Daily updates on the emerging novel coronavirus from the Johns Hopkins Center for Health Security.
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EPI UPDATES
: There are
currently
at least 549 cases and 17 deaths in China. A number of Asian countries are reporting imported cases, as is the United States. To date, bo secondary transmission has been found in cases detected outside China.
A
press conference
with National Health Commission experts contained a number of new epidemiological insights. Direct quotes are included here for clarity. 1)
When coronavirus is in SARS, the incubation period is up to 14 days. This time, according to the current patient statistics, it is estimated to be within 10 days. However, this new type of coronavirus infection has great differences among different people after infection. Some patients have a relatively long incubation period after infection, and they develop onset in two or three days. The longest is 10 days. We estimate the incubation period to be slightly longer and set it to 14 days. 2) The incubation period may now also be contagious, so this point needs to be taken very seriously, because now I also understand the situation of some patients, the patients themselves do not have fever, and those who have contacted him in the early stage have fever. People may also have infections and fevers later.
Hong Kong
announced their first two cases today. The first case is a 56M Hong Kong resident in good health, returned from Wuhan by say of Shenzhen in mid-January. His condition is stable. The second case is a 39M from wuhan with URI symptoms. He traveled from Wuhan by way of Shenzhebei. He is in stable condition.
Macau
announced their first confirmed case, a 52 year old woman. The case has a travel history to Wuhan, returned on 19 Jan. She is in stable condition.
PHEIC RECOMMENDATION DELAYED:
The WHO Emergency Committee met today to discuss whether to recommend a PHEIC declaration. WHO Director General Dr. Tedros announced that a decision had not been reached due to a lack of information on which to base their assessment. The EC will convene again tomorrow. They are requesting additional information from China in order to support their decsion-making process.
WUHAN QUARANTINED:
Chinese officials
report
: "
From 10:00 on January 23, 2020, the city's urban bus, subway, ferry, and long-distance passenger transportation will be suspended; for no special reason, citizens should not leave Wuhan, and the airport and train station from the Han corridor will be temporarily closed. Recovery time will be announced separately." I
t was also announced that the responsibility for outbreak control in the most-affected region will be shifted to the Hubei Province level. Wuhan Municipal Health Commission will no longer be posting updates.
CCDC WEEKLY PAPER ON nCOV
: The
report
describes early features and findings of the outbreak. Briefly, four patients who worked at the Huanan Seafood Wholesale Market were admitted for pneumonia to the same hospital in Wuhan. The original case definition was: an illness of unknown etiology with 1) fever with or without a recorded temperature; 2) radiographic evidence of pneumonia; 3) low or normal leukocyte count or low lymphocyte count during the early stage of disease; and 4) no improvement or worsening symptoms after 3 to 5 days of antimicrobial treatment per standard clinical guidelines. “Most patients had severe and nonproductive cough following illness onset, some had dyspnea, and almost all had normal or decreased leukocyte counts and radiographic evidence of pneumonia.” The age range of patients is 26-89, median age is 57. No cases have been identified in contacts under follow-up. Sixteen healthcare workers have been infected. Two other clusters have also been identified. Among 198 confirmed patients, 22% report contact with the Huanan market, 32% report contact with symptomatic people, and 51% report no relevant history.
NEW ECDC RISK ASSESSMENT
: The European Centre for Disease Prevention and Control has published a new
risk assessment
. They find that: “the potential impact of 2019-nCoV outbreaks is high; further global spread is likely; there is currently a moderate likelihood of infection for EU/EEA travellers visiting Wuhan; there is a high likelihood of case importation into countries with the greatest volume of people travelling to and from Wuhan (i.e. countries in Asia); there is a moderate likelihood of detecting cases imported into EU/EEA countries; adherence to appropriate infection prevention and control practices, particularly in healthcare settings in EU/EEA countries with direct links to Wuhan, means that the likelihood of a case reported in the EU resulting in secondary cases within the EU/EEA is low.” This is divergent from the
Jan 17
version which assessed the overall risk to be low.
INTERNATIONAL SCREENING MEASURES
- Australia - Australia will begin screening passengers arriving from Wuhan, although authorities warned that an outbreak would be hard to prevent.
- UK - Passengers on the direct Heathrow - Wuhan (3x weekly) will be screened upon arrival. PHE has also increased its risk assessment from “very low” to “low”.
- US - CDC officials said Tuesday that screening for nCoV would be expanded to include Chicago and Atlanta.
FINANCIAL IMPACT OF EPIDEMICS
Japan’s Nikkei 225 Index declined on yesterday’s coronavirus outbreak news, only to rebound in today’s trading. More broadly, markets have proved resilient during past infectious disease outbreaks. A 2006
study
by Fidelity International
concluded
: “We cannot draw any fixed conclusions about the effects of pandemics upon stock-market performance. Equity markets react unpredictably to the unknown; nevertheless, such events should not be examined in isolation, but viewed in common with other prevailing market conditions. In investment terms, it is hard to mitigate the effects of events such as pandemics or war.”
ADDITIONAL RESOURCES:
- For the latest case counts (unverified, but most frequently updated)
- For quick access to the latest province-level official situation reports
- Johns Hopkins University’s Center for Systems Science and Engineering has developed a GIS visualization tool for the 2019-nCoV outbreak.
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