Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security.
The Center for Health Security will be analyzing and providing update on  the emerging novel cor on avirus. If you would like to receive these daily  update s, please  sign up here and select COVID-19. Additi on al resources are also available  on  our  website .

March 5, 2020

Note: although we include case counts to help provide situational awareness to our readers, the numbers are constantly changing. Please refer to the WHO or the public health agencies of the affected countries for the latest information.

GLOBAL SITUATION REPORT The WHO COVID-19 Situation Report for March 4 reports 93,090 total cases worldwide (2,223 new), including 3,198 deaths. A total of 77 countries have reported cases, including 4 new countries yesterday: Argentina, Chile, Poland, and Ukraine. 

WESTERN PACIFIC REGION The WHO reported a total of 86,259 COVID-19 cases in the Western Pacific Region (5,837 outside of China), including 3,024 deaths (40 outside China). China’s National Health Commission reported a total of 80,409 total confirmed cases of COVID-19, including 3,012 deaths. Of these, 67,466 cases have been reported in Hubei Province (49,671 in Wuhan), including 2,902 deaths (2,305 in Wuhan). Additionally, the NHC reported 104 cases in Hong Kong (2 deaths), 10 in Macau (zero deaths), and 42 in Taiwan (1 death). South Korea’s CDC reported a total of 5,766 confirmed cases of COVID-19, including 35 deaths (438 new cases and 2 new deaths). Additionally, South Korea’s CDC identified epidemiological links for 69.4% of cases, and the rest are currently under investigation. In the Daegu region, hit hardest by COVID-19, 69.6% of the 4,327 cases have been linked to a single cluster associated with the Shincheonji religious group. South Korea also announced a “special care zone” will be established around Gyeongsan —near Daegu—after an increase in COVID-19 incidence in the city linked to the same religious group. North Korea is also reportedly affected by COVID-19, according to China’s UN Ambassador, Zhang Jun. The Ambassador called for lifting sanctions in order to support North Korea’s COVID-19 response. We have not seen any official data about cases (eg, via the WHO).

EASTERN MEDITERRANEAN REGION The WHO reported a total of 2,544 cases of COVID-19 in the Eastern Mediterranean Region, including 77 deaths (all in Iran). The Iranian Ministry of Health confirmed 3,513 cases of COVID-19, including 107 deaths. Iran reportedly canceled prayer services for Friday in major cities in an effort to mitigate the risk of community transmission. Iran’s Minister of Health announced that schools and universities will be closed, and he emphasized that citizens should not increase travel while schools are closed, which could result in further transmission of SARS-CoV-2.

EUROPEAN REGION The WHO reported a total of 3,366 COVID-19 cases in Europe, including 84 deaths. As of March 5 at 6pm, Italy’s Ministry of Health reported 3,296 confirmed COVID-19 cases, including 148 deaths. As of March 4, the Public Health France reported 285 confirmed cases and 4 deaths. Germany’s Robert Koch Institute reported 349 cases nationwide through March 4.

SOUTHEAST ASIA REGION The WHO reported a total of 53 cases of COVID-19 across 5 countries in Southeast Asia, including 1 death.

AFRICAN REGION The WHO reported a total of 7 cases across 3 countries in Africa (zero deaths). 

REGION OF THE AMERICAS The WHO reported a total of 155 cases in the Americas, including 6 deaths (all in the United States).

US UPDATE The US CDC is officially reporting 129 total confirmed cases—80 domestic cases and 49 repatriated cases from China and the Diamond Princess cruise ship—including 9 deaths (data through 4pm on March 3). The WHO Situation Report lists 108 US cases and 6 deaths. Other reports —based on state and local data and updated more frequently—indicate that the total is currently at least 150 cases (including repatriated cases) and 11 deaths across 17 states. Notably , New York City reported 9 new cases linked to the city’s first COVID-19 case, and Los Angeles County (California) declared a state of emergency after identifying 6 new cases.

MASS GATHERINGS Large gatherings around the world are being cancelled, postponed, or modified over concerns about SARS-CoV-2 transmission. Sporting events are foregoing handshakes to mitigate risk, films are delaying premieres over concerns that theaters could elevate transmission risk, and international meetings and conferences are being interrupted. Even events that are continuing as scheduled are losing key participants as companies and individuals withdraw over concerns about the growing COVID-19 epidemic.

The United Nations announced that it is scaling back the 64th session of the Commission on the Status of Women at the UN headquarters in New York, originally scheduled for March 9-20. The meeting will now consist of a single day of procedural reporting; opening statements by the meeting chair, UN General Assembly President, and “several other high-level UN officials”; and minimal action on a political declaration and draft resolutions. After that point, the remainder of the meeting will be postponed, without general debate, side events, or other scheduled items. Countries will be represented by delegations already based in New York rather than sending additional delegation members for the meeting.

MORE CORONAVIRUS ON THE HIGH SEAS After the Diamond Princess and Westerdam cruise ships faced quarantine due to confirmed cases or perceived coronavirus risk, respectively, another cruise ship has been linked to a cluster of COVID-19 cases . The first death in the California, a 71-year-old man from Northern California, was a passenger onboard the Grand Princess cruise ship from February 11-21 for a roundtrip cruise between San Francisco and Puerta Vallarta, Mexico. Health officials believe he may have been exposed to the SARS-CoV-2 virus during his cruise. At least one other passenger from that same cruise has reportedly also been identified as a confirmed COVID-19 case. When the ship returned to San Francisco, thousands of passengers departed and thousands more embarked for the next cruise, a trip to Hawai’i and Mexico and then back to San Francisco. A total of 62 passengers from the February 11-21 cruise remained onboard for the next voyage, and all are currently quarantined in their staterooms, separated from the rest of the passengers due to their potential exposure on the previous cruise. The ship was en route from Hawai’i to Mexico when it was recalled to San Francisco, where all passengers are being held onboard until SARS-CoV-2 testing can be completed. According to Princess Cruise Lines , fewer than 100 passengers, including those on the previous cruise and those experiencing flu-like symptoms, will require testing. The tests will be delivered to the ship via a US Coast Guard helicopter then transported via helicopter to a laboratory in nearby Richmond, California. The Princess Cruise Lines also announced that the Grand Princess’ next cruise, originally scheduled to depart on March 7, has been cancelled.

Passengers on another cruise ship, MSC Opera , were recently recalled from shore excursions in Athens, Greece, after a former passenger was confirmed to be infected with SARS-CoV-2. The case is an Austrian man who disembarked at a previous port call in Genoa, Italy , on February 28 and was then confirmed after returning to Austria. The passengers were held onboard while health officials waited for further guidance, but the ship was ultimately permitted to continue on its cruise, with the next port visit scheduled in Corfu, Greece. MSC Cruises notes that the company has implemented a series of measures in response to the COVID-19 epidemic, including fever screening for all passengers before boarding the ship and denying boarding to individuals who have recently traveled to high-risk countries, including China, South Korea, and Iran as well as high-risk areas of Italy.

AIRLINE INTERRUPTIONS German airline Lufthansa announced several measures that will interrupt airline travel within Europe and to other areas. The airline announced that it will ground 150 aircraft and reduce short- and medium-haul flights by 25% due to decreased demand for air travel. Additionally, Israel expanded travel restrictions to several countries in Europe—including Germany, France, Spain, Austria, and Switzerland—requiring quarantine for travelers originating in those countries. Subsequently, Lufthansa (including Swiss and Austrian Airlines) announced cancellation of all flights to Israel through the end of March ( more than 7,100 total ) due to the new entry limitations. The press release also provides additional detail regarding route cancellations and adjustments within Europe. The biggest changes will be for flights within Germany and between Germany and Italy. Frequency of flights to other destinations will be affected as well, but Lufthansa emphasized that it will continue to service all European destinations, even if less frequently. 

The International Air Transport Association (IATA) published updated forecasts for COVID-19’s financial impact on the air transport industry. IATA estimates that the global revenue loss could be $63-113 billion in 2020, up from the February 20 estimate of $29.3 billion (based largely on interruptions to China only). IATA notes that stock market value for airlines has dropped 25% since the beginning of the epidemic, 21 points greater than the impact during the 2003 SARS epidemic. Alexandre de Juniac, IATA’s Director General and CEO, called on governments to consider airlines when evaluating tax relief and stimulus packages to mitigate economic impacts of the epidemic.

The US Travel Association , a non-profit organization that promotes travel to and within the United States, published new forecasts for COVID-19’s impact on travel to the United States . The group projects that the ongoing coronavirus epidemic could result in a 6% decrease in foreign travel to the United States for February-April 2020. This would be the largest decrease since the 2007-08 financial crisis. A 6% decline in travel could result in an associated $2.5-4.25 billion in economic losses, including to airlines, hotels, restaurants, and tourist attractions. On the domestic side, US airlines have begun to reduce service in response to lower demand for air travel. Yesterday, United Airlines and Jet Blue announced reductions in service due to COVID-19. United will cut flights in the United States and Canada by 10% and international service by 20% in April (including those flights to high-risk areas that have already been cancelled). Jet Blue announced an initial reduction by 5%, and the company will continue to evaluate the situation. Additionally, COVID-19 could potentially impact hiring practices at Jet Blue, and the company is considering voluntary leave policies to save additional money. Impacts on air travel amid coronavirus concerns have led many US airlines to waive flight itinerary change fees, which has also contributed to revenue losses.

RESEARCH UPDATES A pre-print posted by the Shenzhen CDC describes the epidemiology of COVID-19 based on a case series of 391 patients and 1,286 of their close contacts. Among other things, the authors report that 91% of cases presented with mild illness, that the secondary attack rate in households was 15%, and that children were as likely as adults to become infected. As countries evaluate non-pharmaceutical interventions to stem SARS-CoV-2 transmission, the role of children in community spread will be critical to evaluating the value of school closures. Separately, a letter from Singapore provided valuable information regarding the degree of environmental contamination of SARS-CoV-2 in healthcare settings.   

ECONOMIC IMPACTS The International Monetary Fund said yesterday that it was prepared to extend $50 billion to offer relief for economic slowdowns resulting from the COVID-19 epidemic. Countries whose economies rely heavily on revenues from the export of raw materials have been particularly hard hit. Managing Director Kristalina Georgieva laid out several different lending options and noted that one of them, the Catastrophe Containment and Relief Trust, “proved to be effective during the 2014 Ebola outbreak, but is now underfunded with just over $200 million available against possible needs of over $1 billion." 

PHASE 1 CLINICAL TRIAL RECRUITING Per the Wall Street Journa l , the Kaiser Permanente Washington Health Research Institute has begun recruiting for the first US-based Phase I clinical trial for Moderna’s SARS-CoV-2 vaccine. The 45-person trial will be conducted to evaluate the candidate vaccine’s safety, and if successful, larger trials to determine efficacy will follow. The trial’s principal investigator, Dr. Lisa Jackson, noted that having “vaccine supply to conduct a trial within a two-month period is pretty much unprecedented.”

EMERGENCY FUNDING PASSES THE HOUSE The US House of Representatives passed a $8.3 billion emergency supplemental funding bill to support the ongoing response to the COVID-19 epidemic. The vote tally was 415 in favor to 2 opposed. The funding will be used to support state and local public health preparedness programs and medical countermeasure development and procurement. The President is expected to sign the measure into law later this week.