDC and the State Department occurred over whether or not infected passengers should be allowed on the same flight as uninfected passengers. The State department prevailed, and all of the Americans were allowed on the flight.  

Two passengers evacuated from the Diamond Princess have tested positive for the virus in Darwin, Australia. Both cases are clinically doing well and were appropriately isolated. These cases raise questions about the possibility of additional Diamond Princess passengers testing positive after disembarking and previously testing negative in Japan. 

FEDERAL FUNDING FOR PUBLIC HEALTH EMERGENCIES A bipartisan group of Senators (Bill Cassidy of Louisiana, Brian Schatz of Hawaii, Marco Rubio of Florida, Dick Durbin of Illinois, Bill Nelson of Florida, Chris Coons of Delaware) have introduced the Public Health Emergency and Accountability Act , legislation which would create a permanent funding mechanism to improve the speed and effectiveness of response to public health emergencies. 

DIAGNOSTIC TEST DEVELOPMENT CHRONICLED Nature Biotechnology published an analysis of the development of diagnostic tests for SARS-COV-2, citing the impressive progress that has been made within weeks of its emergence, as compared to the roughly six months it took to develop assays for SARS. The article helpfully provides details on 12 products, including their developers, assay type, and current status.