The news cycle moves really fast, and can be difficult to keep up with. That’s why I decided to put together a timeline of COVID-19 (also called coronavirus). This blog post contains everything I could find about it from credible sources.

NOTE: This is what the world knew about coronavirus in January of 2020. Keep in mind that some things have changed as the world learned more about COVID-19.

December 19, 2019: Reuters reported “Chinese officials investigate cause of pneumonia outbreak in Wuhan”

Chinese health authorities said they are investigating 27 cases of viral pneumonia in the central city of Wuhan, after rumors on social media suggested the outbreak could be linked to Severe Acute Respiratory Syndrome (SARS).

Of the people infected, seven were in critical condition and 18 were in stable condition, the Wuhan Municipal Health Commission said on Tuesday and its Weibo social media account. The condition of two other patients had improved to the point where they would be discharged soon, it said.

“The cause of the disease is not clear,” the official People’s Daily newspaper said on Weibo, citing unnamed hospital officials. “We cannot confirm it is what’s being spread online, that it is SARS virus. Other severe pneumonia is more likely.”

All of the patients had been isolated and their close contacts are under medical observation, the Wuhan Municipal Health Commission said. An investigation and cleanup were under way at a seafood market in the city, which is expected to be connected with the cases, it said.

Initial laboratory tests showed that the cases were viral pneumonia. No obviously human-to-human transmission had been found and no medical staff had been infected, the commission said.

A team of experts from the National Health Commission is in Wuhan to carry out tests, state broadcaster CCTV said.

An official at Wuhan Central Hospital, where local media said some of the cases were being treated, declined to comment when contacted by Reuters.

In 2003, Chinese officials covered up a SARS outbreak for weeks before a growing death toll and rumors forced the government to reveal the epidemic, apologize and vow full candor in future outbreaks.

The disease, which emerged in southern China in late 2002, spread rapidly from south China to other cities and countries in 2003. More than 8,000 people were infected and 775 died.

December 31, 2019: The Guardian reported: The World Health Organization (WHO) is alerted by the Chinese authorities of a string pneumonia-like cases in Wuhan, a city of 11 million people. Patients are quarantined and work begins on identifying the origin of pneumonia.

December 31, 2019: The Guardian reported: The World Health Organization (WHO) is alerted by the Chinese authorities of a string of pneumonia-like cases in Wuhan, a city of 11 million people.

Patients are quarantined and work begins on identifying the origin of the pneumonia.

December 31: 2019: PolitiFact posted: China confirms existence of a new virus.


January 2020

January 1

January 1: The U.S. Centers for Disease Control and Prevention (CDC) described coronavirus and the source and spread of the virus:

Coronaviruses are a large family of viruses that are common in people and many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS-CoV, SARS-CoV, and now with this new virus (named SARS-CoV-2).

The SARS-CoV-2 virus is a betacoronavirus, like MERS-CoV and SARS-CoV. All three of these viruses have their origins in bats. The sequences from U.S. patients are similar to the one that China initially posted, suggesting a likely single, recent emergency of this virus from an animal reservoir.

Early on, many of the patients at the epicenter of the outbreak in Wuhan, Hubei Provence, China had some link to a large seafood and live animal market, suggesting animal-to-person spread. Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread. Person-to-person spread was subsequently reported outside Hubei and in countries outside China, including the United States. Some international destinations now have apparent community spread with the virus that causes COVID-19, as do some parts of the United States. Community spread means some people have been infected and it is not yet known how or where they became exposed….

The CDC noted there was no known vaccine to protect against COVID-19 and no medications approved to treat it. Nonpharmaceutical interventions would be the most important response strategy.

The CDC stated is implementing its pandemic preparedness and response plans, working on multiple fronts, including providing specific guidance on measures to prepare communities to respond to local spread of the virus that causes COVID-19. They were able to adapt pandemic guidance developed in anticipation of an influenza pandemic for a potential COVID-19 pandemic.


January 3

January 3: The Guardian reported: The US Centers for Disease Control and Prevention (CDC) identifies a seafood market suspected of being at the centre of the outbreak and it is closed down.

January 3: The Washington Post was the first to report (in March of 2020) that U.S. Intelligence reports warned President Donald Trump about coronavirus in January and February. That article is locked behind a paywall.

Vox posted an article on March 21, 2020, titled: “Intelligence reports warned about a pandemic in January. Trump reportedly ignored them.” It was written by Riley Beggin.

US intelligence officials reportedly warned President Donald Trump and Congress about the threats posed by the novel coronavirus beginning in early January – weeks before the White House and lawmakers began implementing stringent public health measures and as the president minimized the threat posed by the virus in his tweets and public statements.

The fact those warnings were largely disregarded – something first reported by the Washington Post’s Shane Harris, Greg Miller, Josh Dawsey, and Ellen Nakashima – suggests Trump administration officials failed to take action that could have prepared the health care system to handle an influx of patients, helped Americans avoid mass social distancing, and saved lives.

Top health officials first learned of the virus’s spread in China on January 3, US Health and Human Services Secretary said Friday. Throughout January and February, intelligence officials’ warnings became more and more urgent, according to The Post – and by early February, much of the Office of the Director of National Intelligence and the CIA’s intelligence reports were dedicated to warnings about Covid-19.

All the while, Trump downplayed the virus publicly, telling the public the coronavirus “is very well under control in our country,” and suggesting warm weather would neutralize the threat the virus poses.

Privately, Trump reportedly rebutted health and intelligence officials’ attempts to get him to take action to prepare communities in the US while rebuking officials who were delivering sober risk assessments…

January 3: World Health Organization Western Pacific Region posted a thread that began with this tweet:

“#China has reported to WHO regarding a cluster of pneumonia cases in Wuhan, Hubei Province. The Govt has also met with our country office, and updated @WHO on the situation. Govt actions to control the incident have been instituted and investigations into cause are ongoing. 1/3”

“We’re closely monitoring the situation in Wuhan & are in active communication with our counterparts in China. We’ve activated our incident management system across the 3 levels of @WHO (country office, regional office, HQ) & can launch a broader response, if needed. 2/3”

“#China has extensive capacity to respond to public health events and is responding proactively & rapidly to the current incident in Wuhan – isolation patients, tracing close contacts, cleaning up the market, and searching for the cause and additional cases. 3/3”

January 3: World Health Organization Western Pacific Region tweeted: “We’re closely monitoring the situation in Wuhan & are in active communication with our counterparts in China. We’ve activated our incident management system across the 3 levels of @WHO (country office, regional office, HQ), & can launch a broader response, if needed. 2/3”

January 3: World Health Organization Western Pacific Region tweeted: “#China has extensive capacity to respond to public health events and is responding proactively & rapidly to the current incident in Wuhan – isolating patients, tracing close contacts, cleaning up the market, and searching for the cause and for additional cases. 3/3”


January 5

January 5: The World Health Organization posted disease outbreak news titled: “Pneumonia of unknown cause – China” From the disease outbreak news:

On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia of unknown etiology (unknown causes) detected in Wuhan City, Hubei Province of China. As of 3 January 2020, a total of 44 patients with pneumonia of unknown etiology have been reported to WHO by the national authorities in China. Of the 44 cases reported, 11 are severely ill, while the remaining 33 patients are in stable condition. According to media reports, the concerned market in Wuhan was closed on 1 January 2020 for environmental sanitation and disinfection.

The causal agent has not yet been identified or confirmed. On 1 January 2020, WHO requested further information from national authorities to assess the risk.

National authorities report that all patients are isolated and receiving treatment in Wuhan medical institutions. The clinical signs and symptoms are mainly fever, with a few patients having difficulty in breathing, and chest radiographs showing invasive lesions of both lungs.

According to the authorities, some patients were operating dealers or vendors in the Huanan Seafood market. Based on the preliminary information from the Chinese Investigative team, no evidence of significant human-to-human transmission and no health care worker infections have been reported.

Public Health Response

National authorities have reported the following response measures:

  • One hundred and twenty-one close contacts have been identified and are under medical observation;
  • The follow-up of close contacts is ongoing;
  • Pathogen identification and the tracing of the cause are underway;
  • Wuhan Municipal Health Commission carried out active case finding, and retrospective investigations have been completed;
  • Environmental sanitation and further hygiene investigations are under way

WHO risk assessment

There is limited information to determine the overall risk of this reported cluster of pneumonia of unknown etiology. The reported link to a wholesale fish and live animal market could indicate an exposure link to animals. The symptoms reported among the patients are common to several respiratory diseases, and pneumonia is common in the winter season; however, the occurrence of 44 cases of pneumonia requiring hospitalization clustered in space and time should be handled prudently.

Wuhan city, with a population of 19 million, is the capital city of Hubei province, with a population of 58 million people. WHO has requested further information on the laboratory tests performed and the differential diagnoses considered.

WHO advice

Based on information provided by national authorities, WHO’s recommendations on public health measures and surveillance of influenza and severe acute respiratory infections still apply.

WHO does not recommend any specific measures for travellers. In case of symptoms suggestive of respiratory illness either during or after travel, travellers are encouraged to seek medical attention and share travel history with their healthcare provider.

WHO advises against the application of any travel or trade restrictions on China based on the current information available on this event.

January 5: World Health Organization (WHO) posted a thread of tweets:

“On 31 December 2019, WHO was informed of cases of #pneumonia of unknown cause in Wuhan City, #China. A total of 44 cases have been reported: 11 patients are severely ill, while the remaining 33 are in stable condition”. (The tweet included a link to the WHO website – posted above)

“The cause has not yet been identified or confirmed. WHO is closely monitoring the situation and is in close contact with national authorities in #China. #pneumonia”

“WHO’s recommendations on public health measures and surveillance of influenza and severe acute respiratory infections are unchanged. WHO does not recommend any specific measures for travelers, or any travel or trade restrictions. #China #pneumonia”

January 5: World Health Organization (WHO) posted a short thread of tweets:

“Chinese authorities informed WHO that they have ruled out a number of causes of the outbreak of #pneumonia in Wuhan City. [emoji of the Chinese flag]. The pathogen is not influenza, avian flu, adenovirus, SARS, or MERS. Work continues to identify the cause.”

“Chinese authorities updated the figures on the #pneumonuia of unknown cause in Wuhan. A total of 59 cases have been reported, of which 7 are severely ill. The earliest to fall ill was on 12 Dec, the latest on 29 Dec. Investigations continue to identify any other cases or contacts.”


January 8

January 8: World Health Organization Western Pacific Region tweeted a thread which started with:

“Chinese authorities have made a preliminary determination of the cause of the #pneumonia in Wuhan as a novel (new) #coronavirus. @WHO continues to monitor the situation closely and is ready to support #China to investigate and respond to this outbreak. (1/7).”

January 8: World Health Organization Western Pacific Region tweeted: “Preliminary identification of a novel virus in a short period of time is a notable achievement and demonstrates China’s increased capacity to manage new outbreaks. Chinese investigators conducted gene sequencing of the virus, using an isolate from 1 positive patient sample (2/7)”

January 8: World Health Organization Western Region tweeted: “Coronaviruses are a large family of viruses with some causing less-severe disease, such as the common cold, and others more severe disease such as MERS and SARS. Some transmit easily from person to person, while others don’t. (3/7)”

January 8: World Health Organization Western Region tweeted: “According to Chinese authorities, the virus in question can cause severe illness in some patients and does not transmit readily between people. (4/7)”

January 8: World Health Organization Western Region tweeted: “Globally, novel coronavirues emerge periodically in different areas, e.g. SARS in 2002 and MERS in 2012. Several known coronaviruses are circulating in animals that have not yet infected humans. As surveillance improves more coronaviruses are likely to be identified. (5/7)”

January 8: World Health Organization Western Region tweeted: “In the coming weeks, more comprehensive information is reqired to better understand the status and epidemiology of the outbreak, the clinical picture, the source, modes of transmission, extent of inflection and countermeasures. (6/7)”

January 8: World Health Organization Western Region tweeted: “@WHO does not recommend any specific measures for travellers. WHO advises against the application of any travel or trade restrictions on China based on the current information available (7/7).


January 9

January 9: The Guardian reported: The WHO says the outbreak in Wuhan was caused by a previously unknown type of coronavirus, a broad family ranging from the common cold to more serious illnesses like severe acute respiratory syndrome (Sars).

January 9: European Centre for Disease Prevention and Control posted a risk assessment post titled: “Pneumonia cases possibly associate with a novel coronavirus in Wuhan, China”. From the Executive Summary of that report:

Between 31 December and 2019 and 5 January 2020, 59 pneumonia cases possibly associated with a novel coronavirus have been reported in Wuhan, China with a common exposure link to Wuhan’s South China Seafood City market.

The cases showed symptoms such as fever, dyspnoea, and radiological tests compatible with bilateral lung infiltrative lesions. Seven severe cases have been reported, but no deaths. No cases have been reported outside of Wuhan. According to Chinese authorities, no human-to-human transmission could be documented.

Epidemiological investigations including contact tracing are ongoing and hygiene- and environmental sanitation activities in the affected market have been carried out in Wuhan.

Three EU airports have direct flight connections to Wuhan and there are indirect flight connections to other EU hubs. Considering there is no indication of human-to-human transmission and no cases detected outside of China, the likelihood of introduction to the EU is considered to be low, but cannot be excluded. However, more epidemiological and laboratory information is needed in order to elaborate a comprehensive assessment of this event and the possible risk for the international spread.

ECDC is monitoring this event through epidemic intelligence activities. For options for response and safety precautions, see EDCD’s threat assessment.

January 9: The World Health Organization (WHO) posted a statement titled: “WHO Statement regarding cluster of pneumonia cases on Wuhan, China.” From the statement:

Chinese authorities have made a preliminary determination of a novel (or new) cornavirus, identified a hospitalized person with pneumonia in Wuhan. Chinese investigators conducted gene sequencing of the virus, using an isolate from one positive patient sample. Preliminary identification of a novel virus in a short period of time is a notable achievement and demonstrates China’s increased capacity to manage new outbreaks.

Initial information about cases of pnemonia in Wuhan provided by Chinese authorities last week – including the occupation, location and symptom profile of the people affected – pointed to a coronavirus (CoV) as a possible pathogen causing this cluster. Chinese authorize subsequently reported that laboratory tests ruled out SARS-CoV, MERS-CoV, influenza, avian influenza, adenovirus and other common respiratory pathogens.

Coronaviruses are large family of virses with some causing less-severe disease, such as the common cold, and others more severe disease such as MERS and SARS. Some transmit easily from person to person, while others do not. According to Chinese authorities, the virus in question can cause severe illness in some patients and does not transmit readily between people.

Globally, novel coronaviruses emerge periodically in different areas, including SARS in 2002 and MERS in 2012. Several known coranaviruses are circulating in animals that have not yet infected humas. As survillance improves more coronaviruses are likely to be identified.

China has strong public health capacities and resources to report and manage respiratory disease outbreaks. In addition to treating the patients in care and isolating new cases as they may be indentified, public health officials remain focused on continued contact tracing, conducting environmental assessments at the seafood market, and investigations to identify the pathogen causing the outbreak.

In the coming weeks, more comprehensive information is required to understand the current status and epidemiology of the outbreak, and clinical picture. Further investigations are also required to determine the source, modes of transmission, extent of infection and countermeasures implemented. WHO continues to monitor the situatuon closely and, together and, together with its partners, is ready to provide technical support to China to investigate and respond to this outbreak.

The preliminary determination of a novel virus will assist authorities in other countries to conduct disease detection and response. Over the past week, people with symptoms of pneumonia and reported travel history to Wuhan have been identified at international airports.

WHO does not recommend any specific measures for travellers. WHO advises against the application of any travel or trade restrictions on China based on the information currently available.


January 10

January 10: Health Protection Scotland posted information titled: “Wuhan novel coronavirus and avian flu – advice for travelers”. From the advice:

HPS is aware of a reported outbreak of a novel coronavirus in China’s Wuhan City and is monitoring the situation with Public Health England (PHE) and international partners, including the World Health Organization.

The risk for the UK population is very low and the risk for travellers to Wuhan is low, but, ahead of the Chinese New Year this month, travellers are advised to take simple precautions such as practicing good hand, respiratory and personal hygiene, and minimize contact with birds and animals in markets in Wuhan as a further precaution.

If travellers returning from Wuhan become unwell within 14 days of their return, they should call their GP or NHS and report their recent travel…

January 10: World Health Organization South-East Asia posted a news release titled: “Novel Coronavirus in Wuhan, China”

Chinese authorities have reported the detection of a novel (or new) coronavirus, identified in a patient with pneumonia in Wuhan.

For more information, please visit WHO Statement Regarding Cluster of Pneumonia Cases in Wuhan, China.

In response, Thailand has implemented early screening at all international airports that receive flights from Wuhan. A small number of individuals with fever and respiratory symptoms on arrival have been referred for further clinical assessment and lab testing, with the full application of measures for infection prevention and control.

January 10: World Health Organization (WHO) posted “WHO advice for international travel and trade in relation to the outbreak of pneumonia caused by a new coronavirus in China”

On 31 December 2019, a cluster of pneumonia of unknown etiology was reported in Wuhan City, Hubei Province of China. On 9 January Chinese authorities reported in the media that the cause of this viral pneumonia was initially identified as a new type of coronavirus, which is different from any other human coronaviruses discovered so far. Coronaviruses are a large family of respiratory viruses that can cause diseases ranging from the common cold to the Middle-East Respiratory Syndrome and the Severe Acute Respiratory Syndrome (SARS).

The clinical signs and symptoms of the patients reported in this cluster are mainly fever, with a few patients having difficulty in breathing, and chest radiographs showing bilateral lung infiltrates. Some cases were operating dealers or vendors in Huanan Seafood Market. From the currently available information, preliminary investigation suggests that there is no significant human-to-human transmission, and no infections among health care workers have occurred. More information is required to better understand the mode of transmission and clinical manifestation of this new virus. The source of this virus is not yet known.

International travelers: practice usual precautions

While the cause of the pneumonia seems to be a novel coronavirus, transmission potential and modes of transmission remain unclear. Therefore, it would be prudent to reduce the general risk of acute respiratory infections while travelling in or from affected areas (currently Wuhan City) by:

  • avoiding close contact with people suffering from acute respiratory infections;
  • frequent hand-washing, especially after direct contact with ill people or their environment;
  • avoiding close contact with live or dead farm or wild animals;
  • travelers with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands.

Health practitioners and public health authorities should provide to travelers information to reduce the general risk of acute respiratory infections, via travel health clinics, travel agencies, conveyance operators, and at points of entry.

If a traveller on board of an aircraft/a ship has signs and symptoms indicative of acute respiratory infections, the model of Maritime declaration of health (Annex 8 of IHR) or the health part of the aircraft general declaration (Annex 9 IHR) can be used to register the health information onboard and submit to POE health authorities when required by a State Party.

A passenger locator form can be used in the event of a sick traveller detected on board a plane. This form is useful for collecting contact information for passengers and can be used for follow-up if necessary. Travelers should also be encouraged to self-report if they feel ill. The cabin crew should follow the operational procedures recommended by International Air Transport Association (IATA) with regard to managing suspected communicable disease on board an aircraft.

International traffic: no restrictions recommended

Wuhan city is a major domestic and international transport hub. Currently, there are no reports of cases outside Wuhan City. Given the heavy population movements, expected to significantly increase during the Chinese New Year in the last week of January, the risk of cases being reported from elsewhere is increased.

WHO does not recommend any specific health measures for travellers. It is generally considered that entry screening offers little benefit, while requiring considerable resources. In case of symptoms suggestive to respiratory illness before, during or after travel, the travelers are encouraged to seek medical attention and share travel history with their health care provider. WHO advises against the application of any travel or trade restrictions on China based on the information currently available on this event.

As provided by the International Health Regulations (2005) (IHR), countries should ensure that:

  • routine measures, rained staff, appropriate space and stockpile of adequate equipment in place at points of entry for assessing and managing ill travellers detected before travel, on board conveyances (such as planes and ships) and on arrival at points of entry:
  • procedures and means are in place for communicating information ill travellers between conveyances and points of entry as well as between points of entry and national health authorities;
  • safe transportation of symptomatic travellers to hospitals or designated facilities for clinical assessment and treatment is organized;
  • a functional public health emergency contingency plan at points of entry in place to respond to public health events.

January 10: CBC posted “Is Canada at risk from a mysterious virus from China related to SARS?”

For Canadians who remember face masks, quarantines and airport screenings of the SARS epidemic, a mysterious outbreak of pneumonia in China has likely caused the same family of viruses to be raising concern.

Since Dec. 12, 59 people have been reportedly identified and genetically sequenced the previously unknown virus from an infected patient in Wuhan and found remnants of it in 15 others, state-run media agency Xinhua announced Thursday.

The illness has been identified as a new coronavirus, a large family of viruses that can make the jump from animals to humans and range from the common cold to much more serious illnesses, such as SARS or MERS.

Chinese officials have traced the outbreak back to a seafood market in Wuhan, which was shut down and disinfected on Jan. 1. But it’s not yet known how it made a species jump from animals to humans, or if it is transmittable from person to person.

Diseases such as SARS and MERS, influenza and avian influenza have also reportedly been ruled out in tests. World Health Organization representative to China Dr. Gauden Galea said in a statement.

“According to Chinese authorities, the virus in question can cause severe illness in some patients and does not transmit readily between people,” he said.

“In the coming weeks, more comprehensive information is required to understand the current status and epidemiology of this outbreak, and the clinical picture.”

How does this outbreak compare to SARS?

Given the fact that both SARS and the Wuhan outbreak both originated in open-air markets that sold both live and dead animals, the similar origins if the viruses are hard to ignore.

“Certainly there are some parallels, if we’re thinking back to SARS,” said Dr. Kamran Khan, an infectious disease physician and scientist at St. Michael’s Hospital in Toronto.”

“We know that in today’s world, diseases spread incredibly quickly and we don’t actually even know what this is just yet.”

More than 400 Canadians were diagnosed with SARS and 44 died as a result of the 2002-2003 epidemic that killed 774 worldwide. So the current outbreak is something health officials who lived through it are watching closely.

“I think given when it presented, how it presented, it certainly did raise eyebrows and serious concerns,” Dr. Marjorie Pollack, deputy editor of the Program for Monitoring Emerging Diseases (ProMED), said of the current outbreak.

“People who want to be sensationalist and want to blame are throwing stones at China, saying they’re not being transparent enough… They are being transparent with what they know. They’re not being transparent for speculations.”

Information was hard to come by in the early days of the SARS epidemic, too, and health officials in Canada were caught off guard when the virus was confirmed to have landed in Toronto in March 2003.

“This went on for months before, really, the world kind of knew what was happening. And it really started to build up quite a bit of momentum before it started to disperse in different parts of the world,” Khan said.

“We’re getting this information, certainly easier [in this outbreak] … but I still take all of the information as being preliminary at this point.”

For its part, WHO said in a statement that the identification of a new coronavirus in a short period of time is a “notable achievement” that “demonstrates China’s increased capacity to manage new outbreaks.”

Dr. Allison McGeer, an infectious diseases specialist at Mount Sinai Hospital in Toronto, who herself was diagnosed with SARS in 2003, said she’s encouraged by the amount of information released by China so far.

“The fact that we know about it, that we’re talking about it, this is a marker of just how much better things are,” she said.

“A challenge with SARS was when it started, we didn’t know anything about it.”

Could Canada be at risk?

The Public Health Agency of Canada recently updated its website, warning travelers to Wuhan to avoid contact with animals and to report any symptoms to health-care workers.

But assessing the level if risk in Canada for an outbreak like this is largely based on two key factors; whether the virus will spread from person to person and whether health-care workers will be affected on the front lines.

“In the last 15 years, the volume of people travelling through commercial flights has doubled. We’ve become vectors that are moving these diseases very, very, rapidly around the world,” said Khan, who is also the founder and CEO of the company BlueDot, which uses various types of data to study how infectious diseases spread around the world.

“We are not there yet. We are still moving too slow. If we want to get in front of these threats, we are literally going to have to spend knowledge faster than the diseases themselves. And they move quick.”

His data shows that all of the travelers projected to depart from Wuhan on commercial flights from January to March of this year, 4,000 of them are headed to Canada — and the majority to cities such as Toronto and Vancouver.

“Thirty years ago, when somebody turned up in the emergency department in hospital, you didn’t have to worry about where they’d been because air travel was much less common,” said McGeer.

“Now when somebody turns up in your emergency department, they could have been anywhere four days ago. And so SARS was us catching up with the globalization of humans.”

McGeer says that while she can’t guarantee there would be no risk of transmission of a virus like this in Canada if it were to spread overseas, she’s confident health-care workers could do a better job of containing it than they did with SARS.

It can be hard to recognize new viruses early on, she added, which is why airports in Hong Kong, Singapore, and cities around Wuhan will likely be screening travellers in the meantime.”

But a comprehensive 234-page report into the outbreak of SARS in Canada, released by Dr. David Naylor in October 2003 found WHO-ordered airport screening to be completely ineffective.

More than 6.5 million travelers were screened at Canadian airports for SARS by August 2003, with 9,100 passengers isolated for further assessment by nurses or quarantine officers. None had SARS.

A thermal scanner project was also piloted, with 2.4 million passengers screened and 832 requiring further assessment. None of them were found to have SARS either.

So it’s likely not a virus that will be easily detected until health-care workers can test for it based on its genetic sequencing.

“If somebody comes from Wuhan with pneumonia, and we don’t know they came from Wuhan, we’re not looking for it. And if it happens to be transmissible, we’re not going to make the diagnosis,” McGeer said. “So until we have a test for it, it can be very difficult.”

Khan thinks that even with the technological innovations in health care since SARS, the biggest risk related to an outbreak spreading to Canada is the fact that we’re far too “reactive”.

“We spring into action with incredible vigour during an emergency, but then forget about the emergency almost immediately after it’s over,” he said.

“The current events in Wuhan are a reminder about what happened in Toronto and around the world 17 years ago, and are foreshadowing what we will no doubt face again. Will we pay attention, and if so, for how long?


January 11

January 11: The Guardian reported: The Chinese health authorities report the first fatality as a 61-year-old man dies from pneumonia in Wuhan. They revise downwards the number of sick people to 41.

January 11: The World Health Organization (WHO) posted disease outbreak news titled: “Novel Coronavirus – China”. From the news:

On 11 and 12 January 2020, WHO recieved further detailed information from the National Health Commission about the outbreak.

WHO is reassured of the quality of the ongoing investigations and the response measures implemented in Wuhan, and the committment to share information regularly.

The evidence is highly suggestive that the outbreak is associated with exposures in one seafood market in Wuhan. The market was closed on 1 January 2020. At this stage, there is no infection among healthcare workers, and no clear evidence of human to human transmission. The Chinese authorities continue their work of intensive surveilance and follow up measures, as well as further epidemiological investigations.

Among the 41 confirmed cases, there has been one death. This death occurred in a patient with serious underlying medical conditions.

China shared the genetic sequence of the novel coronavirus on 12 January, which will be of great importance for other countries to use in developing specific diagnostic kits.

The cluster was initially reported on 31 December 2019, when the WHO China Country Office was informed. The Chinese authorities identified a new type of coronavirus (novel coronavirus, nCoV), which was isolated on 7 January 2020. Laboratory testing was conducted on all suspected cases identified through active case finding and retrospective review. Other respiratory pathogens such as influenza, avian influenza, adenovirus, Severe Acute Respiratory Syndrome coronavirus (SARS-CoV), Middle East Respiratory Syndrome coronavirus (MERS-CoV) were ruled out as the cause.

According to information conveyed to WHO by Chinese authorities on 11 and 12 January, 41 cases with novel coronavirus infection have been preliminarily diagnosed in Wuhan City. Of the 41 cases reported, seven are severely ill. This is when the one death, mentioned above, was reported, in a patient with other underlying health conditions. Six patients have been discharged from hospital. Symptom onset of the 41 confirmed nCoV cases ranges from 8 December 2019 to 2 January 2020. No additional cases have been detected since 3 January 2020.

he clinical signs and symptoms reported are mainly fever, with a few cases having difficulty in breathing, and chest radiographs showing invasive pneumonic infiltrates in both lungs. National authorities report that patients have been isolated and are receiving treatment in Wuhan medical institutions.

According to the preliminary epidemiological investigation, most cases worked at or were handlers and frequent visitors to the Huanan Seafood Wholesale Market. The government reports that there is no clear evidence that the virus passes easily from person to person.

Currently, no case with infection of this novel coronavirus has been reported elsewhere other than Wuhan.


January 13

January 13: The World Health Organization (WHO) announced it is working with officials in Thailand and China following reports of confirmation of the novel coronavirus in a person in Thailand. The person was a traveler from Wuhan, China, and was identified by Thai officials on January 8, 2020, and hospitalized that day.

January 13: The Guardian reported: The virus spreads beyond China’s borders for the first time with a case emerging in Thailand, according to the WHO, the victim is a Chinese woman diagnosed with mild pneumonia who was returning from a trip to Wuhan.

January 13: The World Health Organization (WHO) posted “WHO statement on novel coronavirus in Thailand”. From the statement:

WHO is working with officials in Thailand and China following reports of confirmation of the novel coronavirus in person in Thailand.

The person was a traveler from Wuhan, China, and was identified by Thai officials 8 January, and hospitalized that day. The person is recovering from the illness according to Thai officials.

The possibility of cases being identified in other countries was not unexpected, and reinforces why WHO calls for on-going active monitoring and preparedness in other countries. WHO has issued guidance on how to detect and treat persons ill with the new virus.

The genetic sequencing shared by China enables more countries to rapidly diagnose patients.

WHO reiterates that it is essential that investigations continue in China to identify the source of this outbreak and any animal reservoirs or intermediate hosts.

Given developments, WHO Director-General Dr Tedros Adhanom Ghebreyesus will consult with Emergency Committee members and could call for a meeting of the committee on short notice.

January 13: World Health Organization South-East Asia posted a news release titled: “Thailand responding to the novel coronavirus”. From the news release:

Current situation:

On January 13, 2020, The Ministry of Public Health of Thailand reported an imported case of infection caused by the novel coronavirus recently identified in Wuhan, China. The concerned individual is a Chinese national who was found to have fever on arrival at Suvarnbhumi airport on 8th January. A clinical diagnosis of mild pneumonia was made after referral to a government hospital. Laboratory testing subsequently confirmed that the novel coronavirus was the cause.

WHO acknowledges the capacity of Thailand’s laboratories to do the complex genetic analysis to confirm the diagnosis.

Background:

Since early December, a number of cases of pneumonia have been detected in persons from Wuhan city in China. Chinese authorities identified a new coronavirus as the agent causing these changes.

Coronaviruses are common – many cause less severe illness such as the common cold; other are known to cause more severe illness (SARS and Middle East Respiratory Syndrome, MERS). Chinese scientists have sequenced and made available the genetic material of this virus – a remarkable achievement in such a short time. This will be critical to helping public health authorities around the world understand this illness and track it.

The way these patients became infected is not yet known. To date, there has been no suggestion of human-to-human transmission of this new coronavirus. There have been no infections reported among health care workers, which can be an early indicator of person to person spread.

At present, WHO does not recommend any specific health measures for travelers in relation to this event. WHO advises against the application of any travel or trade restrictions on China based on the information available. If travelers develop respiratory illness before, during or after travel, they should seek medical attention and share travel history with their health care provider.

The World Health Organization is working with Thailand and other countries to track further infections caused by this new coronavirus and to ensure that they are prevented and controlled. This includes,

  • Providing all countries with a technical package of interim guidance, including: Common case definitions to ensure patients are identified quickly; Information on laboratory methodologies to identify this and other respiratory viruses; Guidance on how to protect health care workers and others; Guidance on clinical management is being quickly reviewed by global experts and will be shared once available.
  • Facilitating information sharing on this and other relevant health events between countries.
  • In the longer term, using the International Health Regulations to develop and strengthen capacities of countries to detect and respond to infections like the new coronavirus.

January 14

January 14: The U.S. Center for Disease Control and Prevention (CDC) reported the onset of 2 additional COVID-19 cases in the United States.

January 14: The U.S. Center for Disease Control and Prevention (CDC) tweeted:

“CDC continues to monitor this ongoing investigation to learn more about this rapidly evolving outbreak #coronavirus. #2019-nCoV” The tweet included a link to the CDC’s information about coronavirus.

January 14: Health Protection Scotland posted a report titled: “Outbreak of pneumonia in Wuhan City, Hubei, China”. From the report:

An outbreak of pneumonia in Wuhan City, Hubei Province, China, has been linked to a newly-discovered coronavirus.

As of 12 January 2020, there have been 41 confirmed cases and one death. The death occurred in a patient with serious underlying medical conditions.

Coronaviruses are a well-recognized cause of human illnesses that range from mild to severe. This outbreak has been linked to possible exposure to infection at the South China Seafood City market in Wuhan. No cases have been confirmed outside the city.

While the risk to UK travellers to Wuhan is currently considered low, because of this general ongoing risk of avian flu in China, travellers are advised to take simple precautions such as practicing good hand, personal and respiratory hygiene, and to minimize contact with birds and animals in markets in Wuhan or elsewhere in China.

If travellers returning from Wuhan or elsewhere in China become unwell within 14 days of their return to the UK, particularly with respiratory symptoms, they should call their GP or NHS 111 and report their recent travel details.

Further information and travel advice can be found on the UK Government website. The European Centre for Disease Prevention and Control (EDCC) has also published a rapid risk assessment on the outbreak.

Further information on travel to China can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

January 14: World Health Organization (WHO) tweeted: “Preliminary investigations conducted by Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus (2019-nCoV) identified in Wuhan, #China”

January 14: European Centre for Disease Prevention and Control posted information titled: “Update: Cluster of pneumonia cases associated with novel coronavirus – Wuhan, China – 2019”. From the information:

As of 13th of January 2020, 59 probable cases of pneumonia associated with a novel coronavirus have been reported in Wuhan City, China. Most cases had an epidemiological link to a Seafood City market (a wholesale market for seafood and live animals). Among the 59 probable cases, 41 tested positive for the novel coronavirus of which seven cases have been discharged from the hospital, six are being treated and remain in severe condition and one case died. The cases showed symptoms such as fever, dyspnoea, and radiological features of bilateral pneumonia. Overall, 763 close contacts have been identified and are being monitored. So far, none of them tested positive for the novel coronavirus.

The onset of symptoms ranged from 8 December 2019 to 2 January 2020. No human-to-human transmission could be documented so far and no cases among health care workers have been reported. Contact tracing activities and applied hygiene and environmental sanitation activities in Wuhan are ongoing and the implicated market was closed to the public on 1 January 2020.

On 11 January 2020, the Wuhan Municipal Health Commission provided an update on the current status of the outbreak, confirming a novel coronavirus as the causative agent of 41 pneumonia cases. Preliminary results from the whole genome sequencing shows that this case has similarity with the SARS coronavirus. Further genetic analyses are ongoing.

According to the authorities, the first death among the confirmed cases occurred on the 9th of January. This case was a 61-year-old male with severe underlying conditions.

Due to enhanced surveillance and entry screening at transport hubs, suspect cases with pneumonia and recent travel history to Wuhan, China, are being detected in Hong Kong, Macau, Singapore, South Korea, and Taiwan. So far, all suspect cases have been discarded after epidemiological and laboratory investigations.

An update published by Wuhan authorities on the 12th of January, confirmed that there were no new cases of novel coronavirus pneumonia detected in Wuhan.

Confirmed imported case in Thailand

On the 13th of January, Thai authorities reported a confirmed imported novel coronavirus case in Thailand. The case is a tourist coming from Wuhan and was placed under isolation at Bamrasnarudura Institute of infectious disease in Bangkok. No further epidemiological and clinical information on this case are currently available to ECDC.

Neighboring territories such as Hong Kong, Malaysia, Myanmar, the Philippines, Singapore, Taiwan, Thailand, Russia and Vietnam implemented entry screening activities to all incoming travellers from Wuhan in their transport hubs such as airports and train stations.

The airport of Wuhan has direct flight connections with some EU cities: Paris (France) with six weekly flights, London (the United Kingdom) with three weekly flights and Rome (Italy) with five weekly flights. Health authorities in the concerned EU/EEA Member States remain vigilant and closely monitor the ongoing situation in China.

ECDC is not aware of any implementation of exit screening in Wuhan international airport.

ECDC is monitoring this event through epidemic intelligence activities, and published a threat assessment brief “Pneumonia cases possibly associated with a novel coronavirus in Wuhan, China” on 9 January 2020. ECDC has also published a “Health emergency preparedness checklist for imported cases of high-consequence infectious diseases.”


January 15

January 15: The Guardian reported: China’s health commission says it cannot confirm human-to-human transmission of the virus but the possibility “cannot be excluded”. The next day a first case of the virus is confirmed in Japan in someone who had stayed in Wuhan in early January.

January 15: World Health Organization Western Pacific posted a thread of tweets that started with this tweet:

“Japan has reported 2019-nCOV in a man in his 30s in Japan who travelled to Wuhan. Japanese offcials report that he did not visit the Huanan seafood market which has been linked to many of the people with #nCov in Wuhan. The patient has been discharged from hospital in Japan.

World Health Organization Western Pacific tweeted: “It is not surprising that there are cases outside of China, and it is possible that there will be cases in other countries in the future. @WHO encourages all countries to continue preparedness activities. We have issued interim guidance on how to do this.”

World Health Organization Western Pacific tweeted: “According to the latest information we have, there is no clear evidence of sustained human-to-human transmission and there are no infections reported among health care workers.”

World Health Organization Western Pacific tweeted: “The fact that some cases do not seem to be linked with the Huanan seafood market means we cannot exclude the possibility of limited human-to-human transmission”.

World Health Organization Western Pacific tweeted: “We are still in the early stages of understanding this new virus, where it came from, and how it affects people. There is still many unknowns, and the situation may continue to evolve.”

World Health Organization Western Pacific tweeted: “Good progress is being made. @WHO is working closely with officials in China, Japan and Thailand regarding the novel coronavirus.”

World Health Organization Western Pacific tweeted: “Travel advice was posted by @WHO on 10 January. Based on currently available information, WHO does not recommend any restriction of travel or trade.” This was the last tweet in the thread.

January 15: CBC reported: “Japan confirms 1st case of mysterious pneumonia linked to China”

Japan confirmed the first case of infection from the new China coronavirus that has killed one person and prompted a travel alert from the U.S. State Department.

A man in his 30’s from Kanagawa prefecture, next to Tokyo, tested positive, Japan’s health ministry said in a statement on Thursday. The man had been to the Chinese City of Wuhan, where there has been an outbreak of pneumonia believed to be caused by the new coronavirus strain, it said.

The U.S. State Department issued a health alert update on Wednesday about travel to the Wuhan region. It referenced an alert by the U.S. Centers for Disease Control and Prevention urging citizens travelling in the region to avoid contact with animals, animal markets, or animal products, among other precautions.

Thai health authorities said on Wednesday they were stepping up monitoring of passengers arriving at airports ahead of the Lunar New Year holiday, when 800,000 Chinese tourists are expected to visit the country.

The World Health Organization has said the new virus could spread quickly and has warned hospitals worldwide.

Coronaviruses are a large family of viruses that cause infections ranging from the common cold to Severe Acute Respiratory Syndrome (SARS). Some of the virus types cause less serious disease, while some — like the one that causes Middle East Respiratory Syndrome (MERS) — are far more severe.

Memories remain fresh in Asia of a 2002-2003 outbreak of SARS, which emerged in China and killed nearly 800 people worldwide.

The World Health Organization has said there may have been limited human-to-human transmission of the new coronavirus in China within families.

The Japanese patient returned from Wuhan this month with a fever and was hospitalized. He was released yesterday after the symptoms subsided, according to the health ministry statement.


January 16

January 16: The U.S. Centers for Disease Control and Prevention (CDC) reported the onset of 1 additional COVID-19 case in the United States.

January 16: Nippon.com (News from Japan) posted an article titled: “Wuhan-Linked Pneumonia Confirmed in Japan for First Time”. From the article:

The first case in Japan of mysterious viral pneumonia, which sickened many people in the Chinese city of Wuhan, has been confirmed, Japanese government sources said on Thursday.

A man in his 30s in Kangawa Prefecture, south of Tokyo, has tested positive for the same strain of coronavirus that caused a pneumonia outbreak in Wuhan, according to the health ministry.

The man is believed to have been infected with the virus in the Chinese city, the sources said.

January 16: SCMP reported: “Wuhan pneumonia: China steps up efforts to control spread of coronavirus”

Chinese authorities have stepped up their efforts to prevent the spread of a respiratory disease linked to a newly discovered coronavirus, as reports suggest the virus has spread to neighboring countries.

Since Wednesday, passengers at Tianhe International Airport in Wuhan – the central Chinese city where the outbreak began — have been required to pass through electronic temperature sensors at each of its exits. Any that are found to have a body temperature of more than 38 degrees Celsius (100 degrees Fahrenheit) are then required to undergo a manual chick and if the high temperature is confirmed, spend a period of time in a quarantine facility.

An internal notice by the airport, which was shared on social media, advised airlines to refund passengers or allow them to change their tickets if they were affected by new checks.

Meanwhile, authorities in Wuhan, which has recorded 41 infections and one fatality, said they had also installed body temperature sensors at three key railway stations in the city.

The new measures come as Japan’s health ministry confirmed on Thursday that a Chinese man living in Kanawaga prefecture, just south of Tokyo, had contracted the virus.

Aged in his 30’s, the man is said to have traveled to Wuhan earlier in the month, where he developed a fever. On his return to Japan, he was admitted to the hospital with pneumonia but was later discharged five days later when his condition improved.

The case is the second to be confirmed outside China, after Thai authorities reported on Monday that a woman from Wuhan was receiving treatment in a hospital in Nonthaburi, just north of Bangkok. She was admitted to hospital three days after developing a fever, sore throat, and a headache.

Meanwhile, Vietnam’s health ministry said on Thursday that two Chinese tourists – a 22-year-old man and a three-year-old by – had been placed in isolation after showing fever-like symptoms on their arrival in the country.

Blood samples from the two patients, who flew into Da Nag on Tuesday as part of the same tour group, were being tested to determine the cause of the fever, it said.

While Chinese officials have found no clear evidence to suggest human-to-human transmission of the virus, it has also not been ruled out.

According to the World Health Organization (WHO), Japanese officials reported that although the infected man in Kanagawa had travelled to Wuhan, he had not visited the Huanan seafood market, which is thought to be the epicenter of the outbreak.

The market also sold live animals such as poultry, bats and marmots, along with wildlife parts, prompting concerns that the infectious respiratory pathogen emerged from an as-yet-unidentified animal reservoir.

The outbreak has also raised concerns that the coronavirus could spread from Wuhan, a major transport hub, to other cities during the Lunar New Year travel season, which is now underway.

The virus has captured world-wide attention because of similarities with the one that caused the 2002-02 outbreak of severe acute respiratory syndrome, which infected more than 8,000 people globally and killed more than 600 in mainland China and Hong Kong.

Other Asian countries have raised the alert with stricter checks on passengers at airports and other transit points since the outbreak, which was identified on January 9 as a new strain of coronavirus, since named 2019-nCoV by the WHO.

On Thursday, the WHO said it was working closely with officials in China, Japan, and Thailand, and encouraged all countries be vigilant.

“It is not surprising that there are cases outside of the People’s Republic of China and it is possible that there will be cases in other countries in the future,” a WHO spokeswoman said.

On Wednesday, the US state department issued a health alert about Wuhan, urging people travelling in the region to avoid contact with animals, animal markets or animal products, among other precautions.

On Thursday, officials from the Centre for Disease Control in Taiwan said they had put Wuhan on a higher level of travel alert as health authorities in the mainland city had been unable to rule out the possibility of human transmission.

Meanwhile, Hong Kong’s Centre for Health Protection said that as well as reporting cases of people suspected of developing respiratory symptoms after visiting Wuhan, medical workers should flag up patients who had visited a hospital in mainland China or had close contact with someone confirmed to have been infected with the new virus.


January 17

January 17: The Guardian reported: A second person, a 69-year-old-man, dies in Wuhan, according to authorities. That same day, the CDC announces that it will begin screening passengers arriving from Wuhan at three airports: San Francisco, New York’s JFK and Los Angeles (LAX) airports.

January 17: World Health Organization posted News titled: “Lack of new antibiotics threatens global efforts to contain drug-resistant infections”. From the News:

Declining private investment and lack of innovation in the development of new antibiotics are undermining efforts to combat drug-resistant infection, says the World Health Center Organization (WHO).

Two new reports reveal a weak pipeline for antibiotic agents. The 60 products in development (50 antibiotics and 10 biologics) bring little benefit over existing treatments and very few target the most critical resistant bacteria (Gram-negative bacteria).

While pre-clinical candidates (those in early-stage testing) are more innovative, it will take years before they reach patients.

“Never has the threat of antimicrobial resistant been more immediate and the need for solutions more urgent,” says Dr Tedros Adhanom Ghebeyesus, Director of WHO. “Numerous initiatives are underway tp reduce resistance, but we also need countries and the pharmaceutical industry to step up and contribute with sustainable funding and innovative new medicines.”

The reports (Antibacterial agent in clinical development – an analysis of the antibacterial clinical development pipeline and its companion publication, Antibacterial agents in preclinical development) also found that research and development for antibiotics is primarily driven by small- or medium-sized enterprises with large pharmaceutical companies continuing to exit the field.

Clinical development review

WHO in 2017 published the priority pathogens list, 12 classes of bacteria plus tuberculosis that are posing increasing risk to human health because they are resistant to most existing treatments. The list was developed by a WHO-led group of independent experts to encourage the medical research community to develop innovative treatments for these resistant bacteria.

Of the 50 antibiotics in the pipeline, 32 target WHO priority pathogens but the majority have only limited benefits when compared to existing antibiotics. Two of these are active against the multi-drug resistant Gram-negative bacteria, which are spreading rapidly and require urgent solutions.

Gram-negative bacteria, such as Klebsiella pneumoniae and Escherichia coli, can cause severe and often deadly infections that pose a particular threat for people with weak or not yet fully developed immune systems, including newborns, aging populations, people undergoing surgery and cancer treatment.

The report highlights a worrying gap in activity against the highly resistant NDM-1 (New Delhi metallo-beta-lactamase 1), with only three antibiotics in the pipeline. NDM-1 makes bacteria resistant to a broad range of antibiotics, including those from the carbapenem family, which today are the last line of defense against antibiotic resistant bacterial infections.

“It’s important to focus public and private investment on the development of treatments that are effective against the highly resistant bacteria because we are running out of options,” says Hanan Balky, WHO Assistant Director-General for Antimicrobal Resistance. “And we need to ensure that once we have these new treatments, they will be available to all who need them.”

On a more positive note, the pipeline for antibacterial agents to treat tuberculosis and Clostridium difficile (which causes diarrhea) is more promising, with more than half of the treatments fulfilling all the innovation criteria defined by WHO.

Preclinical development review:

The pre-clinical pipeline shows more innovation and diversity, with 252 agents being developed to treat WHO priority pathogens.

However, these products are in the very early stages of development and still need to be proven effective and safe. The optimistic scenario, the report indicates, is for the first two to five products to become available in about 10 years.

WHO on AMR

New treatment alone will not be sufficient to combat the threat of antimicrobial resistance. WHO works with countries and partners to improve infection prevention and control and to foster appropriate use of existing and future antibiotics.

In the area of research and development, WHO and the Drugs for Neglected Diseases Initiative (DNDi) have established the Global Antibiotic Research and Development Partnership (GARDP), a non-profit research and development organization accelerating the development of new and improved antibiotics to tackle drug-resistant infections. GARDP’s strategy is to deliver five new treatments by 2025. GARDP is working with more than 50 public and private sector partners in 20 countries to develop and ensure sustainable access to treatments, promoting responsible use and affordability to all in need.

January 17: Centers for Disease Control and Prevention posted: “Public Health Screening to Begin at 3 U.S. Airports for 2019 Novel Coronavirus (“2019-nCoV”)

The Centers for Disease Control and Prevention (CDC) and the Department of Homeland Security’s Customs and Border Protection (CBP) will implement enhanced health screenings to detect ill travelers traveling to the United States on direct or connecting flights from Wuhan, China. This activity is in response to an outbreak in China caused by a novel (new) coronavirus (2019 nCoV), with exported cases to Thailand and Japan.

Starting January 17, 2020, travelers from Wuhan to the United States will undergo entry screening for symptoms associated with 2019-nCoV at three U.S. airports that receive most of the travelers from Wuhan, China: San Francisco (SFO), New York (JFK), and Los Angeles (LAX) airports.

“To further protect the health of the American public during the emergency of this novel coronavirus, CDC is beginning entry screening at three ports of entry. Investigations into this novel coronavirus are ongoing and we are monitoring and responding to this evolving situation,” said Martin Cetron, M.D., Director of CDC’s Division of Global Migration and Quarantine.

Based on current information, the risk from 2019-nCoV to the American public is currently deemed to be low. Nevertheless, CDC is taking proactive preparedness precautions.

Entry screening is part of a layered approach used with other public measures already in place to detect arriving travelers who are sick (such as detection and reporting of ill travelers by airlines during travel and referral of ill travelers arriving at a US port of entry by CBP) to slow and reduce the spread of any disease into the United States.

CDC is deploying about 100 additional staff to the three airports (SFO, JFK, and LAX) to supplement existing staff at CDC quarantine stations located at those airports.

CDC is actively monitoring this situation for pertinent information about the source of outbreak, and risk for further spread through person-to-person or animal-to-animal transmission. CDC continues and more is learned about the newly emerging virus but is an important public health tool during periods of uncertainty and part of a multilayered government response strategy. As new information emerges, CDC will reassess entry screening measures and could scale activities up or down accordingly.

On January 11, 2020, CDC updated a Level 1 Travel Health Notice (“practice usual precautions”) for travelers to Wuhan City and an updated Health Alert to health care professionals and public health partners with new and updated guidance is forthcoming.

China health officials report that most of the patients infected with 2019-nCoV have had exposure to a large market where live animals were present, suggesting this is a novel virus that has jumped the species barrier to infect people. Chinese authorities additionally report that several hundred health care workers caring for outbreak patients are being monitored and no spread of this virus from patients to health care workers has been seen. They report no sustained spread of this virus in the community, however there are indications that some limited person-to-person spread may have occured. CDC is responding to this outbreak out of an abundance of caution, ready to detect people infected with 2019-CoV.

January 17: European Centre for Disease Prevention and Control posted information titled: “Rapid Risk Assessment: Cluster of pneumonia cases caused by a novel coronavirus, Wuhan, China, 2020”. From the Executive Summary of the information:

A novel coronavirus (2019-nCoV) has been isolated and considered the causative agent of the cluster of 41 pneumonia case in the area of Wuhan, Hubei province in China, and three travel-related cases in Thailand and Japan, arriving from Wuhan.

The majority of detected pneumonia cases reported having visited the Wuhan Huanan Seafood Wholesale Market recently before disease onset. For a few cases there was no direct connection with a food market. The Wuhan Huanan Seafood Wholesale Market has been closed and disinfected. However, there is no information available on restrictions at any other food markets in Wuhan. If the sources of the infections are indeed certain animals sold in the market, other markets in the city may continue to pose a risk of infection. At the moment, there is no information on the source of infection or the transition mode. The occurrence of a few cases having no history of contact with the implicated market or other any similar market suggests the possibility of the infection source being even more widely distributed.

As of 16 January 2020, there is no clear indication of sustained human-to-human transmission. The report of two small family clusters in Wuhan and the exposure history of the imported Japanese case (history of contact with a person with an acute, not laboratory confirmed, respiratory infection in Wuhan), suggest the person-to-person transmission may have occurred. In the absence of detailed information from the ongoing studies in China, it is impossible to quantify the potential of the 2019-nCoV for human-to-human transmission.

The clinical information on confirmed 2019-nCoV cases reported so far suggests a milder disease course than that observed in SARS-CoV and MERS-CoV cases. However, in the absence of results from ongoing epidemiological investigations, it is impossible to assess whether there are population groups at higher risk of severe illness.

January 17: Centers for Disease Control and Prevention (CDC) posted a press briefing transcript titled: “Transcript of 2019 Novel Coronavirus Response Telebriefing”. From the transcript:

Operator: Good afternoon, and thank you for standing by, as a reminder, today’s conference is being recorded, if you have any objections, you can disconnect at this time. Your lines are in a listen only mode until the question and answer session of today’s conference. At that time, you may press star followed by the number one to ask a question. Please unmute your phones and state your name when prompted. It is now my pleasure to turn the conference over to Benjamin Haynes. Thank you, you may go ahead,

Ben Haynes: Thank you, Michelle, and thank you all for joining us for today’s telebriefing regarding the 2019 Novel Coronavirus and the proactive action the CDC is taking.  We’re joined today by Dr. Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases, and Dr. Marty Cetron, director of CDC’s Division of Global Migration and Quarantine. Drs. Messonnier and Cetron will provide opening remarks before taking your questions.  I would now like to turn the call over to Dr. Messonnier.

Nancy Messonnier: Great. Good afternoon and thank you for the opportunity to provide you with an update regarding the outbreak of pneumonia in Wuhan City, China, which has been identified as being caused by a novel coronavirus.  This is a serious situation.  We have faced this challenge before first with SARS and later with MERS.  Both outbreaks were complex and required a comprehensive public health response.  Because of that experience, we know it’s crucial to be proactive and prepared.  Frist, outbreaks of new diseases among people are always a public health concern.  Second, while the discovery of a new virus can be exciting, we are still learning about it.  This means our recommendations will continue to evolve as we learn more about the virus.  Since the outbreaks of MERS and SARS, we have made improved in our capacity in the United States and around the world.  We’re now better poised to respond to this new threat quickly and collaboratively.  Based on the information that CDC has today, we believe the current risk from this virus to the general public is low.  For a family sitting around the dinner table tonight this is not something that they generally need to worry about.

Now I would like to provide you with the most current information we have. Please know that we are still early in this response and the situation is still evolving hour by hour and day by day.

On December 30th, China reported an outbreak of respiratory disease in Wuhan City, it’s a major transportation hub about 700 miles south of Beijing with the population of more than 11 million people. An investigation led by local officials identified a new coronavirus as the cause of the outbreak. Coronaviruses are a large family of viruses, some causing illness in people, and others that circulate among animal, including camels, cats, and bats. Rarely animal coronaviruses can evolve and infect people and then spread between people.

This was the case with MERS and SARS. There have been a lot of developments in this outbreak over the last few days, and I want to share what we know based on the latest public health reports. Regarding the source, most of the patients in the outbreak have reportedly had some link to a large seafood and live animal market which does suggest animal to human spread. The market was closed early this month for disinfection and cleaning.

In terms of severity, China has reported 45 cases to date. The most recent four cases were just reported within the past hour or two. And there have been two deaths. Those patients who died were older adults. And one of the two patients had known serious underlying medical conditions. Some patients have been described as being seriously ill, while others have recovered and been discharged from the hospital. As relates to the spread of the virus, we’re still learning more. While most of these infections seem to be happening from animals to people, there is some indication that limited person-to-person spread is happening, including outside of Asia. Just this week, three cases outside of China have been identified, two in Thailand, one in Japan, all in travelers from Wuhan.

Now I’d like to talk a little bit about what CDC has been doing.  Last week we established an incident management structure to coordinate our response.  We’re monitoring the international situation with our teams on the ground in China, Thailand, and Japan as well as working closely with colleagues at the World Health Organization.  We have been updating the CDC web site daily to include new information and I would direct you there for the latest case counts and updated information in terms of our response. 

We issued a level one travel notice first, which reminds travelers to practice usual cautions for Wuhan City, China, that was earlier this month and we’ve continued to update it based on new information.  We sent out a health advisory via the Health Alert Network updating health care workers and public health partners on this outbreak and will be sending out additional guidance either later today or tomorrow.  Our laboratory is using genetic sequences provided by the Chinese and already has the ability to identify this pathogen were it to occur in the United States.  We’re working on a specific diagnostic test to detect this virus and we’ll be distributing this test to state health departments.

I’m going to stop there and hand over the briefing to my colleague, Dr. Marty Cetron, the Director of the Division of Global Migration and Quarantine. He’ll talk to you about the precautions we’re taking at airports to identify possible novel coronaviruses. Marty.

Marty Cetron: Thank you, Nancy. To further protect the health of the American public during the emergence this new coronavirus, beginning today CDC will be screening passengers on direct and connecting flights from Wuhan. This will begin tonight at New York, JFK airport, the first of the three main airports and one of the two that receive direct arriving flights from Wuhan.

While a remarkable amount has been learned since the first detection of this virus last month, it’s still early and much remains unknown as Dr. Messonnier pointed out. The investigation into this novel coronavirus is ongoing and dynamic, and CDC is actively engaged on the many fronts that Dr. Messonnier outlined. We are preparing across the public health and health care system to prevent, detect, and respond to this novel coronavirus.

The earlier we detect a case, the better we can protect the public and the more we can understand about this virus, and its risk for spread. CDC will implement public health entry screening at San Francisco airport, New York JFK and LAX airport. These airports receive the vast majority of travelers from Wuhan. As I mentioned, JFK and also San Francisco are the only two airports in the United States with direct flights from Wuhan. LAX was included because of the equivalent large volume of passengers coming from indirect flights.

Entry screening is only one part of a layered approach that includes altering the nation’s public health system and health care delivery systems. When used with other public health measures already in placer rapid detection of ill arriving travelers, we can slow and reduce the spread of disease into the United States. It is early in this outbreak. The virus is novel, and while we have expertise with SARS and MERS, humility is important. There is so much work to be done as the outbreak investigation unfolds and is very dynamic as you heard. As we learn more about this newly emerging virus, CDC will adjust its screening and response procedures appropriately. Thank you.

Ben Haynes: Thank you, doctor and doctor, Michelle we are ready to open up for questions.

Operator: Thank you, sir. At this time, if you would like to ask a question or if you do have any comments, you may press star one. Please unmute your phones and state your name when prompted. Again, that is star one for any questions. One moment, please. Andrew Joseph from STAT, you may go ahead.

Andrew Joseph: Hi, thanks very much. With three exported cases identified already, but only 45 identified in Wuhan, are you working under the assumption that the outbreak is actually bigger than that in Wuhan, that you think there might be more unidentified cases so far?

Nancy Messonnier: Yes, this is Dr. Messonnier, and I would say that this is the stage of investigation we need to proceed cautiously and be prepared to respond quickly to any eventuality. So of course, we’re generally concerned that there might be more cases, but we need to wait until our colleagues in China complete their investigation. That said, that is one of the reasons we’re standing up screening in the United States to make sure that we have the means to detect a case early here so that we can detect it early and learn more about it.

Andrew Joseph: Thank you.

Operator: Thank you, our next question comes from Mike Stobbe with the Associated Press, you may go ahead,

Mike Stobbe: Thank you for taking my call. Just a couple. I wanted to make sure to clarify, CDC is trying to develop the diagnostic test to determine the virus, but when you all will be screening people, you’ll be looking at symptoms. You won’t b able to actually test for the virus, is that correct? And I also wanted to ask, just to make sure I have the most current information. There’s not screening planned at the Wuhan airport in China or underway right now. It’s screening on the receiving end, not before they get on the plane? Thank you.

Nancy Messonnier: I think we’ll trade off on those questions. The diagnostic one is mine. We actually do have laboratory diagnostics here at CDC that are stood up. The first diagnostics that we’d be relying on is based on sequence. My compliments to our colleagues in China. They identified this pathogen very quickly and quickly put that sequence up where it’s publicly available to all the scientists around the world.

That is how our colleagues in Japan and Thailand identified cases. They compared the sequences that they found in Japan and Thailand to the sequence that the Chinese collaborators posted. So we at CDC also have the ability to do that today, but we are working on a more specific diagnostic. We expect to have that imminently, and samples from patients who are appropriately identified with screening both at the airports or elsewhere in the United States, CDC stands ready to actually do laboratory diagnostic tests to identify whether they do have novel coronavirus. Marty.

Marty Cetron: Yeah, so Mike, your question about what, I think you were asking whether we’re going to be doing any diagnostics at the airport, and the answer to that is now. We will do symptom-based screening in persons that have the epi link to Wuhan, and we will take a temperature, and then we will triage for evaluation those patients of concern where they will be referred to a facility that can do a regular diagnostic work up and collect the specimens that Nancy was referring to in terms of sending to CDC for reference testing for coronavirus. So that’s the basic sequence.

Regarding exit screening in Wuhan, to the best of our knowledge, it is not ongoing at this time although there have been many people who have pointed out that the efficiency of exit screening obviously on a global perspective is an important step that compliments entry screening activities. So, one is hopeful that that will move but as you can imagine, Wuhan is a dealing with a lot of issues at the present and will continue to, you know, apply requests through formal channels that exit screening also be added to the compliment of the tool box.

Ben Haynes: Next question, please.

Operator: Thank you, Denise Grady from New York Times, you may go ahead.

Denise Grady: Hi, thank you very much. I just want to specify a little more, what exactly does screening involve. Is there also any kind of question, are you looking only at temperature, are you looking at coughing, how do you tell apart somebody who’s coughing and has got a runny nose to someone who might be of concern, where exactly are they going to be taken? And what about people traveling with them? What kinds of plans are in place to deal with this if somebody is thought to be a possible case?

Marty Cetron: Thanks for that question. Excellent question. We will be capturing the information of the person who comes, in addition we will be asking questions about symptoms, and we will be taking a temperature check. And those that have symptoms that are compatible and a fever will be moved to what we call a tertiary screening by our quarantine medical officers for further investigation regarding exposures and contact and family issues. But all members of the same family will go through the same screening.

The sick individual will be triaged to evaluation in preidentified designated facilities and we have been working with our public health partners and our clinical partners as well as the transport services and we have been through this type of protocol before in 2014 and 2016, during the Ebola entry screening which lasted many months, over a year. And those individuals will be transported safely, without exposing others, and evaluated under CDC guidance for infection control precautions and recommendations. And that’s the basic sequence.

The ability to make the — refine the diagnosis and your point is well taken, we’re in the middle of respiratory virus season. It will be for more likely that these symptoms will be caused by the common circulating winter viruses, including influenza, parainfluenza, RSV, and many others than it will be this novel virus. While we have been in contact with some of our partners that are screening in other countries, it is our understanding that they have screened thousands before they found these one a two individual cases. So, we are expecting that, you know, this is going to be a triage scenario, and there is the capability in these referral centers for doing rapid diagnostics for the other causes of respiratory illness. So, thank you for your question.

Denise Grady: Thank you. Are you able to tell us where the facilities are, where people are going to be taken in these cities, New York, San Francisco, LA?

Marty Cetron: We generally — we generally don’t, you know, pre-identify publicly those institutions. But needless to say there’s extensive preparedness network that has gone on for a very long time to identify the facilities that have the appropriate precautions and capability to deal with patients like this. And I have just been updated that perhaps as of today or this morning, Wuhan may be beginning exit screening. We’ll conform that, but some of the media reports are indicating that.

Ben Haynes: Next question, please.

Operator: Thank you. Lena Sun from the Washington Post, you may go ahead.

Lena Sun: Yes, hi. I have a couple of questions. Thank you. Dr. Messonnier, do we know more about whether people are in the limited human-to-human transmission, if they can only spread when they’re symptomatic, and also Dr. Marty Cetron, could you please give us a sense of the volume of flights coming directly or connecting to Wuhan to these airports? I believe the top 20 airports from Wuhan are all in Asia, but of course, from Bangkok, Hong Kong, Taipei, a ton of them come here. Where do the US arriving flights sort of fit in that volume of space?

Nancy Messonnier: Okay. That was only two questions.

Lena Sun: I have a follow up, but I’m holding it.

Nancy Messonnier: The answer to the first question is we don’t know. MERS and SARS, which are similar to this novel coronavirus, we know from investigation of those two viruses that they are more likely to spread when somebody is more contagious and that asymptomatic people can spread, but at a much lower rate. So, it certainly is reasonable to ask the same question of this coronavirus, but it really would be premature to conclude that because we frankly don’t have enough information yet and that’s why we are taking this cautious approach.

Lena Sun: Okay. Again, just ask a quick follow up to that related question, you know, the Chinese have been giving out some information but they haven’t given any kind of a time line when people were symptomatic, how long they were sick for, any of that detail. Have you guys pressed them for that, or do you already have that information?

Nancy Messonnier: We don’t have all the information at the level of detail that our scientists would prefer. You know CDC scientists and we want to see every tidbit of data ourselves and that’s not the situation we’re in right now. We are in more of a waiting mode, waiting to see what our colleagues from China are releasing. It is a fast-moving situation, again, as identified, you know, again within the past hour, four more cases have been reported. Things are still moving fast and information is still coming on. We generally know that the incubation period is around 2 to 14 days, and there’s nothing that we’ve seen with this outbreak that is not consistent with that, but we really don’t have the level of detail that would allow us to be really completely confident that this virus is behaving the way we expect.

Marty Cetron: About the travel volume, just to give you some feel. So we have data, we look at data from the past year, and then we actively are getting data from each day’s arrivals confirming not only the capacity of a flight by how many bodies are in seats.

And the annual data in general arrives for the past year from Wuhan with itineraries originating in Wuhan and ending in the United States is over 60,000, probably ranging from 60 to 65,000 per year. There’s some asymmetry in that not all months are equal, the peak seasons in China travel to the U.S. usually arrives in January due to the Chinese Lunar New Year, which is up coming.

And we also have weekly estimates for these three airports and we’re expecting that the screening over the next couple of weeks could include as many as 5,000 people per month with direct or indirect flights from Wuhan. But it will really vary, and this is something each day that we get sort of an updated number. What’s different and unique about this is the two, the two direct flights that will originate. Recall that during 2014-16, there were no direct flights from West Africa to the United States, they were all indirect. So, we’ll be screening episodically these large volume of arrivals three times a week from JFK and San Francisco in particular.

Ben Haynes: Next question, please, Michelle.

Operator: Thank you. Nurith Aizenman from NPR.

Nurith Aizenman: I have a question from each of you and also a follow up. The first question is from the test. I’m trying to picture this. Someone comes in, they do have symptoms. Maybe they have something that makes you think they really should be screened. They’re taken to this location, you know, and then the test is done, how quickly, if they’re testing of the things that are easily known, you can easily identify if it’s something other than this new coronavirus, how quickly would that occur realistically, are we talking an hour, like all day, overnight, just some sense of the time line that someone might be detained.

The other questions is, again, on this issue of the incubation period we are seeing, I mean, there’s been dribs and drabs about when the last symptoms were — onset of symptoms were reported by these cases but it sounds like its limited to kind of early January. Are we — are you seeing, you know, is it normal to expect kind of a gap in cases and then a reemergence of new cases if there is a lot of human-to-human transmission going on? In other words, like, 14 days on basically around now, we’d start to see like suddenly a new flourishing of cases?

Marty Cetron: So, let me take the issue just to clarify where the diagnostic testing is going to go. People that come to the secondary screening and we have surge CDC staff to these ports obviously, and when they answer the questionnaire, if there’s no concerns about signs and symptoms and they’re afebrile, they’re going to be given a card that they can carry with them as to what symptoms to be alert for in the ensuing 14 days, and how to safely contact and interact with the health care system for care. Those folks would be moving on, and we’ll expect we’ll be able to process them in moving on quite quickly and without significant delays.

For the folks that actually have suspicious signs and symptoms and concerns, they will have a more detailed exam and an inquiry about exposures in tertiary at the airport. Many of those folks will likely end up being referred for further evaluation. It is unlikely that they will be able to make an immediate connecting flight if they had one, and so the types of diagnostics, screening diagnostics for common viruses can be done quickly but it’s still sort of an amount of hours of turn around in that process.

Currently they have to be shipped to CDC and tested here in reference labs. And the speed in which that turn around occurs will continue to improve over time as we get these laboratory processes up and running for throughput. But perhaps Dr. Messonnier can talk about what the expected time frame is in the screening process.

Dr. Messonnier: We’re sort of on the verge of having a more parsimonious laboratory test, and that will improve things right now. If it was right now today it might be as much as a day but it’s going to get rapidly faster as we work so rapidly on our diagnostics. The second questions is sort of a, I would take it as a theoretical question about incubation periods and waves as opposed to a specific question because I mean I think what you’re asking is, is it possible for there to be one wave and then a lull and then a second wave.

Nurith Aizenman: Exactly. I mean, essentially as we’re looking at what’s happening, right, and we’re trying to figure out what does this tell us, and is it possible that the fact that we haven’t seen a whole lot of cases yet out of Wuhan, doesn’t necessarily tell us much because maybe you would expect to see the next wave like around now is when you would start to expect to see the next wave if there is indeed significant human-to-human transmission?

Nancy Messonnier: Yeah, I think what I would say about that is, you know, we’re trying — I mean, of course we’re hypothesizing and like you, trying to put this story together and see if we can find an easy explanation, but at the same time, even as we speak, more information is flowing in as the Chinese investigators continue their investigations in terms of familial clustering and what exact exposure, what proportion of these cases actually were in the market and what weren’t.

So, I think it’s a little hard to completely feel confident that we have every bit of information and what we’re going to see additional cases all around the world as folks look for it more. Respiratory illnesses in general have a spectrum of illness, and generally we tend to find people who are more on the severe end of illness, but as we start testing more, and as lots of countries stand up diagnostic testing, I expect that we’re going to see more cases, and I think it’s highly plausible that there will be at least a case in the United States, and that’s the reason that we’re moving forward so quickly with this screening that Dr. Cetron is talking about.

Ben Haynes: Next question, please, Michelle we have time for two more. Sorry.

Operator: Thank you. Dan Vergano from Buzzfeed News, go ahead.

Dan Vergano: Thanks for doing this. Why a virus that starts in animals and spreads to people, and shows signs of spreading from people to people, it might be a particular concern in an outbreak like this, you know, like why the concern?

Nancy Messonnier: I think we are concerned anytime there is a new virus or a new pathogen emerging in a population that hasn’t seen it before because what it means is that populations don’t have existing immunity, and we don’t have specific treatments of vaccines. So we’re always concerned about that.

I this particular situation, we are especially concerned about a novel coronavirus because we have the president of MERS and SARS, and those were quite complicated, difficult outbreaks with many people getting ill and deaths, and so understanding that this pathogen looks, at least from a genetic perspective, like those pathogens makes us especially worried. It doesn’t take much for a virus in general to go from being worrisome to being extremely worrisome because they tend to morph and mutate a lot, and so that’s why in this class of viruses, we are especially worried and we’re taking a very cautious approach.

Dan Vergano: Thank you very much.

Ben Haynes: Last question, please.

Operator: Thank you. Elizabeth Cohen from CNN, you may go ahead.

Elizabeth Cohen: Hi, thank you so much for having this teleconference, I have two nuts and bolts questions for Dr. Cetron, I want to make sure I heard two things correctly, you said over the next few weeks we’re expecting 5,000 passengers from Wuhan, and two I think you said the JFK screenings start tonight at SFO, and LAX tomorrow. Did I get those two things right?

Marty Cetron: Yes, so the first direct flight from Wuhan scheduled arrival is around 10:00 p.m. Tonight at JFK, and that will be the first fully screened flight. The — we will serially roll those out. The next direct flight arrives at San Francisco I believe around 11:00 a.m. tomorrow morning, and some of the indirect flights will be screened in LAX also beginning tomorrow morning.

So, as we have surged as I indicated, you know, over a hundred CDC staff to these three airports and rough numbers I gave you around travel was across all three. In terms of that, we’ll actually see realistically how many bodies are in the seats, this is projections based on carrying capacity.

And then I believe it was either you or somebody else that asked about where does the U.S. sort of fit into the total scheme. The — there was a report out that modeled that based on, I think it was 2018 data, the top destination countries, Thailand, Japan and Malaysia. These may have evolved a little bit in 2019, and they may be influenced little bit on a monthly or seasonal basis as to what those orders are, but in general, the U.S. is, you know, not in that top tier as somebody indicated.

Most of these — most of this travel is in Southeast Asia, and so the experience of screening that is going on in many countries right now will be very ill illuminative, both about early detection of cases and the proportion of cases that trigger the screening, you know, as positive screening that actually get confirmed with the novel coronavirus will also help us a lot to find a little bit the scope and magnitude of exportation.

Nancy Messonnier: Well, thank you for joining us today. In closing, I do want to remind you that we’re still in the early days of this investigation. Things continue to evolve. We’re monitoring the situation closely. We’re working to keep you informed every step of the way.

I also want to take a moment to thank the many partners with while we are completely dependent and collaborating on this response. The we here is not CDC in isolation, but clearly our state, local, territorial partners, CBP, FAA, the airlines Our ability to stand up to this kind of response and our ability to intervene this quickly is entirely dependent on those collaborations as well as the many international collaborations in countries where were are working.

The risk of these outbreaks depends on the characteristics of the virus, including if and how well it spreads between people, the severity of resulting illness, and the medical or other measures available to control the impact of the virus such as antiviral treatments or vaccines. The situation could indeed change quickly. Therefore, we are taking a cautious approach to this outbreak and we’re preparing ourselves to respond quickly to any new developments, thank you again.

Ben Haynes: Thank you Dr. Messonnier and Dr. Cetron. And thank you all for joining us for today’s briefing. Please visit the 2019 novel coronavirus web page found at the bottom of the press release for continued updates. If you have further questions, please call the CDC media office at 404-639-3286 or email media @CDC.gov.

Operator: Thank you, this concludes today’s conference call. You may go ahead and disconnect at this time.


January 19

January 19: World Health Organization South-East Asia posted a news release titled: “Update information on Thailand responding to the novel coronavirus”

Current situation:

On 17th January 2020, the Ministry of Public Health of Thailand reported a second imported case of infection caused by the novel coronavirus recently identified in Wuhan, China. The concerned individual is a Chinese national who was found to have fever on arrival at Suvarnbhumi airport on 13th January. A clinical diagnosis of mild pneumonia was made after referral to a government hospital. Laboratory testing subsequently confirmed that the novel coronavirus was the cause.

WHO acknowledges the capacity of Thailand’s laboratory to do the complex genetic analyses necessary to confirm the diagnosis.

Background:

Since early December, a number of cases of pneumonia have been detected in persons from Wuhan city in China. Chinese authorities identified a new coronavirus as the agent causing these cases.

Coronaviruses are common – many cause less severe illness such as the common cold; other are known to cause more severe illness (SARS and Middle East Respiratory Syndrome, MERS). Chinese scientists have sequenced and made available the genetic material of this virus — a remarkable achievement in such a short time. This will be critical to helping public health authorities around the world understand this illness and track it.

The way these patients became infected is not yet known. To date, there has been no confirmation of human to human transmission of this new coronavirus. There have been no infections reported among health care workers, which can be an early indicator of person to person spread.

At present WHO does not recommend any specific health measures for travelers in relation to this event. WHO advises against the application of any travel or trade restrictions on China based on the information available. If travelers develop respiratory illness before, during or after travel, they should seek medical attention and share travel history with their health care provider.

The World Health Organization is working with Thailand and other countries to track further understand infections caused by this new coronavirus and to ensure that they are prevented and controlled. This includes,

  • Facilitating information sharing on this and other relevant health events between countries
  • In the longer term, using the International Health Regulation to develop and strengthen the capacities of countries to detect and respond to infections like the new coronavirus.
  • Providing all countries with a technical package of interim guidance, including:

Case definitions to help with identification of cases

Information on laboratory methodologies to identify this and other respiratory viruses,

Guidance on how to protect health care workers and others;

Information for clinicians on case management

Guidance on Risk Communication

  • The following guidelines are also being developed

Advice for people visiting markets

Guidance on entry & exit screening at airports and other ‘points of entry’

Guidance on case investigation and contact tracing

January 19: World Health Organization Western Pacific Region tweeted: “The Republic of #Korea has confirmed a case of #nCoV2019 in a person who travelled from Wuhan, China. Korean authorities report that she did not visit markets in Wuhan or have contact with animals or other confirmed cases.” This was the start of a thread.

January 19: World Health Organization Western Pacific Region tweeted: “The #nCoV2019 case was detected by thermal scanner during entry at Incheon Airport. She is currently in a stable condition, isolated in hospital for testing and treatment. Contact tracing is underway.”

January 19: World Health Organization Western Pacific Region tweeted: “Since 3 January, Korean health authorities have strenghtened surveillance for #pneumonia cases in health facilities nationwide, and screening for travellers from Wuhan. Public risk communication has also been enhanced.”

January 19: World Health Organization Western Pacific Region tweeted: “@WHO is working closely with the Republic of #Korea, and other countries to continue preparedness activities, and with global networks of experts in relation to the novel #coronavirus (nCoV-2019).” This is the last tweet in that thread.

January 19: World Health Organization Western Pacific Region tweeted: “The total number of confirmed cases of #nCoV2019 reported to date is 205, including 3 deaths. All reported deaths have been in Wuhan, China.”

January 19: Australian Government Department of Health posted “Chief Medical Officer’s statement on novel coronavirus” It is a statement from Professor Brendan Murphy, Australian Government Chief Medical Officer, about cases of novel coronavirus

The Australian Government Department of Health is aware of the cases of novel coronavirus (2019-nCoV) from the region of Wuhan in China, and watching developments very closely.

The situation warrants close attention and an evidence-based response and there is no cause for alarm in Australia.

The situation warrants close attention and an evidence-based response and there is no cause for alarm in Australia.

Australia has well established mechanisms to respond to ill travelers at points of entry.

Under Australian legislation, airlines must report passengers on board showing signs of an infectious disease, including fever, sweats or chills.

Planes reporting ill travellers are met on arrival by biosecurity officers who make an assessment and take necessary actions, such as isolation and referral to hospital where required.

The World Health Organization position does not currently recommend any travel advisory for China, or additional measures at airports beyond our established mechanisms.

The Department of Health is aware that new cases have recently been identified, after a period of a week where no new cases had been identified.

Whilst there is no clear evidence of human-to-human transmission, the recent cases, several days after the closure of the fish market that was initially identified as the likely source, raises direct transmission as a possibility.

Importantly, however, there have been no reported cases of infection in the several hundred health care workers who have been exposed to patients in China.

All confirmed cases have so far been people who have been in Wuhan, or visited Wuhan.

Whilst there have been two deaths, one was a person with significant other medical conditions. Wuhan Tainhe international airport will commence exit screening of passengers.

The World Health Organization is closely monitoring the situation and is in regular contact with Chinese authorities to provide support required. The Department of Health is also in contact with the World Health Organization.

The Department of Health works in partnership with State and Territory Health Officers, to ensure that we continue an evidence based response in Australia. The Chief Health Officers will be meeting this week to further discuss the recent developments with this virus.

Ausralia has processes in place to enhance border measures in relation to a communicable disease, if required, working through our established Health Protection system.

January 19: World Health Organization (WHO) started a thread that began with this tweet: “China has reported 139 new cases of novel #coronavirus (2019-nCoV) in #Wuhan, #Beijing and #Shenzhen over the past two days. This is the result of increased searching and testing for 2019-nCoV among people sick with respiratory illnesses.”

January 19: World Health Organization (WHO) tweeted: “For the first time, there are novel #coronavirus (2019-nCoV) cases reported outside of #Wuhan, within #China. These cases were identified because of searching and testing for cases outside Wuhan.”

January 19: World Health Organization (WHO) tweeted: “WHO has provided advice to countries on how to identify people sick with the novel #coronavirus (2019-nCoV), how to care for them, and how to prevent spread.”

January 19: World Health Organization (WHO) tweeted: “WHO has issued advice for individuals on how to protect themselves and others from the novel #coronavirus (2019-nCoV)

January 19: World Health Organiztion (WHO) tweeted: “An animal source seems the most likely primary spurce of this novel #coronavirus (2019-nCoV) outbreak, with some limited human-to-human transmission occuring between close contacts.”

January 19: World Health Organization tweeted: “WHO urges countries to continue preparedness activities for the novel #coronavirus (2019-nCoV), and continue sharing of information. Speedy information sharing has already had a positive impact on the response.”

January 19: World Health Organization tweeted: “WHO is constantly analyzing data on the novel #coronavirus (2019-nCoV) as we recieve it, and working closely with global networks of experts on a range of topics.”

January 19: World Health Organization tweeted: “As more #coronavirus (2019-nCoV) cases are identified and more analysis undertaken, we will get a clearer picture of disease severity and transmission patterns. We will update and expand our guidance as we learn more.”

January 19: World Health Organization tweeted: “WHO is proposing studies on the novel #coronavirus (2019-nCoV) that can be done in #China and elsewhere to better understand transmission, risk factors, and where the virus is. These studies take time and resources. Some of these studies are being undertaken already.” This was the last tweet in the thread.


January 20

January 20: The CDC reported 1 additional COVID-19 case in the United States.

January 20: World Health Organization South-East Asia posted “Update information on the novel coronavirus”. From the news release:

National authorities in China reported to WHO an additional 139 new cases of novel coronavirus (2019-nCoV) infection.

On January 20th, 2020, national authorities in China reported to WHO an additional 139 new cases of novel coronavirus (2019-nCoV) infection, that were detected in Wuhan, Beijing and Shenzhen over the past two days. This is the result of increased searching and testing for 2019-nCoV among people who are unwell with respiratory illness.

Background:

Since early December, a number of cases of pneumonia have been detected in persons from Wuhan city in China. Cases have now also been detected in Beijing and Shenzen. Chinese authorities identified a new coronavirus as the agent causing the cases. Two imported cases have also been reported in Thailand – in people that had traveled from Wuhan. A case has also been reported in Japan, who had also visited Wuhan.

Coronaviruses are common — many cause less severe illness such as the common cold; other are known to cause more severe illness (SARS and Middle East Syndrome, MERS)

At present, WHO does not recommend any specific health measures for travelers in relation to this event. WHO advises against the application of any travel or trade restrictions on China based on the information available. If travelers develop respiratory illness before, during or after travel, they should seek medical attention and share travel history with their health care provider.

The World Health Organization is working with Thailand and other countries to track further understand infections caused by this new coronavirus and to ensure that they are prevented and controlled. This includes,

  • Facilitating information sharing on this and other relevant health events between countries
  • In the longer term, using the International Health Regulations to develop and strengthen the capacities of countries to detect and respond to infections like the new coronavirus.
  • Providing all countries with a technical package of interim guidance including,

Case definitions to help with identification of cases

Information on laboratory methodologies to identify this and other respiratory viruses,

Guidance on how to protect health care workers and others;

Information for clinicians on case management

Guidance on Risk Communication

  • The following guidelines are also being developed

Advice for people visiting markets

Guidance on entry & exit screening at airports and other ‘points of entry’

Guidance on case investigation and contact tracing

January 20: World Health Organization Western Pacific tweeted: “The total number of confirmed cases of #nCoV2019 reported to date is 222 (China: 218, Thailand: 2, Japan: 1, Rep. of Korea: 1) including 4 deaths (all in Wuhan, China). The number of people reported with 2019-nCOV in Wuhan, China, includes 15 health care workers.” This was the start of a thread.

January 20: World Health Organization Western Pacific tweeted: “It is now very clear from the latest information that there is at least some human-to-human transmission of #nCoV2019. Infections among health care workers strenghten the evidence for this.”

January 20: World Health Organization Western Pacific tweeted: “In addition, info about newly reported #nCoV2019 infections suggests there may now be sustained human-to-human transmission. But more information and analysis are needed on this new virus to understand the full extent of human-to-human transmission and other important details.”

January 20: World Health Organization Western Pacific tweeted: “@WHO continues to work closely with governments and experts on this, and progress is underway. Director-General @DrTedros will convene an Emergency Committee on #nCoV2019 on Wednesday, 22 Jan 2020.” This tweet is the end of the thread.

January 20: The Guardian reported: A third death and more than 100 new cases are announced in China, sparking concerns ahead of the annual lunar new year holiday which begins on 25 January and during which hundreds of millions of Chinese people travel nationwide.

More than 200 cases have been recorded with cases reported in Beijing in the north, Shanghai in the east and Schenzhen in the south. The virus is also detected in South Korea in a Chinese person who has arrived by plane from Wuhan.

In his first public comments on the outbreak, China’s president Xi Jinping says the virus must be “resolutely contained.”

Human-to-human transmission is “affirmative”, a top Chinese expert on infectious diseases, Zhong Nanshan, tells state broadcaster CCTV.

January 20: Ars Technica posted “Outbreak of new virus explodes in China; human-to-human spread confirmed”. It was written by Beth Mole.

An outbreak of a never-before-seen coronavirus in the Chinese city of Wuhan dramatically worsened over the last few days – the case count has more than tripled, cases have appeared in new cities, and authorities have confirmed that the virus is spreading from person to person.

The World Health Organization announced Monday that it will convene an emergency meeting on Wednesday, January 22, to asses the outbreak and how best to manage it.

On Saturday, January 18, the Wuhan Municipal Health Commission reported 136 newly identified cases of the viral pneumonia and one additional death. On Tuesday, January 21, (local time 4:18am), the commission reported another death. That brings Wuhan’s totals to 198 case sand four deaths. Just one day earlier, on January 17, the health commission had reported just 62 cases and two deaths.

The outbreak began in December there and has been linked to a live-animal market in Wuhan called the South China Seafood Wholesale Market. Researchers raced to identify the virus behind the outbreak, confirming quickly that the culprit is a never-before-seen coronavirus – a relative of the virus that caused the SARS (Severe Acute Respiratory Syndrome) outbreak in 2003. Like SARS, experts suspect that the new coronavirus leapt from animals at the market to humans, sparking the outbreak. Many strains of coronavirus circulate in animals and humans, causing mild to severe diseases.

But until this weekend, there were reasons to be optimistic that the new outbreak could be easily managed. Officials in Wuhan quickly shit down the live animal market January 1 for decontamination. On January 11, the health commission reported 41 conformed cases, most of which had clear ties to the market, and there was no clear evidence that the virus was spreading from human to human. No medical staff has been infected, and there had been no sign of new cases since January 3.

That has all changed. As the case tally shot up over the last few days, officials say that there is clear evidence that the virus is spreading from person to person, and at least 14 medical staff members contracted the virus.

Booming bug

“Now we can say it is certain that it is a human-to-human transmission phenomenon,” SARS expert Zhong Nanshan said on state-run television on Monday, according to The New York Times. Zhong is leading a government-appointed expert panel on the outbreak.

Zhong elaborated that there was at least one case of human-to-human transmission in Wuhan, a city in central China, and two cases in families in the southern Guangdong province that borders Hong Kong. He also said that in one case, a single parent spread the virus to at least 14 medical staff members. He referred to such a patient as a “super-spreader,” according to the South China Morning Post, and called these patients key to controlling the outbreak.

“We expect the number of infected cases will increase over the Lunar New Year travel period, and we need to prevent the emergence of a super-spreader of the virus,” Zhong said. Millions are expected to travel during the holiday period.

So far, officials have found cases of the virus in travelers to Thailand, South Korea, and Japan.

Besides Wuhan and Guangdong in mainland China, Chinese health officials have now reported cases in Beijing,Shanghai, and Shenzhen. The total number of cases overall in China has climbed to 218, according to state-run media.

Hong Kong has reported many suspected cases, but none have been confirmed to be linked to the outbreak. The region was hard hit by the 2003 SARS outbreak, which sickened over 8,000 people worldwide and killed 774.

Officials in Hong Kong and many other places have stepped up monitoring and are screening travelers. The US Centers for Disease Control and Prevention ha already announced that it is closely monitoring the outbreak and will screen travelers from Wuhan.

The main symptoms of the virus are fever, cough, chest tightness, and difficulty breathing.

January 20: PolitiFact posted: World Health Organization reports cases in China, Thailand, Japan, and South Korea.

January 20: South China Morning Post posted “Wuhan virus kills fourth patient, infects hospital staff amid fear of ‘super-spreader’

Health authorities in the Chinese city of Wuhan said another person had died from the recently identified coronavirus infection, bringing the total to four.

It added that 15 medical staff in Wuhan had contracted the virus, confirming that it is spreading by human transmission and raising concerns that people at the most virulent stage of infection – so-called super-spreaders – could infect many others.

The World Health Organization (WHO) said it would call an emergency meeting on Wednesday to decide whether the outbreak should be declared an international public health emergency.

The new strain of coronavirus was identified this month after a mystery pneumonia started striking people in Wuhan mid-December. It is so far know to have spread to Thailand, South Korea and Japan in addition to cases in China, in Beijing, Shanghai and the southern province of Guangdong.

The speed of the outbreak has raised fears of another epidemic on the scale of the severe acute respiratory syndrome (Sars) coronavirus, which killed more than 700 people around the world in 2002-03 after originating in China.

One of China’s top Sars experts confirmed on Monday evening that the virus could be transmitted between humans, and that it was likely to have originated from wild animals.

The total number of infections reported in Wuhan – where a seafood and animal meat market is thought to be the centre of the outbreak – had reached 198 by Tuesday. The total number of confirmed cases in mainland China stood at 218, with five in Beijing, 14 in Guangdong and one in Shanghai.

More suspected cases have been reported in Shanghai and Qingdao on the coast, Chengdu and Yunnan province in the southwest, and Guangxi in the country’s south.


January 21

January 21: AAP posted “CDC confirms first U.S. case of new coronavirus”. It was written by Associate Editor Alyson Sulaski Wyckoff. From the news:

The first U.S. case of the novel coronavirus has been confirmed in a man from Snohomish County in Washington state, according to the Centers for Disease Control and Prevention (CDC).

The patient, a man in his 30s, became ill after he returned to the U.S. Jan. 15 from Wuhan, China, which has been battling an outbreak of pneumonia caused by the respiratory virus (2019-nCoV) since December. He sought care at Providence Regional Medical Center – Everett in Snohomish County, where he is recovering. Based on the patient’s symptoms, a clinical specimen was sent to CDC overnight, and laboratory testing confirmed the diagnosis. A CDC team has been deployed to Washington state to support the investigation.

“CDC has been proactively preparing for introduction of this virus,” said Nancy Messonnier, M.D., director of the CDC’s National Center for Immunization and Respiratory Diseases, in a tele briefing with Washington state officials today. “We know today’s news is concerning … now with close to 300 with the novel virus.”

Six patients have died, and while most of those who had been sickened with the virus live in China, several travel-associated cases have been reported in Taiwan, Thailand, Japan and the Republic of Korea.

Older adults may be at increased risk for severe disease, Dr. Messonnier said. She added that the travel alert to Wuhan has been upgraded from a level 1 to a level 2.

The CDC is instituting enhanced airport screening of passengers arriving from China, part of a multilayered process.

In the coming week, health officials will begin public health entry screening of passengers at Chicago’s O’Hare International Airport and Hartsfield-Jackson Atlanta International Airport. Screening was already in place as of Jan. 17 at New York, Los Angeles and San Francisco international airports. To date, no one has been discovered with the virus through entry screening.

The CDC is working closely with global partners and has activated its Emergency Operations Center to provide support. In addition, the CDC is involved in the following:

  • Alerting clinicians to be vigilant for patients with respiratory symptoms and a history of travel to Wuhan, China;
  • Developing guidance for clinicians for testing and management of 2019-nCoV, plus guidance for home care of patients; and
  • Developing a diagnostic test to detect the virus in clinical specimens at a faster rate. Testing currently must take place at CDC, but the agency will share the test with domestic partners in the coming days and weeks

While it was originally thought that the virus was spreading from animal to person, “there are growing indications that limited person-to-person spread is happening. It’s unclear how easily this virus is spreading between people,” the CDC noted in a news release.

“… it’s crucial to be proactive and prepared,” Dr. Messonnier said.

January 21: The CDC reported the onset of 1 more additional COVID-19 case in the United States.

January 21: World Health Organization (WHO) posted a Report titled: “Novel Coronavirus (2019-nCoV) Situation Report -1. The data in it was reported by January 20, 2020. From the report:

SUMMARY

Event highlights from 31 December 2019 to January 2020:

  • On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia unknown etiology (unknown cause) detected in Wuhan City, Hubei Province of China. From 31 December 2019 through 3 January 2020, a total of 44 case-patients with pneumonia of unknown etiology were reported to the WHO by the national authorities in China. During this reported period, the causal agent was not identified.
  • On 11 and 12 January 2020, WHO received further detailed information from the National Health Commission China that the outbreak is associated with exposures in one seafood market in Wuhan City.
  • The Chinese authorities identified a new type of coronavirus, which was isolated on 7 January 2020.
  • On 12 January, 2020, China shared the specific genetic sequence of the novel coronavirus for countries to use in developing specific diagnostic kits.
  • On 13 January, 2020, the Ministry of Public Health, Thailand, reported the first cases of a lab-confirmed novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China.
  • On 15 January, 2020, the Ministry of Health, Labor and Welfare, Japan (MHLW) reported an imported case of laboratory-confirmed 2019-novel coronavirus (2019-nCoV) from Wuhan.
  • On 20 January, 2020, National IHR Focal Point (NFP) for Republic of Korea reported the first case of coronavirus in the Republic of Korea.

Situation update:

  • As of 20 January 2020, 282 confirmed cases of 2019-nCoV have been reported for four countries including China (278 cases), Thailand (2 cases), Japan (1 case) and the Republic of Korea (1 case);
  • Cases in Thailand, Japan and Republic of Korea were exported from Wuhan City, China;
  • Among the 278 cases confirmed in China, 258 cases were reported from Hubei Province, 14 from Guangdong Province, five from Beijing Municipality and one from Shanghai Municipality;
  • Of the 278 confirmed cases, 51 are severely ill, 12 are in critical condition;
  • Six deaths have been reported from Wuhan City.

I. Surveillance

Table 1. Countries, territories, or areas with reported confirmed cases of 2019-nCov, 20 January 2020

Details of cases reported on 20 January 2020:

  • Wuhan City: 60 new confirmed cases including three deaths.
  • Guangdong Province: Fourteen confirmed cases (one case was confirmed on 19 January) including four severe cases, no deaths; Of the 14 confirmed cases, 12 had travel history to Wuhan and two cases had contact history with cases; Nine were male and fives were female
  • Beijing Municipality: Five confirmed cases (two cases were confirmed on 19 January); Of the three new conformed cases on 20 Jan, two were male and one was a female; All five cases had a travel history to Wuhan and are currently asymptomatic.
  • Shanghai Municipality: One confirmed case in a female; Travelled to Shanghai from Wuhan on 12 January; Two contacts have been identified for follow up.

II. PREPAREDNESS AND RESPONSE:

WHO:

  • The WHO has been in regular contact with Chinese as well as Japanese, Korean and Thai authorities since the reporting of these cases. The three countries have shared information with WHO under the International Health Regulations. WHO is also informing other countries about the situation and providing support as requested;
  • On 2 January, the incident management system was activated across the three levels of WHO (country office, regional office, and headquarters);
  • Developed the surveillance case definitions for human infection with 2019-nCoV and is updating it as per the new information becomes available;
  • Developed interim guidance for laboratory diagnosis, clinical management, infection prevention and control in health care settings, home care for mild patients, risk communication and community engagement;
  • Prepared disease commodity package for supplies necessary in identification and management of confirmed patients;
  • Provided recommendations to reduce risk of transmission from animals to humans;
  • Updated the travel advice for international travel in health in relation to the outbreak of pneumonia caused by a new coronavirus in China;
  • Utilizing global expert networks and partnerships for laboratory, infection prevention and control, clinical management and mathematical modeling;
  • Activation of R&D blueprint to accelerate diagnostics, vaccines, and therapeutics;
  • WHO is working with our networks of researchers and other experts to coordinate global work on surveillance, epidemiology, modeling, diagnostics, clinical care and treatment, and other ways to identify, manage the disease and limit onward transmission. WHO has issued interim guidance for countries, updated to take into account the current situation.

III. COUNTRY RESPONSE:

China:

  • National authorities are conducting active case finding in all provinces;
  • Since 14 January 2020, 35 infrared thermometers have been installed in airports, railway stations, long-distance bus stations, and ferry terminals;
  • Search expanded for additional cases within and outside of Wuhan City;
  • Active / retroactive case finding in medical institutions in Wuhan City;
  • The Huanan Seafood Wholesale Market in Wuhan City was closed on 1 January 2020 for environmental sanitation and disinfection. Market inspection in expansion to other markets;
  • Public education on disease prevention and environmental hygiene further strengthened in public places across the city, farmers’ markets in particular.

Thailand:

  • The Department of Disease Control has been implementing its surveillance protocol by fever screening of travellers from all direct flights from Wuhan, China, to the Suvarnabhumi, Don Mueang, Chiang Mai, Phuket and Krabi airports, with the screening protocol starting at Karbi Airport on 17 January 2020;
  • From 3 to 20 January 2020, among 116 flights, 18,383 passengers and aircrew members were screened for respiratory symptoms and febrile illness;
  • As of 20 January 2020, the Department of Disease Control, Ministry of Public Health, Thailand has scaled up the Emergency Operations Center to Level 2 to closely monitor the ongoing situation both at the national and international levels.
  • Risk communication guidance has been shared with the public and a hotline has been established by the Department of Disease Control for people returning from the affected area in China with related symptoms.

Japan:

  • Contact tracing and other epidemiological investigations are underway by the local health authorities in Japan;
  • As of 20 January 2020, 41 contacts have been followed. Of the 41 contacts, 37 have not shown any symptoms, three have left the country and efforts have been made to reach one contact;
  • The Japanese Government scaled up a whole-of-government coordination mechanism on the 16 January;
  • The MWLW has strengthened surveillance for undiagnosed severe acute respiratory illnesses since the report of undiagnosed pneumonia in Whuhan, China;
  • From 6 January, MHLW requested local health governments to be aware of the respiratory illnesses in Wuhan by using the existing surveillance system for serious infectious illness with unknown etiology;
  • NIID is supporting local authorities on epidemiologic investigations including contact tracing;
  • Quarantine and screening measures have been enhanced for travelers from Wuhan city at the point of entries since 7 January;
  • NIID established an in-house PCR assay for nCoV on 16 January;
  • Revision of the risk assessment by NIID is being conducted, including case definition of close contacts;
  • The public risk communication has been enhanced;
  • A hotline has been established among the different ministries in the government;
  • The MHLW is working closely with WHO and other Member States to foster mutual investigations and information sharing.

Republic of Korea:

  • Contact tracing and other epidemiological investigation are underway;
  • The government of the Republic of Korea has scaled up the national alert level from Blue (Level 1) to Yellow (Level 2 out of 4-level national crisis management system);
  • The Republic of Korea health authority has strengthened surveillance for pneumonia cases in health facilities nationwide since 3 January 2020;
  • Quarantine and screening measures have been enhanced for travelers from Wuhan at the point of entries (PoE) since 3 January 2020;
  • Public risk communication has been enhanced.

January 21: Nippon.com (News from Japan) posted “Japan Confirms 41 People with Contacts with Pneumonia Patients”

The Japanese health ministry said Monday that it has identified 41 people who may have had long-term contacts with patients of pneumonia caused by a new strain of coronavirus that has led to an outbreak of the disease in the inland China city of Wuhan.

While three of them have already left Japan, the ministry has been able to get in touch with all of the 41 people, and no new case of infection has been confirmed in the country, the ministry said.

The ministry will monitor the 41 people’s health conditions for about two weeks.

The ministry said last week that it has confirmed the first case of infection with the new coronavirus in Japan, noting that the patient is a Chinese man in Kanagawa Prefecture, south of Tokyo, who tested positive for the virus after returning from Wuhan.

According to the ministry’s announcement on Monday, 38 of the 41 people may have spent a large amount of time with the Chinese man at the workplace or home.

January 21: PolitiFact posted: The first U.S. case is announced in Washington state (as well as Vietnam and Singapore). WHO says the virus risk globally is high.

January 21: The Guardian reported Health officials in Washington state report the first case in the US. The man is in his 30s and is in good condition in a hospital in Everett, Washington, after returning to the area last week from China. He was believed to have travelled to the Wuhan area.

January 21: Health Protection Scotland posted “Outbreak of pneumonia in Wuhan City, Hubei, China: updated” From the report:

An on-going outbreak of pneumonia in Wuhan City, Hubei Province, China has been linked to a newly-discovered coronavirus.

The World Health Organization (WHO) reports that, as of January 20, 2020, there have been 205 cases including three deaths. Coronaviruses are a well-recognized cause of human illnesses that range from mild to severe. This outbreak has been linked to possible exposure to infection at the South China Seafood City market in Wuhan.

As of 20 January, 2020, all cases are people who live in, or have travelled to, Wuhan…

January 21: Australian Government Department of Health posted “Novel coronavirus update”. It is a statement from the Chief Medical Officer about novel coronavirus

The Australian Government Department of Health is working across agencies to implement additional measures to manage the risk of novel coronavirus (2019-nCoV) from the region of Wuhan in China.

I want to reassure Australians that to date there have been no confirmed cases in Australia and the risk of transmission in Australia from this novel coronavirus remains low.

We have well established mechanisms to detect and respond to ill travellers, and processes in place to implement further measures if the risk increases.

This is a rapidly evolving matter with developments in recent days and we remain alert but not alarmed.

Recent developments include significant increases in reported cases, and evidence of limited human-to-human transmission.

After consulting other Government agencies and the states and territories, we are now undertaking evidence based, proportionate additional border measures, particularly in relation to the three weekly direct flights from Wuhan to Sydney.

  • All passengers on these direct flights will recieve information abou the virus on arrival requesting that they identify themselves to biosecurity officers at the airport if they are unwell. If they have symptoms of an infectious disease they will be assessed by NSW Health.
  • Additional information will be displayed at all major international ports around Australia, with instructions on what to do if travellers have symptoms or if symptoms develop.
  • We are currently working with the Department of Foreign Affairs and Trade to update the travel advisory to Wuhan.
  • We are also preparing updated advice for doctors and other health professionals in Australia and will be providing advice on the Department of Health’s website.

There have been no confirmed cases of the virus in Australia.

Australia’s public health systems have identified a number of individuals who have presented with relevant symptoms and travel history to Wuhan.

So far, all but one have been cleared of the novel coronavirus. Laboratory testing results are pending on one remaining case in Queensland.

Key details of the evolving situation and suspected cases in Australia are shared across jusrisdictions through key expert bodies such as the Australian Health Protection Principal Committee and its standing committee, the Commuicable Diseases Network Australia.

Australia has world-class public health systems in place to manage any cases, including isolation facilities in each state and territory.

There is currently no vaccine available for this virus; supportive care is the best available treatment if a case is confirmed.

Background

Coronaviruses are ubiquitous – there are many known viruses in humans and animals including some viruses that cause the common cold.

This novel virus was first detected in the City of Wuhan in China around 30 December 2019.

As of 21 January 2020, 198 confirmed cases of this virus have been detected in the Wuhan region of China, with three deaths.

Twenty-three additional cases have been detected in individuals in Beijing and Guangdong Province (China), Japan, South Korea and Thailand. Some of these individuals have reported a history of travel to Wuhan.

Since 17 January 2020, 136 new cases have been identified in patients in Wuhan with previously unexplained pneumonia.

All reported cases are adults.

The recent increase in the number of cases has been partially due to increased surveillance and testing of cases.

There is likely to be under-reporting and detection, particularly of mild cases, and true numbers are likely to be significantly greater.

A number of clinical symptoms have been reported, fever was the single consistent symptom. Other symptoms include breathing difficulty, coughing and a sore throat.

Among the reported cases, a proportion have experienced severe symptoms, including three deaths in China, with one individual known to have underlying disease.

There is not enough data to assess clinical severity yet, however, on current evidence, the virus is not thought to be a clinically severe as SARS or MERS and investigations are ongoing.

January 21: The Guardian reported: Health officials in Washington state report the first case in the US. The man is in his 30s and is in good condition at a hospital in Everett, Washington, after returning to the area last week from China. He was believed to have travelled to the Wuhan area.

January 21: Health New South Wales Gov posted: “NSW Health advice to travellers returning from Wuhan, China”

As part of an international response, NSW Health will help Commonwealth Biosecurity staff at Sydney Airport monitor travellers returning from Wuhan, where there is an outbreak of novel human coronavirus.

Chinese Health officials have confirmed more than 200 cases of the infection, including people who travelled from Wuhan to other parts of China and to at least four other countries in Asia.

No cases of the novel coronavirus have been detected in NSW.

Director of Health Protection, NSW Health, Dr Jeremy McAnulty said advice is being provided to travellers who may have already returned to NSW from Wuhan as it can take up to two weeks for symptoms to develop.

“Symptoms of the virus include a fever with respiratory symptoms such as a cough, sore throat, or shortness of breath,” Dr McAnulty said.

“There is no need for alarm, but people should be aware of the emerging situation and if they develop symptoms on returning from affected areas overseas, they should call ahead before seeing their GP.

“This virus does not appear to spread easily between people, but anyone with symptoms should practice simple hygiene by covering their mouths and sneezes with a tissue or their elbow and washing their hands thoroughly.”

While the Australian Government Department of Health in consultation with the Australian Government Department of Agriculture has the lead for health matters at the Australian border, NSW Health Minister Brad Hazzard said public health officials are working with the Commonwealth and other jurisdictions to monitor the situation in China.

“Sydney is a popular destination for people travelling from China especially around the time of the Lunar New Year, so up-to-date health advice is paramount,” Mr Hazzard said.

Health workers in NSW public hospitals as well as community-based General Practitioners have already been issued precautionary advice to help them identify any cases of the infection and to apply careful infection control measures to prevent the spread of the novel coronavirus. NSW Health will continue to update all relevant health professionals at Infectious disease alerts.

NSW Health has made novel coronavirus 2019 a notifiable disease under the Public Health Act. Under this requirement, doctors and laboratories must report any suspected cases to NSW Health.

NSW Health has developed and exercised a range of procedures for case finding, diagnosis, and contact tracing for high consequence and infectious diseases (such as pandemic influenza, SARS, MERS and emerging infections) should they occur in NSW.

People who are heading overseas should also check the advice on Smart Traveller (smarttraveller.gov.au). General advice for overseas travellers includes avoiding animals (alive or dead) and animal markets, and avoiding close contact with sick people.

January 21: Centers for Disease Control and Prevention (CDC) posted “First Travel-related Case of 2019 Novel Coronavirus Detected in United States”. From the press release:

The Centers for Disease Control and Prevention (CDC) today confirmed the first case of 2019 Novel Coronavirus (2019-nCoV) in the United States in the state of Washington. The patient recently returned from Wuhan, China, where an outbreak of pneumonia caused by this novel coronavirus has been ongoing since December 2019. While originally thought to be spreading from animal-to-person, there are growing indications that limited person-to-person spread is happening. It’s unclear how easily this virus is spreading between people.

The patient from Washington with confirmed 2019-nCoV infection returned to the United States from Wuhan on January 15, 2020. The patient sought care at a medical facility in the state of Washington, where the patient was treated for the illness. Based on the patient’s travel history and symptoms, healthcare professionals suspected this new coronavirus. A clinical specimen was collected and sent to CDC overnight, where laboratory testing yesterday confirmed the diagnosis via CDC’s Real time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR) test.

CDC has been proactively preparing for the introduction of 2019-nCoV in the United States for weeks including:

  • First altering clinicians on January 8, 2020, to be on the look-out for patients with respiratory symptoms and a history of travel to Wuhan, China.
  • Developing guidance for clinicians for testing and management of 2019-nCoV, as well as guidance for home care of patients with 2019-nCoV.
  • Developing a diagnostic test to detect this virus in clinical specimens, accelerating the time it takes to detect infection. Currently, testing for this virus must take place at CDC, but in the coming days and weeks, CDC will share these tests with domestic and international partners.
  • On January 17, 2020, CDC began implementing public health entry screening at San Francisco (SFO), New York (JFK), and Los Angeles (LAX) airports. This week CDC will add entry health screening at two more airports – Atlanta (ATL) and Chicago (ORD).
  • CDC has activated its Emergency Operations Center to better provide ongoing support to the 2019-nCoV response

CDC is working closely with the state of Washington and local partners. A CDC team has been deployed to support the ongoing investigation in the state of Washington, including potentially tracing close contacts to determine if anyone else has become ill.

Coronaviruses are a large family of viruses, some causing respiratory illness in people and others circulating among animals including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people, such has been seen with Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). When person-to-person spread has occurred with SARS and MERS, it is thought to happen via respiratory droplets with close contacts, similar to how influenza and other respiratory pathogens spread.

The situation with regard to 2019-nCoV is still unclear. While severe illness, including illness resulting in several deaths, has been reported in China, other patients have had milder illness and been discharged. Symptoms associated with this virus have included fever, cough, and trouble breathing. The confirmation that some limited person-to-person spread with this virus is occurring in Asia raises the level of concern about this virus, but CDC continues to believe the risk of 2019-nCoV to the American public at large remains low at this time.

This is a rapidly evolving situation. CDC will continue to update the public as circumstances warrant.

January 21: American Academy of Pediatrics (AAP) posted “CDC confirms first U.S. case of new coronavirus”

The first U.S. case of the novel coronavirus virus has been confirmed in a man from Snohomish County in Washington state, according to the Centers for Disease Control and Prevention (CDC).

The patient, a man in his 30s, became ill after her returned to the U.S. Jan. 15 from Wuhan, China, which has been battling an outbreak of pneumonia caused by the respiratory virus (2019-nCoV) since December. He sought care at Providence Regional Medical Center – Everett in Snohomish County, where he is recovering. Based on the patient’s symptoms, a clinical specimen was sent to CDC overnight, and laboratory testing confirmed the diagnosis. A CDC team has been deployed to Washington state to support the testing investigation.

“CDC has been proactively preparing for introduction of this virus,” said Nancy Messonnier, M.D., director of the CDC’s National Center for Immunization and Respiratory Diseases, in a tele briefing with Washington State officials today. “We know today’s news is concerning… now with close to 300 with the novel virus.”

Six patients have died, and while most of those who have been sickened with the virus live in China, several travel-associated cases have been reported in Taiwan, Thailand, Japan, and the Republic of Korea.

Older adults may be at increased risk for severe disease, Dr. Messonnier said. She added that the travel alert to Wuhan has been upgraded from level 1 to level 2 (see Resources).

The CDC is instituting enhanced airport screening of passengers arriving from China, part of a multilayered process.

In the coming week, health officials will begin public health entry screening of passengers at Chicago’s O’Hare International Airport and Hartsfield-Jackson Atlanta International Airport. Screening was already in place as of Jan. 17 at New York, Los Angeles and San Francisco international airports. To date, no one has been discovered with the virus through entry screening.

The CDC is working closely with global partners and has activated its Emergency Operations Center to provide support. In addition, the CDC is involved in the following:

  • Alerting clinicians to be vigilant for patients with respiratory symptoms and a history of travel to Wuhan, China;
  • Developing guidance for clinicians for testing and management of 2019-nCoV, plus guidance for home care of patients; and
  • Developing a diagnostic test to detect the virus in clinical specimens at a faster rate. Testing currently must take place at CDC, but the agency will share the test with domestic partners in the coming days and weeks.

While it was originally thought that the virus was spreading from animal to person, “there are going indications that limited person-to-person spread is happening. It’s unclear how easily this virus is spreading between people,” the CDC noted in a news release.

“… It’s crucial to be proactive and prepared,” Dr. Messonnier said.

January 21: World Health Organization posted “Novel Coronavirus (2019-nCoV) Situation Report – 1. From the report:

Event highlights from 31 December to 20 January 2020:

  • On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia unknown etiology (unknown cause) detected in Wuhan City, Hubei Province of China. From 31 December 2019 through 3 January 2020, a total of 44 case patients with pneumonia of unknown eitology were reported to WHO by the national authorities in China. During this reported period, the causal agent was not identified.
  • On 11 and 12 January 2020, WHO recieved further detailed information from the National Health Commission China that the outbreak is associated exposures in one seafood market in Wuhan City.
  • The Chinese authorities identified a new type of coronavirus, which was isolated on 7 January 2020.
  • On 12 January 2020, China shared the genetic sequence of the novel coronavirus for countries to use in developing specific diagnostic kits.
  • On 13 January 2020, the Ministry of Public Health, Thailand reported the first imported case of lab-confirmed novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China.
  • On 15 January 2020, the Ministry of Health, Labor and Welfare, Japan (MHLW) reported an imported case of laboratory-confirmed 2019-novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China.
  • On 20 January 2020, National IHR Focal Point (NFP) for Republic of Korea reported the first case of novel coronavirus in the Republic of Korea.

Situation update:

  • As of 20 January 2020, 282 confirmed cases 2019-nCoV have been reported from four countries including China (278 cases), Thailand (2 cases), Japan (1 case) and the Republic of Korea (1 case);
  • Cases in Thailand, Japan and Republic of Korea were exported from Wuhan City, China;
  • Among the 278 cases confirmed in China, 258 cases were reported from Hubei Province, 14 from Guangdong Province, five from Beijing Municipality and one from Shanghai Municipality;
  • Of the 278 confirmed cases, 51 cases are severely ill, 12 are in critical condition’
  • Six deaths have been reported in Wuhan City.

Reported incidence of confirmed 2019-nCoV, 20 January 2020

  • China, Hubei Province – 258
  • China – Guangdong – 14
  • China Beijing Municipality – 5
  • China Shanghai Municipality – 1
  • Japan – 1
  • Republic of Korea – 1
  • Thailand – 2
  • Total confirmed cases – 282

Details of cases reported on 20 January 2020:

  • Wuhan City:
  • 60 new confirmed cases including three deaths.
  • Guangdong Province:
  • Fourteen confirmed cases (one case was confirmed on 19 January) including four severe cases, two critical cases, no deaths;
  • Of the 14 confirmed cases, 12 has travel history to Wuhan and two cases had contact history with cases;
  • Nine were male and fives were female.
  • Beijing Municipality:
  • Five confirmed cases (two cases were confirmed on 19 January);
  • Of the three new confirmed cases on 20 Jan, two were male and one was a female;
  • All five cases had a travel history to Wuhan and are currently asymptomatic
  • Shanghai Municipality:
  • One confirmed case in a female;
  • Traveled to Shanghai from Wuhan on 12 January;
  • Two contacts have been identified for follow up.

II. Preparedness And Response:

WHO:

  • WHO has been in regular contact with Chinese as well as Japanese, Korean and Thai authorities since the reporting of these cases. Three countries have shared information with WHO under the International Health Regulations. WHO is also informing other countries about the situation and providing support as requested;
  • On 2 January, the incident management system was activated across the three levels of WHO (country office, regional office and headquarters);
  • Developed interim guidance for laboratory diagnosis, clinical management, infection prevention and control in health care settings, home care for mild patients, risk communication and community engagement;
  • Prepared disease commodity package for supplies necessary in identification and management of confirmed patients;
  • Provided recommendations to reduce risk of transmission from animals to humans;
  • Updated the travel advice for international travel in health in relation to the outbreak of pneumonia caused by a new coronavirus in China;
  • Utilizing global expert networks and partnerships for laboratory, infection prevention and control, clinical management and mathematical modelling;
  • Activation of R&D blueprint to accelerate diagnostics, vaccines, and therapeutics;
  • WHO is working with out networks of researchers and other experts to coordinate global work on surveillance, epidemiology, modelling, diagnostics, clinical care and treatment, and other ways to identify, manage the disease and limit onward transmission. WHO has issued interim guidance for countries, updated to take into account the current situation.

III. COUNTRY RESPONSE:

China:

  • National authorities are conducting active case finding in all provinces;
  • Since 14 January 2020, 35 infrared thermometers have been installed in airports, railway stations, long-distance bus stations, and ferry terminals;
  • Search expanded for additional cases within and outside Wuhan City;
  • Active / retroactive case finding in medical institutions in Wuhan City;
  • The Huanan Seafood Wholesale Market in Wuhan City was closed on 1 January 2020 for environmental sanitation and disinfection. Market inspection in expansion to other markets;
  • Public education on disease prevention and environmental hygiene further strengthened in public places across the city, farmers’ markets in particular.

Thailand:

  • The Department of Disease Control has been implementing its surveillance protocol by fever screening of travelers from all direct flights from Wuhan, China to the Suvarnabhumi, Don Mueang, Chiang Mai, Phuket and Krabi airports, with the screening protocol starting at Krabi Airport started on 17 January 2020;
  • From 3 to 20 January 2020, among 116 flights, 18,383 passengers and aircrew members were screened for respiratory symptoms and febrile illness;
  • As of 20 January 2020, the Department of Disease Control, Ministry of Public Health, Thailand has scaled up the Emergency Operations Center to level 2 to closely monitor the ongoing situation both at the national and international levels;
  • Risk communication guidance has been shared with the public and a hotline has been established by the Department of Disease Control for people returning from the affected area in China with related symptoms

Japan:

  • Contact tracing and other epidemiological investigations are underway by the local health authorities in Japan;
  • As of 20 January 2020, 41 contacts have been followed. Of the 41 contacts, 37 have not shown any symptoms, three have left the country and efforts have been made to reach one contact;
  • The Japanese Government has scaled up a whole-of-government coordination mechanism on the 16 January;
  • The MHLW has strengthened surveillance for undiagnosed severe acute respiratory illness since the report of the undiagnosed pneumonia in Wuhan, China;
  • From 6 January, MHLW requested local health governments to be aware of the respiratory illnesses in Wuhan by using the existing surveillance system for serious infectious illness with unknown etiology;
  • NIID is supporting local authorities on epidemiologic investigations including contact tracing;
  • Quarantine and screening measures have been enhanced for travelers from Wuhan city at the point of entries since 7 January;
  • NIID established an in-house PCR assay for nCoV on 16 January;
  • Revision of the risk assessment by NIID is being conducted, including the case definition of close contacts;
  • The public risk communication has been enhanced;
  • A hotline has been established among the different Member States to foster mutual investigations and information sharing.

Republic of Korea:

  • Contract tracing and other epidemiological investigation are underway;
  • The government of the Republic of Korea has scaled up the national alert level from Blue (Level 1) to Yellow (Level 2 out of 4-level national crisis management system);
  • The Republic of Korea health authority has strengthened surveillance for pneumonia cases in health facilities nationwide since 3 January 2020;
  • Quarantine and screening measures have been enhanced for travelers from Wuhan at the point of entries (PoE) since 3 January 2020;
  • Public risk communication has been enhanced.

January 21: The Centers for Disease Control and Prevention (CDC) “First Travel-related Case of 2019 Novel Coronavirus Detected in United States”

The Centers for Disease Control and Prevention (CDC) today confirmed the first case of 2019 Novel Coronavirus (2019-nCoV) in the United States in the state of Washington. The patient recently returned from Wuhan, China, where an outbreak of pneumonia caused by this novel coronavirus has been ongoing since December 2019. While originally thought to be spreading from animal-to-person, there are growing indications that limited person-to-person spread is happening. It’s unclear how easily this virus is spreading between people.

The patient from Washington with confirmed 2019-n-CoV infection returned to the United States from Wuhan on January 15, 2020. The patient sought care at a medical facility in the state of Washington, where the patient was treated for the illness. Based on the patient’s travel history, and symptoms, healthcare professionals suspected this new coronavirus. A clinical speciman was collected and sent to CDC overnight, where laboratory testing yesterday confirmed the diagnoses via CDC’s Real time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR) test.

CDC has been proactively preparting for the introduction of 2019-nCoV in the United States for weeks, including:

  • First alerting clinicians on January 8, 2020, to be on the look-out for patients with respiratory symptoms and a history of travel to Wuhan, China.
  • Developing guidance for clinicians for testing and management of 2019-nCoV, as well as guidance for home care of patients with 2019-nCoV.
  • Developing a diagnostic test to detect this virus in clinical specimens, accelerating the time it takes to detect infection. Currently, testing for this virus must take place at CDC, but in the coming days and weeks, CDC will share these tests with domestic and international partners.
  • On January 17, 2020, CDC began implementing public health entry screening at San Francisco (SFO), New York, (JFK), and Los Angeles (LAX) airports. This week CDC will add entry health screening at two more airports – Atlanta (ATL) and Chicago (ORD).
  • CDC has activated its Emergency Operations Center to better provide ongoing support to the 2019-nCoV response.

CDC is working closely with the state of Washington and local partners. A CDC team has been deployed to support the ongoing investigation in the state of Washington, including potentially tracing close contacts to determine if anyone else has become ill.

Coronaviruses are a large family of viruses, some causing respiratory illness in people and others circulating among animals including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people, such as has been seen with Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

When person-to-person spread has occurred with SARS or MERS, it is thought to happen via respiratory droplets with close contacts, similar to how influenza and other respiratory pathogens spread. The situation with regard to 2019-nCoV is still unclear. While severe illness, including illness resulting in several deaths, has ben reported in China, other patients had milder illness and been discharged. Symptoms associated with this virus have included fever, cough, and trouble breathing. The confirmation that some limited person-to-person spread with this virus is occurring in Asia raises the level of concern about this virus, but CDC continues to believe the risk of 2019-nCoV to the American public at large remains low at this time.

This is a rapidly evolving situation. CDC will continue to update the public as circumstances warrant.

January 21: Washington Governor Jay Inslee posted a statement titled: “Inslee statement on novel coronavirus case confirmed in Washington”. From the statement:

Gov. Jay Inslee issued a statement in response to the confirmed case of novel coronavirus in Washington, the first confirmed case in the U.S.

“I’d like to thank the Washington State Department of Health, the Snohomish County Public Health Department and the Centers for Disease Control and Prevention for their quick action on this.

“Based on what we know now, risk to the general public is low. Our local and state health departments were prepared for this contingency. They have practiced and drilled for this situation, and they were ready. The quick response also shows the importance of a strong public health system, which we have here in Washington state.

“We want to make it clear: our teams are employing a layered approach to combat this. We have strong partnerships and a tiered public health system in place. 

“We take this very seriously and, while this is the first case in the U.S., there will likely be others. Washington state will continue to work to share information and help however we can.”

January 21: Reuters posted “Macau confirms first Wuhan virus case, tightens screening in casinos”. It was written by Donny Kwok.

The Chinese-ruled gambling hub of Macau confirmed on Wednesday its first case of pneumonia linked to an outbreak of a newly identified coronavirus and tightened temperature screening measures in casinos and around the city.

The death toll from the flu-like coronavirus in China rose to nine on Wednesday with 440 confirmed cases.

The virus, originating in Wuhan at the end of last year, has spread to Chinese cities including Beijing and Shanghai, as well as the United States, Thailand, South Korea, Japan and Taiwan.

The Macau case involves a 52-year-old Wuhan businesswoman who reported to hospital on Tuesday, said Macau Secretary for Social Affairs and Culture Ao Leong Lu, who vicechairs a committee set up to respond to the virus.

The woman took a high-speed train to the Chinese city of Zhuhai on Jan 19, then a shuttlebus to Macau. She had dinner with two friends, then went to the hotel and spent a long time in casinos. She was in a stable condition in an isolation ward. Her two friends were also being monitored and were in isolation.

Speaking at a news conference in Macau, Ao and other officials said authorities were coordinating with six gaming enterprises to introduce temperature screening machines at all entrances into casinos.

A total of 405 guest entrances and 47 staff entrances have already been provided with portable screening devices and all casino staff had to wear surgical masks. All performers and staff at the events hosted across Macau will be screened.

Entry points into Macau will also have temperature checks and visitors will be asked to fill in a health declaration form. Bus stops, taxi stands and wet markets will be cleaned more frequently.

The tourist-magnet casino industry in Macau, which returned to Chinese rule in 1999, accounts for more than 80% of the revenue in the city of 600,000 people. Macau is a popular Lunar New Year destination for mainland Chinese.

Coronavirus are a family of viruses named because of the crown-like spikes on their surfaces that cause respiratory illnesses ranging from the common cold to the deadly Severe Acute Respiratory Syndrome (SARS).

January 21: Centers for Disease Control and Prevention (CDC) posted “Transcript of Update on 2019 Novel Coronavirus (2019-nCoV)”. From the transcript:

Operator: Standby for today’s conference, we will begin in just a few moments. Know if you are standing by, all lines will be listen only. You can press start and 1 to ask a question on the phone line. This call is being recorded if you have objections, you can continue next disconnect at this time. You may begin.

Ben Haynes: Thank you, Sarah, and thank you for joining us for today regarding the CDC 2019 novel coronavirus response. We are joined today by Dr. Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Disease and health officials from the state of Washington. Dr. Messonnier will provide opening remarks before taking your questions. I will now turn the call over to Dr. Messonnier.

Nancy Messonnier: Good afternoon and thank you all for joining us. During our briefing last Friday, I foreshadowed that we could see a novel coronavirus infection in the United States, most likely in a traveler from Wuhan. Today I am joined by representatives from the state of Washington to announce that we have now confirmed the first case of novel coronavirus in the United States.

CDC has been proactively preparing for an introduction of the virus here. We know that today’s news is concerning. I’m grateful with the work being done at all levels within the federal government and at the state and local level to prepare and respond. Based on international reports, there are now close to 300 people who have been confirmed with this novel coronavirus in China, and there have been travel associated introductions in Thailand, Japan, Taiwan, and South Korea. Additional deaths have also been reported. Human to human spread has been confirmed. How easily or sustainably this virus is spreading remains unknown. These new developments further emphasize CDC’s proactive approach in responding to this evolving outbreak.

In terms of our response: Over the weekend CDC finalized development of a real time Reverse Transcription-Polymerase Chain Reaction – abbreviated as rRT-PCR – test that can diagnose this new virus. We used this test to quickly confirm our first U.S. case. Right now, testing for this virus must take place at CDC, but in the coming weeks, we anticipate sharing these tests with domestic and international partners through the agency’s International Reagent Resource.

Yesterday, we activated our Emergency Operations Center in response to the newest developments. I know a lot of you are likely wondering about the entry screening that we started on Friday at San Francisco airport, New York JFK, and LAX airport. So far, CDC staff have screened over 1,200 passengers. However, no individuals have been referred to a hospital or discovered yet through entry screening. This is an evolving situation and again, we do expect additional cases in the United States and globally. This week CDC will add entry health screening at two more airports – Atlanta Hartsfield-Jackson and Chicago O’Hare. Today, we will also be raising our travel health notice from a level 1 to a level 2. Preliminary information suggests that older adults with underlying health conditions may be at increased risk for severe disease.

I’m now going to hand the briefing over to my colleague, Washington State Secretary of Health, John Wiesman, who will introduce key players in Washington state and outline what the public health system is doing in response to the case. Dr. Wiesman.

John Wiesman: Great, thank you Dr. Messonnier. I appreciate that.  Hello, I am John Wiesman, Secretary of Health for the state of Washington. I first want to begin by recognizing the quick, collaborative work being done with our local and federal public health and healthcare partners. Over the holiday weekend, this group of people quickly identified a possible risk, coordinated the patient care, sent samples to CDC, and CDC tested them immediately. Together we are implementing actions to ensure the public’s health is protected.  

I am also thankful that the man who tested positive for this virus acted so quickly to seek treatment.  Because of that we were able to isolate him from the public. His actions gave us a head start. All of this work means we believe the risk to the public is low. It’s true that we are learning more about the new coronavirus. We have a strong public health team here in Snohomish county and Washington state. And together with our partners at CDC, we will share any additional information as we learn it. To give you information about the situation, I’ll hand it over to our state infectious disease epidemiologist, Dr. Scott Lindquist and Dr. Chris Spitters, the health officer from Snohomish Health District, who will tell you more about the current situation. Dr. Lindquist.

Scott Lindquist: Thanks, this is Scott Lindquist, the state epidemiologist for Washington state. And I just want to remind everyone how we had anticipated screening, so our system was ready despite a holiday weekend. This is a man in his 30s in a county north of Seattle, Snohomish County, and we have been in close contact, thanks to the CDC’s Emergency Operations Center helping direct the appropriate specimen collection, isolation, and investigation procedures with the local health jurisdiction. So, I’ll turn it over to our local health officer, Dr. Chris Spitters, who can give us some details of where they’re working on this patient right now. Chris.

Chris Spitters: Thank you Scott. Last night, the Snohomish Health District coordinated with the Snohomish county emergency medical system to safely transport the patient to Providence Regional Medical Center in Everett. That facility is following our jointly developed infectious disease protocols to ensure prevention of transmission in the facility. As stated earlier, the risk to the general public is low.  We are working with the medical center to ensure that the small number of healthcare workers and patients that may have been exposed are notified for symptom watch and monitored.

No one wants to be the first in the nation in these types of situations, but these are the types of situations that public health and its partners train and prepare for. Because of this, everything has been going along quite smoothly and on behalf of the Snohomish Health District, I’d like to thank the Centers for Disease Control, the Washington State Department of Health, and Providence Regional Medical Center, as well as all of our local partners in Snohomish county for their support and collaboration in this effort.

Nancy Messonnier: Thank you all. I just wanted to add briefly that a CDC team has been deployed to support the ongoing investigation in the state of Washington, including tracing close contacts to determine if anyone else has become ill. As always, we stand by to help out state, local, and global partners in any way we can. As I mentioned on Friday, we have faced similar challenges before – with SARS and MERS. Those outbreaks were complex and required a comprehensive public health response. Because of that experience, we know it’s crucial to be proactive and prepared. 

The confirmation that human to human spread with this virus is occurring in Asia certainly raises our level of concern about this virus, but we continue to believe the risk of this novel coronavirus to the American public at large remains low at this time. Activation of the EOC and the enhanced airport entry screening reflect the continuation of CDC’s very aggressive public health response strategy. Enhanced airport screening is just one part of a layered approach to increasing the public health and healthcare delivery system to raising its awareness to properly detect the cases early. 

This individual had a level of concern that enabled him to seek medical care promptly and his clinicians appropriately evaluated and reported the patient. I want to remind everyone that we are still in the early days of this investigation – both domestically and abroad. We are monitoring the situation closely and working to keep you informed every step of the way.  

I want to take a moment to thank our colleagues in Washington at both the state and local level, as well as the healthcare staff that have been fully engaged and collaborating with us since yesterday when this case was discovered and tested as novel coronavirus. Our ability to coordinate and react this quickly is entirely dependent on these collaborations. We are aware that this situation could change quickly.  Therefore, we at CDC are taking a cautious approach to this outbreak and are prepared to respond to any new developments.

Ben Haynes: Thank you, doctor, we are now ready for questions.

Operator: The first question is from Helen Branswell with STAT, your line is open.

Helen Branswell: Thank you very much. In this case with this individual, can you give us information about his condition? Is he ill? Do you know if he had contact with people who were contagious?

Nancy Messonnier: Washington state we will let you answer that.

Chris Spitters: So, regarding the patient’s condition, they are in good condition and again, they’re currently hospitalized out of an abundance of precaution and for short term monitoring. Not because there was a severe illness. At this point, the individual has reported that he did not visit any of those implicated markets and did not know anyone who was ill. He was just traveling from that area.

Ben Haynes: Next question please.

Operator: Thank you, our next question from Evan Brown with Fox News, your line is open.

Evan Brown: Thank you very much. Just thinking back a number of years to the Ebola incident in Dallas. We saw a real push to not only have that individual placed in isolation as well as the other folks who became ill with very strict isolated standards. Is this a scenario where this same contingency is needed? Or no? What type of care is given to the patient for this? Are they isolating him and what type of medications can he get? Or is it a matter of supportive care?

Nancy Messonnier: This is CDC, maybe we’ll give a general answer and then we’ll turn it over to Washington for you to talk specifically about this patient. Thank you for that question. It’s actually important to clarify that the precautions for this patient are standard isolation precautions. This is something that many hospitals know how to do and we’re grateful that in this region in Washington state they were prepared for this contingency. So this is not a situation like the Dallas one. This is something where most hospitals in the region should have a hospital that can utilize these kinds of precautions. Washington?

This is CDC, maybe I’ll also say this is a hugely important issue and the health of our healthcare workers is very important to all of us. And we are practicing very, we are being proactive at all levels to make sure that as much as possible the people taking care of this patient are careful and cautious. And CDC will be working closely with the state health department on the particulars of this patient’s care.

Scott Lindquist: Just regarding the Dallas or the Texas incident, this is again, not the same situation and plus this is an area of the state that has drilled recently on transporting a person in the ambulance and what types of isolation they should require. And there’s no question that there is isolation equipment available to the hospital. Again, we are very comfortable that this patient is isolated, poses a very little risk to the staff or the general public in this current situation. And again, because of an abundance of caution, we have used pretty strict isolation requirements and hospitalization because it is the first person in the UntiedStates. We will likely learn from this and future cases and we will adjust our recommendations accordingly.

Ben Haynes: Next question please.

Operator: Our next question comes from Lena Sun with the Washington Post.

Lena Sun: Hi, can someone go over the basics with us. When did this person arrive? Did they arrive through one of the airport screening locations? Were they on a direct flight from Wuhan? What was the timeframe? Is this person a resident of the United States he went to China for business or pleasure and is now back in the United States?

Scott Lindquist: We can give you the detail we know that that’s our priority today is really all the details of flight numbers, seat numbers, and people that would have been exposed. What we know currently is he proceeded the institution of the screening at the airports. He came in before that screening was done and was actually not with symptoms when he came to the United States.

But this was a very astute gentleman that is looking at internet activity and had actually researched this and shared this information with his provider. We know it was not a direct flight from Wuhan to Sea-Tac, which is our local airport. And that’s really our challenge going forward.

We had talked about this on Friday that while we weren’t screening at Sea-Tac, we potentially could have a traveler the came through many routes. So we decided to activate and be ready before all the screening airports were set into motion. So, this gentleman kind of proceeded and slipped around that type of screening, but because the public health system was aware and because this is a really agreeable gentleman who was looking out for his health care, we were able to detect it early and really minimize ongoing exposure to anybody.

Lena Sun: So I have a follow-up question that I want to understand. So, this gentleman came to Seattle and you’re not sure how. It was not a direct flight and because he was monitoring the internet and did not have symptoms, when he started to get symptoms, he proactively reached out to providers or health officials?

Scott Lindquist: Correct, that’s exactly how he did it. Chris, is there anything you would like to add?

Chris Spitters: Just to add on that he has been fully cooperative.

Lena Sun: Okay, is he a resident of the United States?

Chris Spitters: Yes, a resident of the U.S.

Nancy Messonnier: Before we move on, I just want to say that as this situation and as the information has been accumulating over the weekend, CDC has been thinking and rethinking our stance and we made some decisions on Sunday even in advance of this case. And Dr. Marty Cetron, who many of you know, is just going to tell use where we are on that screening.

Marty Cetron: First, I want to highlight the fact that, leave not doubt, entry screening is just one part of a multilayered system. The point is to alert the system. Individuals are often very empowered to make good decisions if they are informed. Healthcare systems and public health departments, as you just heard, are being alerted. The entry screening is one part of that with notices going out.

The screening system started after the Seattle case, this gentleman was indirect, not on a direct flight. Over the weekend with the increasing cases, we decided to more into this full on 100% coverage strategy which means adding additional airports and instructing on Sunday the Department of Homeland Security and the Department of Transportation to begin our funneling approach and redirect all the traffic to the airports that have screening to the benefit of the alert can be more completely covered.

So that plan is in place, the new airports will be rolling online this week and the operationalizing of the funneling, which is a very complex process involves reissuing tickets and rerouting passengers from all over the globe through connecting and direct flights. All of that is part of the strategy that was actually initiated before we even heard about this case to compete that coverage.

Lena Sun: I have another follow-up question. The reporter would like to know the date of when this gentleman came to Seattle?

Marty Cetron: Our best understanding is on the 15th of January. The screening initiated on the 17th.

Lena Sun: When did he reach out to providers?

Scott Lindquist: Yeah, he actually reached out on the 16th. This is Scott Lindquist. He actually reached out to his medical provider on the 19th. We were in communication with the CDC Emergency Operations Center coordinating specimens that were shipped overnight and had the results the following day, incredibly fast.

Ben Haynes: Next question, please.

Operator: The next question comes from USA Today. Your line is open.

Grace Hauch: Hi there. I wonder if this gentleman came through Sea-Tac why there is a screening there and at Chicago, has screening begun or is it about to begin? Are they other airports considering?

Marty Cetron: Yeah, no, the kind of active screen isn’t in place at Sea-Tac and as I indicated last Friday, when we spoke, you have to go down to a lot of airports to do this across the country, for every single possible flight. So, we concentrate that by volume and when we get to the top five as we are looking at here in this regard, that we begin to redistribute the flights so they can be concentrated in the airports.

However, all 14 airports that had passengers had notices and had been put on alert, had been working from the airport quarantine stations with their public health partners. So, again, it’s a multistep process. It rolls out and, in fact, this idea of funneling means redirecting and reissuing tickets so all the arriving passengers from Wuhan would come into the airports where we can surge this capacity at. All the airports are doing other steps, particularly passenger education, as which you can see if very important in this regard. And that education is in both English and Mandarin.

Ben Haynes: Next question, please.

Operator: The next question is from Ryan with the Seattle Times, your line is open.

Ryan Blethen: Hi, I wasn’t let onto the phone call until the question-and-answer period and I may be asking about things already covered. Where in Washington state is this man? You can start with that.

I am curious as to where he is in Washington in which hospital he is at? And what are hospitals doing in Washington now to look for this? Also, on the screening question, is Sea-Tac going to be one of the airports that will be screening for this now?

Chris Spitters: So the gentleman is a Snohomish county resident and he is currently at Providence Medical Center. This is Chris, I am the health officer of the Snohomish Health District.

Marty Cetron: I think it’s important to point out that all the quarantine stations do enhanced education and respond to any illness report. I indicated that active screening, which is where every passenger is questioned and has a temperature check is going on at the top three airports right now – JFK, San Francisco which has direct flights and LAX which has most of the indirect flights. Additional screening will be added to Chicago and Atlanta this week and rolled out as soon as the capacity. And the rest of the airports, all of the people who originate in Wuhan and travel to the United States, all of those tickets, passengers will be routed into these five.

Scott Lindquist: And this is Scott Lindquist, the state epidemiologist for Washington state. This is part of our larger plan of preparing the hospitals and the healthcare system for all hazard preparedness which means Ebola, SARS, MERS, or in this case, the novel coronavirus. Most of these hospitals have been prepared with infection control with how to sample, how to isolate. And we were well prepared as this hospital is one of the hospitals that recently did a drill as well as our ambulance system for transporting the patients.

John Wiesman: And just sort of reinforcing the layered approach here, hospitals need to be prepared with patient education. In this case we don’t believe even if we had active screening at the airport that this patient would have been picked because at the time, we don’t believe the patient had symptoms of a fever. So, this is the important piece about having a strong public health system all across the country that is prepared for this kind of biosecurity approach.

Ben Haynes: Two more questions. Our next question comes from Roni Rabin with the New York Times.

Roni Rabin: I also came in very late and right now what is being done to secure or what steps is the CDC doing about that? You have people in China who are working with the Chinese authority.

Nancy Messonnier: This is CDC. As you say, there is new information hour by hour, day by day that we are tracking and following closely. We do have staff in China and Thailand and they have long term placements there working closely with the ministries of health. We also have staff at WHO and certainly have collaborated with global health leaders worldwide. We and the global health community are really working together to understand the situation. Information is rapidly evolving and we hope that over the next coming days, the situation will become clearer and certainly as you point out, the key issue that we all need to understand is how easily or sustainably the virus is spread from human to human and that is information we don’t completely have nailed down yet. But we’re continuing to work globally with all our partners to better understand it.

Roni Rabin: Thank you. Can you still hear me? In the case of the Washington patient –? Just a reminder of the timeline.

Scott Lindquist: Just a reminder of the timeline. This gentleman presented on Sunday, specimens were obtained, and the results were learned on Monday. And today, Tuesday, our priority is doing contact investigation and tracing. So, we have had three people assigned to us from CDC that are here and that is our priority to determine what it means to be at risk, who those people are, doing the contact investigations all the way from China to his home here in Snohomish county. That’s exactly what our priority is right now early in this investigation.

Nancy Messonnier: Just to add that we are grateful that the patient is doing well and that is clinically not ill and he has been so cooperative. Things have been moving quickly and the health department has appropriately been prioritizing their activities. But there will be a whole set of activities to come in the coming days. But their first priority was clearly making sure this patient was healthy and being appropriately treated as we move on to the next phase.

Ben Haynes: Last question.

Operator: The last question comes from Julie Steenhuysen with Reuters, your line is open.

Julie Steenhuysen: Are you coordinating with the world health organization in terms of how to treat this patient? What are you using at this point?

Nancy Messonnier: There is a global effort to share information about potential treatments. That’s globally among the community of people that have dealt with similar issues with MERS and SARS, as well as inter-governmentally within the United States. So all those conversations are ongoing and very active. That being said, as our collaborators in Washington state said, the gentleman is right now very healthy. I think that would be characterized that he is getting supportive care and monitoring.

Chris Spitters: That’s absolutely correct, I have nothing to add.

Julie Steenhuysen: One more follow-up, is CDC working with NIH to develop a vaccine and where is that effort?

Nancy Messonnier: NIH has always been very active in this area and there is early work early and early conversations. As you know, the development of a vaccine is a complex process. It’s not something that’s going to be available tomorrow. But there are active conversations about vaccines as well as diagnostics [editor’s note: therapeutics should be replaced with diagnostics.]

Ben Haynes: Thank you Dr. Messonnier, Dr. Cetron and colleagues from the state of Washington. I’d also like to thank you all for joining us for today’s briefing. Please visit the 2019 novel coronavirus webpage for continued updates. If you have further questions, please call the CDC media line at 404-639-3286 or email media@cdc.gov.

Operator: That does conclude today’s call. Thank you for participating. You may disconnect your lines at this time.


January 22

January 22: World Health Organization Western Pacific China posted “Mission summary: WHO Field Visit to Wuhan, China 20-21 January 2020”.

On 20-21 January 2020, a World Health Organization (WHO) delegation conducted a field visit to Wuhan to learn about the response to 2019 novel coronavirus (2019-n-CoV). The mission was part of the on-going close collaboration between WHO and Chinese national, provincial, and Wuhan health authorities in responding to 2019-n-CoV.

The delegation visited the Wuhan Tianhe Airport, Zhongnan hospital, Hubei provincial CDC, including the BSL3 laboratory in China’s Center for Disease Control (CDC). The delegation observed and discussed active surveillance processes, temperature screening at the airport, laboratory facilities, infection prevention and control measures at the hospital and its associated fever clinics, and the deployment of the rRT-PCR test kit to detect the virus.

Data collected through detailed epidemiological investigation and through the deployment of the new test kit nationally suggests that human-to-human transmission is taking place in Wuhan. More analysis of the epidemiological data is needed to understand the fill extent of human-to-human transmission. WHO stands ready to provide support to China to conduct further detailed analysis.

The delegation discussed China’s plan to expand 2019-nCoV definition. This will allow China and the international community to build a clearer picture of the spectrum of severity of the novel coronavirus. The new case definition and the provision of test kits to all provinces of the spectrum of severity of the novel coronavirus. The new case definition and the provision of test kits to all provinces, are expected to lead to further increases in the number of cases identified and confirmed in Hubei Province and other provinces. Increases in conformed cases are to be expected as testing is increased.

The delegation discussed with the local authorities their on-going efforts to communicate to the general public to expect more cases of 2019-nCOV to be confirmed, and to follow public health advice regarding infection control procedures. This is especially important at a time when seasonal influenza is at its highest, and over the Chinese New Year period when many people travel across China. The delegation and their counterparts agreed close attention should be paid to hand and respiratory hygiene, food safety, and avoiding mass gatherings where possible. People with fever should avoid close contact with others and seek medical help.

The facilities for fever triage and for treatment of suspected and confirmed cases were visited in Zhongnan hospital. The delegation witnessed the systems that have been put in place to provide high quality diagnostic, treatment, and isolation services. The identification among 16 health care workers reinforces the importance of ensuring appropriate infection prevention and control measures are in place for patients, staff and hospital visitors at all times. All health professionals should adhere to infection control procedures even in parts of the health care system that do not usually deal with cases of infectious diseases.

On 21 January 2020, at the conclusion of the visit the Chinese Government has released the primers and probes used in the rRT-PCR test kit. This follows China’s rapid identification of the virus and sharing of the genetic sequence. The primers will assist with establishing real-time RT-PCR for the detection of 2019-n-CoV in other countries. Chinese experts also shared with the delegation a range of protocols that will be used in developing international guidelines, including case definitions, clinical management protocols, and infection control among others.

The delegation commended the commitment and capacity demonstrated by national, provincial, and Wuhan authorities and by hundreds of local care workers and public health specialists working to respond to the 2019-nCOV outbreak. While challenges still remain regarding the transmission, epidemiology, and our understanding of the behavior of the virus, WHO and its partners will work together with China to respond to this outbreak.

January 22: People’s Daily, China, the largest newspaper in China, tweeted: “No people in #Wuhan, C China’s Hubei will be allowed to leave the city starting 10 a.m. of Jan 23. Train stations and airport will shut down; the city bus, subway, ferry and long-distance shuttle bus will also be temporarily closed: local authority #WuhanPneumonia #coronavirus”

January 22: South China Morning Post posted “China has been transparent about Wuhan outbreak, virus expert Zhong Nanshan says”

Chinese officials have been transparent in handling the Wuhan coronavirus outbreak and the participation of a Hong Kong professor through the process indicates the Beijing has no secrets to hide, said one of the country’s leading experts on communicable diseases.

Dr Zhong Nanshan, whose team is advising the leadership on how to handle the crisis, told a new conference in Guangzhou on Tuesday that China had not held back information in reporting the outbreak in Wuhan, which has sucked more than 300 people across the country since early December.

As of Tuesday night, Chinese authorities said, at least six people – all in Wuhan – have died after contracting the virus and a total of 15 medical personnel, also in Wuhan, have been infected.

Zhong cited the involvement of Professor Yuen Kwok-yung, a top infectious-disease expert at the University of Hong Kong, as proof that Chinese leaders understand the importance of transparency in handling the public health emergency.

Yuen was among a group of experts who visited Wuhan on Sunday to assess the situation in the central China city, which has a population of 11 million. Speaking in Hong Kong on Tuesday, Yuen warned that the coronavirus outbreak in Wuhan has entered the stage of transmission among families and hospitals taking it a step closer to a full-blown community epidemic.

“This time I worked together with Professor Yuan to determine how the infection has spread [in China],” said Zhong, who was China’s best-know expert during the 2002-2003 Sars crisis, which killed more than 700 people globally.

“Phase one of the transmission is from animals to human … and we are now in phase two, which is about human to human.”

“According to Professor Yuen, we will be in phase three if we have a clear spreader of the virus,” he added.

China’s credibility raised at it tries to dispel fears it will cover up the spread of the virus.

Zhong said that Yuen’s participation should help allay concerns among that China would cover up the epidemic or was reluctant to share information.

“There are people in Hong Kong who believed that China would not report infections truthfully,” Zhong said. “But Professor Yuen has now participated in a number of our major meetings [about the outbreak] including the one chaired by Vice-Premier Sun Chunlan and he (Yuan) had even offered some suggestions in the meetings.”

“He has very good ideas of what’s happening in China,” Zhong added.

“So he has taken part in our highest level of discussions and he has knowledge of how we are handling the situations,” Zhong said. “[This] also enables us to have relatively good cooperation with the authorities in Hong Kong, both in the government and technical levels.”

Regarding criticism that Wuhan had been slow in publicizing information about the outbreak, Zhong defended the municipal government, saying that local officials had tried their best to report suspected cases as fast as possible and that the could only confirm cases after test result had been verified by higher authorities.

He supported the decision by the Wuhan government to impose a travel ban on travellers who have been detected with high temperatures – a symptom of infection.

“The leadership in Wuhan is very concerned about outbound travel and has taken serious steps to monitor passengers’ temperature,” he said. “The government would stop any passengers who have developed a fever, and I fully support such measures.”

Reports that the virus was spreading raised particular concern, as more than 450 million Chinese are expected to travel over the Lunar New Year holiday period, according to official estimates. On Tuesday the US Centers for Disease Control and protection confirmed that the first known case of Wuhan coronavirus had been identified in the United States.

Zhong warned that the current outbreak could exacerbate if more medical personnel catch the virus.

“We must pay special attention to hospitals so they would not fall to human-to-human transmission,” he said. “The consequence can be very serious if infection happens between patients and doctors.”

“We must keep up our guard so hospitals would not become the venues where the disease spreads,” he added.

January 22: The Guardian posted “Coronavirus: WHO steps back from declaring public health emergency”

The World Health Organization has stepped back from declaring the growing viral pneumonia outbreak in China to be a public health emergency of international concern, saying its expert committee would meet again on Thursday to discuss more evidence from its teams on the ground.

“This is an evolving and complex situation,” said Dr Tedros Adhanom Ghebreyesus, the director-general of the WHO. “Today there was an excellent discussion but it was also clear that to proceed we need more information.”

“The decision is one I take extremely seriously and one I am only prepared to make with appropriate consideration of all the evidence.”

More than 540 people have been taken to hospital with breathing difficulties and 17 have died, all in Hubei province, the Chinese authorities said on Wednesday. Many more are thought to have developed a milder form of the illness. UK infectious disease experts have doubled their estimate of the likely number of cases during the coronavirus outbreak to 4,000.

The WHO’s emergency committee met as the international spread of the virus became clear, following the diagnosis of cases in people who have travelled not only to other regions of China but also abroad. There have been cases in Thailand, Japan, South Korea, and most recently, the United States.

The coronavirus is from the same family that caused 800 deaths globally from Sars (severe acute respiratory syndrome) in 2022-03 and Mers (Middle East respiratory virus), identified in 2012.

The UK government said on Wednesday morning that it was implementing checks on travelers arriving from the city of Wuhan, but within hours, it became clear that the three direct flights a week to Heathrow would not be arriving. Chinese state media announced that Wuhan was shutting down outbound flights and trains.

The official Xinhua News Agency said people had been asked not to leave Wuhan without specific reasons. The People’s Daily newspaper tweeted that no one would be allowed to leave the city from 10am on Thursday and that train stations, the airport, city busses, subways, ferries and long-distance shuttle busses would be temporarily closed.

Members of WHO’s emergency committee, who praised China for its openness in sharing data and information, said that in circumstances where a new and infectious virus was circulating, they would recommend that mass gatherings should be avoided.

Responding to the public transport ban, Dr Didier Houssin, chair of the committee, said: “We need some time to understand the specific measures that have been taken.” The WHO team in China would be reporting overnight on developments.

The committee said that the virus is mostly affecting older people, with 73% of patients over the age of 40. Nearly two-thirds (64%) are male and 40% of those who have died had underlying conditions that made them vulnerable to a new virus, such as heart disease or high blood pressure. That was typical of the coronaviruses, they said. The fatality rate so far appears to be lower than Mers, which kills a third of those who get it, or Sars which has a death rate of around 10%.

The new coronavirus has been linked to a market selling seafood and live animals in Wuhan, which has now been closed. The type of coronavirus has never been identified before and it has been confirmed that human-to-human transmission is taking place.

Experts believe it is quite possible the disease, which causes coughing, fever and breathing problems, will arrive in the UK. It can take at least five days for symptoms to show. If flights resume, the airport checks may not pick it up, but will serve to alert people to the need to get medical attention if they fall sick.

Prof Neil Ferguson’s team at Imperial College London, who carry out disease modelling for the WHO, said they had increased their estimate from 1,700 cases at the end of last week to 4,000. However, they say there is considerable uncertainty and the true number could be between 1,000 and 9,700.

“You should not interpret that as the epidemic doubling in size in five days,” Ferguson said. The increase was due to more information coming out of China, where doctors were struggling to deal with a rapidly evolving situation. “All the reports I have read from within China [suggest] that hospitals are now overwhelmed with suspect cases.”

Experts say the spread of the coronavirus fulfills the criteria of the WHO to declare it of international concern. “Personally, I think this is a big event,” said Hornsby. “Is it extraordinary? Yes, it pretty much is. We haven’t seen this large-scale spread since Sars.”

The Chinese authorities were criticized for failing to share information about the Sars epidemic which began in China in 2002 but spread globally. There have been around 2,500 cases of Mers, which is far less transmissible, mostly in Saudi Arabia.

“This is a new and rapidly evolving situation where information on cases and the virus is being gathered and assessed daily. Based on the available evidence, the current risk to the UK is considered low. We are working with the WHO and other international partners, have issued advice to the NHS and are keeping the situation under constant review,” said Dr Nick Phin, the deputy director of the National Infection Service at Public Health England.

“Individuals should seek medical attention if they develop respiratory symptoms within 14 days of visiting Wuhan, either in China or on their return to the UK. They should phone ahead before attending any health services and mention their recent travel to the city.”

Public Health England has shifted its risk assessment slightly from “very low” to “low”, but, said the transport secretary, Grant Shapps, “obviously we want to stay ahead of the issue so we are keeping a very close eye on it.”

The UK Foreign Office has updated its advice for Britons travelling to China, warning the virus had spread to other areas outside Hubei province.

January 22: South China Morning Post posted: “First Wuhan coronavirus case confirmed in United States as authorities say threat to public from deadly pneumonia still ‘low’

Public health officials in Washington state confirmed on Tuesday the first case of Wuhan coronavirus in the United States.

The patient was admitted to hospital on Sunday, after arriving in Seattle from Wuhan, China, on January 15, officials at the US Centres for Disease Control and Prevention (CDC) said.

The man, a US resident in his 30s, “is in good condition and hospitalized out of an abundance of precaution and for short-term monitoring”, a local health office, Chris Bitters, said. “He reported that he did not visit any of those impacted markets [in Wuhan] and did not know anyone who was ill. He was just travelling from that area.”

Initial transmissions of the virus have been traced back to Wuhan’s Huanan Wholesale Seafood Market, which has since been closed. Weeks after the market city in central China became “ground zero”, the authorities said human-to-human transmission played a role in the outbreak.

The CDC received samples of the previously unknown virus the day before the patient sought medical attention in Seattle for the symptoms he recognized in reports about the illness, Scott Lindquist, state epidemiologist for communicable diseases said. That enabled health authorities to confirm the diagnosis on Monday.

CDC officials called the case’s risk to the general public “low” because he was admitted to hospital early and had been very cooperative with health authorities.

“I’m grateful that the man who tested positive for this virus acted so quickly to seek treatment. Because of that we were able to isolate him away from the public, and these actions gave us a head start,” said Washington State Secretary of Health John Wiesman. “All tis work means that we believe the risk to the public is low.”

Still, more cases are expected to emerge in the US.

“This is an evolving situation and … we do expect additional cases in the United States and globally,” Nancy Messonnier, director of the CDC’s National Centre for Immunization and Respiratory Disease, said.

To take further precautions, Chicago O’Hare International Airport and Hartsfield-Jackson Atlanta Airport will begin screening for signs of the virus in passengers this week, adding to the list of airports that had already started this procedures.

New York’s John F. Kennedy International Airport, San Francisco International Airport and Los Angeles International Airport began the screening last week.

Additionally, the CDC changed its travel notice for China to an “alert level 2” from “watch level 1” Messionner said.

The death toll from the Wuhan coronavirus, which has sickened more than 300 people across China, has risen to nine. The central city of Wuhan, the epicenter of the outbreak, has stepped up controls to contain its spread.

Chinese officials reported as early as Wednesday that the total number of confirmed cases had jumped to 324, the bulk of them in Hubei province. Others were reported in Beijing, Shanghai, Tianjin, Guangdong, Zhenjiang, Henan and Chongqing.

Cases have also been confirmed in Taiwan, South Korea, Japan and Thailand, while Hong Kong reported 118 reported 118 suspected cases, including 88 people who have been discharged.

According to Wuhan health authorities, 15 medical personnel in the city had contracted the virus, confirming that it is spreading by human transmission and raising concerns that people at the most virulent stage of infection – so-called super-spreaders – could infect many others.

Authorities announced tightened inspection measures over travellers to and from the city, including a ban on outbound tour groups, and vehicle spot checks for wildlife and live animals.

Airline stocks in the US led a broad decline in the markets following the CDC’s confirmation of the Washington state coronavirus case.

United Airlines and Delta Air Lines both declined more than 2.5 per cent, while American Airlines tumbled by 4.2 per cent. The Dow Jones Industrial Average fell 152 points, or 0.5 per cent to 29,196, ending a week-long rise.

The US patient is undergoing treatment at Providence Regional Medical Centre Everett, north of Seattle.

January 22: The European Centre for Disease Prevention and Control posted “Risk assessment: Outbreak of acute respiratory syndrome associated with a novel coronavirus, Wuhan, China: first update”. From the Executive Summary of the information:

A novel coronavirus (2019-nCoV) has been isolated and considered the causative agent of the cluster of 448 pneumonia cases in the area of Wuhan, Hubei province in China, as well as four travel-associated cases in Thailand, Japan and South Korea.

On 31 December 2019, the Wuhan Municipal Health Commision in Wuhan City, Hubei province, China reported a cluster of pneumonia cases of unknown aetiology, with a common reported link to Wuhan’s Huanan Seafood Wholesale Market (a wholesale fish and live animal market selling different animal species).

On 9 January 2020, China CDC reported that a novel coronavirus (2019-nCoV) had been detected as the causative agent and the genome sequence was made publicly available. Sequence analysis showed that the newly-identified virus is related to SARS-CoV clade. Detection systems have been developed and are available for the Member States through WHO and the European Virus Archive global catalogue.

As of 20 January 2020, a total of 295 laboratory-confirmed cases infected with 2019-nCoV have been reported, 291 from Wuhan, China and four travel-associated from Thailand (2), Japan (1) and South Korea (1). Four deaths have been reported among the cases. Chinese health authorities have confirmed human-to-human transmission and 15 healthcare workers are reported to have been infected in Wuhan, and in China. It is possible that further cases will also be detected among travelers from Wuhan to other countries.

These are considerable uncertainties in assessing the risk of this event, due to lack of detailed epidemiological analyses.

On the basis of the information available, ECDC considers 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/EAA 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/EAA 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/EAA is low.

January 22: The CDC reported the onset of 1 more additional COVID-19 case in the United States.

January 22: PolitiFact posted: A reporter asks if there are worries about a pandemic. Trump responds: “No. Not at all. And we have it totally under control. It’s just one person coming in from China, and we have it under control. It’s going to be just fine.”

January 22: World Health Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report – 2”. From the report:

SUMMARY

Situation update:

  • As of 21 January 2020, a total of 314 confirmed cases have been reported for novel coronavirus (2019-nCoV) globally;
  • Of the 314 cases reported, 309 cases were reported from China, two from Thailand, one from Japan and one from the Republic of Korea;
  • Cases in Thailand, Japan and the Republic of Korea were exported from Wuhan City, China;
  • Of the 309 confirmed cases in China, 270 cases were confirmed from Wuhan;
  • Of the 270 cases, 51 cases are severely ill and 12 are in critical condition;
  • Six deaths have been reported in Wuhan;
  • Four of five deaths, with available epidemiological information, had underlying comorbidities;
  • To date, sixteen health care workers have been infected;

Reported incidence of confirmed 2019-nCoV cases

  • Hubei Province: 270
  • Guangdong Province: 17
  • Beijing Municipality: 5
  • Shanghai Municipality: 2
  • Chongqing Municipality: 1
  • Zhejiang Province: 5
  • Jiangxi Province: 2
  • Sichuan Province: 1
  • Tianjin Municipality: 2
  • Henan Province: 1
  • Shandong Province: 1
  • Yunnan Province: 1
  • Taiwan, China: 1
  • Japan: 1
  • Republic of Korea: 1
  • Thailand: 2
  • TOTAL: 314

Details reported on 21 January 2020:

Additional 32 cases (11% increase in number of cases) have been reported since the last situation report published on 21 January 2020. Cases have been reported in seven additional provinces and two municipalities. One case was reported in Taiwan, China.

  • Wuhan City:
  • Twelve additional confirmed cases were reported.
  • Guangdong Province:
  • Three additional confirmed cases including one male and two females;
  • Of the three confirmed cases, two had travel history to Wuhan and none had contact history with cases
  • Shanghai Municipality:
  • One additional confirmed case with no information available as of now;
  • Twenty closed cases for the first case mentioned in the situation report published on 21 December 2020 are being followed up.
  • Hunan Province:
  • One confirmed case in a female, Wuhan resident;
  • Date of symptom onset is unknown, currently in stable condition.
  • Shangong Province:
  • One confirmed case in a male, Wuhan resident;
  • Fifty-three contacts have been identified and are followed.
  • Sichuan Province:
  • One confirmed male, works in Wuhan.
  • Zhejiang Province:
  • Five confirmed cases;
  • All five cases had travel history to Wuhan and are currently in stable condition.
  • Chongqing Municipality:
  • One confirmed case in a female with travel history to Wuhan;
  • Current condition is unknown.
  • Tianjin Municipality:
  • Two cases, one male and one female, not epidemiologically linked to each other;
  • Both had travel history to Wuhan;
  • Current condition is unknown for both cases.
  • Yunnan Province:
  • One confirmed case in a male;
  • Current condition is unknown
  • Taiwan, China:
  • One confirmed case in a female, Wuhan resident;
  • No history of visiting the traditional markets or hospitals in Wuhan;
  • No contact with confirmed cases;
  • No contact with live animals;
  • Date of symptom onset was 11 January 2020;
  • Contact tracing and epidemiological investigations are underway.

As of 21 January, 16 cases have been reported among health care workers in Wuhan. Detailed exposure information from these health care workers is not currently available to WHO.

II. PREPAREDNESS AND RESPONSE:

WHO:

  • WHO has been in regular and direct contact with Chines as well as Japanese, Korean and Thai authorities since the reporting of these cases. The three countries have shared information with WHO under the International Health Regulations. WHO is also informing other countries about the situation and providing support as requested;
  • On 2 January, the incident management system was activated across the three levels of WHO (country office, regional office, and headquarters);
  • Developed the surveillance case definitions for human infection with 2019-nCoV and is updating it as per the new information becomes available;
  • Developed interim guidance for laboratory diagnostics, clinical management, infection prevention and control in health care settings, home care for mild patients, risk communication and community engagement;
  • Prepared disease commodity package for supplies necessary in identification and management of confirmed patients;
  • Provided recommendations to reduce risk of transmission from animals to humans;
  • Updated the travel advice for international travel in health in relation to the outbreak of pneumonia caused by a new coronavirus in China;
  • Utilizing global expert networks and partnerships for laboratory, infection prevention and control, clinical management and mathematical modelling;
  • Activation of R&D blueprint to accelerate diagnostics, vaccines, and therapeutics;
  • WHO is working with our networks of researchers and other experts to coordinate global work on surveillance, epidemiology, modelling, diagnostics, clinical care and treatment, and other ways to identify, manage the disease and limit onward transmission. WHO has issued interim guidance for countries, updated to take into account the current situation.

III. COUNTRY RESPONSE

China:

  • National authorities are conducting active case finding in all provinces;
  • Since 14 January 2020, 35 infrared thermometers have been installed in airports, railway stations, long-distance bus stations, and ferry terminals;
  • Search expanded for additional cases within and outside Wuhan City;
  • Active / retroactive case finding in medical institutions in Wuhan City;
  • The Huanan Seafood Wholesale Market in Wuhan City was closed in 1 January 2020 for environmental sanitation and disinfection. Market inspection in expansion to other markets;
  • Public education on disease prevention and environmental hygiene further strengthened in public places across the city, farmers’ markets in particular.

Thailand:

  • The Department of Disease Control has been implementing its surveillance protocol by fever screening of travellers from all direct fights from Wuhan to the Suvarnabhumi, Don Mueang, Chiang Mai, Phuket and Krabi airports, with the screening protocol starting at Krabi Airport started on 17 January 2020;
  • From 3 to 20 January 2020, among 116 flights, 18,383 passengers and aircrew members were screened for respiratory symptoms and febrile illness;
  • As of 22 January 2020, the Department of Disease Control, Ministry of Public Health, Thailand has scaled up the Emergency Operations Center to Level 2 to closely monitor the ongoing situation both at the national and international levels;
  • Risk communication guidance has ben shared with the public and a hotline has been established by the Department of Disease Control for people returning from the affected area in China with related symptoms.

Japan:

  • From 6 January, the Ministry requested local health governments to be aware of the respiratory illness in Wuhan by using the existing surveillance system for serious infectious illness with unknown etiology;
  • Quarantine and screening measures have been enhanced for travellers from Wuhan at the point of entries since 7 January;
  • National Institute of Infectious Diseases (NIID) established an in-house PCR assay for nCOV on 16 January;
  • The Japanese Government scaled up a whole-of-government coordination mechanism on the 16 January;
  • As of 21 January, National Institute of Infectious Diseases (NIID) announced it will conduct active epidemiological investigations for confirmed cases and close contacts;
  • The Ministry of Health has strengthened surveillance for undiagnosed severe acute respiratory illnesses since the report of undiagnosed pneumonia in Wuhan;
  • Revision of the risk assessment by NIID is being conducted, including case definition of close contacts;
  • The public risk communication has been enhanced;
  • A hotline has been established among the different ministries in the government;
  • The MHLW is working closely with WHO and other related Member States to foster mutual investigations and information sharing.

Republic of Korea:

  • Contact tracing and other epidemiological investigation are underway;
  • The government has scaled up the national alert level from Blue (Level 1) to Yellow (Level 2 out of 4-level national crisis management system);
  • The health authority strengthened surveillance for pneumonia cases in health facilities nationwide since 3 January 2020;
  • Quarantine and screening measures have been enhanced for travelers from Wuhan at the point of entries (PoE) since 3 January 2020;
  • Public risk communication has been enhanced.

January 22: Nippon.com (News from Japan) posted “Japan Struggling to Prepare for Coronavirus Threat”. From the article:

As Japan prepares for an influx of Chinese visitors during the Lunar New Year holiday period, hotels and other commercial facilities are struggling to devise measures for preventing the spread of a new coronavirus strain from China.

One major hotel chain operator said that it does not plan to take special measures against the threat of coronavirus. Hotel reception staff are unable to take ordinary prevention measures such as wearing surgical masks from a hospitality persepctive.

Another hotel company, Prince Hotels Inc., plans to post warnings around the lobby in Japanese, English and Chinese calling on visitors to alert hotel staff if they feel unwell.

Restaurant chain giants McDonald’s Co. (Japan) and Ootoya Holdings Co. <2705> are also unable to take special measures, falling back on ordinary hygiene management measures such as making employees wash their hands.

One source from a major department store operator said that companies’ hands are tied, as measures to distinguish Chinese visitors from other people would be infeasible.

January 22: The Guardian reported: European airports from London to Moscow step up checks on flights from Wuhan.

The WHO’s chief, Tedros Adhanom Ghebreyesus says he is postponing the decision on whether or not to declare a global health emergency. “I have decided to ask the emergency committee to meet again tomorrow to continue their discussion,” he said, referring to a group of international experts who met for several hours at the WHO in Geneva.

January 22: Australian Government Department of Health posted: “Chief Medical Officer’s interview on ABC Radio AM about novel coronavirus”

SABRA LANE: Australia’s Chief Medical Officer is Professor Brendan Murphy. When I spoke with him earlier, I began by asking what will happen if the World Health Organization decides to declare this outbreak a public health emergency.

[Excerpt]

PROFESSOR BRENDAN MURPHY: Well, that sets up a range of responses from the World Health Organization, it ups their response and their involvement in managing the outbreak in China. It probably won’t have much significance for us in terms of our response, we’ve already ramped up our national response. Things have changed a lot over the last three or four days. There have been a significant increase in case numbers, evidence some human-to-human transmission, and we’ve heard reports now of six deaths, even though the case numbers are probably over 300. So we have more concern than last week, but we’re well-prepared in this country to respond.

SABRA LANE: All right. If that declaration is made, Australian researchers will be involved in trying to create a vaccine. Is that right?

PROFESSOR BRENDAN MURPHY: Potentially. There is a group at The University of Queensland that have been funded by the Coalition for Epidemic Preparedness Innovations (CEPI) and the Australian government to develop approaches to use recombinant virus vaccines. That would certainly be an option that the World Health Organization would explore. But that’s still to be determined.

SABRA LANE: How dangerous is this virus? Given that Chinese authorities have admitted it’s been transmitted from person-to-person?

PROFESSOR BRENDAN MURPHY: Well, there’s a lot we don’t know about this virus at this moment, Sabra. We don’t know how efficiently it’s transmitted from human-to-human. We don’t whether the cases – which nearly all have risen in Wuhan – how many of them have come from person-to-person or how many have come from the as-yet undetermined animal vector, where we believe the virus originated from. We also don’t know how severe it is. We know that there are a lot of mild cases, there are probably mild cases that haven’t been detected. But there have been a relatively small number of severe cases and six deaths. So we know that it can cause a severe illness.

SABRA LANE: How can people prevent it spreading and how can they lower their risk of catching it?

PROFESSOR BRENDAN MURPHY: Well at the moment in Australia, there is no evidence that this virus is present. The risks really at present remain particularly focused on people coming from that region in China, particularly the city of Wuhan. That’s why we’ve ramped up biosecurity measures, meeting those three direct flights from Wuhan a week. And anyone who’s come from Wuhan or from a city where – or been in contact with anyone with this virus who develops flu-like symptoms should seek medical attention. In Australia, we have well-established procedures to isolate and test for this virus.

SABRA LANE: And that first flight from Wuhan, since the alert was sort of increased, if you like, here in Australia is tomorrow.

PROFESSOR BRENDAN MURPHY: Correct.

SABRA LANE: Wuhan is the centre of the outbreak as you’ve been mentioning. Some other nations are screening passengers, including taking their temperatures before they get off the plane. Is Australia considering measures like that?

PROFESSOR BRENDAN MURPHY: We are meeting every passenger, providing information to them, asking them to declare if they’ve got any symptoms. But we know that an incubation period for a virus like this could last seven days. We know in our experience in swine flu and other epidemics that measuring temperature might pick up a few people but it also misses a lot of people, and it probably doesn’t add anything to the biosecurity measures that we’ve put in place.

SABRA LANE: China seems to have been upfront about this. The President has said containing it is a top priority. It appears to be a complete turnaround from how it handled the SARS outbreak. What do you make of their approach this time?

PROFESSOR BRENDAN MURPHY: I think it’s admirable. The Chinese are being transparent. They’ve shared the virus sequence. And they’ve instituted open and transparent public health response. And I think it’s a wonderful development. And as you say, it’s quite different to how they dealt with SARS.

SABRA LANE: Just getting back to passengers. How come we won’t be screening passengers? That we are relying on those people being upfront and saying yes, I’ve got symptoms. A lot of people have spent money to come here and they might be anxious about being up front.

PROFESSOR BRANDEN MURPHY: We showed in the swine flu pandemic, we picked up less than 10 per cent of people with swine flu that came through by temperature screening. It really isn’t very effective. Many people don’t have a temperature. It’s probably more important to tell people on the flight the information so if they get symptoms after they arrive that they seek medical attention. Biosecurity officers are trained to identify a sick person coming off the plane, and there’s a legal requirement that airlines, if they detect a sick person on a plan they are required to declare that before they arrive. So we have pretty good measures in place and we think they’re proportionate.

SABRA LANE: Brendan Murphy, thanks for joining AM.

January 22: South China Morning Post posted “Why wild animals are a key ingredient in China’s coronavirus outbreak”

Before its closure, exotic animals – from snakes to civet cats – were available at a wet market in the central Chinese city of Wuhan that is ground zero of a new virus killing people with pneumonia-like symptoms and infecting growing numbers of others around the world.

According to official reports, as of 11pm Wednesday, the previously unknown coronavirus had killed 17 people and infected 541 others.

Most of the infections and all of the deaths were in Hubei province where Wuhan is located, including 375 in the city itself. Many worked or died near Huanan Wholesale Seafood Market, which experts believe is the source of the outbreak, with the virus jumping from wild animals on sale there.

The market was shut down in late December at the start of the outbreak and is now under surveillance by security staff.

One stall that was on the east side of the market caught people’s attention online. According to a menu posted by the stallholder on Dazhong Dianping – the most popular review and rating app in China, around 100 varieties of live animals and poultry were available, from foxes to wolf cubs and masked palm civets.

The civets are thought by the World Health Organization to have been an intermediate host carrying a virus from bats that jumped to humans in a wet market in Guangdong province near Hong Kong that led to the outbreak of severe acute respiratory syndrome (Sars) in 2002-03. Sars killed 774 people worldwide and infected 8,098 in total.

Residents confirmed that crab, shrimp and striped bass were the main items sold in the 50,000 square meter (12.35 acre) market, but in other corners, exotic animals were also on offer.

A woman living nearby surnamed Ai, 59, said she saw some stallholders selling live animals in the market.

“There were turtles, snakes, rats, hedgehogs and pheasants,” she said. She added that more stalls in the west part of the market sold live animals.

Another stallholder who sells vegetables near the seafood market said he knew the market sold live animals.

“Some stalls have more kinds [of live animals] and some have less, but they have sold these for a long time,” he said, declining to give his name because of the sensitivity of the issue.

A notice from the Wuhan Administration for Industry and commerce in September also showed that live animals were on sale in the market. In the notice, it said government officials inspected eight stalls that sold live animals, including tiger frogs, snakes, and hedgehogs, and checked their wildlife business licenses and approval documents. “Unapproved wildlife business is strictly forbidden,” it said.

Captive breeding of wildlife for commercial purposes is allowed in China but companies must get a license from provincial authorities, according to the national wildlife protection law.

Health authorities in Wuhan said on Sunday they would increase controls on agriculture and seafood markets, and ban the sale of live poultry and wildlife.

That ban was spelt out in banners hanging from the gate and along the streets to Wuhan’s Bashazhou agricultural market just outside the third ring road on Tuesday. The market is the biggest wholesale outlet of its kind in central China and sells vegetables, fruit, seafood and agricultural by-products. But one of the vendors, Duan, who mainly sells salmon, said he had never heard about wild animals being traded in the market.

There were no obvious sign of live poultry or wildlife for sale 1,000km away at a wet market in Yuexiu district in Guangzhou, a city known for adventurous diners.

Many mainland cities including Guangzhou, Shenzhen, and Beijing have banned sales of life poultry and animals in their downtown area in the wake of epidemic disease outbreaks in recent years.

However, on Yuexiu vendor said he had live chickens for sale. “Wait a moment. I’ll get it from the back door,” he said.

Trading was hectic in a market in Conghua district, also in Guangzhou, where the sale of live poultry was legal. Live chickens were sold at 17 yuan (US$2.46) for half a kilogram at some stands, where dozens of potential customers were in lively bargaining with stall holders, undeterred by developments in Wuhan.

Zhong Nanshan, director of the China State Key Laboratory of Respiratory Disease and a world expert on the Sars virus, said after a visit to Wuhan that the source of the new coronavirus was probably from wildlife, such as bamboo rats or badgers.

“The outbreak concentrated in two districts on Wuhan, where there are big seafood markets,” Zhong said in an interview with broadcaster CCTV on Monday.

“While they are called seafood markets, many vendors are selling game. According to preliminary epidemiological analysis the virus is probably transmitted from wildlife [at the markets] to humans.”

Shi Zhengli, a researcher with the Wuhan Institute of Virology at the Chinese Academy of Sciences, said the real problem was in people’s behaviour, rather than with the animals.

“The simplest way to prevent such infectious diseases is to stay away from wildlife, say no to game, void their habitats and livestock and farms mixing with wildlife, Shi said.

Hu Xingdou, an independent political economist, said Chinese people’s love for eating wildlife had deep cultural, economic and political roots.

“While the West values freedom and the human rights, Chinese people view food as their primary need because starving is a big threat and an unforgettable part of the national memory,” Hu said.

“While feeding themselves is not a problem to many Chinese nowadays, eating novel food or meat, organs or parts from rare animals or plants has become a measure of identity to some people.”

The 2003 Sars outbreak saw a decline in consumption of exotic animals by normally adventurous Chinese diners in the following years. According to a survey released in 2006 by San Francisco-based WildAid and the official China Wildlife Conservation Association, about 70 per cent of 24,000 people surveyed in 16 mainland cities had not eaten wild animals in the previous year, up from 51 per cent in a similar survey in 1999. While number fell, it showed 30 per cent of those surveyed were still eating wildlife.

January 22: World Health Organization (WHO) tweeted: “The total number of confirmed cases if the 2019 novel #coronavirus reported globally to date is 581. The total number of cases from mainland China is 571. This includes 95 severe cases and 17 people who have died. #nCoV2019”. This tweet was the start of a thread.

January 22: World Health Organization (WHO) tweeted: “Hong Kong SAR has reported 1 case of #nCoV2019, Macao SAR has reported 1 case, and Taiwan, China has reported 1 case. All of these cases are people who travelled from Wuhan.”

January 22: World Health Organization (WHO) tweeted: “Japan, the Republic of #Korea and the #USA have each reported 1 case of novel #coronavirus. #Thailand has reported 4 cases of #nCoV2019.” This was the last tweet in the thread.

January 22: The Japan Times posted an article from Reuters titled: “Chinese doctor investigating outbreak says he was infected”

A Chinese physician who was investigating the outbreak of a deadly new virus in central China says he himself have been infected.

Wang Guangfa, who heads the Department of Pulmonary Medicine at Beijing’s Peking University First Hospital, was part of a team of experts that earlier this month visited Wuhan, where the virus emerged.

“I was diagnosed, and my condition is fine,” Wang told Kong’s Cable TV on Thursday, thanking people for their concern.

The death toll from the flu-like coronavirus strain, which officials have confirmed can be transmitted between humans, had climbed to six as of Tuesday, with the number of reported cases rising above 300. Fifteen medical personnel are among those infected.

Wang, who conducted research on Severe Acute Respiratory Syndrome (SARS) in 2003, said he was receiving treatment and would have an injection soon. He did not give details on how he may have been infected.

“I don’t want everyone to put too much attention on my condition,” he told the channel.

Wang told state media on Jan. 10 that the outbreak appeared to be under control, with most patients, showing mild symptoms and some having been discharged.

He could not be reached by Reuters on Tuesday.

January 22: South China Morning Post posted “China virus: Taiwan tells people not to go to Wuhan amid outbreak”

Taiwan has suspended travel by tour groups to and from Wuhan and has called on Taiwanese not to visit the city in central China, after the first confirmed case of the new coronavirus was detected on the island.

President Tsai Ing-wen said on Wednesday that the Ministry of Transport and Communications had posted a travel warning for Wuhan and ordered all domestic travel operators to temporarily suspend tours to the city. Earlier, she called on the island’s residents not to visit the Wuhan area unless absolutely necessary.

“We will also temporarily stop all Wuhan tour groups from coming to Taiwan,” she said. “During the Lunar New Year, I want to remind people not to panic and to continue their everyday lives, just to remember to stay informed with official information and to manage your own health, to avoid the threat of this virus.”

Tsai also urged Beijing to be “open and transparent” about information on the outbreak, and called on the World Health Organization “not to exclude Taiwan over political considerations”. Taiwan is not a member of the international organisation and has been blocked from attending its annual summit, the World Health Assembly, amid rising pressure from Beijing, which claims the self-ruled island as part of its own territory.

Authorities have confirmed 440 cases of the virus in mainland China, mostly in Wuhan, where on Tuesday authorities said nine people had died.

The outbreak has spread to cities including Beijing and Shanghai, with cases also confirmed in Thailand, South Korea and Japan, as well as Taiwan. On Tuesday, the United States also confirmed its first case of the coronavirus.

Taiwan had stocks of 44 million surgical face masks and almost 2 million N95 face masks, which offer greater protection, and would release them as needed, Tsai added, calling on people not to hoard them.

Taiwanese Transport Minister Lin Chia-lung wrote on his Facebook page that the island’s airlines should consider suspending routes to Wuhan.

Taiwan on Tuesday confirmed its first case of infection from the new coronavirus, a woman in the 50s who had returned after working in Wuhan,

China’s severe acute respiratory syndrome (Sars) coronavirus epidemic in 2002-2003 killed more than 700 people.

January 22: Australian Government Department of Health posted “Chief Medical Officer’s interview on the Today Show about novel coronavirus”

KARL STEFANOVIC: In the last few minutes it’s been revealed the Queensland man suspected of contracting the virus has been released from isolation. That’s good news. Doctors are saying he’s no longer displaying any symptoms. However, United States confirms its first case of the virus this morning to Australia’s Chief Medical Officer. Brendon Murphy joins us now. Brendan, good morning to you. All of this is a big worry.

PROFESSOR BRENDAN MURPHY: Good morning Karl. I think our concern has increased over the last three or four days for a number of reasons. That there’ve been significant increases in case numbers in Wuhan in China, where the disease originated. We now have evidence of some human-to-human transmission which we didn’t have before. And whilst there are many mild cases, there have been some serious cases and as we’ve heard this morning, reports of up to six deaths. So for that reason, we have in Australia instituted proportionate border measures in relation to direct flights to Wuhan. But I should say that we are very well prepared as a nation to deal with any case of this disease if it does come from China.

KARL STEFANOVIC: Brendan, the reality is that Wuhan is a significant transport hub in China, that any transport hub in China means a lot of people. A lot of people going there, a lot of people going elsewhere from there. Trying to contain this thing is going to be incredibly difficult. Now it’s all about treating, is it not? And what should people know about travel in and out of China and also just generally speaking about this?

PROFESSOR BRENDAN MURPHY: So, we’ve updated our travel advisory suggesting that people exercise extreme caution. I personally wouldn’t be considering travel to those parts of Wuhan where the markets are. So we’ve updated that travel advisory. You’re right that it’s never completely possible to contain viruses when, for a lot of them, there is an incubation period of sometimes up to seven days where people are asymptomatic. So our focus is on directly dealing with the major traffic from Wuhan, providing information, meeting everyone who comes off those planes. We’ve now declared this a Listed Human Disease with biosecurity implications and we want to make sure that anyone who’s come from Wuhan or the are where this infection has been, if they do develop symptoms, seek medical attention and we’re well prepared to respond if that happens.

KARL STEFANOVIC: Brendan, the issue is, and I’m sure you’ve been on a flight recently, anyone who arrives on a flight from anywhere, a long distance flight and that’s what we’re talking about here, symptoms of this are cough, shortness of breath, sore throat, runny nose – they’re almost cold-like symptoms, aren’t they? I mean, this is going to be so broad. The logistics in China to narrow down someone who might have it are pretty extreme.

PROFESSOR BRENDAN MURPHY: That’s exactly right. I mean, one of the particular features of this virus is that nearly everyone has a fever. But you’re right, it’s not really distinguishable from the flu and it is flu season in China at the moment. That’s why we are very much focusing our attention on those direct flights from Wuhan where there is a higher risk. But again, people who are unwell, who come off a flight like that, are probably just as likely to not have this virus as something else. But that’s why we’ve developed protocols for the biosecurity officers and the public health officers to try and determine whether the risk is significant.

KARL STEFANOVIC: Brendan, the issue is, and I’m sure you’ve been on a flight recently, anyone who arrives on a flight from anywhere, a long distance flight and that’s what we’re talking about here, the symptoms of this are cough, shortness of breath, sore throat, runny nose – they’re almost cold-like symptoms, aren’t they? I mean, this is going to be so broad. The logistics in China to narrow down someone who might have it are pretty extreme.

PROFESSOR BRENDEN MURPHY: That’s exactly right. I mean, one of the particular features of this virus is that nearly everyone has a fever. But you’re right, it’s not really distinguishable from the flu and it is flu season in China at the moment. That’s why we are very much focusing our attention on those flights from Wuhan where there is a higher risk. But again, people who are unwell, who come off a flight like that, are probably just as likely to have this virus as something else. But that’s why we’ve developed protocols for the biosecurity officers and the public health officers to try and determine whether the risk is significant.

KARL STEFANOVIC: Well, we’re well versed in it. We did a terrific job a couple of years ago so it means we’re prepared for it. And do things like wearing masks on planes help at all?

PROFESSOR BRENDAN MURPHY: No, I don’t think there’s evidence to suggest that we should go to that stage at the moment. Obviously if you were in contact with someone with the virus, then you would want to take protection.

KARL STEFANOVIC: Do you have any further update on this Brisbane person?

PROFESSOR BRENDAN MURPHY: What I’ve been told is that the tests aren’t back yet. But that the person is well and is now at home in home quarantine, waiting for the tests. But the good news is that there’s no clinical concern about this person but we still don’t know whether they’ve had this virus or just another virus such as flu.

KARL STEFANOVIC: Do you have a specific test for it?

PROFESSOR BRENDAN MURPHY: There are specific tests being developed. They’re just – they’ve been developed over the last few days at some of our specialist labs, yep.

KARL STEFANOVIC: Okay. This stuff is moving pretty quickly but we appreciate your time and expertise on it. Thank you so much. Professor Brendan Murphy there.

January 22: South China Morning Post posted “Tracking Wuhan virus a ‘jigsaw puzzle’ as China cracks down with quarantine powers”

Tracking down the source and the infection route of the newly emerged coronavirus in the central Chinese city of Wuhan is akin to putting a jigsaw puzzle together, as the death toll rises and carriers of the pathogen emerge across the country and the world, according to a disease specialist.

“It’s early days, it’s a real jigsaw puzzle right now,” said David Heymann, professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine.

“Right now, it doesn’t look like this is a particularly lethal virus. It’s lethal in people who have co-morbidities, elderly people who have diabetes and chronic lung disease, and that’s very similar to what the influenza virus does,” said Heymann, who is a former executive director of the World Health Organization’s Communicable Diseases Cluster, where he headed the global response to the Sars virus in 2002-03.

“What’s key to all of this is good infection prevention and control in hospital settings. If health workers continue to get infected now that they know this virus is present, they can inadvertently infect other patients,” he said.

China’s National Health Commission (NHC) said on Wednesday that tougher measures introduced this week authorized hospitals nationwide to quarantine any suspected carriers of the virus and their close contacts, even against their will. The coronavirus has killed 17 people – all of them in Hubei province – sine it first caught the attention of medical authorities a little over three weeks ago. As of 11pm Wednesday, 541 people in mainland China had been infected, according to official reports.

“The basic [measures beyond quarantine] are contact tracing, identifying people who might have been exposed, and making sure that they understand that if they develop a fever, they must immediately report to a health facility because that’s the time they become infectious,” said Heymann, who is chair of an advisory body to the WHO.

He said another measure was to isolate patients with the disease and to take care of them until the immune system could rid the body of the virus. “There’s no other medicine right now that can treat it.”

Wuhan, in Hubei province, has remained the ground zero of fatalities and infections since the outbreak was first reported on December 31 and with no drugs available to fight the virus, containment and quarantine are the tools China is turning to try and control it.

That had now reached a “most critical stage,” Li Bin, the director of the NHC, said on Wednesday.

The challenge for the authorities is how and to do what extent to quarantine a city such as Wuhan, which has a larger population than New York and is a major hub in China’s rail network, with an average of 700,000 passengers a day passing through its three main stations. It also has an international airport with direct flights to the United States and the rest of Asia.

China is also this week experiencing its largest single annual mass migration of people as hundreds of millions travel across the county for the Lunar New Year holiday.

Li, of the NHC, said there was a risk of the virus mutating and spreading further during the country’s annual peak travel period.

“The virus is mainly transmitted through the respiratory tract,” Li said. “Now, during Chinese New Year, the surge [in people moving around the country] increases the risk of the epidemic’s spread and the difficulty of prevention and control. We must not take it lightly.”

The virus, which has pneumonia-like symptoms, has most recently been discovered in travellers in Hong Kong and the US for the first time. Infected individuals have also been found in Taiwan, Thailand, South Korea and Macau, with most of the cases involving people travelling from Wuhan.

China’s stricter quarantine measures came as the provincial government in Hubei, where Wuhan is located, announced a “grade II public health emergency” – the second-highest level of emergency response – in the early hours of Wednesday morning.

“This means that various local authorities, government departments and medical institutions can legally screen for fever patients, and conduct isolated treatment of confirmed or suspected cases, as well as isolated treatment and medical observations of others in close contact with those people,” Xu Shuqiang, director of the health emergency response office at China’s Ministry of Health, said.

On Tuesday, the NHC upgraded the coronavirus to a Class B infectious disease but said it would use the stricter control measures for a Class A disease to handle the outbreak, meaning any infection nationwide must be reported within two hours and monitored.

A Class B classification gives the government the power to stop travel to, from and within a city, and to take other emergency measures that would effectively shut down a city.

Closing down a city the size of Wuhan would be unprecedented in China, but the country’s top infectious disease expert said quarantine was the only way to stop the disease at present.

“As soon as it spreads from human to human, quarantine must be the first priority,” Zhong Nanshan said at a briefing on Thursday. “At the moment, I don’t think quarantine has been implemented thoroughly enough.”

The disease is believed to have first appeared in a seafood and animal meat market in Wuhan.

The first cluster of infections in December involved people who worked at the market, suggesting that the virus had jumped from an animal host in the same way that the severe acute respiratory syndrome (Sars) epidemic began.

Gao Fu, director of China’s disease control and prevention centre, said at the briefing that the source of the disease was a wild animal sold at the seafood market, but did not elaborate on what species it was, or how the disease spread from animals to humans.

As many as 15 medical staff in Wuhan have been infected with the virus which exposed “weak links” in preventive measures in medical institutions, according to Jiao Yahui, deputy director in charge of medical affairs with the NHC.

“We are in a gradual process of learning the development stages and characteristics of the virus,” said Jiao, who also paid tribute to front-line medical staff confronting the outbreak.

Heymann said it was not possible to make predictions of how the virus would proceed from now.

“Influenza viruses can’t be stopped, they run their course and they stop. It would not be wrong to make any type of estimate of what might happen in the future because not enough is known to base that estimate on. The WHO will be looking at all the evidence and making recommendations for the world to follow.”


January 23

January 23: World Health Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report – 3”. From the report:

Situation Update:

A total of 581 confirmed cases have been reported for novel coronavirus (2019-nCoV) globally.

Of the 581 cases reported, 571 cases were reported from China.

Cases have been reported in Thailand, Japan, Hong Kong Special Administrative Region, Taipei Municipality, China, Macau Special Administrative Region, United States of America and the Republic of Korea, all had travel history to Wuhan.

Of the 571 confirmed cases in China, 375 cases were confirmed from Hubei Province.

Of the 571 cases, 95 cases are severely ill.

Seventeen deaths have been reported (all from Hubei Province).

Reported incidence of confirmed 2019-nCoV cases:

  • Hubei Province: 375
  • Unspecified: 131
  • Guangdong Province: 26
  • Beijing Municipality: 10
  • Shanghai Municipality: 9
  • Chongqing Municipality: 5
  • Zhejiang Province: 5
  • Jiangxi Province: 2
  • Sichuan Province: 2
  • Tianjin Municipality: 2
  • Henan Province: 1
  • Hunan Province: 1
  • Shandong Province: 1
  • Shandong Province: 1
  • Yunnan Province: 1
  • Taipei Municipality: 1
  • Hong Kong Special Administrative Region: 1
  • Macau Special Administrative Region: 1
  • Japan: 1
  • Republic of Korea: 1
  • Thailand: 4
  • United States of America: 1
  • TOTAL: 581

January 23: The Guardian posted “China virus: ten cities locked down and Beijing festivities scrapped”. It was written by Lily Kuo. From the article:

Chinese authorities have imposed lockdown measures on ten cities in an unprecedented effort to contain the outbreak of the deadly new virus that has made hundreds of people ill and spread to other parts of the world during the busy lunar new year travel period.

Authorities banned transport links from Wuhan, the capital of Hubei province, on Thursday morning, suspending buses, subways, ferries, and shutting the airport and train stations to outgoing passengers. Later in the day, the nearby central Chinese cities of Huanggang and Ezhou announced similar measures. Travel restrictions were also placed on the smaller cities of Chibi and Zhijang.

Starting at midnight, long-distance buses, the rapid transit system, and the train station in Huanggang would be shut, according to a notice from the local government. Cinemas, internet cafes and other entertainment venues would all stop operation. Residents should not leave the city, except for “special reasons”.

A government notice in Ezhou said the city’s railway would stop operating on Thursday evening. In nearby Chibi, authorities said buses and rural transport links would be halted. Officials ordered tour operators to cancel operations and said no more large-scale cultural events were to be held.

On Friday, Huangshi in Hubei province also halted public transport. The People’s Daily newspaper said Xiantao, Enshi, Qianjang and Xianning were also subject to travel restrictions.

There have been 830 confirmed cases in China of the coronavirus, from the same family of viruses that gave rise to Sars. Chinese authorities say 95 patients remain in a critical condition.

On Thursday, Hebei’s provincial health authority said an infected patient had died, marking the first confirmed death outside Hubei provence, where the outbreak began. On Friday morning the official death toll rose to 25.

Cases have also been confirmed in the US, the UK, Taiwan, South Korea, Thailand, Japan, Hong Kong, Vietnam and Singapore.

Officials worry the weeklong lunar new year holiday, which begins on Saturday and usually sees hundreds millions of Chinese crisscross the country, will exacerbate an outbreak that has reached almost all of China’s provinces.

The state-run Beijing News said the capital had cancelled events including two well-known lunar new year temple fairs. The Forbidden City, the palace complex in Beijing that is now a museum, announced it will close indefinitely on Saturday.

The country’s railway operator, China State Railway Group, said passengers would be able to receive full refunds on tickets nationwide starting on Friday.

While sweeping measures are typical of China’s communist government, large-scale quarantines are rare around the world, even in deadly epidemics, because of concerns about infringing on people’s liberties, and the effectiveness of such measures in unclear.

“To my knowledge, trying to contain a city of 11 million people is new to science,” Gauden Galea, the World Health Organization’s representative in China, told the Associated Press. “It has not been tried before as a public health measure. We cannot at this stage say it will or will not work.”

Late on Thursday, Wuhan City authorities said that limits on car travel would be reduced for the first time at noon on Friday.

In Wuhan, supermarket shelves were empty and local markets sold out of produce as residents hoarded supplies and isolated themselves at home. Petrol stations were overwhelmed as drivers stocked up on fuel, exacerbated by rumours that reserves had run out. Local residents said pharmacies had sold out of face masks.

“When I saw the news when I woke up, I felt like I was going to go crazy. This is a little too late now. The government’s measures are not enough,” said Xiao, 26, a primary schoolteacher in Wuhan, who asked not to give her full name.

Anxiety in Wuhan has been exacerbated by reports that hospitals are turning patients away because they do not have enough room. A hospital contacted by the Guardian on Thursday said it had between 500 and 600 patients and recommended patients go to a community health centre instead. Eight hospitals in Wuhan put out calls for donations of protective equipment, according to Chinese media.

Officials said they would build a new hospital in six days to accommodate patients, modelled after an isolation facility constructed in Beijing during the SARS outbreak.

Hubei officials said schools, on break for the spring festival holiday, would delay the beginning of the spring term.

The illness from the newly identified coronavirus appeared last month in Wuhan, an industrial and transportation hub in central China. The vast majority of cases in the mainland have been in the city.

Analysts have predicted the reported cases will continue to multiply. “Even if [the number of cases] are in the thousands, this would not surprise us,” Galea said. The number of cases was not an indicator of the outbreak’s severity, so long as the mortality rate remained low, he added.

The coronavirus family includes the common cold as well as viruses that cause more serious illnesses, such as the Sars outbreak that spread from China to more than a dozen countries in 2002-03 and killed about 800 people, and Middle Eastern respiratory syndrome which developed from camels.

China is keen to avoid repeating mistakes with its handling of Sars. For months, even after the illness had spread around the world, China parked patients in hotels and drove them around in ambulances to conceal the true number of cases and avoid WHO experts.

In the current outbreak, China has been credited with sharing information rapidly, and President Xi Jinping has emphasized that as a priority.

On Thursday, a WHO committee said the outbreak does not yet constitute a public health emergency of international concern. Previous emergencies have included Ebola and Zika.

January 23: The Guardian reported: As Chinese authorities say 17 people have died and more than 500 have been infected, air and rail departures from Wuhan are suspended.

January 23: Nippon.com (News from Japan) posted an article titled: “Japanese Man Develops Severe Pneumonia in Wuhan”. From the article:

A Japanese man has been hospitalized in the Chinese city of Wuhan due to severe pneumonia, an official at the Japanese embassy in Beijing said Thursday.

Authorities are investigating whether the pneumonia was caused by a new strain of coronavirus.

Cases of pneumonia stemming from the virus are spreading, mainly in China. The Chinese government confirmed 571 cases in the country as of midnight Wednesday (4 p.m. GMT).

January 23: Director-General of the World Health Organization (WHO) Tedros Adhanom Ghebreysus tweeted: “I am not declaring the new #coronavirus outbreak a public health emergency of international concern today. The Emergency Committee was divided over whether the outbreak represents a PHEIC. This is an emergency in China, but has not yet become a global health emergency.”

January 23: Director-General of the World Health Organization (WHO Tedros Adhanom Ghebreysys tweeted: “This should not be taken as a sign that @WHO does not think the situation is serious. WHO is following this new #coronavirus outbreak every minute of every day, at county, regional and global level. I will not hesitate to reconvene the committee at a moment’s notice if needed.”

January 23: The Hollywood Reporter posted “Shanghai Disney Resort Shuts Down as Coronavirus Spreads”. It was written by Patrick Brzeski. The article included Disney’s full statement:

The Walt Disney Co. is preparing to close its Shanghai Disney Resort in response to the growing outbreak of coronavirus currently sweeping China.

As of Friday afternoon, local time, China’s National Health Commission had confirmed 875 cases of coronavirus infection nationwide, with 26 deaths. Most troubling, all but two of the country’s 31 provinces and municipalities had reported cases of the virus, suggesting that Beijing’s belated but now aggressive measures to contain the infection were falling short.

Disney said Friday that it would be joining public facilities across China, including the nation’s 70,000 cinemas and the Forbidden City in Beijing, in closing its gates. Public health officials have urged citizens to avoid congregating in crowded public spaces. Disney said it would close the theme part and facilities surrounding it on Saturday.

“We will continue to carefully monitor the situation and be in close contact with the local government,” Disney said in a statement on its website and posted across social media. “We will announce the reopening date upon confirmation,” it added.

The public health crisis in China has already dealt a hammer blow to the Beijing film industry, forcing studios to cancel the release of their biggest movies during the most popular moviegoing week of the year. The Disney closure arguably marks the first moment when the virus has had a significant impact on a U.S. entertainment firm. The Chinese New Year, also called Spring Festival, is China’s busiest travel and vacation period, and the holiday has delivered big attendance numbers to Disney’s Shanghai park in years past.

Shanghai Disneyland had planned several special attractions to draw in guests to celebrate the traditional family holiday with some Western entertainment. Mickey, Minnie and other Disney characters were outfitted in special Spring Festival costumes crafted by Chinese designer Guo Pei, while special red and gold lanterns were hung to line the roads and alleys of Mickey Avenue. The park also created an extra-impressive fireworks display to explode over the compound every night of Spring Festival. The show will be accompanied by an underscore of traditional Chinese music narrated by Mickey himself.

Read Disney’s full statement below:

In response to prevention and control of the disease outbreak and in order to ensure the health and safety of our guests and Cast, Shanghai Disney Resort is temporarily closing Shanghai Disneyland, Disneytown including Walt Disney Grand Theater and the Wishing Star Park, starting January 25, 2020. We will continue to carefully monitor the situation and be in close contact with the local government, and we will announce the reopening date upon confirmation.

Shanghai Disney Resort will assist in the refund for guests who have purchased tickets for admission to Shanghai Disneyland, have booked a resort hotel, or have booked tickets for Beauty and the Beast Mandarin Production through the original ticket purchase channel, and we will introduce the detailed procedure and guidelines via the resort’s official platforms as soon as possible.

We wish our guests a healthy and happy Spring Festival!!

January 23: World Health Organization Western Pacific tweeted: “The total number of confirmed cases of the 2019 novel #coronavirus reported globally to date is 845. The total number of cases from mainland China is 830. This includes 177 severe cases and 25 people who have died. #nCoV2019”. This tweet was the start of a thread.

January 23: World Health Organization Western Pacific tweeted: “Hong Kong SAR has reported a total of 2 cases of #nCoV2019, Macao SAR has reported 2 cases, and Taiwan, China has reported 1 case.”

January 23: World Health Organization Western Pacific tweeted: “Republic of Korea has reported 2 confirmed cases of novel #coronavirus. #Japan, #Nepal, #Singapore, & #USA have each reported 1 case of #nCoV2019”

January 23: World Health Organization Western Pacific tweeted: “Understanding of #nCoV2019 is still evolving. Based on current info, most confirmed cases are not severe. Among those who have died, most are over 65 yrs with underlying health conditions. But there is still much more to learn about this virus, and we continue to monitor closely.”

January 23: World Health Organization Western Pacific tweeted: “WHO DG @DrTedros has not declared #nCoV2019 a public health emergency of international concern. He stressed that it is an emergency in China, but not yet a global health emergency. @WHO is following #nCoV2019 very closely and the Emergency Committee may be reconvened at any time.”

January 23: Nippon.com (News from Japan) posted an article titled: “Japanese Firms Banning Travel to Wuhan due to Pneumonia Outbreak”. From the article:

More and more Japanese companies are banning their employees from traveling to the Chinese city of Wuhan due to the spread of pneumonia caused by a new strain of coronavirus.

Some Japanese department stores have allowed their workers to wear face masks as visitors from China are expected to increase during the Chinese Lunar New Year holiday.

Honda Motor Co. <7267> which has a plant in Wuhan, where the new coronavirus originated, banned business trips there in principle, starting on Wednesday. The plant will be closed until Feb. 2 due to the holiday.

Subaru Corp. <7270> notified workers that nonessential trips to China should be avoided.

“We’ll secure safety for our employees and prevent a spread of the disease,” a company official said.

January 23: World Health Organization (WHO) posted “Statement on the first meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)”

The meeting of the Emergency Committee convened by the WHO Director-General under the international Health Regulations (IHR) (2005) regarding the outbreak of the novel coronavirus in 2019 in the People’s Republic of China, with exportation currently reported in the Republic of Korea, Kapan, Thailand, and Singapore, took place on Wednesday, 22 January 2020, from 12:00 to 16:30 Geneva time (CEST) and on Thursday, 23 January 2020, from 12:00 to 15:10. The Committee’s role is to give advice to the Director-General, who makes the final decision on the determination of a Public Health Emergency of International Concern (PHEIC). The Committee also provides public health advice or suggests formal temporary recommendations as appropriate.

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference.

The Director-General welcomed the Committee and thanked them for their support. He turned the meeting over to the Chair, Professor Didier Houssin.

Professor Houssin also welcomed the Committee and gave the floor to the Secretariat.

On 22 January, representatives of WHO’s legal department and the department of compliance, risk management, and ethics briefed the Committee members on their roles and responsibilities.

Committee members were reminded of their duty for confidentiality and their responsibility to disclose personal, financial, or professional connections that might be seen to constitute a conflict of interest. Each member who was present was surveyed and no conflicts of interest were judged to be relevant to the meeting.

The Chair then reviewed the agenda for the meeting and introduced the presenters.

On 23 January, representatives of the Ministry of Health of the People’s Republic of China, Japan, Thailand and the Republic of Korea updated the committee on the situation in their countries. There have been increased numbers of reported cases in China, with 557 confirmed as of today.

Conclusions and Advice

On 22 January, the members of the Emergency Committee expressed divergent views on whether this event constitutes a PHEIC or not. At that time, the advice was that the event did not constitute a PHEIC, but the Committee members agreed on the urgency of the situation and suggested that the Committee should be reconvened in a matter of days to examine the situation further.

After the announcement of new containment measures in Wuhan on 22 January, the Director-General asked the Emergency Committee to reconvene on 23 January to study the information provided by Chinese authorities about the most recent epidemiological evolution and the risk-management measures taken.

Chinese authorities presented new epidemiological information that revealed an increase in the number of cases, of suspected cases, of affected cases, of affected provinces, and the proportion of deaths in currently reported cases of 4% (17 of 557). They reported fourth-generation cases in Wuhan City, as well as other nearby cities). After this presentation, the EC was informed about the evolution in Japan, Republic of Korea, and Thailand, and that one new possible case had been identified in Singapore.

The Committee welcomed the efforts made by China to investigate and contain the current outbreak.

The following elements were considered critical:

Human-to-human transmission is occurring and a preliminary R0 estimate of 1.4-2.5 was presented. Amplification has occurred in one health care facility. Of confirmed cases, 25% are reported to be severe. The source is still unknown (most likely an animal reservoir) and the extent of human-to-human transmission is still not clear.

Several members considered that it is still too early to declare a PHEIC, given its restrictive and binary nature.

Bad on these divergent views, the EC formulates the following advice:

To WHO

The Committee stands ready to be reconvened in approximately ten days’ time, or earlier should the Director-General deem it necessary.

The Committee urges to support ongoing efforts through a WHO International multidisciplinary mission, including national experts. The mission would review and support efforts to investigate the animal source of the outbreak, the extent of human-to-human transmission, the screening efforts in other provinces of China, the enhancement of surveillance for severe acute respiratory infections in these regions, and to reinforce containment and mitigation measures. A mission would provide information to the international community to aid in understanding of the situation and its potential public health impact.

WHO should continue to provide all necessary technical and operational support to respond to this outbreak, including with its extensive networks of partners and collaborating institutions, to implement a comprehensive risk communication strategy, and to allow for the advancement of research and scientific developments in relation to this novel coronavirus.

In the face of an evolving epidemiological situation and the restrictive binary nature of declaring a PHEIC or not, WHO should consider a more nuanced system, which would allow an intermediate level of alert. Such a system would better reflect the severity of an outbreak, its impact, and the required measures, and would facilitate improved international coordination, including research efforts for developing medical counter measures.

To the People’s Republic of China

Provide more information on cross-government risk management measures, including cirrus management systems at national, provincial, and city levels, and other domestic measures.

Enhance rational public health measures for containment and mitigation of the current outbreak.

Enhance surveillance and active case finding across China, particularly during the Chinese New Year celebration.

Collaborate with WHO and partners to conduct investigations to understand the epidemiology and the evolution of this outbreak, including specific investigations to understand the source of the novel coronavirus, notably the animal reservoir and animals involved in the zoonotic transmission, as well as the understanding of its full potential for human-to-human transmission, and where transmission is taking place, the clinical features associated with infection, and the required treatment to reduce morbidity and mortality.

Continue to share full data on all health cases with WHO, including genome sequences and details of any health care worker infections or cluster.

Conduct exit screening at international airports and ports in the affected provinces, with the aims early detection of symptomatic travelers for further evaluation and treatment, while minimizing interference with international traffic.

Encourage screening at domestic airports, railway stations, and long-distance bus stations as necessary.

To other countries

It is expected that further international exportation of cases may appear in any country. Thus, all countries should be prepared for containment, including active surveillance, early detection, and isolation and case management, contact tracing and prevention of onward spread of 2019-nCoV infection, and to share full data with WHO.

Countries are required to share information with WHO according to the IHR.

Technical advice is available here. Countries should place particular emphasis on reducing human infection, prevention of secondary transmission and international spread and contributing to the international response through multi-sectoral communication and collaboration and active participation in increasing knowledge on the virus and the disease, as well as advancing research. Countries should also follow travel advice from WHO.

To the global community

As this is a new coronavirus, and it has been previously shown that similar coronaviruses required substantial efforts for regular information sharing and research, the global community should continue to demonstrate solidarity and cooperation, in compliance with Article 44 of the IHR (2005), in supporting each other on the identification of the source of this new virus, its full potential for human-to-human transmission, preparedness for potential importation of cases, and research for developing necessary treatment.

The Director-General thanked the Committee for its advice.


January 24

January 24: The CDC reported the onset of 1 more additional COVID-19 case in the United States.

January 24: World Health Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report 4”. From the report:

Situation Update:

A total of 846 confirmed cases have been reported for novel coronavirus (2019-nCoV) globally.

Of the 846 cases reported, 830 were reported from China.

Eleven confirmed cases have been reported outside of China in six countries.

Of these 11 confirmed cases, 10 had travel history to Wuhan

One confirmed case in Vietnam had no travel history to any part of China but was a family member of a confirmedcase who visited Wuhan. This suggests an instance of human to human transmission that occured in Vietnam.

Of the 830 confirmed cases in China, 375 cases were confirmed in Hubei Province.

Of the 830 cases, 177 cases have been reported as severely ill.

Twenty-five deaths have been reported to date.

On 24 January 2020, the number of confirmed cases of 2019-nCoV has increased by 265 cases since the last situation report published on 23 January 2020, including China which reported additional 259 confirmed cases.

Reported incidence of confirmed 2019-nCoV cases:

China:

  • Unspecified: 384
  • Hubei Province – 375
  • Guangdong Province – 32
  • Beijing Municipality – 10
  • Shanghai Municipality – 9
  • Chongqing Municipality – 5
  • Zhejiang Province – 5
  • Jiangxi Province – 2
  • Sichuan Province – 2
  • Tianjin Municipality – 2
  • Henan Province – 1
  • Hunan Province – 1
  • Shandong Province – 1
  • Taipei Municipality – 1
  • Hong Kong Special Administrative Region – 2
  • Macau Special Administrative Region – 2
  • Japan – 1
  • Republic of Korea – 2
  • Viet Nam – 2
  • Republic of Singapore – 1
  • Thailand – 4
  • United States of America – 1
  • TOTAL: 846

January 24: President Trump tweeted: “China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi!”

January 24: American Academy of Pediatrics (AAP) posted “2nd U.S. case of coronavirus confirmed in Chicago”

A second case of a novel coronavirus has been confirmed in a Chicago woman and is one of 63 potential cases under investigation in 22 states.

The case follows confirmation of the virus earlier this week in a Washington state man in his 30s. Eleven other patients have tested negative, and 50 are waiting on test results, according to the Centers for Disease Control and Prevention (CDC).

“While this situation poses a very serious public health threat, CDC believes the immediate risk to the U.S. public is low at this time, but the situation continues to evolve rapidly,” said Nancy Messonnier, M.D., director of the CDC’s National Center for Immunization and Respiratory Diseases.

The Chicago woman is in her 60s and returned from Wuhan, China, the center of the new virus’ outbreak on Jan. 13, She fell ill several days later. She has had limited contact with other people since her return and is being treated in an isolation room at a local hospital where authorities said she is doing well. Those known to have come in contact with her have not displayed symptoms of illness.

“This is all very reassuring as far as infection risk to the general public, which remains low nationally and locally here in Chicago,” said Chicago Public Health Commissioner Allison Arwady, M.D., M.P.H.

China first reported cases in late December and linked the virus to a large market with seafood and live animals in Wuhan, a city of more than 11 million people and a major transportation hub. The pathogen is genetically similar to those that caused outbreaks of Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), and there is evidence of human-to-human spread.

The global case count has reached 881, and there have been 26 deaths, according to a tally by Johns Hopkins University. While most of the cases are in China, cases have been confirmed in Thailand, Hong Kong, Japan, Macau, Vietnam, Singapore, South Korea, Taiwan and the U.S.

On Thursday, the World Health Organization declined to declare an international public health emergency but did not rule out doing so in the coming days or weeks.

The CDC recommends avoiding nonessential travel to Wuhan. Those who do travel to China should avoid people who are sick and practice good hand hygiene. Upon their return, they should monitor themselves for fever and respiratory symptoms for 14 days and contact their health care provider immediately if they get sick.

In the past week, the CDC has screened about 2,000 people arriving from Wuhan at international airports in Los Angeles, New York City, San Francisco, Chicago and Atlanta. Officials said they are continuing to evaluate their approach as China implements new travel restrictions in Wuhan and other cities.

January 24: Nippon.com (News from Japan) posted “Second Case of Wuhan-Linked Pneumonia Found in Japan”

The Japanese health ministry said Friday that it has confirmed the country’s second case of infection of a new strain of coronavirus believed to be behind the pneumonia outbreak in the Chinese city of Wuhan.

A man in his 40s who is a resident of Wuhan developed pneumonia and tested positive for the new virus during his visit to Japan as a tourist. He is currently hospitalized in Tokyo.

January 24: CGTN, China Global Television Network, tweeted: “Liang Wudong, a doctor at Hubei Xinhua Hospital who had been at the front line of the #CoronavirusOutbreak battle in Wuhan, dies from the virus at age 62.”

January 24: Prime Minister of Australia Scott Morrison tweeted: “Update on Coronavirus”. The tweet included a screenshot of that update, which said:

Today the first case of Coronavirus has been confirmed in Australia.

The patient, a man from Wuhan in China, flew to Melbourne from Guangong on 19 January. He is now being treated in isolation in Victoria. Authorities are tracing and contacting all passengers who traveled on the same flight to Melbourne and anyone he has been in contact with since.

As previously advised by the Chief Medical Officer, Professor Brendan Murphy it was always expected that Australia would see cases of this virus.

The Australian Government has already enacted new measures to protect Australians. From today, anyone arriving in Australia on flights from other parts of China will be met an provided instructions on what to do if they have symptoms, or start to develop them.

Australians are being strongly advised not to travel to Wuhan or the Hubei Province in China. Chinese authorities have also imposed travel restrictions in at least five cities in the Hubei province. Australians travelling to these area may not be able to leave until restrictions are lifted.

I am receiving daily briefings from health authorities and the Chief Medical Officer and we will continue to monitor and take action where necessary.

Australia has a first class health system and we are extremely well prepared to diagnose, manage and isolate any case of Coronavirus.

January 24: Australian Government Department of Health posted “Chief Medical Officer’s update on novel coronavirus”. It is a transcript of Professor Brendan Murphy’s press conference about novel coronavirus.

PROFESSOR BRENDAN MURPHY: We’ve just completed a meeting with the Australian Health Protection Principal Committee, which consists of all the senior public health officials in every state and territory in the Commonwealth and a range of technical experts. And I’ve also just finished briefing the Prime Minister, Minister Hunt, the Minister for Health, and the Foreign Minister on the discussions at that meeting and the current latest data.

So, the latest data from China is that there are now 844 cases worldwide; 830 in China, 14 cases in locations outside of China, and you can see some of those on our map up on the wall there. There are now 25 deaths 24 of which have been in Wuhan, the main epicenter of this outbreak, and one in someone in Beijing. And again, the story around the deaths are that they have pretty much been elderly people or people with other medical conditions. People who are generally frail. That’s the word we’re getting from China. Approximately 25 per cent of people who contract this infection and who have been detected and diagnosed seem to get a more severe illness. But we do know, or we do suspect, that there are a number of additional cases that are so mild that they haven’t come to attention and been detected or diagnosed at the moment.

You will have heard that the WHO Emergency Committee met again overnight and decided yet again not to declare a public health emergency of international concern. That doesn’t mean, in any way, that they’re not taking this seriously. In fact, they made it very clear that the director-general made it clear, that they do see this as a serious issue and they are upping some of their responses. They’re sending in a new specialist team in, and they believe the country should be prepared and taking action as we are. So, of course, it doesn’t change our response in Australia. But they feel that unless there’s more sustained human- or evidence of sustained human-to-human transmission in countries outside of China, that there are some technical reasons why it doesn’t fulfill the criteria for meeting that definition of, a public health emergency of international concern. So, that’s the current situation internationally.

In Australia, we still have no confirmed cases. There are several patients who are being tested every day. People who have had a relevant travel history and who have developed respiratory symptoms. None of those have turned out to be positive. But, as I’ve said on previous occasions, should we get a positive case in Australia, we are extremely well-prepared to isolate and manage them. The Health Protection Principle Committee discussed a range of materials which are now on our Department of Health wbsite. There’s now good clinical guidelines. We’ve provided new information to every health practitioner, relevant health practitioner, in the country and emergency department, and there’s a lot of new information up on our website.

So, that’s the situation at the moment. It’s pretty much as it’s been over the last few days. As more information comes out from China, as they get more diagnostic information, we always expect the case numbers to increase. And the nature of the disease doesn’t seem to be showing any signs of changing. It is of concern that there are some cases outside China, but they are small in number and they are being well-managed in those locations.

So, I’ll leave it there, and happy to take any questions.

QUESTION: You said this morning that the WHO was split on whether to declare a public health emergency. Just explain that.

PROFESSOR BRENDAN MURPHY: Well, I think the Emergency Management Committee – the director-general, said that they were divided. Some of the members felt that it wasn’t worth declaring. Others felt that, because of these technical reasons, that it wasn’t quite ready. But he made it very clear that that didn’t make any difference to the fact the WHO regards this as a very significant issue and that people should be responding.

QUESTION: So, what powers would declaring something like that give them? What would the practical difference be?

PROFESSOR BRENDAN MURPHY: It really – I don’t think it would make an awful different on top of what they’re already doing because they’re already activating the sort of things that they would do in that circumstances. I think the big difference is, in a public health emergency of national concern, if there are lots of foci of transmission outside of the one area, there’s greater international coordination required. And that’s probably not necessary at the moment. Every country is responding appropriately.

QUESTION: You mentioned the WHO upping their response and sending a specialized team. What is that new specialized team; what are they going to be doing?

PROFESSOR BRENDAN MURPHY: Well, I think the director-general this morning talked about sending an expert team particularly to try and identify the source. We still – they’re still not clearly identified what animal, vector, and how the disease originally came across, but also to assist the Chinese. The Chinese, as we’ve said on many occasions, have been incredibly open and willing to get assistance. So, the WHO has been doing that as well as – they are activating some of their networks to look at the potential of vaccine development and the like.

QUESTION: As you observe what’s going on and see a lot of these cities in China being locked-down, shutdown, in quarantine – what’s your response to that? Is that a good idea, is it a bit too extreme; it;s called unprecedented.

PROFESSOR BRENDAN MURPHY: It is unprecedented, and I suspect it might be more difficult to do in Australia than it might be in China. But I think it has made a big difference to us, because it means that the potential of travel to Australia of people from that big epicenter is significantly reduced. So, we had put in place, as you know, a range of border measures to deal with those direct flights from Wuhan. They were enacted yesterday, but we don’t need to do that right now. We are very aware, however, because the cases have been seen in parts of China other than Wuhan, and in other countries we have to be aware that a person could come from another port into Australia. So, we are making sure that these warnings are up on all of our borders, and that border security officials are briefed.

QUESTION: With that 14 cases – number 14 cases outside of China, is that expected to increase, given all the trouble – the Lunar New Year?

PROFESSOR BRENDAN MURPHY: Look, I think the pattern over the last week would suggest that we’re likely to see more cases outside of China. I think that’s that pattern we’ve observed. And you can never be sure about anything, but I think that’s likely.

QUESTION: Even with the lockdown and quarantine?

PROFESSOR BRENDEN MURPHY: Yes, I think because there will be people – incubation period of these sort of viruses, and there are people who will have left Wuhan before the lockdown who might be in other places, yep.

QUESTION: And how long do you expect this situation to run for? What’s the kind of –

PROFESSOR BRENDAN MURPHY: You can’t be sure. I think we have to, you know – if we start to see – we suspect that we’ll see increasing numbers of cases for some time, but eventually hopefully it will peak and we’ll se a plateauing. But these things are very hard to predict, and predictions are often proven to be wrong. So, we’re just keeping a watching brief and responding as appropriately.

QUESTION: And is there a risk that, as it does go on, that the virus mutates and becomes more severe? Or are those concerns misplaced?

PROFESSOR BRENDAN MURPHY: Look, there’s always a risk with a virus that’s novel to the human species. And in the experience of SARS, there were what we called super-spreaders, some mutations that were very infectious. There’s no clear evidence that that’s happened with this virus at the moment, but that’s always a risk, yep.

QUESTION: You said they’re trying to work out the source of what animal it started in. How important is that to figure that out? What would that do in the context of this?

PROFESSOR BRENDAN MURPHY: Well, it would help ensuring that that source can be completely dealt with. Now, the markets have been closed so – but it would help in future prevention of outbreaks.

QUESTION: And there are some cases being investigated in New South Wales – I think four at the moment. How concerned should people be about those investigations, and… ?

PROFESSOR BRENDAN MURPHY: I don’t think there should be concern. I think this people all have had travel history, relevant travel history. They’re all likely to have come from outside. If one or more are eventually found to be positive, New South Wales Health will – has very well-established practices. They’ll be quarantined and looked after.

QUESTION: You mentioned that peak – do you think that’s going to happen in the Lunar New Year, given we probably won’t see that kind of travel again for at least…

PROFESSOR BRENDAN MURPHY: I wouldn’t want to predict. Predictions in these things are very dangerous.

QUESTION: And just on finding if someone’s positive or not, you mentioned yesterday a one-step test. Are we likely to know within one to two days?

PROFESSOR BRENDEN MURPHY: Yes, I think that we heard our briefing today, that the testing has matured, and the laboratories now believe that they can get an answer which is good enough to act on within the same day now.

QUESTION: Right.

QUESTION: How confident are you in accuracy of the figures coming out of China on how many infections they have?

PROFESSOR BRENDAN MURPHY: Well, I think as I’ve mentioned we are – we always believe there are likely – it’s not just because of reporting, but in a case like this there are likely to be underestimations of the true numbers where there are likely to be milder cases because we know there are many mild people with this disease that probably haven’t been counted or even tested. So, we believe, and nobody has any reason not to believe, the Chinese are being incredibly open and I think the reason the numbers have gone up a lot recently is they’re just getting on top of the data and reporting it better. I don’t think there’s any suggesting that anything is being hidden.

QUESTION: How would you characterise the difference between their reaction this time and the SARS pandemic?

PROFESSOR BRENDAN MURPHY: Very different. The international community has really praised China for their prompt and transparent action.

QUESTION: We never saw a vaccine developed for SARS. Are we likely to see one developed now?

PROFESSOR BRENDAN MURPHY: Well I think it depends on how long this disease lasts in its active stage. We certainly have better technology to develop vaccines there’s new recombinant technology that can produce vaccines in theory within, you know, a turnaround of 16 to 20 weeks.

January 24: Nippon.com (News from Japan) posted “Infectious Disease Risks Haunting Japan in Olympic Year”

Japan faces rising risks of infectious diseases being carried in from abroad, as more than 40 million people are expected to visit the country in 2020, when the Tokyo Olympics and Paralympics will be held.

While the outbreak in China of pneumonia believed to be linked to a new strain of coronavirus has emerged as a new source of concern, Japan’s National Institute of Infectious Diseases has identified measles, invasive meningococcal disease (IMD), Middle infectious diseases that require caution during the 2020 Tokyo Games, after studying factors such as how contagious they are and whether there is a risk of group infections.

Measles is spreading in the Philippines and other places. Japan was verified in 2015 by the World Health Organization as having achieved measles elimination but continues to see group infections due to imported cases.

In 2015, four people from Scotland and elsewhere were infected with IMD at an international scouting even in Yamaguchi Prefecture, western Japan. Another infection case was reported last year after the Rugby World Cup in Japan.

Although rare in Japan, IMD is one of the infectious diseases that people must exercise vigilance against, according to the Japanese Association for Infectious Diseases.

January 24: Bloomberg posted “Malaysia Reports First Confirmed Cases of Novel Coronavirus”. It was written by Anuradha Raghu.

Malaysia reported its first confirmed case of the novel coronavirus, after three members of a family tested positive.

A woman and her two grandchildren — Chinese nationals from Wuhan — traveled to Malaysia from Singapore, Health Minister Dzulkefly Ahmad said in a briefing in Kuala Lumpur on Saturday. They are related to a 66-year-old man and his son who had tested positive for the virus in Singapore.

Singapore health authorities tipped Malaysia off that the family had entered the country. The three positive cases in Malaysia are in stable condition with cough symptoms, and have been isolated, the health minister said. Five others who were traveling with them have tested negative for the virus, Malaysia said.

January 24: Reuters posted “Malaysia confirms fourth case of coronavirus infection”. It was written by Joseph Sipalan.

Malaysia reported a fourth case of coronavirus infection late Saturday, just hours after it announced its first confirmed cases.

The newly identified virus can cause pneumonia, which has been deadly in some cases. It is still unclear how dangerous it is and how easily it spreads between people.

Health Ministry Director-General Noor Hisham Abdullah said the latest case was a 40-year-old man from Wuhan, China, who was part of a tour group that traveled by bus to the southern state of Johor from Singapore on Wednesday.

The man suffered from fever the next day and sought treatment at a hospital in Johor. Tests by Malaysia’s Crisis Preparedness and Response Centre confirmed he was suffering from the coronavirus, Noor Hisham said…

…Health Minister Dzulkefly Ahmad had earlier announced three confirmed cases of coronavirus infection in three Chinese nationals, the first reported in Malaysia.

The three were related to a 66-year-old man confirmed by Singapore to have tested positive for the virus.

The infected individuals were a 65-year-old woman, who is the wife of the man with the virus in Singapore, and their two grandsons, aged 11 and 2, Dzulkefly said…

January 24: People’s Daily, China, the largest newspaper in China, tweeted: “A total of 450 professional #PLA medical staff from Shanghai, Chongqing, and Xi’an arrived at #Wuhan at 23:44 on Friday to deal with the #pneumonia caused by the novel #coronavirus.”

January 24: PolitiFact posted Trump tweets, “It will all work out well.”

“China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi!”

January 24: Nippon.com (News from Japan) posted “Japan’s Abe Orders Prompt Update on New Coronavirus”

Japanese Prime Minister Shinzo Abe instructed cabinet members Friday to provide the public promptly with accurate information about pneumonia linked to a coronavirus outbreak in the Chinese city of Wuhan.

Abe also instructed them to provide support to Japanese nationals abroad through local embassies.

“I want the public to take usual preventative measures against colds and stay calm without becoming overly concerned about the outbreak,” he told a meeting of relevant ministers.

Japan has confirmed its second case of the new strain of coronavirus, while in China, more than 800 cases have been reported with the death toll far exceeding 20.

Abe called on the ministers to continue making the utmost efforts to prevent the spread of the virus in Japan and ensure the safety of Japanese citizens abroad.

January 24: UK Department of Health and Social Care posted “CMO for England statement on the Wuhan novel coronavirus”. It is a statement from the Chief Medical Officer for England, Professor Chris Whitty, on Wuhan novel coronavirus”

COBR met today to discuss the situation in Wuhan, China, and elsewhere in Asia. I updated on the current situation, the preparedness of the NHS, and possible next steps.

I am working closely with the other UK Chief Medical Officers. We all agree that the risk to the UK public remains low, but there may well be cases in the UK at some stage. We have tried and tested measures in place to respond. The UK is well prepared for these types of incidents, with excellent readiness against infectious diseases.

We have global experts monitoring the situation around the clock and we have a strong track record of managing new forms of infectious disease. We have access to some of the best infectious disease and public health experts in the world from around the UK.

There are no confirmed cases in the UK to date. We have been carefully monitoring the situation in Wuhan, China , since the beginning of the outbreak and are now implementing our planned response.

A public health hub will be set up in Healthrow from today. This consists of clinicians and other public health officials, in addition to existing port health measures.

The World Health Organization has rightly responded quickly and China has introduced strong public health measures.

January 24: Reuters reported that Shanghai had shut down all cinemas during the Lunar New Year holidays, which last until January 30. The virus outbreak in China prompted seven Chinese films that were set to premiere during the country’s Lunar New Year holiday to postpone screenings.

January 24: Centers for Disease Control and Prevention posted “Second Travel-related Case of 2019 Novel Coronavirus Detected in United States”

The Centers for Disease Control and Prevention (CDC) today confirmed the second infection with 2019 Novel Coronavirus (2019-nCoV) in the United States has been detected in Illinois. The patient recently returned from Wuhan, China, where an outbreak of respiratory illness caused by this novel coronavirus has been ongoing since December 2019.

The patient returned to the U.S. from Wuhan on January 13, 2020, and called a health care provider after experiencing symptoms a few days later.  The patient was admitted to a hospital, where infection control measures were taken to reduce the risk of transmission to other individuals. The patient remains hospitalized in an isolation room in stable condition and is doing well.

Based on the patient’s travel history and symptoms, health care professionals suspected 2019-nCoV. A clinical specimen was collected and sent to CDC, where laboratory testing confirmed the infection. The Illinois Department of Public Health (IDPH) and the Chicago Department of Public Health (CDPH) are investigating locations where this patient went after returning to Illinois and are identifying any close contacts who were possibly exposed.  The patient has limited close contacts, all of whom are currently well and who will be monitored for symptoms. Since returning from China, the patient has had very limited movement outside the home.

CDC is taking aggressive public health measures to help protect the health of Americans. While CDC considers this a serious public health threat, based on current information, the immediate health risk from 2019-nCoV to the general American public is considered low at this time.  CDC is working closely with the Illinois Department of Public Health, the Chicago Department of Public Health, and other local partners. A CDC team has been deployed to support the ongoing investigation.

However, CDC has been proactively preparing for the introduction of 2019-nCoV in the U.S. for weeks, including:

  • First alerting clinicians on January 8 to be on the look-out for patients with respiratory symptoms and a history of travel to Wuhan, China.
  • Developing guidance for clinicians for testing and management of 2019-nCoV, as well as guidance for home care of patients with 2019-nCoV.
  • Has developed a diagnostic test to detect this virus in clinical specimens. Currently, testing must take place at CDC, but CDC is preparing to share these test kids with domestic and international partners.
  • Implementing public health entry screening at Atlanta (ATL), Chicago (ORD), Los Angeles (LAX), and San Francisco (SFO) airports. CDC is currently evaluating the extent and duration of this enhanced screening.
  • CDC has activated its Emergency Operations Center to better provide ongoing support.

Coronaviruses are a large family of viruses, some causing respiratory illness in people and others circulating among animals including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people, such as has been seen with Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). Investigations are ongoing to learn more, but person-to-person spread of 2019-nCoV is occurring.

It is likely there will be more cases reported in the U.S. in the coming days and weeks. CDC will continue to update the public as circumstances warrant. While the immediate risk of this new virus to the American public is believed to be low at this time, there are simple daily precautions that everyone should always take. It is currently flu and respiratory disease season, and CDC recommends getting vaccinated, taking everyday preventive actions to stop the spread of germs, and taking flu antivirals if prescribed. Right now, CDC recommends travelers avoid all nonessential travel to Wuhan, China. In addition, CDC recommends people traveling to China practice certain health precautions like avoiding contact with people who are sick and practicing good hand hygiene.

January 24: CDC Travel Health tweeted: “Update: CDC recommends travelers avoid all nonessential travel to #Hubei Provence, #China, including #Wuhan.” The tweet included a link to CDC information about this recommendation. It also included a graphic of a map of the world with “Travel Notice Warning (Level 3): Avoid Nonessential Travel” on it.

January 24: CNN Business posted “McDonald’s closes restaurants in five Chinese cities because of the coronavirus”. It was written by Danielle Wiener-Bronner.

McDonald’s closed restaurants in five Chinese cities and is implementing new health protocals in the region as the deadly coronavirus continues to spread.

On Friday, the company shuttered locations in Wuhan, Ezhou, Huanggang, Quianjaing and Xiantao – all cities that have been impacted by the Chinese government’s travel restrictions, company spokesperson Barry Sum told CNN Business in an email. At least 10 cities in central Hubei provence are facing travel restrictions, including Wuhan, where this strain of coronavirus originated.

“McDonald’s restaurant operation in Hubei province runs normally in cities where public transportation is available,” Sum said. “Staff and customers’ safety is our first priority and we have comprehensive, precautious measures being implemented to all restaurant operations and office staff.” It’s not clear when the affected restaurants will reopen.

At least 800 people have been infected with the virus, which has killed dozens. The respiratory infection has spread to Japan, Thailand and the United States, among other countries. Major cities including Beijing have canceled some or all major Lunar New Year celebrations in an attempt to prevent more illness and death.

McDonalds “will maintain close communication with local health and other relevant authorities, actively implementing any guidance by medical authorities for containment of the virus, and continue to work together to fight this epidemic,” Sum said.

In addition to suspending service, McDonald’s is also enacting new standards to monitor employees for signs of the infection. The company shared on its Chinese social media platforms that “all restaurants are required to commence a system of measuring body temperature of all crews upon arrival at work,” adding that it has “established reporting, recording and observation mechanism for employees traveling to and from Wuhan during the New Year Spring Festival.”

Employee with fevers or cold symptoms are to be sent home. Additionally, workers will start wearing masks and are being instructed to wash their hands and use disinfectants more frequently.

The chain is also placing hand sanitizers in stores for customer use, increasing the frequency of cleanings in stores and instructing suppliers to take safety precautions.

January 24: The Guardian reported: China said on Saturday that the death toll has risen to 41, with 1,287 affected.

January 24: Nippon.com (News from Japan) posted “Japan Raises Travel Advisory Level for Hubei Province”. From the article:

Japan has decided to raise its travel advisory for China’s Hubei Province to Level 3, Foreign Minister Toshimitsu Motegi said Friday.

The move means Japanese citizens are advised to avoid any travel to the province hit hard by a pneumonia outbreak caused by a new strain of coronavirus.

The epicenter of the outbreak is Wuhan, the capital of the province.

January 24: The Guardian posted “Coronavirus: death toll reaches 41 in China with first cases in Europe”. It was written by Rebecca Ratcliffe and Denis Campbell.

China has expanded an unprecedented lockdown during the country’s most important holiday to 13 cities and at least 36 million people, as efforts to contain the deadly new coronavirus were stepped up around the world and the first cases were reported in Europe.

Restrictions on movement were widened on Friday in China in an effort to stop the spread of the disease. Late on Friday, authorities confirmed a further 15 deaths and 180 new cases of coronavirus, bringing the total number of fatalities to 41 people and more than 1,000 affected.

Cases have been reported across South Korea, Japan, Singapore, Hong Kong, Macao, Taiwan, the United States, Thailand and Vietnam. On Friday the first cases were reported in Europe with France saying it had identified three cases. The French health minister, Agnès Buzyn, said it was likely there would be other cases.

Buzyn added that the cases involved people who had travelled to China and two of them were from the same family.

Chinese officials shut down part of the Great Wall and suspended public transport in the affected cities, stranding millions of people at the start of the lunar new year holiday amid growing anger about the government’s handling of the crisis. Beijing’s famous temple fairs, a tradition during lunar new year celebrations, will not go ahead, while Shanghai Disneyland announced it would also close indefinitely. McDonalds’s announced it has also suspended its business in five affected cities.

The developments came as:

  • The virus claimed its first victims outside Hubei as well as its youngest victim, a 36-year-old man who was admitted to hospital in the central province earlier this month but died of a sudden cardiac arrest on Thursday.
  • Authorities in China were racing against the clock to build a new 1,000-bed hospital dedicated to the disease within days.
  • The US, South Korea and Japan detected their second cases, and Singapore reported two more, for a total of three.

In the UK, tests for the virus on 14 people were reported to have come back negative as the government sought to calm public concern. With tests still in progress on several other possible cases, the health secretary, Matt Hancock, chaired a meeting of the emergency Cobra committee to ensure appropriate measures were in place should the virus reach the UK.

Leaving Whitehall after the meeting, he told reporters that the risk remained low.

However chief medical officer Prof Chris Witty cautioned that it was “highly likely” that cases would be seen in the UK. But he stressed that contingency plans were ready for that eventuality.

British universities meanwhile began taking measures to stop the spread of the virus warning students considering travelling home to China that they risk being quarantined on their return. Medical experts also remained at every UK airport with information on the virus being given to passengers returning from China.

Elsewhere, private schools were also gearing with contingency plans for overseas pupils who were unable or unwilling to return home for upcoming holidays. China sends more pupils to UK fee-paying schools than any other country.

In Wuhan, the city in Hubei that is the epicenter of the disease, hospitals were struggling with an overflow of patients and a lack of supplies. At least eight hospitals in the city made pleas for donations of masks, goggles, gowns and other protective medical gear. Administrators at Wuhan University People’s hospital set up a group chat on the popular WeChat messaging app to coordinate donations.

It is feared that the lunar new year holiday, when hundreds of millions of people travel across the country and abroad, could few the spread of the virus. A growing number of airports are introducing screening for passengers who arrive from China.

China says the virus, which is from the same family of viruses as SARS, is mutating and can be transmitted through human contact.

Some have questioned if the closures of airports and train stations in Wuhan on Thursday morning were introduced too late, since many residents will already have set off for the holiday. On Friday, the People’s Daily, the Chinese Communist party’s main newspaper, called for people who have recently been to Wuhan to isolate themselves at home, even if they don’t have symptoms.

Beijing is to take stricter and more targeted measures in the coming days, state television reported, without giving further details. “The spread of the virus has not been cut off … Local authorities should take more responsibility and have a stronger sense of urgency,” state broadcaster CCTV said.

The World Health Organization stopped short of declaring the outbreak to be a public health emergency of international concern, but called on the global community to work together to fight the virus.

Other cities, including Ezhou, Huanggang, Chibi, Qianjaing, Zhjiang, Jingmen and Xiantao have introduced similar measures.

In Zhijiang city, all public venues have been shut down except hospitals, supermarkets, farmers’ markets, gas stations and drug stores. Indoor entertainment venues in Enshi city have also been shut down.

There is suspicion among many in China that officials may be downplaying the number of cases recorded over recent weeks, recalling the government’s reluctance to disclose the full scale of the 2002-03 Sars outbreak, which killed almost 800 people.

Some residents have set up volunteer groups to escort medical staff to and from hospitals, she said. All public transport has been suspended and taxi drivers are often reluctant to drive people to medical facilities, fearing they might be infected.

People who sought treatment in Wuhan this week told the Guardian they had ben turned away from hospitals, which have been inundated with patients. Facilities are reportedly running out of beds and diagnostic kits for patients who present with fever-like symptoms, which means many people do not know for sure if they have the virus.

The initial symptoms are similar to those of a cold and flu, and include a cough or fever. Most of the people who have died in the outbreak have been older men, but on Friday it was confirmed that at 36-year-old man had died, the youngest person yet.

Footage posted on Weibo that appeared to be taken inside Wuhan’s hospitals, showed overcrowded facilities that are struggling to cope. One video, apparently taken at Hankou People’s hospital, showed long queues of patients wearing masks, waiting to be checked. The man filing claimed there were only four doctors on duty and that people had been waiting for several hours for treatment. Another video showed a patient lying on the floor, apparently having fainted.

A British man in Wuhan, who only gave his first name, Paul, said his family were well but anxious to leave. He was mostly staying indoors, he said, but friends who lived nearby had been round to visit. The family were due to fly to Japan for a holiday but are now stuck in Wuhan after all flights were cancelled.

“Wearing masks is the main thing security people at our complex insist,” he said. “We are getting temperature checked coming and going from where we live.”

In the US, the Centre for Disease Control and Prevention said it had 63 patients under investigation, with the second confirmed case diagnosed in a 60-year-old woman from Chicago who had traveled to Wuhan in December.

January 24: World Health Organization Philippines tweeted: “Based on the results that came out today from the confirmatory testing done in Australia of the 5-year-old in Cebu, he is negative from the 2019 novel #coronavirus.” This tweet was the start of a thread.

January 24: World Health Organization Philippines tweeted: “This means that the Philippines continues to have no confirmed case of 2019 novel #coronavirus. However, it is likely that we will see more cases in China and in other countries in coming days and weeks.”

January 24: World Health Organization Philippines tweeted: “The Philippine Department of Health, Bureau of Quarantine and airport authorities are continuing active case findings for possible cases of 2019 novel #coronavirus in the country.” This was the last tweet in the thread.

January 24: The Guardian “French cases show coronavirus has reached Europe”

France has identified three cases of the deadly new coronavirus from China, the first cases in Europe.

Two of the cases were announced by the health minister, Agnès Buzyn, on Friday evening. She said that both of those affected had traveled to China.

The third case was announced a few hours after the press conference. Two of the three infected people belong to the same family, authorities said.

The minister said she believes that one reason why France is the first European country to have confirmed cases is that it has developed a test allowing medics to rapidly diagnose those affected. “You have to treat an epidemic as you would a fire, that’s to say find the source very quickly,” she said. “We identified the first positive cases very quickly.”

One of the patients, a 48-year-old man, passed through Wuhan, the Chinese city at the centre of the outbreak, before travelling to France on Wednesday, the minister said. He is in the south-western city of Bordeaux. “He’s been put in an insulated room so as to avoid any contact with the outside world. He’s fine,” she said.

She said he is a French national who traveled to China for work and lives in the Bordeaux area. He was in contact with about 10 people before he was taken into care, the minister said. French authorities are seeking to contact them.

The mayor of Bordeaux, Nicolas Florian, told residents not to be concerned about the case. “There is no imminent danger. It’s under control, in hospital… There is no cause for alarm, and no reason to panic,” he told France Bleu radio.

The other person referred to by Buzyn is in hospital in Paris. The minister said they also travelled to China but she had little information about that case, which was confirmed shortly before she spoke at the news conference.

The minister urged people who suspect they may have the virus to call emergency services and to stay at home to avoid spreading the disease.

The newly discovered virus has killed 41 people and infected more than 1,000. Most of the cases and all of the deaths so far have been in China, where officials have imposed severe restrictions on travel and public gatherings.

Cases have also been reported in South Korea, Japan, Singapore, Hong King, Macao, Taiwan, the US, Thailand and Vietnam.

January 24: Nippon.com (News from Japan) posted “Japan Govt, Firms Concerned about Supply Chain Damage from New Virus”

In the wake of the spread of pneumonia caused by a new strain of coronavirus after an outbreak in Wuhan, China, the Japanese government and companies operating in the city are strengthening their vigilance.

A prolonged outbreak is likely to deal a blow to the supply chains of Japanese firms such as automakers and electronic equipment makers.

“We’ll closely watch the disease’s economic impacts with high interest,” Japanese industry minister Hiroshi Kajiyama told a press conference on Friday.

Wuhan is a core of supply chains in Asia, bringing together cutting-edge factories that make semiconductors and other high-tech components.

Some 160 Japanese companies operate in the city, including Honda Motor Co. <7267>, Nissan Motor Co. ,<7201> Denso Corp. <6902>, and Daikin Industries Ltd. <6367>.

January 24: Minister for Health & Ambulance Services, Victoria, Australia, Jenny Mikakos MP tweeted: “We have confirmed a case of the 2019 novel coronavirus in Victoria – the first in Australia. There is no need for the community to be alarmed, our health system is well prepared to manage infectious diseases.”

The tweet included a link to the Victoria State Government website to a press release titled: “First novel coronavirus case in Victoria”. From the press release:

Victoria’s Department of Health and Human Services has confirmed the first Australian case of the 2019 novel coronavirus.

The man is in his 50s, a visitor from China, is in a stable condition with the respiratory illness. He was confirmed as positive at 2:15am today following a series of tests.

The patient is being treated in an isolation room at Monash Medical Centre Clayton in accordance with recommended infection control procedure.

He had been to the city of Wuhan, China in the two weeks prior to the onset of his illness…

January 24: AFP News Agency correspondent Xinqi Su tweeted: “First recorded death of doctor in mainland China due to #nCoV2019 came on the first day of the Lunar New Year. Liang Wudong, and E.N.T. dept doctor of Hubei Xinhua Hospital, passed away one week after he was admitted to Jinyintan Hospital, his colleague said.”

January 24: AFP News Agency correspondant Xinqi Su also tweeted: “Another doctor lost in the fight against #nCoV2019- Jiang Jijun, a 51yo veteran infectious disease doctor, died of a sudden heart arrest on his way to the fever clinic on Jan. 23. His colleague said he was exhausted by a two to three-fold surge in service demand due to the epidemic.”

January 24: The Guardian reported that China’s Hainan province quarantines tourists from Hubei province.

In China’s Haikou city, the capitol of the southern island province of Hainan, will start a 14-day centralized medical observation for tourists from the central Hubei province, the local government in Haikou has announced.

Tourists from Hubei, especially from Wuhan city, are not allowed to leave the hotel where the medical observation will be held during the 14-day period, it said.

Hubei has confirmed 729 cases of the new coronavirus, with 39 deaths as of January, the provincial health authorities said.

January 24: Australian Foreign Minister & Minister for Women Marise Payne tweeted: “We have raised our travel advice for Wuhan and Hubei province to level 4 – “Do not travel.” Chinese authorities have restricted travel in at least 5 Hubei cities. Australians going there may not be able to leave until restrictions are lifted.”

The tweet included in link to information about Level 4: Do not travel.

If you are already in this location, you should consider leaving if it’s safe to do so. If you do travel, get professional security advice. Your travel insurance policy might be void. The Australian Government may not be able to help you.

At level 4, your health and safety is at extreme risk. This may be because of a high threat of terrorist attack, conflict, violent social unrest, widespread infectious disease, or critical levels of violent crime. It could be a combination of risks.

If you travel to this location you’re at a high risk of death, imprisonment, kidnapping, or serious injury.

If you get into trouble, the Australian Government may be unable to help. In most cases, our ability to provide consular assistance in these destinations is extremely limited.

Any travel by Australian officials to ‘Do Not Travel’ locations is subject to high-level approval. It includes rigorous risk assessment and movement planning usually involving the use of armoured vehicles.

You should not travel to this location. If you are already in a ‘do not travel’ area, you should consider leaving. If, despite our advice, you decide to travel to a location with a travel advice level of 4, it’s your responsibility to follow all the advice for levels 1, 2, and 3, as well as the following.

Before you go

  • Check your travel insurance. Most standard policies won’t cover you for ‘Do not travel’ destinations
  • Consider your security. Get independent, professional security advice. You may need to hire personal protection.
  • Have robust management measures in place. This includes a detailed emergency management plan.
  • Understand that you could die. Make sure you have an up to date will and enduring power of attorney. Designate appropriate insurance beneficiaries.

It’s your responsibility to take care of your security. The Australian Government can’t provide security assistance or advice.

January 24: Reuters reported “Japan confirms third case of Wuhan virus”

Japan has confirmed a third case of infection by China’s coronavirus, the health ministry said on Saturday.

The latest case was confirmed in a woman in her 30s who lives in Wuhan, the Chinese city at the center of the outbreak. She arrived in Japan on Jan. 18, the ministry said.

The death toll from China’s coronavirus outbreak jumped on Saturday from 41 to 26 a day earlier. More than 1,300 people have been infected globally.

January 24: New York State Health website “Governor Cuomo Outlines State Response to First Two Confirmed Cases of Novel Coronavirus in United States”

Governor Andrew M. Cuomo today announced a series of actions to raise awareness and prepare New York State in response to an outbreak of a novel coronavirus in China after the US Centers for Disease Control and Prevention announced two confirmed cases in the United States – one in Washington State and one in Chicago. The State Department of Health currently has four persons under investigation for novel coronavirus that are under isolation as their cases are being tested at the CDC. So far, one of these cases has been proven negative and three are still pending. While the risk for New York is currently low, the Governor is calling for increased vigilance to ensure New Yorkers are protected.

“As we learn about the first confirmed cases of this novel coronavirus in the United States and potentially in New York, I want to assure New Yorkers that were are prepared,” Governor Cuomo said. “We are undertaking a wide-reaching and rigorous effort with all stakeholders, including healthcare providers to keep New Yorkers safe. The symptoms of the virus are very similar to a common cold – if you are concerned that you might be ill, please follow our guidance to protect yourself and others.”

Last week the Department of Health issued guidance to healthcare providers, healthcare facilities, clinical laboratories and local health departments to provide updated information about the outbreak, and ensure the proper protocols are in place if a patient is experiencing symptoms consistent with the novel coronavirus, had a travel history to Wuhan, China, or had come in contact with an individual who was under investigation for this novel coronavirus.

Additionally, the Department has hosted a series of informational webinars for hospitals and local healthcare providers. Today the Department hosted a webinar for medical professionals at colleges and universities – many of which host international students – to disseminate information about the virus, infection control recommendations and the current criteria for testing.

Last week’s guidance coincided with the start of a CDC-led airport entry screening program at John F. Kennedy International Airport for passengers arriving from Wuhan, China. Chinese officials have since closed transport in and out of Wuhan and other cities in the province, including the international airports. DOH, Port Authority and the New York City Health Department will continue to work collaboratively with CDC as their travel screening process evolves. To date, no passenger has required further evaluation as a result of the CDC-led passenger program at JFK. To raise further awareness for all international travel, Governor Cuomo has directed the Port Authority to post informational signs at all four Port Authority international airports.

New York State Health Commissioner Dr. Howard Zucker said, “This virus is being carefully monitored at federal, state and city levels to ensure the public’s health and safety, and while awareness is important, the current risk to New Yorkers is low. People who have traveled abroad recently and have symptoms that mimic the flue should see their doctor. We are working closely with the Centers for Disease Control to receive daily updates and stand ready to assist.”

Symptoms of the novel coronavirus may include:

  • Runny nose
  • Headache
  • Cough
  • Sore throat
  • Fever
  • A general feeling of being unwell

The CDC recommends that individuals avoid all nonessential travel to Wuhan, China, but has provided specific information for those who are still planning a trip to Wuhan and for individuals who have recently returned from that city and may be experiencing the above symptoms. While there is currently no vaccine for this novel coronavirus, everyday preventative actions can help stop the spread of this and other respiratory viruses, including:

  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based sanitizer.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.

Individuals who are experiencing symptoms and may have traveled to areas of concern, or who have been in contact with somebody who has traveled to these area, should call ahead to their healthcare provider before presenting for treatment.

January 24: Centers for Disease Control and Prevention (CDC) posted”Transcript of 2019 Novel Coronavirus Response”

Ben Haynes: Good morning, thank you for joining us for today’s update on the 2019 Novel Coronavirus response.  We are joined today by Dr. Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases; Dr. Marty Cetron, director of CDC’s Division of Global Migration and Quarantine; and health officials from the Illinois Department of Health.  Following opening remarks, we will open it up for your questions.  I would now like to turn the call over to Dr. Messonnier.

Dr. Nancy Messonnier: Good morning, thank you for joining us.  Over the last week, I’ve said that with our advanced surveillance and detection capacity, we expect find more cases of novel coronavirus in the United States associated with the ongoing and expanding outbreak in Wuhan, China. We understand that some people are worried about this virus and how it may impact Americans. While this situation poses a very serious public health threat, CDC believes that the immediate risk to the U.S. public is low at this time, but the situation continues to evolve rapidly. Today I am joined by representatives from Illinois and Chicago to announce that we have confirmed a second travel-related U.S. infection of novel coronavirus.  I would like to hand the briefing over to my colleague Illinois Department of Public Health State Epidemiologist Dr. Jennifer Layden, who will discuss about the specifics about this patient and the specific actions taken by IDPH. Dr. Layden.

Dr. Jennifer Layden: Thank you Dr. Messonnier, and good morning. I am Dr. Jennifer Layden, the State Epidemiologist and Chief Medical Officer for the Illinois Department of Public Health. I would like to start by thanking our local public health partners in Illinois, healthcare partners and the CDC for the coordinated and collaborative work on this rapidly evolving situation.  It is because of the diligent work by numerous health professionals that we were able to identify this confirmed travel-associated case of novel coronavirus quickly while also taking measures to prevent others from being exposed.  IDPH has been closely monitoring this international outbreak and began proactively preparing in the event the outbreak expanded. 

We have been providing the CDC guidance, resources, and recommendations to our local health departments, hospitals, and clinicians; developed a dedicated website and webpage; and held webinars this week for local health departments, clinicians, and healthcare facilities across the state. 

Earlier this week we were notified by our local health department partners of a Chicago resident who had returned from Wuhan on January 13. The individual did not have symptoms while traveling. More recently, the individual began experiencing symptoms, called healthcare providers and ultimately was admitted to the hospital and placed in isolation. As the patient did in this case, we ask that any individuals who begin experiencing symptoms and have recently traveled to Wuhan or had contact with someone diagnosed with the novel coronavirus, call their healthcare provider or hospital before seeking treatments so that the appropriate infection control measures can be put in place. 

Coordination between the hospitals, local and state health departments allowed specimens to be quickly shipped and tested at the CDC. This coordination between providers, hospitals, and public health is critical for our continued effort to best respond to and reduce transmission. The Illinois Department of Public Health will continue to partner with the CDC and has invited them to Illinois to assist with this investigation. 

IDPH is ready to bring testing online at our state labs when testing is available from the CDC. We will continue to communicate and coordinate with our local health departments and numerous clinical partners as we respond to this evolving situation.  I would now like to turn it over to Dr. Allison Arwady, the Chicago Department of Public Health Commissioner, who can provide more information about this patient and the next steps of the investigation.

Dr. Allison Arwady: Thank you, Dr. Layden. This is Dr. Allison Arwady, the Commissioner of the Chicago Department of Public Health. The patient is a woman in her 60s and a Chicago resident. Most importantly, I am pleased to report she’s clinically doing well and is in stable condition. 

She traveled to Wuhan, China in late December and returned to the U.S. on January 13. A few days after arriving home, the patient began to feel unwell. As you heard, she called ahead to alert her doctor to her illness. The doctor appropriately asked about travel history and quickly put a mask on the patient helping to limit the potential risk of spreading infection. Her doctor then referred her directly to a hospital with infection control capabilities for further work up. 

Hospital staff placed her in the appropriate vetting for infection control, performed a full clinical work up, and worked with public health to arrange testing for novel coronavirus at CDC. The patient is clinically doing well, currently in stable condition and remains hospitalized primarily for infection control. The patient has been very helpful as we have been gathering information about her contacts in recent days. 

Again, she was not symptomatic when flying, and based on what we know now about this virus, our concern for transmission before symptoms developed is low. So that is reassuring.  She has limited close contacts, all of whom are currently well, and will be monitored for symptoms. 

Since returning from China, the patient has had limited movement outside her home.  Now that the test is positive, we will be continuing to collect and confirm information on her activities and contacts. But we know already for example that she had not taken public transportation or attended any large gathering.  And actually, to our best knowledge at this point, she has not had extended close contact with anyone outside her home since returning from China. 

This is all very reassuring in terms of infection risk to the general public which remains low nationally and locally here in Chicago. I want to thank the federal state and many local partners who have worked together not just in response to this case but over many years to ensure the Chicago area is well prepared to respond to emerging and infectious diseases.

Dr. Messonnier: Thank you both. This is Dr. Messonnier and I want to take a moment to thank our colleagues in Illinois at the state and local level who have been working with us since earlier this week when the patient was identified. Like we did with the state of Washington, a CDC team has been deployed to support the ongoing investigation in Illinois, and as always, we standby to help state, local, and global partners. 

I also would like to thank all the states and clinicians who have reached out to us over the last few days to discuss potential cases, and who have followed up by sending samples if it was warranted.  This is a sign that the public health system is working. To date, we have 63 of what we are calling patients under investigation or PUIs from 22 states. So far, only two have been confirmed positive and 11 tested negative. We anticipate by next week we’ll begin regular reporting of case information on our website. 

There are likely to be many more PUIs identified in the coming days. We have faced similar public health challenges before. Those outbreaks were complex and required a comprehensive public health response. This is what we are preparing for.  We have an aggressive response with the goal of identifying potential cases early. We want to make sure these patients get the best and most appropriate care. This is a rapidly changing situation both abroad and domestically, and we are still learning. 

Let’s remember this virus is identified within the past month and there is much we don’t know yet. We are expecting more cases in the U.S., and we are likely going to see some cases among close contacts of travelers and human to human transmission. Our goal is always to protect the health of Americans. We at CDC have our best people working on this problem. We have support across the entirety of the Federal Government. We have one of the strongest public health systems in the world. 

Again, while there are many unknowns, CDC believes that the immediate risk to the American public continues to be low at this time, but that the situation continues to evolve rapidly. CDC recommends travelers avoid all non-essential travel to Wuhan. We also recommend people traveling to other parts of China practice certain health precautions, like avoiding contact with people who are sick and practicing good hand hygiene. 

Returning travelers with symptoms, or close contact with people confirmed with coronavirus, may be asked to take precautionary measures and there may be some disruptions. I want to thank those people in advance for their cooperation. Everyone can do their part here. 

Although Chinese officials have closed transport within and out of Wuhan, China, CDC will continue to conduct enhanced screening at five designated airports: New York JFK, San Francisco, LAX, Chicago O’Hare and Atlanta Hartsfield-Jackson. We are currently evaluating the extent and duration of this enhanced screening.  Every day we learn more and every day we assess to see if our guidance or response can be improved.  As the response evolves, CDC will continue our aggressive public health response strategy.  Thank you.

Ben Haynes: Thank you Dr. Messonnier. We are ready to take questions.

Operator: Thank you, we will now begin our question/answer segment. You may press star 1 to ask a question and one moment please for our first question.

Our first question comes from Lena Sun with the Washington Post.

Lena Sun: Thank you doctors for holding this call and thank you so much for starting it on time for those of us who were on the other call yesterday. I have a question; can you tell us how many people have been screened and is it possible to get a list of the 22 states and how many people — how many close contacts are being monitored?

Dr. Marty Cetron: Yes, we have screened over 2,000 folks to date as of yesterday, and that’s about 200 flights. We have not found any cases; one person was sent for additional medical evaluation. That’s the current status of screening at the five ports for the active entry screening.

Dr. Messonnier: In terms of the number of states, I don’t have that information today. It is one of those things we are hoping to be able to post on the web next week.

OK, I am sorry, I am – Nina, there are 22 states. The specific information about which state is again something we hope to post by next week. I’m sorry, I missed the third question? Oh, the contact list.

I think it would be premature for us to give you absolute numbers, but I ask my colleagues in Chicago, Illinois, if you want to give a sense of how many people you are tracking.

Dr. Allison Arwady: This is Allison Arwady in Chicago. We are currently working to determine exactly what our list is going to be for monitoring, this patient had limited close contacts and the ones that have been identified are currently well will certainly be working with the CDC team on the ground to make sure there is a full list of those folks as well as healthcare workers caring for the patients. We are not ready to share details at this time. We are well on our way to having all of that established.

Dr. Messonnier: This is Dr. Messonnier again, I would just like to say that given the unknowns as we continue to learn about the virus, the public health community is airing on the side of caution in terms of the following close contacts as you would expect at this point in the investigation.

Ben Haynes: Next question, please.

Operator: Next question comes from Helen Branswell with STAT.

Helen Branswell: Is there any indication of illness among the contacts of the patient with illness in Washington State. That’s the first. The second in your discussion with the woman who was in Wuhan, the new case, is there any indication of how she may have become infected? Did she go to the fish market or was she around people who were sick? And the third question is for Dr. Cetron, given that flights out of Wuhan have been stopped, what are you actually doing at the five airports now and was the number of cities that you are trying to monitor from expanded?

Dr. Messonnier: The first answer, to whether or not there is illness among contacts of Washington state, is at this time we have not identified any illnesses among the contacts of the initial patient in Washington state. Dr. Layden or Dr. Arwady, do you want to answer the second question about what you know about how she potentially became infected.

Dr. Allison Arwady: We are not at this time releasing any personal information about the patient. Certainly, with the CDC team on the ground, we’ll be gathering additional information about her activities and travel in China just like what we are doing here on the Chicago side. Decisions to screen and test these patients, as folks know, are purely based on being in Wuhan as opposed to specific activities. That’s what we can share at this point.

Dr. Marty Cetron: And Helen this is Dr. Marty Cetron, and I think your point is well taken. We have seen a fairly dramatic change in the situation in China with the government’s announcement of travel bans and restrictions out of Wuhan and actually those are extending of travel bans and restrictions out of Wuhan and actually those are extending to additional cities as we speak.

As you would expect, we are reevaluating the approach, and as I said earlier when we first began entry screening with a clear focus on the epidemic epicenter that we would continue to evaluate the balance and utility of a border entry screening program based on the totality of the circumstances.

Those circumstances have clearly changed. We are reevaluating that approach and watching for both expansion to other cities as well as concentrating the efforts. As you heard today, it is really important to point out that both of the initial first two U.S. cases were asymptomatic and afebrile when they arrived.

The concentration of resources and efforts need to be focused on the tremendous work that our state and local partners are doing to rapidly identify cases and contacts and assure that the American health is protected. So, there will be a balance and a shifting in how we look at entry screening as we go into the new scenario with the travel closures.

Operator: Thank you. The next question will come from Elvia Malagon, with the Chicago Tribune.

Elvia Malagon: Is there any indication that the patient has traveled with anyone, when she went to China, and have any of those people been tested for this?

Dr. Allison Arwady: There were no other Chicago or Illinois residents that traveled with this patient. Therefore, we are not testing anybody in that setting. We are through following on with her close contacts in any of these situations.

Operator: This question comes from Issam Ahmed AFP. You may ask question. Your line is open.

Issam Ahmed: Out of the 63 cases on the investigation you mentioned, 11 tested negative. So just to get a breakdown, those 11 are out of the 63 and the two confirmed positives are out of the 63 total?

Dr. Messonnier: Yes, that’s correct, 63 is the total nimble of cases under investigation. As you know from other outbreaks, we use that term loosely to provide the number of people who we are doing an evaluation with. We think that number has gone up as a testament to the diligence of our partners at the local state level, the diligence of clinicians and those two positive and the other patients’ samples are in the process of arriving or in the process of being tested her at the CDC. As you heard from Illinois, we are rapidly working at the CDC to get those tested out where they can meet closer to the patients to really try as quickly as possible to be able to provide diagnoses.

Issam Ahmed: Perfect, and when you get those, do you know the timeline when it will be out?

Dr. Messonnier: I would say that we are working to expedite it as quickly as possible.

Operator: This question comes from Denise Grady with the New York Times.

Denise Grady: A couple of things. When you are following patients, I realized that you are testing but also you are looking at an incubation period and is there some period during which the person is OK and then you are figuring no problem. Is the incubation period known yet?

Dr. Messonnier: In general, the information that we have so far suggests an incubation period around two weeks. That’s not surprising given the kind of virus this is. That’s a general guideline. In terms of following, you know what really it is the state and the local health departments who are following and investigating these cases and how they proceed with that investigation partly depends on their clinical suspicion of whether this is likely to be a positive case.

And so, for example, with this patient, the health department had a very high degree of suspicion and even before the diagnosis had already started to thin about their initial investigations. And I don’t know if doctor, if you want to talk about what you were doing.

Dr. Jennifer Layden: Sure, this is Dr. Layden. We started to work with both, in this case before it was confirmed, the patient and others to identify any potential areas of exposures and potential close contacts and we are working closely with local health departments and the CDC to prioritize contacts. And we’ll be monitoring through systems we developed these individuals through the extent of the incubation period.

Denise Grady: Thank you, can I ask one more just follow up on that. When samples are sent in and tested, what are the samples and what are you testing from the patients?

Dr. Messonnier: Thank you. We are generally testing respiratory samples, but we are also testing blood, and we are currently working to expand the kind of diagnostics we can do, but the focus right now is the real-time PCR is respiratory specimens and sometimes blood.

Operator: Next question comes from Steven Gray; your line is open.

Melissa Para: Thank you, this is actually Melissa Para. I just wanted clarification on how exactly you guys are keeping track of those travelers who may have been asymptomatic when they arrive at Chicago O’Hare but may develop symptoms later on.

Dr. Marty Cetron: Now that’s a great question, and the point is well taken that these patients were asymptomatic when they arrived. We are alerting them, and we have expanded the alerts to travelers to include all travelers that are coming from any potential area, and getting the word out through a number of different outreach sources for self-monitoring as well as the vigilance, the signs, the cards, the airport screens. The cards we are handing out say clearly, be aware to monitor your symptoms in the next 14 days, and this is how to engage the healthcare system safely and have your physician report to the public health infrastructure.

So that its the current monitoring process. With the ban in Wuhan, we wouldn’t expect to see if the travel ban is effective, additional cases coming in. So, it is the last 14 days before the ban where this pool of folks we are identifying now is where that focus is. We need to increase vigilance and awareness of the entire system from travelers and people who get sick and clinicians as well to be on the alert for that. So, we are pushing that message out from several sources, and an important one is this conference right now, so you can help us actually get that message out pretty effectively. Thank you.

Melissa Para: One follow-up question. We are still learning more about this and symptoms can kind of range all over the place, but is it possible that you know I understand that we have non-contact thermometers at the airport, but is it possible there may be patients who may have this and don’t have a fever that may pass through that screening because they’re not showing a fever as the symptom?

Dr. Messonnier: So, I think that is entirely true and part of what the message the Dr. Cetron was trying to give, illnesses like this have an incubation period and here can often be periods of mild illness before more serious illness occurs. We are really still working to understand the full spectrum of illness associated with this novel coronavirus.

What our focus still is for travelers and clinicians, is the people with recent travel who have fever and respiratory symptoms and I think that really should be the focus. Of course the problem this time of the year is that it is cold and flu season and there are a lot of respiratory viruses that are circulating including influenza.

But, we ask clinicians, travelers and the entire community to be vigilant. We want everyone to air on the side of caution if they have those symptoms, and they have a travel history, to call their healthcare provider right away.

Operator: Next question comes from Sarah Omermohle with Politico. Your line is open.

Sarah Owermohle: Thank you. I want to ask what kind of dialogue you guys are having with Chinese health authorities, and if that helps the understanding of when people present symptoms or when they transmit this disease to others, and the source of it as well as if there is any inkling of where it is coming from and also on the diagnostic tests you are developing. How long is the turnaround time to definitively say this is the Wuhan virus and how much turnaround of people sending samples to you and the time it takes to get those to you?

Dr. Messionner: I am going to answer the second question first. Once the sample is prepared at CDC, the time it takes to actually do the test is four to six hours which is a very typical time for a real-time PCR. As you say, part of the delay is the sample getting to CDC, and entirely one of the reasons we are focusing on the possibility of getting those tests out closer to the patients so the results can become available more quickly.

For that question, what I would say is that, CDC has a team that’s been in China for many years where we work closely with the Department of Health in China, and one of the things we have been working with them is preparedness for respiratory diseases and influenza for a long-term partnership, and in that way there is a strong collaboration.

The situation in China continues to evolve rapidly. I think we should be clear to compliment the Chinese on the early recognition of the respiratory outbreak center in the Wuhan market, and how rapidly they were able to identify it as a novel coronavirus and publish that information and make it available for all countries, like the U.S. That step was key for use having the diagnostics so that we could identify it here.

Over the past few days, there has been a large amount of information coming out of China, we are working closer with all the global partners under the umbrella of WHO, but also directly, to synthesize that information and that’s one of the reasons we have been so clear that this situation is rapidly evolving because information is coming in hour by hour and day by day.

Operator: Thank you. This question comes from Rob Stein with NPR, your line is open.

Rob Stein: Thank you very much for taking my question. I had a couple of questions, one was, can you tell us the hospital that the woman was treated in at Chicago? Also, can you tell us anything more about where you are targeting the testing? Are there specific places for your priorities of getting the testing out to?

Dr. Allison Arwady: This is Alison Arwady in Chicago. For the first question, to protect patient’s privacy when the Chicago Department of Public Health or Illinois Department of Public Health are investigating a patient with communicable diseases, we do not routinely name the hospitals where the patient sought care.

I do want to say, that we would potentially name hospitals in three situations: Number one, if we have concern the general public may be at risk of infection; Number two, if we could not identify individuals who needed follow-up monitoring; Or number three, if we believe there has been transmission within the hospital itself. In this case, based on everything we know now, none of these situations apply, so we are sticking to our standard communicable disease release.

In the interest of balancing patient’s privacy and transparency, if we have any evidence or reasons to believe the general public is at risk of transmission in the hospital, we would hare the name of the hospital at that time.

Dr. Messonnier: In terms of the second question, the prioritization of the diagnostic kits, we are working rapidly to get it to every state because we believe it is likely that many states will have patients under investigation that they’ll want to do diagnostics. But we are certainly paying special attention to those states that have larger populations returning from Wuhan, to make sure they have that availability first.

In terms of other countries, CDC has an incredibly strong infrastructure for this exact kind of development of diagnostics, and we’ll certainly be working to make sure that we use those resources to help all the countries around the world that are in need of those resources and all the countries around the world that are in need of our help with diagnostics and in this case we are working with the World Health Organization who is coordinating a lot of those efforts.

Operator: this question comes from Dawn Kopecki with CNBC News.

Dawn Kopecki: Can you talk a little bit about the incubation period, has it been confirmed that it is a two-week incubation period? If so, how does that compare to SARS which has an incubation period of two to seven days. This seems to be spreading faster than SARS and although it is not as lethal. In the first ten weeks there was about 400 and some SARS patients about there are 900 in the first three weeks with this. So, can you talk about how this compares to SARS in terms of how contagious it is. Is it considered over the two weeks period and how much more rapidly is it spreading than SARS?

Dr. Messionnier: I think I would start by saying again that it is really in the early days and we are continuing to accumulate information every day that is helping us to understand this virus. Right now, our understanding of the incubation period is somewhere around 14 days.

I do agree with you that information of MERS and SARS was slightly shorter. But I think it’s premature to judge that as being distinctly different because we really are still in the learning phase of this novel pathogen that’s just emerged and been identified.

What an incubation period means is that is an average time that somebody takes from the time that they’re exposed to the time that they are sick. But anytime that there is an incubation period, it is not a hard and fast number. There is always range around it, and so that’s why the health department is being cautious in terms of identifying potential contacts.

In terms of infectiousness and severity, I think it is a little premature to absolutely say, whether it is similar or different than SARS or MERS or all the other human coronaviruses. We are looking at that closely, and we have an approach that we take to try to compare different viruses, and we’re looking at the information we have on SARS and MERS as well as other coronaviruses, and rapidly trying to synthesize all the information from the countries, especially the Chinese data that is much more available over the last couple of days, and I hope that we’ll have more direct information about that issue soon.

But I think it would be premature to conclude that we know whether it is more or less infectious than SARS and more or less severe than SARS. It is just too early to say that.

Operator: The last question comes from WebMD.

WebMD: Thanks. I read in the report today that, in terms of symptoms, this is mostly lower respiratory symptoms. Does that mean congestion so that you have difficulty breathing and perhaps pneumonia without congestion?

Dr. Messonnier: What I would say is that information is emerging, and I think the reports are useful and interesting, but it is not an accumulation of all the available data. Early on our understanding is that, in Wuhan the case definition was somewhat narrower and focused on pneumonia, and you can hypothesize that by focusing on pneumonia you might miss milder disease. So, our focus on this is to have a high degree of suspicion for people with fever and respiratory symptoms, and that’s how we have communicated that to our state and local partners and clinicians and travelers.

WebMD: Got it. So, patients with this cold have like runny nose – I am just trying to understand what the symptoms are.

Dr. Messonnier: I think that again, I would not say the patient can have, I would say that we need to continue to investigate and understand this. Our focus on travelers and the message we want to make sure we’re getting to travelers and in the healthcare, community is that we are looking for returning travelers who have fever, cough, and respiratory symptoms. But, if you have a suspicion and if you’re concerned because you have a fever and you returned, we want you to contact your healthcare provider. It is better to be safe and be evaluated, and as more information becomes available, we will be communicating that.

WebMD: Ok, thank you.

Ben Haynes: Thank you, to our colleagues and our doctors. A transcript of this briefing will be available at the CDC press room. Remember to visit our coronavirus web page for updated response information. If you have further question, contact the main media line, 404-639-6286 or e-mail us.

Operator: We thank you for your participation. You may disconnect your lines.

January 24: Illinois Governor JB Pritzker posted a thread of tweets starting with this one: This morning the Centers for Disease Control and Prevention announced confirmation that the first case in Illinois of novel coronavirus in an individual who travelled to the city of Wuhan in central China. At this time, the risk to the general public remains low.

January 24: Governor JB Pritzker tweeted: I want to assure Illinoians that we are closely monitoring this situation and taking every precaution. Our Illinois state and local agencies and officials – along with our federal counterparts including the CDC – are highly engaged in this coordinated response.”

“The people of Illinois that our health officials will continue to coordinate with federal officials in a robust manner to take all cautions and to communicate with the public.”

Governor JB Pritzker ended his thread with this tweet: “The same precautions you take during flu season are the same precautions you should take for this virus. Take extra care to wash your hands. Visit a doctor if you’re experiencing symptoms, particularly if you or a loved one has recently traveled abroad.”

January 24: Illinois Department of Public Health posted “City of Chicago Announces First Local Patient with Travel-Related Case of 2019-Novel Coronavirus”.

Patient is the second of two nationally diagnosed cases, officials note small risk to the general public.

The Chicago Department of Public Health (CDPH) today joined state and federal health officials as well as other City departments in reporting the first local resident with a confirmed case of 2019 novel coronavirus (2019-nCoV). Health officials reassured the general public that the risk of the virus spreading still remains low. The U.S. Centers for Disease Control and Prevention (CDC) first confirmed Friday morning the second case of coronavirus in the United States. The patient recently returned to Chicago from Wuhan, China, where an outbreak of pneumonia caused by the virus has been ongoing since December 2019.

“We’re pleased that the patient is doing well and getting the proper care, that the public health system responded appropriately, and that the risk of transmission to the general public is low,” said Allison Arwady, MD, MPH, Commissioner of the Chicago Department of Public Health. “We have worked very closely with federal, state, and local partners, not just in response to this case, but over many years to ensure the Chicago area has strong public health systems and is well prepared to respond to emerging infectious diseases.”

The patient is in stable condition and remains hospitalized. Based on the information currently known about her activities since her return, there is no immediate health risk to the general public. The patient, a woman her 60s, took the proper steps of calling ahead to her doctor before arriving at the emergency room and had not extend contact since arriving back in the U.S. She has since limited all close contacts. The general health risk from 2019-nCoV in both U.S. and Chicago is still deemed to be low at present.

“The Illinois Department of Public Health is working closely with the Centers for Disease Control and Prevention, the Chicago Department of Public Health, other local health departments, hospitals, clinicians, and other medical providers to proactively identify and aggressively respond to any possible cases of novel coronavirus,” said IDPH Director Dr. Ngozi Ezike. “Our ultimate goal is to identify and contain any illnesses to prevent the spread of disease. We understand there is a lot of interest, but there are still many unknowns with this novel virus and the situation is rapidly evolving. As we learn more, and when cases are confirmed, we will make sure to share that information.”

The Illinois Department of Public Health, Chicago Department of Public Health, and Cook County Department of Public Health are working in tandem to identify any close contacts who may have been exposed after the patient returned from China. Additionally, a CDC team has also been deployed to support the ongoing investigation, including tracing close contacts to determine if anyone else has become ill.

The patient returned to the U.S. from Wuhan on January 13, prior to the implementation of screening procedures at five U.S. airports, including the addition of O’Hare International Airport earlier this week. However, the City has been working closely with the CDC and other federal, state and local agencies, including the Department of Aviation (CDA) and the Chicago Fire Department, to proactively prepare for local cases since learning of the outbreak.

“The Chicago Department of Aviation has no higher priority than the safety and well-being of the traveling public, as well as our airport community. From the moment information came to light about this particular strain of coronavirus, CDA’s safety and security team has been closely monitoring the situation and interfacing with our federal and public health partners,” CDA Commissioner Jamie L. Rhee said. “As always, we want to be sure we’re able to support any special efforts related to the coronavirus, while at the same time maintaining normal operations — and that has happened. In addition to our valued travelers, we are working hard to ensure the tens of thousands of individuals who make their living at O’Hare airport have the most up-to-date information on the coronavirus, as well as ongoing efforts to keep the public and our airport family safe.”

Chinese authorities first identified the new coronavirus, which has resulted in hundreds of confirmed human infections in China and exported cases in Thailand, Japan, South Korea and the United States/ On Tuesday, January 21, the CDC confirmed the first case of novel coronavirus in the United States in the state of Washington. The patient was also a traveler who had recently returned from Wuhan.

Coronaviruses are a class of respiratory viruses that range from the common cold to more serious illnesses like SARS and MERS. They can cause fever, cough, difficulty breathing, and pneumonia. Coronaviruses are generally spread via droplets in the air, like when people cough and sneeze, similar to the common cold.

It is currently undetermined whether there is a limited person-to-person spread or if there is a possibility of an animal-to-person spread.

There are no additional precautions recommended for the general public to take. However, as a reminder, CDPH always recommends everyday preventive actions to help prevent the spread of respiratory viruses, including:

  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.

For more information, visit www.chicago.gov/2019-nCov.

January 24: Billboard reported – The Chinese government has closed the Mercedes-Benz Arena indefinitely. The venue’s promoter and its joint-venture partner, a media group owned by the Shanghai government, have postponed over a dozen shows until the virus is contained.

January 24: World Health Organization posted: “Updated WHO advice for international traffic in relation to the outbreak of the novel coronavirus 2019-nCoV

This is an update to the WHO advice in relation to the outbreak of the novel coronavirus nCoV, published by WHO on 10 January 2020. Since that date, travel-related cases linked to Wuhan City have been reported in several countries. For details about the current outbreak in China and the exported cases, please refer to the Disease Outbreak News and the situation reports published by WHO.

So far, the main clinical signs and symptoms reported in this outbreak include fever, difficulty in breathing, and chest radiographs showing bilateral lung infiltrates. As of 24 January 2020, human-to-human transmission has not been confirmed largely in Wuhan city, but also some other places in China and internationally. Not enough is know about the epidemiology of 2019-nCoV to draw definitive conclusions about the full clinical features of the disease, the intensity of the human-to-human transmission and the original source of the outbreak.

International travellers: practice usual precautions

Coronaviruses are a large family of respiratory viruses that can cause diseases ranging from the common cold to the Middle-East Respiratory Syndrome (MERS) and the Severe Acute Respiratory Syndrome (SARS). In case of symptoms suggestive of acute respiratory illness before, during or after travel, the travellers are encouraged to seek medical attention and share travel history with their health care provider.

Public health authorities should provide to travelers information to reduce the general risk of acute respiratory infections, via health practitioners, travel health clinics, travel agencies, conveyance operations and at points of entry.

WHO’s standard recommendations for the general public to reduce exposure to and transmission of a range of illnesses are as follows, which include hand and respiratory hygiene, and safe food practices:

  • Frequently clean hands by using alcohol-based hand rub or soap and water;
  • When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw tissue away immediately and wash hands;
  • Avoid close contact with anyone who has a fever and cough;
  • If you have fever, cough and difficulty breathing seek medical care early and share previous travel history with your health care provider;
  • When visiting live makers in areas currently experiencing cases of novel coronavirus, avoid direct unprotected contact with live animals and surfaces in contact with animals;
  • The consumption of raw or undercooked animal products should be avoided. Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods, as per good food safety practices.

WHO technical guidance on surveillance and case definitions, laboratory guidance, clinical management for suspects novel coronavirus, one care for patients with suspected novel coronavirus, infection prevention and control, risk communications, disease commodity package, and reducing transmission from animals to humans is available on the WHO website.

Health measures related to international traffic

The current outbreak originated in Wuhan city, which is a major domestic and international transport hub. Given the large population movements, expected to significantly increase during the Chinese New Year in the last week of January, and the observed human to human transmission, it is not unexpected that new confirmed cases will continue to appear in other areas and countries.

With the information currently available for the novel coronavirus, WHO advises that measures to limit the risk of exportation or importation of the disease should be implemented, without unnecessary restrictions of international traffic.

According to Chinese authorities, all unnecessary or non-essential large-scale public gatherings will not be approved during the Spring Festival, which starts on 25 January in China.

Advice for exit screening in countries with ongoing transmission of the novel coronavirus 2019-nCoV (currently People’s Republic of China)

  • Conduct exit screening at international airports and ports in the affected areas, with the aims early detection of symptomatic travelers for further evaluation and treatment, and thus prevent exportation of the disease while minimizing interference with international traffic.
  • Exit screening includes checking for signs and symptoms (fever above 38°, cough), interview of passengers with respiratory infection symptoms leaving the affected areas with regard to potential exposure to high-risk contacts or to the presumed animal source, directing symptomatic travelers to further medical examination, followed by testing for 2019-nCoV, and keeping confirmed cases under isolation and treatment.
  • Encourage screening at domestic airports, railway stations, and long-distance bus stations as necessary.
  • Travelers who had contact with confirmed cases or direct exposure to potential source of infection should be placed under medical observation. High-risk contacts should avoid travel for the duration of the incubation period (up to 14 days).
  • Implement health information campaigns at points of entry to raise awareness of reducing the general risk of acute respiratory infections and the measures required, should a traveler develop signs and symptoms suggestive of infection with the 2019-nCoV and how they can obtain assistance.

Advice for entry screening in countries/areas without transmission of the novel coronavirus 2019-nCoV

  • Evidence shows that temperature screening to detect potential suspect cases at entry may miss travelers incubating the disease or travelers concealing fever during travel and may require substantial investments. However, during the current outbreak with the novel coronavirus 2019-nCoV, the majority of exports cases were detected through entry screening. The risk of importation of the disease may be reduced if temperature screening at entry is associated with early detection of symptomatic passengers and their referral for medical follow up.
  • Temperature screening should always be accompanied by dissemination of risk communication messages at points of entry. This can be done through posers, leaflets, electronic bulletin, etc., aiming at awareness among travelers about signs and symptoms of the disease, and encouragement of health care seeking behavior, including when to seek medical care, and report of their travel history.
  • Countries implementing temperature screening are encouraged to establish proper mechanism for data collection and analysis, e.g numbers of travelers screened and confirmed cases out of screened passengers, and method of screening. In implementing entry screening, countries should take into account national policies and capacity.
  • Public health authorities should reinforce collaboration with airlines operators for case management on board aircraft and reporting, should a traveler with respiratory disease symptoms is detected, in accordance with the IATA guidance for cabin crew to manage suspected communicable disease on board an aircraft.

Previous advice with regard to procedures for a sick traveller detected on board a plane and requirements for IHR capacities at points of entry remains unchanged (see WHO advice published 10 January 2020).

WHO advises against the application of any restrictions of international traffic based on the information currently available on this event.

January 24: The Guardian posted: “Chinese city plans to build coronavirus hospital in days”

The Chinese city of Wuhan, the centre of the coronavirus outbreak, has begun the ambitious task of building a 1,000-bed hospital in just 10 days to treat victims of the epidemic.

To speed construction, the hospital is being built with prefabricated buildings around a holiday complex originally intended for local workers, set in gardens by a lake on the outskirts of the city.

Although the timescale is ambitions, China has form for constructing hospitals at short notice in response to major health crises. In 2003, during the Sars outbreak 7,000 workers in Beijing built the Xiaotangshan hospital in the northern suburbs in just a week. Wuhan authorities said the Xiaotangshan hospital, also built using prefabricated buildings, was the template for the new facility in Wuhan, being built on a 25,000 sq metre site.

The hospital in the Chinese capital featured individual isolation units that looked like rows of tiny cabins. Within two months, it treated a seventh of all the country’s Sars patients, Changjiang Daily said, describing it as “a miracle in the history of medical science.” The facility closed less than two months after it was judge that a decisive victory had been won against Sars in China.

Building machinery, including 35 diggers and 10 bulldozers, arrived at the Wuhan site on Thursday night, with the aim of getting the new facility ready by Monday 3 February, state media reported. Earlier reports had suggested the hospital would be completed in under a week.

China State Construction Engineering, one of the companies building the hospital, said on Friday it had more than 100 workers on the site.

Images on state television showed a flurry of activity at the muddy site with dozens of diggers painted in various colours hard at work preparing the ground, as a stream of trucks ferried in materials and equipment.

Using temporary buildings not only facilitates swift construction, but is also keeps the cost down.

Xinhua said the new facility was aimed at “alleviating the shortage of medical treatment resources and improving the ability to care for patients”.

Construction in Wuhan began as reports surfaced of bed shortage in hospitals designated for dealing with the outbreak, which has infected 830 people across China and killed 26. People who sought treatment in the city this week told the Guardian they had been turned away from hospitals, which have been inundated with patients who present with fever-like symptoms.

At least eight hospitals in Wuhan issued public calls for donations of masks, googles [sic], gowns and other protective medical gear, according to notices online.

Administrators at Wuhan university people’s hospital set up a group chat on the popular WeChat messaging app to coordinate donations.

Sars, or severe acute respiratory syndrome, killed 349 people in mainland China and 299 in Hong Kong in 2002-2003.


January 25

January 25: CGTN, China Global Television Network tweeted: “#UPDATE Xinhua Hospital says 62-years-old ENT specialist, Dr. Liang Wudong, who is suspected to have died from the coronavirus Saturday retired in March 2019.”

January 25: The CDC reported the onset of 3 additional COVID-19 cases in the United States.

January 25: New South Wales Health posted: “Novel coronavirus statistics – 11AM”

  • NSW – number of cases confirmed – 0
  • NSW – number of cases under investigation – 5

We will not be disclosing the hospital location of patents under investigation for privacy reasons.

We will update the public of any confirmed cases and need to disclose a person’s movements.

January 25: World Health Organization (WHO) posted a “Novel Coronavirus (2019-nCoV) Situation Report – 5”

SUMMARY

Situation Update:

  • A total of 1,320 confirmed cases have been reported for novel coronavirus (2019-nCoV) globally.
  • Of the 1,320 cases reported, 1,297 cases were reported from China, including Hong Kong SAR (5 confirmed cases), Macau SAR (2 confirmed cases), and Taipei (3 confirmed cases.)
  • A total of 1,965 suspected cases have been reported from 20 Chinese provinces, regions and cities (excluding Hong Kong SAR, Macau SAR and Taipei).
  • Of these 23 confirmed cases, 21 had travel history to Wuhan City, China; one case in Australia had direct contact with a confirmed case from Wuhan while in China; and one confirmed case in Viet Nam had no travel history to any part of China as mentioned in the situation report published on 24 January. According to preliminary investigations, this constitutes an instance of human-to-human transmission within a family.
  • Of the 1,287 confirmed cases (excluding Hong Kong SAR, Macau SAR, and Taipei), 237 cases have been reported as severely ill.
  • Forty-one deaths have been reported to date (39 deaths in Hubei province, one death in Hebei province and one in Hellongjaing province).
  • On 25 January 2020, the number of reported confirmed cases of 2019-nCoV has increased by 474 cases since the last situation report published 24 January 2020.

WHO’s assessment of the risk of this event has not changed since the last update (22 Jan): very high in China, high at the regional level and high on the global level.

Reported Incidences of confirmed 2019-nCoV, 25 January 2020:

  • China: – 1297 – including confirmed cases in Hong Kong SAR (5 confirmed cases), Macau SAR (2 confirmed cases) and Taipei (3 confirmed cases.
  • Japan: 3
  • Republic of Korea: 2
  • Viet Nam: 2
  • Republic of Singapore: 3
  • Australia: 3
  • Thailand: 4
  • Federal Democratic Republic of Nepal: 1
  • United States of America: 2
  • French Republic: 3
  • TOTAL: 1320

II. PREPAREDNESS AND RESPONSE

WHO:

  • WHO has published an updated advice for international traffic in relation to the outbreak of the novel coronavirus 2019-nCoV.
  • WHO has been in regular and direct contact with Member States where cases have been reported. WHO is also informing other countries about the situation and providing support as requested.
  • On 2 January, the incident management system was activated across the three levels of WHO (country office, regional office, and headquarters).
  • Developed the surveillance case definitions and reporting forms for human infection with 2019-nCoV and is updating it as the new information becomes available.
  • Developed interim guidance for laboratory diagnosis, clinical management, infection prevention and control in health care settings, home care for patients with suspected novel coronavirus, risk communication, and community engagement.
  • Prepared diseases commodity package for supplies necessary in identification and management of confirmed patients.
  • Provided recommendations to reduce risk of transmission from animals to humans.
  • Utilizing global expert networks and partnerships for laboratory, infection prevention and control, clinical management and mathematical modelling.
  • Activation of R&D blueprint to accelerate diagnostics, vaccines, and therapeutics.
  • WHO is working with our networks of researchers and other experts to coordinate global work on surveillance, epidemiology, modelling, diagnostics, clinical care and treatment, and other ways to identify, manage the disease and limit outward transmission. WHO has issued interim guidance for countries, updated to take into account the current situation.

The strategic objectives of the response are to interrupt the transmission of the virus from one person to another in China, to prevent exportation of cases from China to other countries and territories, and to prevent further transmission from exported case if they were to happen. This can be achieved through a combination of public health measures, such as rapid identification, diagnosis and management of cases, identification and follow up of the contacts, infection prevention and control in healthcare settings, implementation of health measures for travellers, awareness raising in the population, risk communication.

During previous outbreaks due to other coronavirus (Middle-East Respiratory Syndrome (MERS) and the Severe Acute Respiratory Syndrome (SARS)), human to human transmission occurred through droplets, contact and fomites, suggesting that the transmission mode of the 2019-nCoV can be similar. The basic principles to reduce the general risk of transmission of acute respiratory infections:

  • Avoiding close contact with people suffering from acute respiratory infections.
  • Frequent hand-washing, especially after direct contact with ill people or their environment.
  • Avoiding unprotected contact with farm or wild animals.
  • People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands).
  • Within healthcare facilities, enhance standard infection prevention and control practices in hospitals, especially in emergency departments.
  • WHO does not recommend any specific measures for travelers. In case of symptoms suggested of respiratory illness either during or after travel, the travelers are encouraged to seek medical attention and share their travel history with their health care provider. Travel guidance has been updated.

III. COUNTRY RESPONSE

China:

  • Public education on disease prevention and environmental hygiene further strengthened in public places across the city, farmer’s markets in particular. As of 23 January, the National Health Commission revised protection standards and specifications for medical workers and strengthened prevention and control measures against 2019-nCoV.
  • National authorities are conducting active case finding in all provinces.
  • Search expanded for additional cases outside Wuhan.
  • Active / retroactive case finding in medical institutions in Wuhan.
  • The Huanan Seafood Wholesale Market in Wuhan was closed on 1 January 2020 for environmental sanitation and disinfection. Market inspection in expansion to other markets.

Australia:

  • Updated General Physicians, pharmacists, emergency departments, and the broader health system on the situation as it evolves to enable possible cases to be rapidly identified, diagnosed and managed.
  • Developed diagnostic tests through the Public Health laboratories to rapidly diagnose cases
  • Supported the Commonwealth to provide advice and assess travelers for illness on the direct flight from Wuhan to Sydney on 23 January.
  • Providing regular updates to the community through media briefings, media release and social media including in Mandarin.
  • Infection with 2019-nCoV is now notifiable under New South Wales Public Health Act 2010, so doctors and pathology laboratories are required to notify NSW Health of all people suspected to have this infection.

January 25: People’s Daily, China, the largest newspaper in China, tweeted: “Doctor Liang Wudong at the ENT department of Hubei Xinhua Hospital who had been at the front line fighting against #nCoV2019 in Wuhan, died from the virus on Sat at the age of 62. #RIP”. The tweet included a large, black and white, photo of Doctor Liang Wudong.

January 25: The Times of India posted: “Coronavirus: China ‘shuts 10 cities; 12 quarantined in India”

Twelve people who returned from China and Hong Kong have been quarantined (as a precautionary measure) in hospitals in India – three, including a Briton, in Mumbai, and nine in Kerala’s Ernakulam and Thrissur — as China locked down 10 cities and closed a part of the Great Wall to control the outbreak of a new strain of coronavirus (nCoV) that has killed 26 people and affected 1,100 people across the globe.

Nepal was the latest to confirm an nCoV case: a student who had returned from China’s Wuhan was treated for respiratory problems and discharged. But the authorities are now searching for the man and is family after samples taken from him and sent to a Hong Kong laboratory tested positive.

Samples from two people in Mumbai and one each from Hyderabad and Bengaluru tested negative, health officials said late on Friday. One woman in Kottayam, Kerala, has ben isolated at home and was under observation after she developed a fever.

January 25: New South Wales Health posted “Novel coronavirus statistics – 5PM”

  • NSW – number of cases confirmed – 0
  • NSW – number of cases under investigation – 7

We will not be disclosing the hospital locations of patients under investigation for privacy reasons.

We will update the public immediately of any confirmed cases and need to disclose a person’s movements.

January 25, 2020: The Japan Times posted “Japan confirms third case of new coronavirus infection”

The health ministry said Saturday that it has confirmed a third case of a new deadly virus that has been rapidly spreading in China and beyond.

The patient is a woman from the central Chinese city of Wuhan, where the outbreak of the mysterious coronavirus began, the ministry said, adding she arrived in Japan in Jan. 18.

The ministry has not disclosed her nationality or which airport or port she used when she entered the country.

The woman in her 30s, who is in stable condition, is said to have had no symptoms at the time of arrival but developed a fever and started coughing on Tuesday night, according to the ministry.

She visited a Tokyo hospital on Thursday and later tested positive for the virus, which has killed at least 41 people in China.

She has not been hospitalized as she has been exhibiting only minor symptoms and is staying in her hotel room, a ministry official said at a news conference.

She came to Japan as part of a family of four. However, so far the other three have not developed any symptoms, the official said.

He added that the number of people suspected of contracting the virus “is not sharply increasing” in Japan. But he stopped short of saying how many have tested negative or are currently under observation.

The number of people with pneumonia caused by the virus topped 1,300 worldwide on Saturday, just as hundreds of millions of Chinese citizens set out on domestic and overseas trips at the start of the Lunar New Year holiday.

January 25: CNN Philippines tweeted: “JUST IN: Hong Kong declares Wuhan virus outbreak an “emergency” The Hong Kong Disease contingency plan has been upgraded from “serious” to “emergency” level, Hong Kong Chief Executive Carrie Lam announces s- via @CNN”

January 25: CNN Philippines also tweeted: “Lam also says schools in the city will be suspended until February 17. This is amid rising fears of the virus’s spread.”

January 25: People’s Daily, China, the largest newspaper in China tweeted: “#HongKong to suspend high-speed rail and flights connecting the city with Wuhan indefinitely, HK chief executive Carrie Lam said Sat, vowing to step up quarantine efforts to curb the spread of #nCoV2019.”

January 25: Masslive.com posted “Wuhan bans cars, Hong Kong closes schools as coronavirus spreads”. The source is the Associated Press.

The virus-hit Chinese city of Wuhan, already on lockdown, banned most vehicle use downtown and Hong Kong said it would close schools for two weeks as authorities scrambled Saturday to stop the spread of an illness that has infected more than 1,200 people and killed 41.

Hong Kong leader Carrie Lam said her government will raise its response level to emergency, the highest one, and close primary and secondary schools for two more weeks on top of next week’s Lunar New Year holiday. They will re-open Feb. 17.

Lam said that direct flights and trains from Wuhan would be blocked. The outbreak began in the city in central China and has spread nationwide and overseas, fueled by millions of people traveling during the country’s biggest holiday.

In a sign of the growing strain on Wuhan’s health care system, the official Xinhua news agency reported that the city planned to build a second makeshift hospital with about 1,000 beds. The city previously announced that construction of a hospital of the same size is underway and expected to be completed Feb. 3…

…China cut off trains, planes and other links to Wuhan on Wednesday, as well as public transportation within the city, and has steadily expanded a lockdown to 16 surrounding cities with a combined population of more than 50 million, greater than that of New York, London, Paris and Moscow combined.

The cities of Yichang, Suizhou and Jingzhour were the latest added to the list on Friday evening and Saturday…

January 25: New South Wales Health posted “Coronavirus cases confirmed in NSW”

NSW Health is urging people who have recently returned from Wuhan or have been in contact with a confirmed case of novel coronavirus infection to ensure they are aware of symptoms and seek immediate health assessment if symptoms develop within 14 days.

Three adult males have been diagnosed with the novel coronavirus. Two cases had travelled to Wuhan, China, and one case had direct contact with a confirmed case from Wuhan while in China.

NSW Chief Health Officer, Dr. Kerry Chant, said these cases demonstrate the importance of returning travellers knowing the symptoms of novel coronavirus infection.

“Anyone with these symptoms should practice simple hygiene by covering their coughs and sneezes with a tissue or their elbow and washing their hands thoroughly.”

Dr Chant said it is important people take action to keep their family and friends safe, so don’t be afraid to speak to your doctor if you have any symptoms.

NSW Minister for Health, Brad Hazzard, urged anyone with symptoms to come forward as soon as they feel unwell.

“It is important people feel confident contacting their GP or local emergency Department.

“They should also call ahead to speak to their GP or local emergency Department. If the GP considers novel coronavirus testing is needed they will be referred to the Emergency department for testing.”

A male in his 50s arrived in Sydney from Wuhan, China, on China Eastern flight number MU749 on 20 January 2020. He developed symptoms that night and he subsequently attended a GP. He was diagnosed in hospital with novel coronavirus on 25 January 2020.

A man in his 30s arrived in Sydney from China, on 6 January 2020. He did not develop symptoms until 15 January 2020 and saw his GP. He was diagnosed in hospital with novel coronavirus on 25 January 2020. He had contact with a person from Wuhan diagnosed with the virus.

A man in his 40s arrived in Sydney after being in Wuhan, China, on 18 January 2020. He did not develop symptoms until 24 January 2020 and self-presented to hospital on the same day. He was diagnosed in hospital with novel coronavirus on 25 January 2020.

All three patients are currently in isolation in NSW hospitals.

Public Health Units are following up contacts of these patients in accordance with the National Guidelines.

As part of the ongoing international response, NSW Health will continue to work closely with Commonwealth Government agencies to monitor travellers returning from Wuhan, China.

Health workers in NSW public hospitals and community-based GPs have been issued advice to help them identify any cases and apply careful infection control measures to prevent the spread of the novel coronavirus.

January 25: World Health Organization Western Pacific tweeted: “The total number of confirmed cases of 2019 novel #coronavirus reported from mainland China is 1,975. This includes 237 severe cases and 56 people who have died. #nCoV2019 #nCoV”. This was the first tweet in a thread.

(This tweet was corrected by another tweet that followed the thread: “Correction: The total number of confirmed cases of the 2019 novel #coronavirus reported from mainland China to date is 1,975. This includes 324 severe cases and 56 pople who have died. #nCoV2019#nCoV”)

January 25: World Health Organization Pacific continued its thread with another tweet: “Hong Kong SAR has reported a total of 5 cases of #nCoV2019, Macao SAR has reported 2 cases, and Taiwan, China has reported 3 cases.”

January 25: World Health Organization Pacific continued its thread with another tweet: “Among other countries in the @WHO Western Pacific Region, #Australia, #Malaysia & #Singapore have each reported 4 cases of the 2019 novel #coronavirus. #Japan has reported 3 cases. The Republic of #Korea and #Vietnam have each reported two cases.

January 25: South China Morning Post reported “Retailers, manufacturers shutting doors, letting employees work from home as Wuhan viral outbreak spreads”

From Ikea to personal care manufacturer Beiersdorf, businesses are shutting their doors and telling employees to stay home in Wuhan, the epicenter of a viral outbreak that has killed more than three dozen and spread from China to as far away as the United States.

But, the question for corporate leaders is whether a travel ban in Wuhan and seven other cities in Hubei Province amid fears over the spread of coronavirus will keep workers home after the Lunar New Year holiday break, stifle the transport of goods from the logistics and manufacturing centre and keep consumers on the sidelines.

The businesses most directly affected, so far, have been transport and tourism – related industries with airlines cancelling flights, hotels waiving cancellation charges and travelers staying home during what is normally one of the busiest travel times of the year in the mainland. Some three billion trips were expected within China this year during the 40-day Lunar New Year holiday travel period.

“The 2002-2003 experience from Sars [severe respiratory acute syndrome] disease suggests that if we assume a similar scenario, we could see some short-term impact on consumption and tourism for a few months, but it is unlikely to impact manufacturing/industrial sectors,” Suresh Tantia, senior Asia-Pacific investment strategist at Credit Suisse, said. “During the Sars breakout in late 2002, the public awareness rose in February-April 2003. During these months China’s retail sales growth moderated, but exports/imports and fixed asset investment were stable.”

The Sars epidemic in 2003 afflicted more than 8,000 people in 37 countries worldwide and killed 299 people in Hong Kong.

Tanita said policymakers in China may be forced to step up monetary and fiscal easing to support growth if there is a slowdown in consumption in the mainland.

Banks advise caution in travel as Wuhan coronavirus outbreaks worsens.

The coronavirus outbreak in Wuhan has infected more than 1,100 people and resulted in at least 41 deaths with confirmed cases reported in mainland China, Hong Kong, Macau, Japan, Singapore, South Korea, Taiwan, Thailand and the United States.

Local officials have barred travel to and from eight cities in Hubei Province: Wuhan, Huanggang, Ezhou, Chibi, Xiantao, Qianjiang, Zhijiang and Lichuan.

Trains, busses and ferries in and out of Wuhan were stopped at 10am on Thursday. Didi, the Chinese-ride sharing service, also said in a statement that it would halt services in Wuhan at noon on Friday at the request of local authorities.

Wuhan, city of 11 million people, is an important logistics and manufacturing hub in central China, located in the east-west conduit.

It serves as an important transport line for China, both by air and the nation’s network of high-speed railways. At the end of 2018, there were 430 high-speed trains that stopped in Wuhan daily, according to city data. The city’s airport handled 2.9 million passengers in November, the most recent data available…

January 25: Australian Ministers Department of Health posted a media release titled: “First confirmed case of novel coronavirus in Australia”. It was written by The Honorable Greg Hunt, MP, Minister for Health. From the media release:

The first case of novel cornavirus (2019-nCoV) has been confirmed by Victoria Health Authorities this morning.

The Commonwealth Department of Health is in close contact with Victorian health authorities and has notified the World Health Organization.

The patient, a man from Wuhan, flew to Melbourne from Guandong on 19 January.

Minister for Health Greg Hunt said, “Australia has world-class health systems with processes for the identification and treatment of cases, including isolation facilities in each state and territory, these processes have been activated.”

“Our laboratories have developed testing processes for this novel coronavirus that can provide a level of certainty within a day.”

Australian Chief Medical Officer Professor Brendan Murphy said Victoria had acted swiftly and appropriately.

“Victoria has followed its strict protocols, including isolating the affected person. I understand the patient has pneumonia and is in a stable condition.”

The virus originated in mainland China – the overwhelming majority of cases are there – and the only clear evidence of human-to-human transmission is in the Wuhan region.

Minister Hunt said, “Victorian and Commonwealth authorites will be undertaking “contact tracing” for passengers who travelled on this flight and to provide them with information and advice.”

Australia will continue to monitor the situation closely and continue to act on the best available evidence and advice:

  • Overnight, DFAT raised the level of travel advice for Wuhan and Hubei Province in China to ‘level 4 – do not travel’ and has issued a Smartraveller bulletin on the virus outbreak. The advice level for China as a whole has not changed.
  • Border measures are already in place to detect travellers who are unwell coming into the country.
  • Whilst, the Chinese authorities have now stopped all traffic from Hubei province as an added precaution, the Government is ensuring that all passengers on flights from other parts of China will be met and provided information on arrival.
  • Information is also on display at all major international ports around Australia, with instructions on what to do if travellers have symptoms or if symptoms develop.
  • Human coronavirus with pandemic potential’ is now a Listed Human Disease under the Biosecurity Act 2015, enabling the use of enhanced border measures.
  • The Department of Health has provided primary and community health care workers and Emergency Departments in Australia with updated advice.
  • The Chief Medical Officer convened a national teleconference of the Australian Health Protection Principle Committee (AHPPC) this morning to inform State and Territory Authorities and to coordinate further national action.

Professor Murphy said it was important people who had recently arrived in Australia from Wuhan, and those in close contact with them, watch for signs of the coronavirus.

“We don’t know exactly how long symptoms take to show after a person has been infected, but there is an incubation period and some patients will have very mild symptoms,” Professor Murphy said.

“Symptoms include fever, cough, sore throat, vomiting and difficult breathing. Difficulty breathing is a sign of possible pneumonia and requires immediate medical attention.”

“People who arrive in Australia from an international flight with these symptoms should alert their airline, or a biosecurity officer if they have disembarked.”

If people start getting symptoms in the next week after arriving in Australia, they should see a doctor or go to hospital if they are very ill. If they have travelled to Wuhan, they should call ahead to ensure others aren’t put at risk…

January 25: Australian Government Department of Health posted “Chief Medical Officer’s update on novel coronavirus”.

PROFESSOR BRENDAN MURPHY: [Confirms the first case of novel coronavirus has been identified in Australia]… from Wuhan travelled to Melbourne last Sunday on a flight on the 19th. On flight CZ321from Guangzhou and he was well when he arrived but developed an illness during last week and is currently in stable condition under isolation in a hospital in Melbourne. As we indicated earlier in this week, given the number of cases that have been found outside of China and the significant traffic from Wuhan city in the past to Australia, it was not unexpected that we would get some cases.

So this is the first confirmed cases. There are other cases being tested each day. Many of them are negative but I wouldn’t be surprised if we had further confirmed cases. As I’ve said previously however Australia is very well prepared. We have excellent State and Territory health systems. All of whom have protocols to isolate and rapidly diagnose conditions such as this. And this is evidenced by what happened with this gentleman in Melbourne, who is now under isolation and being managed. This morning I convened an emergency meeting of the Australian Health Protection Principle Committee to discuss this first positive case and we discussed the protocol for contact tracing of passengers adjacent to him in the train, in the plane sorry, and providing information to other passengers on that plane.

As I’ve previously advised, we have a lower risk now of people coming from Wuhan because the Chinese government have now stopped all transport out of Wuhan. However, there may be some people who have been in Wuhan, who got out before the travel ban was instituted by China and they may make their way to Australia from other ports in China.

So for the time being as of this afternoon we’ll be meeting all flights from China – and there are a very large number of flights to Australia each week from China – and providing information to all passengers in English and Mandarin, encourage them if they’ve been from that Hubei province of China, particularly the city of Wuhan. And if they get any illness when they’re here to seek medical attention and identify themselves as having come from that region of China. We are intending- Minister Hunt is proposing to convene a meeting of health ministers this afternoon just to make sure that all health ministers are well apprised of the situation. And the Australian Government Crisis Committee will also be meeting just to make sure that everybody is fully prepared and fully understands the implications of having one or more positive cases in Australia.

We’re still in a learning curve about this virus. Information from China is showing significant increase in numbers, now over 1,300 confirmed cases, and the death toll is now up to 41. Again, the vast majority, 39 of those deaths, have been from people in that epicentre in Wuhan province and we have as you will have heard reports now of a further exported cases to other countries in increasing numbers. But again, they are small numbers and we’re confident that outside of the major epicentre in China there is not yet evidence of significant or any human to human spread.

But clearly, we’re keeping a watching eye on this situation and will watch the situation internationally very closely. In terms of the Australian public unless you have been in close contact with someone who is unwell and has come from that part of China, there is no need for current concern.

There is no evidence that this virus is being transmitted at all in Australia. But clearly, our message is for people who have come from that part of China, there is no need for current concern. There is no evidence that this virus is being transmitted at all in Australia.

But clearly our message is for people who have come from that part of China in recent weeks who do develop any symptoms particularly: fever, cough, shortness of breath, vomiting, often flu like symptoms and maybe they may just have the flu but to call ahead to their doctor or their hospital nearby to wan them and to come in and get checked.

So the risk really is in people who’ve come from that part of China. There is at this stage no risk to the general Australian community. And I want to emphasize that. But clearly, we are keeping a very close eye on this situation so that’s probably all I need to say that the moment I’m happy to take questions.

QUESTION: How many people have been tested and tested negative to this.

PROFESSOR BRENDAN MURPHY: That is a daily evolving number probably a dozen so far I think in Australia. But there are people being tested today so I can’t confirm that accurately.

QUESTION: Can you tell us where this gentleman was from or where he has been?

PROFESSOR BRENDAN MURPHY: He was from Wuhan and he came from Wuhan to Guangzhou on an earlier flight and then from Guangzhou to Melbourne on a direct flight. So he’s come from the area where the virus was.

QUESTION: Do you think the Chinese government is misleading in how bad this virus actually is?

PROFESSOR BRENDEN MURPHY: I don’t believe so. I think the Chinese government has taken very proportionate measures. I mean it’s quite an extraordinary measure to lock down an entire province. It’s not just the city of Wuhan but its surroundings cities now where they have banned all travel out of those cities. They have been very transparent. The fact that the data is evolving rapidly each day is more than I think, that due to the fact that they are requiring that data. I don’t believe there’s any evidence that they’re not being open and transparent.

QUESTION: Do you have concerns given the incubation period, that we’ll have multiple cases of this virus appearing in Australia?

PROFESSOR BRENDAN MURPHY: It’s very hard to tell. Given that it was only last weekend as you recall that Friday of the previous week there had been no new cases reported for 10 days or only about 45 cases. There was a fairly relaxed international message clearly over the course of the last weekend things exalted and since the Chinese government stopped travel from last Thursday the risk to Australia I think is more in those people who travelled in the week up to Thursday when the travel ban was put in place.

And there are potentially others like this person who travelled to Australia who were well when they arrived and who may develop disease but we just don’t know. Given that the travel has now stopped from that region and there are no clear epicentres outside of that region where there are human to human transmission I suspect the risk of people coming from other parts of China or the world is very low. But we just need to keep watching and seeing what develops.

QUESTION: The flu season is in China because it’s cold. Is that going to be a problem in Australia when it comes to our winter time and our flu season?

PROFESSOR BRENDAN MURPHY: Well I think the flu season is a problem because a lot of people from that part of China who develop this symptoms will have the flu and including people who may have come from here. I think it’s just too early to say what the cause of this virus is going to be over the next months. And I think that’s probably a bit premature to postulate whether the flu season will have anything to do with it here.

QUESTION: Can you tell us how many people have been tested today?

PROFESSOR BRENDAN MURPHY: I can’t tell you because the state and territory health services are testing. They arrange tests. They’ve got their own labs but we – I believe they’re probably in the order of a half dozen people who are having tests across the country today. We’ve had many tests in the last few days and they’ve all been negative except this one.

QUESTION: And how did it come about that he tested positive. Did he present himself with symptoms?

PROFESSOR BRENDAN MURPHY: He did. He developed symptoms and he sought – he contacted ahead of the hospital and turned up to the hospital wearing a mask. And the hospital- he was very responsible citizen and went to hospital, decried that he’s come from Wuhan and he was unwell and they rapidly isolated him and organized the test.

QUESTION: How old is this man?

PROFESSOR BRENDAN MURPHY: In his 50s. Thank you very much.

January 25: New South Wales Health posted Novel Coronavirus statistics (as of 11AM that day). Number of confirmed cases: 0. Number of cases under investigation: 5.

January 25: New South Wales Health posted another Novel Coronavirus statistics (as of 5PM that day). Number of cases confirmed: 0. Number of cases under investigation: 7.

January 25: The European Center for Disease Prevention and Control posted information titled: “Novel coronavirus: three cases reported in France”. From the information:

French health authorities have confirmed three cases of novel coronavirus (2019-nCoV) virus in France since 24 January 2020. The first confirmed cases in Europe are not unexpected given the developments of the last few days with several 2019-nCoV cases reported in countries outside of China.

The fact that these cases were identified, proved that detection and confirmation of this novel virus is working in France. showing a high level of preparedness to prevent and control possible infections of 2019-nCoV.

Most EU countries have plans and measures in place to contain this kind of infections and Europe has well-equipped laboratories that can confirm probable cases in addition to hospitals that are prepared to treat patients accordingly. EU/EEA countries should ensure that timely and rigorous infection prevention and control measures (IPC) are applied around people diagnosed with 2019-nCoV, Such measures will keep the likelihood of further sustained spread in both healthcare and community settings low.

In the past, systematic implementation of infection prevention and control measures were effective in controlling both SARS-CoV and MERS-CoV.

ECDC is working with the EU/EEA Member States to ensure that they are prepared to manage any imported cases. ECDC is monitoring this event through epidemic intelligence activities, and provides risk assessments to guide EU Member States and the EU Commission in their response activities.

At this stage, it is likely that there will be more imported cases in Europe. Even if there are still many things unknown about 2019-nCoV, European countries have the necessary capacities to prevent and control an outbreak as soon as cases are detected.

ECDC will update its dedicated page with the recent developments in the course of the day with most recent confirmed data.

January 25: China correspondent, British Broadcasting Corporation (BBC) tweeted: “The streets are empty in the small towns of Hubei Province where the #coronavirus outbreak started. #China”. The tweet included a short video, which appears to be taken from a vehicle driving through a street. There are no people in the video.

January 25: Australian Government Department of Health posted “Chief Medical Officer’s interview on Weekend Sunrise about novel coronavirus”

MATT DORAN: And for more, Australian Chief Medical Officer Professor Brendan Murphy joins us live from Canberra. Professor, thank you for your time on a busy day. There are now four confirmed cases across the country. That is of course expected to rise. How are you going tracking down the other passengers on these particular flights?

PROFESSOR BRENDAN MURPHY: Good morning. So, the passengers on those two flights, the lists have been provided and the contact information to the Victorian health authorities from the Victorian plane, and they’ve [also] in the process of doing so with the New South Wales plane, and the state and territory health departments will be contacting people. It’s important to note that people in the plane generally probably have a pretty low risk. We tend to provide more detailed contact to those who were sitting in close proximity to those suspected cases. But both of them only really developed significant symptoms after arrival. So this is just being precautionary.

ANGELA COX: China’s president has warned the spread of the virus is accelerating. There were some concerns earlier last week that China was downplaying the severity of this. What are your thoughts about how quickly it’s spreading? You’d obviously be looking very closely at how quickly this virus spreads.

PROFESSOR BRENDAN MURPHY: So, obviously we are concerned about what’s happening in China. As you say there has been a significant increase in reported numbers and an increase in the reported deaths, and as we know there are now over 40 cases that have been exported out of China to other countries including Australia.

Given the traffic from that part of Hubei province to Australia before China locked that area down on Thursday, as Dr. Bowden in Victoria said, we have always expected that we would be seeing some cases who have traveled from China to here in the last few weeks. We are very well prepared as evidenced by the way both New South Wales and Victoria have dealt rapidly with those cases and isolated them.

MATT DORAN: Professor, given the enormous area we’re talking about in China – you’re talking about trying to effectively quarantine maybe 60 million people – the question I guess for me becomes: When do authorities here consider limiting the intake of passengers from China more broadly, as opposed to this particular province?

PROFESSOR BRENDAN MURPHY: It’s very, very difficult to close the borders to an infectious disease. As you have heard, those four cases were all well when they arrived. People can come to Australia from a variety of ports around the world and the World Health Organization is certainly not recommending any sort of border control measures of that nature.

MATT DORAN: Is that something you’re considering, though, Professor?

PROFESSOR BRENDAN MURPHY: No. At the moment our focus is on making sure that everyone who comes from China is provided information about this disease and told to contact medical authorities or their GP or an emergency department if they become unwell. I think it is important to note that the Chinese authorities have really stopped travel out of that major epicentre of the diseases and that has significantly reduced the potential traffic. But we know that here are pockets in other parts of China. So that’s why every flight from China is now being met and information being provided.

ANGELA COX: Okay. Thank you so much Professor Brendan Murphy for your time this morning.

PROFESSOR BRENDAN MURPHY: Thank you.


January 26

January 26: The European Centre for Disease Prevention and Control posted an update titled: “Risk assessment: outbreak of acute respiratory syndrome associated with a novel coronavirus, China; First cases imported in the EU/EEA; second update”

A novel coronavirus (2019-nCoV) has been isolated and considered the causative agent of the cluster of 2026 pneumonia cases in the area of Wuhan, Hubei province in China, as well as 38 imported cases monitored from other countries around the world. Fifty six deaths have been reported among the cases.

On 31 December 2019, a cluster of pneumonia cases of unknown aetiology was reported in Wuhan, Hubei Province, China. On 9 January 2020, China CDC reported a novel coronavirus (2019-nCoV) as the causative agent of this outbreak, which is phylogenetically in the SARS-CoV clade.

As of 26 January 2020, a total of 2,026 laboratory-confirmed 2019-nCoV cases have been reported, 1,988 in China and 38 imported cases from other countries around the world. Fifty six deaths have been reported among the cases. Chinese health authorities have confirmed human-to-human transmission outside Hubei province and 16 healthcare workers are reported to be infected.

Imported cases in Europe

On 23 January 2020, the first imported cases (3) of 2019-nCoV were identified in France.

The rapid increase in the number of reported cases can be partly attributed to the ongoing improved testing protocols and epidemiological investigations on the Chinese authorities; however, since the original source remains unknown and human-to-human transmission has been documented, further cases and deaths are expected. Further cases are also expected among travellers from Hubei Province. Therefore, health authorities in Member States should remain vigilant and strengthen their capacity to respond to such an event.

There are considerable uncertainties in assessing the risk of this event, due to lack of detailed epidemiological analyses.

On the basis of the information currently available, ECDC considers 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/EAA citizens residing in or visiting Wuhan, Hubei province, China;
  • there is a high likelihood of further case importation into countries with the greatest volume of people who have travelled from Wuhan, Hubei Province (i.e. countries in Asia)’
  • there is a moderate likelihood of further case importation into EU/EAA countries;
  • adherence to appropriate infection prevention and control practices, particularly in healthcare settings in EU/EEA countries with direct links to Hubei, means that the likelihood of a case detected in the EU resulting in secondary cases within EU/EEA is low;
  • the impact of the late detection of an imported case would be high, therefore in such a scenario the risk of secondary transmission in the community setting is estimated to be very high.

January 26: Nippon.com (News from Japan) posted “Japan Govt Urged to Prevent Spread of New Coronavirus”

A Japanese ruling party official on Sunday called on the government to take “full-scale border control measures” to prevent the spread of pneumonia caued by a new strain of coronavirus while paying close attention to related information from the World Health Organization.

In a television program, Tomomi Inada, executive acting secretary-general of the Liberal Democratic Party, also urged the government of Prime Minister Shinzo Abe to ensure that the public are fully given necessary information on the new virus originating in the inland China city of Wuhan.

Noting that China’s government decided on Saturday to effectively ban oversees travel by Chinese nationals from Monday, Tetsuro Fukuyama, secretary-general of the main opposition Constitutional Democratic Party of Japan, said in the TV program that the move by Beijing is certain to have a considerable impact on Japan’s tourism industry and that the Japanese government should give consideration to the issue.

According to China’s government, nearly 2,000 people in the country have developed pneumonia caused by the new virus and the death toll has topped 50.

January 26: New South Wales Health another Novel Coronavirus statistics – 9AM

NSW – number of cases confirmed – 3

NSW – number of cases under investigation – 2

We will not be disclosing the hospital locations of patients under investigation for privacy reasons.

We will update the public immediately of any additional confirmed cases and the need to disclose a person’s movements.

January 26: Nippon.com (News from Japan) posted “Govt to Bring Japanese Nationals in Wuhan Back Home”

Prime Minister Shinzo Abe said Sunday that the government will bring back home Japanese nationals in Wuhan, the epicenter of a new type of coronavirus that has caused a number of people to develop pneumonia, and areas near the inland Chinese city.

“As soon as coordination with the Chinese government is made, we will help all Japanese nationals willing to return home to get back to Japan using all available measures, including chartered flights,” Abe told reporters at his official residence.

“We are making adjustments with the Chinese government at various levels,” he said, adding that the Japanese government will accelerate the preparations in order to have Japanese citizens in Wuhan and nearby areas return home as soon as possible.

Around 710 Japanese nationals are now believed to be in Wuhan, according to Japan’s Foreign Ministry. Traffic to and from Wuhan, the capital of Hubei Province, has been shut off to prevent any further spread of the virus. Similar traffic shutdown has also been in place in some 10 other cities in the Chinese province.

On Sunday afternoon, the ministry began a survey targeting Japanese nationals in the province through its website, asking those willing to return home to inform Japan’s embassy in Beijing of their names, gender, passport numbers and other data.

January 26: New South Wales Health posted Novel Coronavirus Statistics – 5PM

  • NSW – number of cases confirmed – 3
  • NSW – number of cases under investigation – 1 (see below)

Preliminary test results have shown the above case currently under investigation has tested positive for the Novel Coronavirus. Confirmation is expected tomorrow. Public health follow-up of this probable case is being undertaken in accordance with the national guidelines and the patient remains in isolation.

Of the five cases that were under investigation today, four have now been cleared of the infection.

We will update the public immediately should this case be confirmed.

January 26: Australian Government Department of Health posted a transcript titled: “Chief Medical Officer’s update on novel coronavirus”. It is a transcript of Professor Brendan Murphy’s press conference about novel coronavirus in Australia.

Well, thank you for coming this afternoon to get an update on the coronavirus situation. I can report there have been no new confirmed cases in Australia. The number of four cases; three in Sydney and one in Melbourne remains the same. The four patients, I believe, are all in stable condition in isolation in hospital. Information just released from China shows, as expected, the number of cases has increased to over 2000 and now 56 deaths.

Nearly all of those deaths are in the Hubei province, which includes the city of Wuhan. That province has been the focal point of this infection. But we do know that there have been more than 40 cases exported to other countries and there have been cases seen in other provinces of China.

As I have advised previously, since the Chinese have essentially locked down Hubei province and stopped people leaving, the risk of infected people who might be incubating the virus coming to Australia remains lower than it was before that time.

However, because people could have left the province before the lockdown and could come to Australia via a number of flights, we are now meeting every flight from China and providing the passengers with an information sheet, asking them to identify themselves if they’re unwell on the flight, but also to identify if they become unwell, particularly with fever or cough or other respiratory symptoms after they have been in Australia.

If any of those people with a relevant travel history or have been in contact with someone with this condition gets those symptoms, we want them to call ahead to their GP or their emergency department and go and be tested. The chances are they won’t have this condition, but the really important thing in Australia is that we identify and be able to isolate people with this virus. We have an excellent public health system in every state and territory with good protocols for isolation and treatment of people.

So the risk to the Australian population is – there is no risk at the moment other than people who have come from – with that travel history or have been in contact with people. So there is no cause for general concern, but we are very focused on identifying anyone who may have come with this disease in recent weeks.

QUESTION: How many people have actually been contacted that were on planes with these people that were travelling?

BRENDAN MURPHY: At the moment, the Commonwealth has provided information to the Victorian authorities on all of the passengers on the Victorian plane and are providing more information on the New South Wales plane – the two planes that are being followed up. I think it’s important to note that both the passenger on the Victorian plane and the New South Wales plane didn’t develop symptoms until after they landed in Australia. And we do know that it’s likely, because this virus is similar to other coronaviruses, that people aren’t infectious until they have symptoms. But because these two patients developed symptoms within about 24 hours of arrival, we’re being absolutely cautious and contacting those people.

Now, the earlier people to be contacted are those who were sitting within the two rows in front or behind them in the plane because they are the only people with any real potential of any cross-infection. But then we will also contact everyone else who was on the flight later, or the state and territory health authorities will, to ensure that they get information and particularly are reassured.

QUESTION: Is there any reason why it’s taking so long to track down all those passengers and they haven’t been contacted?

BRENDAN MURPHY: To actually get the contact details of the passengers, you have to go manually through those arrival cards. You know, those cards that you’ve all filled in when you arrive in Australia. And then you have to be able to decipher what people have written for their contact details, and that takes a lot of time. But the Victorian health authorities were given the information yesterday, as soon and the Commonwealth finished that. And we’r working 24 hours a day to identify those people.

So the state health authorities are taking their time and contacting, as I said, those people who are at the highest risk – who were sitting close to the people. But we don’t really believe the risk of contracting this virus from those other plane passengers is high. It would be much higher if those people had had symptoms or been unwell on the flight, but they weren’t.

QUESTION: There are reports that there have been alerts going out in New South Wales in some areas of – to be wary of coronavirus. Can you explain more about that?

BRENDAN MURPHY: I’m not aware of those alerts, I’m sorry.

QUESTION: So there are no new cases at the moment. Do you know how many test results are still waiting to [indistinct]?

BRENDAN MURPHY: Look, this is a moving feast. There have been several tests done every day. I don’t actually know how many are being done in the preliminary test or the confirmed test. I’m not aware of any highly likely positive that’s being worked up at the moment. But I would not be surprised if there ware some more cases because we, knowing what’s happened in other countries and knowing the traffic from that part of China to Australia, it’s highly likely that we may see some more. But as I’ve said on many occasions, we are incredibly well-prepared to isolate and deal with that and to prevent any transmission of the virus in this country.

QUESTION: Considering that the Australian Open is on at the moment, are they any concerns or any contingency plans…

BRENDAN MURPHY: I don’t think any – there’s no evidence to suggest that we would need to do that at the moment.

QUESTION: Once someone contracts coronavirus, how infectious is it? You were talking about two rows before and being on the plane.

BRENDAN MURPHY: We’re still understanding about this virus. Initially, as you know, in China it was reported that most cases came from an animal species. We now know that there is clear human-to-human transmission. We believe it’s when these people are asymptomatic, as I said. So if someone is just incubating in the plane, we don’t think they’re infectious. So we – clearly, there is some evidence of infectiousness when people have symptoms and fever. So that’s the concern and that’s when we would want to isolate people who might have come from that area who have symptoms to wear a mask and be isolated.

QUESTION: Is it a matter of, if someone coughs on you and they’ve got it you’ll get it, or is it airborne?

BRENDAN MURPHY: Well, again, we don’t fully understand everything about this virus, but we believe that it’s likely to be aerosol spread. So, coughing on someone would present a risk, but we don’t really have good data on the infectivity or how high the risk of human-to-human transmissions is. That data issuing developed and being updated at the moment. But we’re still understanding this virus fully.

QUESTION: Are treatment plans changing the more we understand about it?

BRENDAN MURPHY: There is no available specific treatment for a coronavirus. The treatment is supportive – looking after people, making sure they’re isolated, giving them oxygen if they do have pneumonia, and making sure that secondary complications are treated. But it is a supportive treatment at the moment.

QUESTION: Could we just explain; how does it actually kill someone? It’s obviously [indistinct]…

BRENDAN MURPHY: Well, again, people, generally speaking, we believe from reports from China that the people who have severe disease have a severe lung involvement – a severe pneumonia – and that is likely to lead to other complications, particularly if you have other illnesses and comorbidities, and that’s probably the main way of killing people. But we don’t fully understand that at the moment.

QUESTION: At this stage, perfectly healthy people in the prime of their life – should they be concerned, then?

BRENDAN MURPHY: We, again, as we have said previously, the advice from China is that a significant number of the people who have died had other illnesses. But probably not all. So like as sometimes happens in influenza, sometime people who are otherwise healthy can get a serious illness with an infection. But again, we’re talking only about people who may have come from China at the moment; we’re not talking about people in Australia who haven’t come from China or haven’t been in contact with someone in another country with this disease being at risk.

So we’re not suggesting that people should be worried in Australia at the moment.

QUESTION: Just going on mathematics, the amount of people on all the flights that have come on that we’ve now had cases reported on. That’s, you know, 800 [indistinct] – I mean 800 people at least. Just on the mathematics, we are expecting more people to get [indistinct] …

BRENDAN MURPHY: As I’ve been saying all week, I think it’s quite likely we will get some more cases, we just don’t know. We just have to be prepared, but I suspect it will be relatively small numbers, but we have to be prepared for whatever happens.

QUESTION: And should Australians be concerned about the flights that still keep coming from China?

BRENDAN MURPHY: Well, I think we – the Chinese authorities have, as I said, locked down the Hubei province. So, that’s where the vast majority of these cases are now. We know that there are small pockets in other parts of China but the Chinese authorities are quarantining them. So I suspect the risk of people coming from other parts of China is relatively low. But just to be sure, we’re providing that information to all passengers.

QUESTION: And so, as you said that you’re not quite sure how many are being contacted on the flights that have come in, including that one on Sunday with the Victorian [indistinct]. Do we know if there’s been a struggle to contact some? Because given they’ve moved on, they might not have registered their correct details, they might not even be in the country still.

BRENDAN MURPHY: So, these contacts are being done by the relevant state health authorities. So, the Victorian health department and the New South Wales health department. The Commonwealth provides the information from our Border Force, and you’d have to probably ask them how they’re going with the contact. But I know they’re working flat-out on that at the moment in both states.

QUESTION: Families of the patients confirmed to have coronavirus haven’t been quarantined. Is that decision being changed at all?

BRENDAN MURPHY: The state health departments are doing contact tracing of those patients, and I can’t comment on exactly what quarantine provisions they are contemplating because that is in their court.

QUESTION: Okay. And with, you know, [indistinct], what are you guys telling healthcare providers? Because often that’s next for transmission. We’ve seen Chinese healthcare providers already die in contact with coronavirus. What are you telling doctors, nurses?

BRENDAN MURPHY: So, healthcare providers in Australia are well trained to deal with communicable diseases. They are well trained in the use of personal protective equipment and isolation. I have just today, sent a message to every emergency physician, every GP – or about to send later today in the country, giving them an update on this condition and outlining the need to be aware of peoples’ travel history and how to deal with people if they come. So, I’ve been in contact with the presidents of both colleges of GPs, the college of Emergency Medicine, the president of the AMA, and they’re all standing by later today to send out these messages.

QUESTION: The man from Victoria who is confirmed to have it – he went to the GP on Thursday wearing a facemark. And despite the, the doctor still didn’t, kind of, have the red flag that this person might have coronavirus. Does that concern you?

BRENDAN MURPHY: Look, I’m not aware of the exact circumstances of that clinical interaction. But that was one of the reasons prompting me to send this message to all doctors today to remind them. We have previously provided information, but we’re trying to reinforce it at the moment.

QUESTION: Would you expect a GP who hasn’t picked up coronavirus, which was the case in Victoria, to be facing a bit of, like, disciplinary action?

BRENDAN MURPHY: Look, I can’t comment on the circumstances of what happened in that clinical interaction. I don’t know the details. So it probably would be speculation.

QUESTION: Would you be recommending an investigation?

BRENDAN MURPHY: Look, again, I would need to find out what happened in the circumstances before I’d make any comment on that.

QUESTION: And the US is looking at evacuating its citizens from Japan. Would you support Australia doing the same thing, or is that too risky?

BRENDAN MURPHY: So, I’m advised by the Minister of Health that the Foreign Minister, Minister Payne, will be making a statement in relation to Australian nationals in Hubei province later today.

QUESTION: And do you have any idea what she’ll be saying?

BRENDAN MURPHY: No, I don’t. That’s in the province of the Foreign Affairs Department. I know that they are actively engaging with our citizens in Hubei province, but it’s the Foreign Minister’s job to make an announcement about – or statements about that later.

QUESTION: As a doctor though, do you support that evacuation happening? Or is it too risky?

BRENDAN MURPHY: I’m not – the Foreign Affairs Department is obviously contacting our people. I don’t know the numbers of where they are at the moment. We would need to be – to look at the circumstances before I could make an assessment of that.

QUESTION: On a purely practical level, the common facemarks that we’re seeing on the people who arrive at airports – are they effective in preventing spread?

BRENDAN MURPHY: Obviously, there’s standard surgical masks are less effective than the properly grades masks that you can buy – the ones that prevent small particles from coming in. So, we are always recommending that people use those proper masks.

QUESTION: So if someone’s wearing just that usual surgical mask, they could still be spreading the virus?

BRENDAN MURPHY: But there’s significantly less — reduced chance, even from the surgical mask. But it’s not complete protection, no.

QUESTION: Just on, it’s probably a little bit out of your realm, but I understand the Matildas are playing over in China and it’s been moved, but do you suggest that they should possibly not be going to China at all?

BRENDAN MURPHY: I don’t think I should comment on that. That’s a matter for the Matildas.

Thanks very much, everybody. Thanks for coming.

January 26: CDC tweeted: “CDC confirms 3 new cases of novel #coronavirus (#2019 infection in the U.S., 1 in AZ & 2 in CA, bringing total to 5. All US cases travelled from Wuhan, China. More cases may be identified. However, risk to US general public is considered low.”

January 26: New South Wales Health posted “Novel coronavirus statistics – 9AM”

NSW – number of cases confirmed – 3

NSW – number of cases under investigation – 2

We will not be disclosing the hospital locations of patients under investigation for privacy reasons.

We will update the public immediately of any additional confirmed cases and the need to disclose a person’s movements.

January 26: World Heath Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report – 6”. From the report:

Data was reported by 26 January 2020.

Situation update:

  • On 26 January 2020, the number of reported confirmed cases of novel coronavirus (2019-nCoV) has increased by 694 cases since the last situation report published yesterday.
  • A total of 2,014 confirmed 2019-nCoV cases have been reported globally;
  • Of the 2,014 cases reported, 1,985 cases were reported from China, including Hong Kong SAR (4 confirmed cases), Macau SAR (2 confirmed cases), Taipei (3 confirmed cases).
  • Twenty-nine confirmed cases have been reported outside of China in ten countries. (see table-1) Of these 29 exported cases, 26 had a travel history from Wuhan City, China.
  • Among the three cases identified in countries outside of China:
  • One case in Australia had direct contact with a confirmed case from Wuhan while in China;
  • One case in Australia reported today, travel history is not yet known;
  • One case in Viet Nam had no travel history but was in contact with a confirmed case (his father with travel history to Wuhan), resulting in human-to-human transmission within a family.
  • Of the 1,975 confirmed cases (excluding Hong Kong SAR, Macau SAR and Taipei), 324 cases have been reported as severely ill.
  • Fifty-six deaths have been reported to date (52 deaths in Hubei province and 4 from outside Hubei)

WHO’s assessment of the risk of this event has not changed since the last risk assessment conducted on 22 January: very high in China, high at the regional level and high at the global level.

I. SURVEILLANCE

Limiting international spread of 2019-nCoV depends on understanding the global epidemiology. Key questions that global surveillance must answer to include the following:

  • How fast is 2019-nCoV spreading from China to other countries?
  • Where are cases exported from and to?
  • What types of exposures are reported by travellers originating in Wuhan or in other provinces in China reporting cases and human to human transmission?
  • Are individuals symptomatic before travel and potentially detectable through exit or entry screening?
  • Is there person-to-person transmission occurring in countries reporting imported cases?
  • What is the clinical presentation of illness among travelers?

Reported incidence of confirmed 2019-nCoV cases (Table 1)

  • China: 1,985
  • Japan: 3
  • Republic of Korea: 2
  • Viet Nam: 2
  • Singapore: 4
  • Australia: 4
  • Malaysia: 3
  • Thailand: 5
  • Nepal: 1
  • United States of America: 2
  • France: 3
  • TOTAL: 2,014

II. PREPAREDNESS AND RESPONSE:

WHO:

  • WHO has been in regular and direct contact with Member States where cases have been reported. WHO is also informing other countries about the situation and providing support as requested.
  • Developed the surveillance case definitions and reporting forms for human infection with 2019-nCoV and is updating it as the new information becomes available.
  • Developed interim guidance for laboratory diagnosis, clinical management, infection prevention and control in health care settings, home care for patients with suspected novel coronavirus, risk communication and community engagement.
  • Prepared disease commodity package for supplies necessary in identification and management of confirmed patients.
  • Provided recommendations to reduce risk of transmission from animals to humans.
  • WHO has published an updated advice for international traffic in relation to the outbreak of the novel coronavirus 2019-nCoV.
  • Activation of R&D blueprint to accelerate diagnostics, vaccines, and therapeutics.
  • WHO is providing guidance on early investigations. The first protocol that is available is a: Household transmission investigation protocol for 2019-novel coronavirus (2019-nCoV) infection.
  • WHO has developed an online course to provide general introduction to emerging respiratory viruses, including novel coronaviruses.
  • WHO is providing guidance on early investigations, which are critical to carry out early in an outbreak of a new virus. The data collected from the study protocols can be used to refine recommendations for surveillance and case definitions, to characterize the key epidemiological transmission features of 2019-nCoV, help understand spread, severity, spectrum of disease impact on the community and to inform operational models for implementation of countermeasures such as case isolation, contact tracing and isolation. The first protocol that is available is a: Household transmission investigation protocol for 2019-novel coronavirus (2019-nCoV) infection.
  • WHO is working with its networks of researchers and other experts to coordinate global work on surveillance, epidemiology, modelling, diagnostics, clinical care and treatment, and other ways to identify, manage the disease and limit onward transmission. WHO has issued interim guidance for countries, updated to take into account the current situation.
  • Utilizing global expert networks and partnerships for laboratory, infection prevention and control, clinical management and mathematical modelling.

WHO Is working with networks of specialists to analyze 2019-nCoV full genome as they become available.

WHO has not received evidence that the virus has changed. WHO awaits further information from Chinese officials.

Current estimates of the incubation period range from 2-10 days, and these estimates will be refined as more data become available. Understanding the time when infected patients may transmit the virus to others is critical for control efforts. In previous outbreaks of other coronavirus, such as Middle East Respiratory Syndrome coronavirus (MERS-CoV), some individuals can be asymptomatic and transmit to others. Detailed epidemiological information from more people infected is needed to determine the infectious period of 2019-nCoV.

WHO has issued advice to people on how to protect themselves from 2019-nCoV infection, as for any virus that spreads via the respiratory route.

In addition, it is vitally important in health care settings, that health care workers are able to protect themselves from infection. WHO guidance on infection prevention and control measures in health care facilities is here.

January 26: California Department of Public Health posted “Two Confirmed Cases of Novel Coronavirus in California”

The California Department of Public Health (CDPH) has been informed that one individual in Los Angeles County and one individual in Orange County have tested positive for novel coronavirus 2019 (nCoV-2019). This information is confirmed by the Los Angeles County Department of Public Health (LADPH), the Orange County Health Care Agency (OCHCA), and the U.S. Centers for Disease Control and Prevention (CDC).

“The California Department of Public Health has been preparing for this situation by working closely with local health departments and health care providers,” said Dr. Angell, CDPH Director and State Health Officer. “We are supporting ongoing efforts by the Los Angeles County Department of Public Health, and the Orange County Health Care Agency to respond to these cases, and will continue working with our partners to monitor for any additional cases that may occur in California, to ensure that persons can be safely and effectively evaluated for this novel virus, and to protect the health of the people of California.”

At this time, no other persons infected with nCoV-2019 have been identified in California. Currently, the immediate health risk from nCoV 2019 to the general public is low.

It is very important for persons who have recently traveled and who become ill to notify their health care provider of their travel history. Persons who have recently traveled to Wuhan, China, or who have had contact with a person with possible novel coronavirus infection should contact their local health department or health care provider.

CDPH has been prepared and is continuing with the following actions:

  • Providing information about the outbreak and how to report suspect cases to local health departments and health care providers in California.
  • Coordinating with CDC personnel who are doing screening of travelers from Wuhan, China at SFO and LAX airports.
  • Assuring that health care providers know how to safely manage persons with possible nCoV-2019 infection.
  • Supporting hospitals and local public health laboratories for collection and shipment of specimens for testing at CDC for nCoV-2019.
  • Activating CDPH’s Emergency Operations Center to coordinate response efforts across the state.

The nCoV-2019 outbreak in China continues to evolve and California is prepared for more cases that may arise. CDPH considers this a very important public health event: we are closely monitoring the situation and providing updates to partners across the state to support their preparedness efforts.

As with any virus, especially during the flu season, CDPH reminds you there are a number of steps you can take to protect your health and those around you:

  • Washing hands with soap and water.
  • Avoiding touching eyes, nose or mouth with unwashed hands.
  • Avoiding close contact with people who are sick are all ways to reduce the risk if infection with a number of different viruses.
  • If someone does become sick with respiratory symptoms like fever and cough, they should stay away from work, school or other people to avoid spreading illness.

CDPH will not be providing additional information about the patients beyond what is being shared by the LADPH and OCHCA.

January 26: New York State Health website posted “Governor Cuomo Announces State’s Continued Response to Novel Coronavirus as Three More Individuals are Identified for Testing in New York State”

Governor Andrew M. Cuomo today announced New York State’s latest efforts to prepare and respond to the outbreak of a novel coronavirus in China, after the U.S. Centers for Disease Control and Prevention now confirms three cases in the United States. While there have been no confirmed cases in New York State, as of today, the New York State Department of Health has sent seven total cases to CDC for testing. Three of those cases remain in isolation as their cases are tested at CDC.

“While the experts still believe the risk of catching this novel coronavirus is currently low in New York, I want all New Yorkers to know we are prepared and continue to take all necessary steps to keep people informed and safe to keep people informed and safe,” Governor Cuomo said. “I have directed the Department of Health and other state agencies to continue working closely with the CDC, the World Health Organization, our local and federal government partners, and New York’s healthcare providers to ensure we stay ahead of this situation.”

With travelers expected to begin returning to the US this week from Lunar New Year celebrations in China, the New York State Department of Health (DOH) has begun working with the Port Authority of New York and New Jersey to post multilingual sinage about the virus at all four Port Authority International airports. DOH is also working with the Metropolitan Transportation Authority to place informational signage on subways and busses.

Information about the novel coronavirus is available here.

On Friday, the State Department of Health held an informational webinar on the coronavirus with over 400 participants from New York’s colleges and universities, many of which have international students and faculty. DOH will circulate guidance this week on messaging to students about the virus, how to prevent it and how it spreads. This is in addition to a series of informational webinars DOH has already held for hospitals and local healthcare providers.

Last week the Department of Health issued guidance to healthcare providers, healthcare facilities, clinical laboratories and local health departments providing updated information about the outbreak, and ensuring proper protocols are in place if a patient is experiencing symptoms consistent with the novel coronavirus, had a travel history to Wuhan, China, where the novel coronavirus originated, or had come in contact with an individual who was under investigation for this novel coronavirus.

Last week’s health guidance coincided with the start of a CDC-led airport entry screening program at John F. Kennedy International Airport for passengers arriving from Wuhan, China. Chinese officials have since closed transport in and out of Wuhan and other cities in the province, including their international airports. DOH, Port Authority, and the New York City health Department will continue to work collaboratively with CDC as their travel screening process evolves. To date, no passenger has required further evaluation as a result of the CDC-led passenger screening program at JFK. To raise further awareness for all international travel, Governor Cuomo has directed the Port Authority to post informational signs at all four Port Authority International airports.

New York State Health Commissioner Dr. Howard Zucker said, “We encourage all New Yorkers to take normal precautions against sickness, such as regular hand washing and avoiding close contact with people who are sick. We will continue to work with our partner at the CDC and are prepared to assist in any way necessary to ensure the health of New Yorkers.”

Symptoms of the novel coronavirus may include:

  • Runny nose
  • Headache
  • Cough
  • Sore Throat
  • Fever

The CDC recommends that individuals avoid all nonessential travel to Wuhan, China, but has provided specific information for those who are still planning a trip to Wuhan for individuals who have recently returned from that city and may be experiencing the above symptoms.

While there is currently no vaccine for this novel coronavirus, everyday preventative actions can help stop the spread of this and other respiratory viruses, including:

  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.
  • Individuals who are experiencing symptoms and may have traveled to areas of concern, or have been in contact with somebody who has traveled to these areas, should call ahead to their healthcare provider before presenting for treatment.

January 26: Centers for Disease Control and Prevention (CDC) posted a media statement titled: “CDC confirms additional cases of 2019 Novel Coronavirus in United States”. From the media release:

The Centers for Disease Control and Prevention (CDC) today confirmed additional travel-related infections of 2019 Novel Coronavirus (2019-nCoV) in the United States, this time in Arizona and California. These patients recently returned to the U.S. from Wuhan, China, where an outbreak of respiratory illness caused by a novel coronavirus has been ongoing since December 2019. This brings the total number of 2019n-CoV infections detected in the United States to five.

Based on the patient’s travel history and symptoms, healthcare professionals suspected 2019-nCoV. Clinical specimens were collected and sent to CDC, where laboratory testing confirmed infection with 2019-nCoV. Investigations are underway to determine where these patients went after returning to the United States and any close contacts who were possibly exposed. CDC teams have been deployed to support these efforts.

This is a rapidly evolving situation, and we are still in the early days of the investigation – both domestically and abroad. CDC continues to monitor the international situation with our teams on the ground in affected countries, to monitor the international situation with our teams on the ground in affected countries, as well as domestically in the four states with confirmed cases – Arizona, California, Illinois, and Washington. CDC is leaning forward with an aggressive public health response strategy and working closely with state and local public health authorities to identify potential cases early and make sure patients get the best and most appropriate care.

It is likely there will be more cases reported in the U.S. in the coming days and weeks, likely including person-to-person spread. In previous outbreaks with MERS and SARS, the two other coronaviruses that have jumped the species barrier to cause severe illness in people, person-to-person spread has been seen, including among healthcare workers caring for patients ill with coronavirus infection. This underscores the importance of appropriate precautions in the health care setting as well in homes of people who are infected with 2019-nCoV but who may not be hospitalized. CDC has developed guidance for both situations.

This is a very serious public health situation. We understand that some people are worried about this virus and how it may impact Americans. Outbreaks of new disease are always of concern- and in today’s connected world, an outbreak anywhere can be a risk everywhere. Risk is dependent on exposure. Someone who is in close contact with a person who is infected with 2019-nCoV will be at greater risk of infection and should take the precautions outlined in CDC’s guidance for preventing spread in homes and communities. While this is a serious public health threat, CDC continues to believe the immediate risk to the U.S. general public is low at this time.

Right now, CDC recommends travelers avoid all nonessential travel to the Hubei Province, China. In addition, CDC recommends people traveling to other parts of China practice certain health precautions like avoiding contact with people who are sick and practicing good hand hygiene. For the general public, no additional precautions are recommended at this time beyond the simple daily precautions that everyone should always take. It is currently flu and respiratory disease season, and flu activity is still high and expected to continue for a number of weeks. CDC recommends getting a flue vaccine, taking everyday preventative actions to stop the spread of germs, and taking flu antivirals if prescribed.

As we learn more about this novel coronavirus, we will continue to update our guidance. Please visit the CDC website which is updated daily, for the latest information related to our response.

January 26: Billboard reported – Canto-pop singer Andy Lau canceled 12 concerts scheduled throughout February at the Hong Kong Coliseum. The My Love Andy Lau World Tour Hong Kong 2020 was scheduled to start on Feb. 15 and end on Feb. 28. Lau said in a statement: “Sorry about this. I wish that everyone will remain healthy. And that we get through this difficulty together.” According to the South China Morning Post, more than 100,000 fans will be impacted by the cancellations.

January 26: Australian Government Department of Health posted “Chief Medical Officer’s interview on ABC Radio on Novel coronavirus”

JOSH SZEPS: We can now speak to Australia’s Chief Medical Officer Professor Brendan Murphy, who joins us from Canberra. Professor Murphy, thanks very much for being with us. How concerned should we be about coronavirus?

BRENDAN MURPHY: Clearly, we are concerned at what’s happening in China. It’s clear that this disease is not under control. The Chinese authorities are taking very significant measures, as your reported just outlines, to contain the epicentre of the infection in Hubei Province. But we know that it has spread to small pockets in other parts of China, generally people from that area of Hubei Province.

And we know there are more than 40 exported cases including to Australia. Again, isolated cases, no evidence of any human-to-human transmission outside of China. All of the cases outside of China do seem to have come from China. And we are very well-prepared in Australia, we have very strong public health response systems, as evidenced by the way the four cases identified yesterday have been managed.

JOSH SZEPS: When you say no evidence of human to human transmission outside of China, would that have anything to do with the specifics of the virus itself? Or is that just the fact that we’re dealing with it well?

BRENDAN MURPHY: Well I think it’s probably that there are small numbers and it’s being dealt with well in those countries. It’s pretty clear now from the data coming out of China that close contacts of infected people can contract the virus. So the virus is clearly being proven to have human to human transmission. But if we get onto it well and you don’t get a focus of cases then that can be prevented.

JOSH SZEPS: One of the characteristics of this virus, as I understand it, is that it can begin with symptoms that are almost identical to a common cold or a flu and those can last for some number of days. Does that pose a specific challenge?

BRENDAN MURPHY: It does because it is flu season in China and probably most people with those sort of symptoms, which are relatively non-specific — fever is prominent, cough, breathlessness – probably don’t have this virus. That’s why we’re focusing on our public health message in Australia to say that if you have come from that Hubei Province of China in the last two or three weeks and you become unwell, please tell ahead to your doctor or your emergency department, call ahead and tell them that you’ve had that travel history, and be tested. Most people will probably be negative, but we need to capture anyone who’s come from China, particularly before they closed down the area late last Thursday.

JOSH SZEPS: But, to clarify, if you haven’t been to China and if you just have a bit of a sniffle and you’ve eaten some dumplings, you don’t need to be rushing to an emergency room just yet.

BRENDAN MURPHY: No, indeed. The only other situation where you might be at risk is if you’ve been a close family contact of someone who’s come from China who is unwell, and that’s pretty unlikely.

JOSH SZEPS: Professor Murphy, thank you so much for your time. Good talk to you.

BRENDAN MURPHY: Pleasure.


January 27

January 27: Arab News (News from Japan) posted “Japan to Designate New Pneumonia as Specified Disease”

The Japanese government said Monday it will designate pneumonia caused by a new type of coronavirus that is spreading mainly in China as a specified infectious disease.

The government plans to make the move at a cabinet meeting Tuesday. The designation under the infectious disease law will allow authorities to conduct compulsory hospitalization of infected patients and stop them from attending work.

Prime Minister Shinzo Abe unveiled the policy at a meeting of the Budget Committee of the House of Representatives, the lower chamber of the Diet, Japan’s parliament.

“The government will make the utmost efforts to prevent the spread of the infections in Japan,” Abe said.

The designation of a specified infectious disease is made when the disease is not included in the major infectious diseases in the law.

In 2003, the government designated severe acute respiratory syndrome, or SARS, as a specified infectious disease. A similar measure was taken for Middle East respiratory syndrome, or MERS, in 2014.

The government also accelerated its preparations to evacuate Japanese nationals from Wuhan, Hubei Province, where the outbreak of the new coronavirus started.

The government will send commercial chartered flights as early as Tuesday so that all Japanese nationals willing to return home can do so.

At a press conference, Chief Cabinet Secretary Yoshihide Suga said that some 560 Japanese nationals are in the Chinese province.

“We’ll help all Japanese nationals there who want to return home to come back to Japan as soon as arrangements are made with the Chinese government.” Suga said.

Toshihiro Nikai, secretary-general of the ruling Liberal Democratic Party, told reporters that he hears the government will start sending the flights as early as Tuesday.

The government is also considering utilizing a government plane for the evacuation, informed sources said.

At a meeting Monday, the Tokyo metropolitan government confirmed that up to about 50 inpatient beds at four metropolitan government-linked hospitals can be made available to people returning to Wuhan.

In response to China’s ban on group tours to oversees destinations, Suga said that the government will closely watch effects of the measure on the Japanese economy.

As the number of Chinese travelers to Japan has been surging recently, the government will gather information and closely monitor the situation, he said.

January 27: New South Wales Health posted “Advice for parents ahead of school returning”

With students returning to school next week, parents of children who have had contact with a confirmed case of novel Coronavirus are being urged to keep their children at home and monitor for symptoms.

NSW Chief Health Officer, Dr Kerry Chant explained that any child who has been in contact with a person confirmed as having novel coronavirus must not attend school or childcare for 14 days after the last contact with the infected person.

“14 days represents the internationally recognized incubation period for the disease,” Dr Chant said.

“After this time the child is considered not to be at risk of infection.”

Students who have traveled to Wuhan and Hubei during the school holidays can return to school but should be carefully monitored for symptoms of coronavirus infection.

“The most common symptom is a fever,” Dr Chat said.

“Other symptoms include cough, sore throat, and shortness of breath.”

Anyone who exhibits these symptoms should be isolated immediately from other people and seek medical attention as soon as possible.

If you develop a fever, a cough, sore throat or shortness of breath within 14 days of travel to Hubei or contact with a person with confirmed coronavirus, you should immediately isolate yourself from other people. Contact your GP or your emergency department or call the health direct helpline 1800 022 222 and seek medical attention as soon as possible.

Minister for Health, Brand Hazzard explained that NSW Health has processes in place to identify any close contacts of cases confirmed in Australia.

“Advice about not attending school would be provided to these close contacts,” he said.

There are currently four confirmed cases of novel coronavirus in NSW. All cases had travelled to Wuhan, China or had contact with a confirmed case in China.

Parents with concerns can contact their local Public Health Unit on 1300 066 055 for advice or visit the dedicated NSW Health information page a COVID-19 (Coronavirus).

NSW Department of Education has issued guidance to all NSW Schools, which included information to guide school staff in the event of a child becoming sick.

January 27: UK Department of Health and Social Care posted “Wuhan coronavirus: Health Secretary’s statement to Parliament”. It is a statement from the Secretary of State for Health and Social Care Matt Hancock.

Mr Speaker, with your permission, before turning to the Bill I would like to update the House on the ongoing situation with the Wuhan coronavirus.

The Chief Medical Officer continues to advise that the risk to the UK population is “low” and has concluded that while there is an increased risk of likelihood that cases may arise in this country, we are well prepared and well equipped to deal with them.

As of 2pm, there are currently no confirmed cases in the UK. We are working night and day with the World Health Organization and the international community and are monitoring the situation closely. Our approach has been guided by the Chief Medical Officer, Professor Chris Whitty.

As I set out in my statement on Thursday, coronavirus presents with flu-like symptoms including a fever, a cough, or difficulty breathing. The current evidence is that most cases appear to be mild.

However, this is a new disease and the global scientific community is still learning about it. I have therefore directed Public Health England to take a belt and braces approach, including tracing people who have been to Wuhan in the past 14 days.

Coronaviruses do not usually spread if people don’t have symptoms – however we cannot be 100 per cent certain.

From today, we are therefore asking anyone in the UK who has returned from Wuhan in the last 14 days to self-isolate. Stay indoors and avoid contact with other people – and to contact NHS 111. If you are in Northern Ireland, you should phone your GP.

If you develop respiratory symptoms within 14 days of travel from the area, and are now in the UK, call your GP or ring 111 informing them of your symptoms and your recent travel to the city.

Do not leave home until you have been given advice by a clinician.

Public Health England officials are continuing to trace people who have arrived in the UK from Wuhan. Having eliminated those who we know have since left the country, there are 1,460 people we are seeking to locate.

The Foreign Office is rapidly advancing measures to bring UK nationals back from Hubei Provence.

I have asked my officials to ensure there are appropriate measures in place upon arrival to look after them and protect the public.

If you are in Hubei Province and wish to leave, please get in contact with the Foreign Office.

The UK is one of the first countries in the world to have developed an accurate test for this coronavirus and PHE is undertaking continuous refinement of this test. PHE has this morning confirmed to me that it can scale up this test so we are in a position to deal with cases in this country if necessary.

Mr Speaker, I want to stress that the NHS remains well prepared. The NHS has expert teams in every ambulance service and a number of specialist hospital units with highly trained staff and equipment ready to receive and care for patients with any highly infectious, disease including this one.

The NHS practices and prepares its response to disease outbreaks and follows tried and tested procedures, following the highest safety standards possible for the protection of NHS staff, patients and the public. Specific guidance on handling the Wuhan coronavirus has been shared with NHS staff.

Madame Speaker this is a timely reminder to have a first-class health care system and this bring me to this Bill.

January 27: New South Wales Health posted “Novel coronavirus statistics”

NSW – number of cases confirmed – 4

NSW – number of cases under investigation – 5

January 27: Nippon.com (News from Japan) posted “Honda, Aeon to Bring Home Japanese Workers from Wuhan”. From the article:

Honda Motor Co. <7267> and Aeon Co. <8267> will bring home Japanese workers from Wuhan, China, due to the spread of pneumonia caused by a new strain of coronavirus, officials at the two Japanese companies said Monday.

The companies will use flights chartered by the Japanese government for the evacuation from Wuhan, the capital of Hubei Province, the officials said.

A chartered flight will leave for Wuhan as early as Tuesday, Toshihiro Nikai, secretary-general of the ruling Liberal Democratic Party, told reporters. The new virus is believed to have originated in the inland Chinese city.

Honda has an auto assembly plant in Wuhan. Japanese workers and theri family members, totaling some 30, will be brought back home, company officials said. A few Japanese workers who oversee the plant will stay there, they said.

Aeon, which runs five supermarket stores in Wuhan, will allow workers who hope to go back to Japan to do so, company officials said.

January 27: New South Wales Health @NSWHealth tweeted: “1/2 @NSWHealth has been made aware of a social media post that is being widely circulated warning people to not consume certain foods or visit certain locations in Sydney. This post has not originated from NSW Health or any related entity…

January 27: New South Wales Health @NWSHealth tweeted: “2/2 Further, there is no such entity as the “Department of Diseasology Parramatta”. NWS Health would like to assure the community that the locations mentioned in this post pose no risk to visitors, and there have been no “positive readings” at train stations.”

January 27: New South Wales Health posted “Novel coronavirus statistics – 11:30 am”

NSW – number of cases confirmed – 4

NSW – number of cases under investigation – 6

We will not be disclosing the hospital locations of patients under investigation for privacy reasons.

January 27: CDC Travel Health tweeted: “CDC recommends travelers avoid all nonessential travel to #China due to the ongoing #2019nCoV (#coronavirus) outbreak. The outbreak is growing and there is limited access to adequate medical care in affected areas”.

January 27: President Trump tweeted: “READ THE TRANSCRIPTS!”

For context, Trump was using one of his catchphrases in an effort to provide misinformation about his impeachment. Specifically, he wants people to read what he refers to as a “transcript” of a call between himself and President of Ukraine Volodymyr Zelenskyy.

In that call, the House of Representatives concluded, as part of an investigation, that Trump withdrew Congress approved funding for Ukraine until and unless President Zelenskyy publicly announced that Ukraine was investigating former Vice President Joe Biden because Biden’s son, in the past, had worked for a large Ukraine business.

The “transcript” is not a transcript – it is a memo written by Trump’s Attorney General. A transcript does not exist, because the U.S. Government stopped recording calls after former President Nixon was impeached for his tape recordings of conversations.

Also, for context, President Trump was impeached by the U.S. House of Representatives. January 27, 2020, was the start of the Senate hearing that was being publicly broadcast.

In short, Trump is more focused on himself than on the coronavirus (that he had been warned about.)

January 27: World Health Organization Western Pacific posted a thread that started with this tweet: “The total number of confirmed cases of the 2019 novel #coronavirus reported from mainland China to date is 4,515. This includes 976 severe cases and 106 people who have died. #nCov #nCoV2019 #2019nCoV”.

January 27: World Health Organization Western Pacific tweeted: Hong Kong SAR has reported a total of 8 cases, Macao SAR has reported 7 cases, and Taiwan, China has reported 4 cases. #coronavirus #nCoV #nCoV2019 #2019nCov”

January 27: World Health Organization Western Pacific tweeted: “Among other countries in the @WHO Western Pacific Region: Austraia & Singapore have each reported 5 cases; Japan, Malaysia & the Republic of Korea: 4 cases each; Vietnam: 2 cases; Cambodia: 1 case. #coronavirus #nCoV #nCoV2019 #2019nCoV”

January 27: World Health Organization Western Pacific tweeted: “For more information in other regions, follow @WHO, including daily SitReps

Reduce your risk of coronavirus infection by washing hands frequently, and following these measures [emoji of an arrow pointing down]

Reduce your risk of coronavirus by:

  • Clean hands with soap and water or alcohol-based hand rub
  • Cover nose and mouth when coughing and sneezing with tissue or flexed elbow
  • Avoid close contact with anyone with cold or flu-like symptoms
  • Thoroughly cook meat and eggs
  • Avoid unprotected contact with live wild or farm animals

January 27: Nippon.com (News from Japan) posted “GMO Employees to Work from Home amid Coronavirus Concern”

GMO Internet Inc. <9449> said Monday it has told about 4,000 employees, about 90 pct of its workforce in Japan, to work from home amid concerns over a new coronavirus.

The measure will last for about two weeks starting Monday, the Japanese internet service provider said.

Subject to the measure are employees working in offices in Tokyo’s Shibuya district, the western city if Osaka and the southwestern prefecture of Fukuoka.

The company said it has told workers in Beijing, Shanghai, and other places in China, including those on business trips, to return to Japan.

The moves are to “secure employee’s safety and continue providing stable services,” a GMO Internet official said.

January 27: Ohio Department of Health tweeted: “Ohio currently has zero cases of #Coronavirus. We are continuing to monitor the situation closely with @CDCgov.”

January 27: New York State website posted “Governor Cuomo Issues Update on Novel Coronavirus as Two More New Yorkers Identified for Testing Bringing Total to Nine”. From the news:

Samples From Four Found to be Negative at CDC, Five Results Still Pending

No Confirmed Cases in New York

Governor Andrew M. Cuomo today announced an update on the status of testing for the Novel Coronavirus in New York State, after the US Centers for Disease Control and Prevention has confirmed five cases in the United States.

“While there have been no confirmed cases in New York State, as of today, our Department of Health has sent samples for nine individuals to CDC for testing: four of these samples have proven negative and five results are still pending,” Governor Cuomo said. “These five individuals remain in isolation as their samples are tested at CDC. While the risk for New Yorkers is currently low, we are still working to keep everyone informed, prepared, and safe.”

January 27: Australian Government Department of Health posted a transcript titled: “Chief Medical Officer’s update on novel coronavirus”. It is a transcript of Professor Brendan Murphy’s doorstop about novel coronavirus”. From the transcript:

BRENDAN MURPHY: [Inaudible] Four elsewhere in China. The average age of the deaths, the median age I should say is 71 and a half years, which suggests that they’re in an elderly population in the main. Although there have been some young people in that group. There are 54 exported cases now in a range of countries, generally in small numbers. In Australia, there are now five confirmed cases: four in New South Wales, in Sydney, currently at Westmead Hospital and one in Melbourne in Monash Medical Centre. I’m advised that all five remain stable. There are a number of other Australians who have been tested and have been negative.

I’ve been regularly updating the Prime Minister, the Minister for Health, and Government on the developments. I think one thing we are noticing is that in China, whilst more than half the cases are still in the Hubei province, we are seeing increasing numbers across the other provinces in China. We still don’t know whether those increasing numbers are due to people who’ve come from the Hubei province, left that province before it was locked down and developed symptoms.

There is still no evidence yet of sustained human to human transmission outside of the Hubei province. In Australia, our focus, as I’ve said on many occasions, is the early detection of anyone who may have come from China, particularly the Hubei province, within the last two weeks; the incubation period being up to 14 days.

And our message remains the same: if you develop flu-like symptoms, fever, cough, contact either your GP or your local emergency department, tell them before you come that you’ve had a relevant travel history to China and attend to be tested. The majority of people that have been tested turn out to be negative.

We have increased some of the border measures today. As we’ve previously advised, every flight from China now is being met by border security officers who are going on the plane and distributing information to every passenger trying to identify any unwell passengers. The airlines are also required to identify any unwell passengers and if they are unwell, there’s a process of screening them. Every passenger on those flights from China is given an information sheet in Chinese and Mandarin, sorry, Mandarin and English and told to undertake, to watch themselves, and to contact their doctor or their emergency department should they develop symptoms over the following 14 days.

In addition, because there are some people who could come from China via other countries, and other ports within 14 days, we are now making announcements in the arrivals halls of airports, again in English and Mandarin, pointing out that anyone who may have come from China from whatever flight or whatever port they’re on, pointing out the risks and identifying that there is printed material available for them to collect at the airport if they have come from China so that all of the people who may have come from China can get that information.

Again, we have no evidence there’s a risk to the Australian public. There’s no human to human transmission that’s been identified in this country. I convened this afternoon the Australian Health Protection Principle Committee and we have been looking at the data, and as I said, the concern, I think, is the number of cases outside of the Hubei province in China, and that’s why we are starting to look at people who have come from parts of China other than Hubei as potentially at risk. Although, our focus still remains on that Hubei province of China, which is the epicentre and which is the only place where human to human transmission has been identified.

So I think I might leave it at that and be happy to take any questions.

QUESTION: There’s huge numbers of Chinese travelers – 43 flights into Australia today. These messaging and pamphlets, is that really enough to kind of deter this?

BRENDAN MURPHY: Well, I think the important thing is that everybody who comes from China is aware of the risk. The risk is probably greater after they’ve arrived because most – all of the cases that have been identified to date were perfectly well when they arrived, but they have all presented to doctors or emergency departments baed on their knowledge of the risks. So, the most important thing is to get that information out there. So we feel that is a proportionate measure.

QUESTION: Should we be quarantining these passengers when they arrive?

BRENDEN MURPHY: There is no evidence to suggest that – and I’m not aware of any first world country that’s doing that. I don’t think there’s sufficient evidence of the risk. I think, as I said before, now that the Chinese Government has locked down the Hubei Province, which is where the majority of these people come from, it’s quite hard to get out of China from those at-risk areas, and we think the risk of someone coming on current flights is probably very low. So you might be quarantining thousands of people for little benefit.

QUESTION: Do you think like Rome and other cities we should cancel Chinese New Year celebrations here?

BRENDAN MURPHY: We don’t believe that there is any good reason to cancel any public gatherings. There is no evidence of human to human transmission in Australia. Were there evidence of human to human transmission, that’s a very different matter.

QUESTION: Because there were 11 people in Melbourne being tested today. Are those people now clear or?

BRENDAN MURPHY: I haven’t got the final update. All I know is that as of half an hour ago, there were no other highly probable cases in Australia. But there are being people tested every day and there will be more probably that turn out to be positive.

QUESTION: Is that the same situation then in Perth? We were told there were four people in isolation there.

BRENDAN MURPHY: I think — I’m advised that one of the people being tested in Perth may be positive and the others look like they may be negative but that’s still to be confirmed.

QUESTION: The Chinese Health Commission is now saying that people can be contagious during the incubation period. Is that something that you accept and does it change your response at all?

BRENDAN MURPHY: Again, the expert panels that met later today were not convinced of that at the moment. They were not convinced that evidence is being presented. It would be very unusual because this virus is similar to the SARS and MERS viruses and they were not infectious before symptoms. And the evidence that we’ve seen doesn’t suggest there’s clear proof of that. But we’re urgently seeking urgent advice from the World Health Organization and international experts because if that were to be the case, it would have implications for how we do contact tracing.

QUESTION: Do you urge people to contact their GP’s not emergency departments but another the message that the public is receiving, do not call of visit GP, call this helpline. Is there a bit of mix messaging, what should people be doing?

BRENDAN MURPHY: No, I think they are saying, if you are unwell. The hotline is if you want information generally just to find out about it and get general information. But if you have come back from China, particularly the Hubei Provence in the last two weeks and you develop a fever, cough, or respiratory symptoms, you need to get tested. And that’s when we say you should ring your general practitioner or your emergency department, say that you are someone who’s recently returned from China, particularly the Hubei Provence and ask for advice about coming in to be isolated and tested.

QUESTION: Were you told that there was a patron at the Australian Open, at the tennis yesterday that was taken off and is now in isolation. Do you know about this, can you tell us what the situation is?

BRENDAN MURPHY: I have no knowledge of that sorry.

QUESTION: So you don’t know if the paramedic could be infected as well?

BRENDAN MURPHY: I have no knowledge of anything at the Australian Open. I’m sorry, I can try and find out.

QUESTION: New South Wales is now urging parents to not send their kids to school if they’ve been in contact with anyone who’s a confirmed case. And there’s also a petition circulating around Melbourne calling for any kids who have just come back from the area to not be sent to school for about two weeks. Are these reasonable responses.

BRENDAN MURPHY: So again with the expert committee, that met earlier today, all of our viral and infectious disease experts, they have confirmed their position which is that any child that has been a contact of someone who has this disease should be excluded from school for 14 days. But children who are well who have not had any contact or any exposure to an infected person that may have come back from China, should not be excluded. That remains the position of ever jurisdictional department at the moment.

QUESTION: What about advice to unis and more so to students.

BRENDAN MURPHY: So our advice to universities is again anyone who’s come back from China, students particularly those who are from the Hubei Province, should be very aware of the risks. That they should monitor themselves and if they become unwell with any of these symptoms, they should do the same as anybody else. They should contact their GP or the university medical centre or the local hospital and go and be tested.

QUESTION: We understand that the relatives of people who have been in contact with the confirmed case in Victoria haven’t all been tested, does that sound right to you? Or would all kind of immediate family – ?

BRENDAN MURPHY: [Interrupts] There probably isn’t the basis to test people. What the public health authorities do is they closely monitor the direct contacts. Make sure that again a child wouldn’t go to school, if they’re not exposing health care facilities or public places and they would monitor them to see if they develop any symptoms. There probably isn’t any value testing someone early on in the exposure.

QUESTION: Is testing an expensive process?

BRENDAN MURPHY: Testing is being done by public health laboratories at no cost to the consumers. So the governments collectively around the country are paying for testing.

QUESTION: But for governments, I guess my question is, are they holding off for, like a combined for a cost and reasonable – ?

BRENDAN MURPHY: [Interrupts] No government is holding off on costs. This is a public health issue of grave concern, and we have in Victoria, Victoria infectious diseases research lab, which is our major national centre is working 24 hours a day testing at the moment. So no expense is being spared for testing.

QUESTION: What’s the median age of the Australians who have or the people in Australia who have tested positive for this virus?

BRENDAN MURPHY: So there are only five of them. The youngest is a university student, a female. The rest are all males and I can’t remember exactly but I think they’re ranging from about mid 30’s to about 60, but I would have to confirm that again, I haven’t got that information with me today.

QUESTION: Do they have any other health problems or issues?

BRENDAN MURPHY: I’m advised that they are stable and they’re not seriously unwell and I’m not aware of any other health conditions that they might have.

QUESTION: Could I just ask as well, there’s many people who book and make GP appointments over the internet. I gather you’re insisting that they pick up the phone?

BRENDAN MURPHY: We do not want people to book over the Internet and just turn up to a GP’s surgery. We want everybody who is unwell and has had the relevant travel history to notify the GP or the emergency department before they attend for testing.

QUESTION: Have all GP’s been sort of briefed? And have you asked the AMA been able to reach all the GP’s?

BRENDAN MURPHY: So just yesterday we, I wrote a personal letter to every GP and emergency physician. And the colleges, the relevant colleges circulated those through their networks, providing updates to them and providing messages. We’ve also provided mass information in the past but this was further messaging. The AMA, the college of GP’s, the college of rural and remote medicine, the college of emergency medicine have been incredibly positive and cooperative in trying to get that message out.

Just today, we’ve also sent a similar message to all of our pharmacists, because a lot of people who develop flu-like symptoms will attend pharmacies for advice and we are making sure that the pharmacists are aware of what advice to give, which is to recommend that people call ahead to the GP or ED before they go and get tested.

QUESTION: I’m hoping you don’t send those letters via Australia Post?

BRENDAN MURPHY: We have electronic communications. Thanks Hannah, thanks very much everybody

January 27: Nippon.com (News from Japan) posted an article titled: “Japan Firms to Bring Home Workers from Coronavirus-Hit Wuhan”.

Many Japanese companies have decided to call back expatriate workers from the city of Wuhan, the epicenter of a pneumonia outbreak, as the Japanese government plans to charter evacuation flights.

Companies will bring home Japanese workers and their families from the inland China city, currently under lockdown to prevent the spread of a new strain of coronavirus believed to be behind the disease.

Honda Motor Co. <7267> will evacuate some 30 people on Japanese government-chartered planes. The automaker’s plant in Wuhan is closed until next Sunday for the Lunar New Year holiday. “We will make decisions on operations from Feb. 3 while monitoring the situation,” a company representative said.

Nissan Motor Co. <7201> will also bring home employees and their families.

Major chipmaking equipment maker Tokyo Electron Ltd. <8035> will bring back some 30 people to Japan, while Nippon Steel Corp. <5401> and tire maker Bridgestone Corp. <5108> will evacuate four employee and one worker, respectively.

January 27: CDC posted a “Transcript of 2019 Novel Coronavirus (2019-nCoV Update). It is a Press Briefing Transcript. From the transcript:

Operator: Good morning and thank you all for holding. Your lines have been placed on a listen only mode until the question and answer portion. At that time then press star one. The call is being recorded. If you have any objections, please disconnect at this time. Now I would like to turn the call over to Paul Fulton. Thank you, you may begin.

Paul Fulton: Thank you all for joining us today for a briefing on CDC’s 2019 novel coronavirus response. We’re joined today by Dr. Nancy Messonnier, the director of CDC’s National Center for Immunization and Respiratory Disease. Dr. Messonnier will make opening remarks before we take questions. I will now turn the call over to Dr. Messonnier.

Dr. Nancy Messonnier: Good morning and thank you for joining us. I’m joined by Dr. Weldon who is leading our task force for this response. To date we have 110 of what we’re calling persons under investigation or PUIs from 26 states. This is a cumulative number and will only increase. We still have only five confirmed positives and 32 that have been tested negative. There have been no new confirmed cases overnight. This information will be posted on our website and updated on our website on Mondays, Wednesdays and Fridays.

I want to give a short update of the laboratory side of our work. Last week, we mentioned CDC has developed a diagnostic test called a real-time reverse transcription preliminary chain reaction, that’s RRTPCR. It can diagnose this new coronavirus in respiratory serum samples from clinical specimens. Last Friday, we publicly posted the protocol for this test. This is a blueprint to make the test. Currently, we’re refining this use of the test so we can provide optimal guidance to states and laboratories on how to use it.

We’re working on a plan now so that priority states get these kids as soon as possible. But in the coming weeks, we’ll share these tests with domestic and international partners so they can test the virus themselves. Our longer-term plan is to share these tests with domestic and international partners through the agency’s international re-agent resource.

Additionally, CDC uploaded the entire genome from the virus from the first and now second cases reported in the United States. All the sequences we extracted are similar the one that china initially posted a couple of weeks ago. This means that right now and based on the CDC’s analysis of the available data it doesn’t look like the virus has mutated.

And we’re growing the virus in cell culture which is necessary for further studies, including the additional genetic characterization. Once isolated the virus will be available in the bei resources repository, which is a NIH resource that supplies organisms and re-agents to the broad community or microbiology and infectious disease researchers.

As we have said since the beginning, this is a rapidly changing situation, both here and abroad. 16 international locations including the U.S. have identified cases of this new virus. I’m sure you’ve seen the reporting and videos coming out of china in Wuhan, particularly. Our thoughts are with the people on the front lines of this emerging public health threat in china.

Right now, we are continuing to screen a few passengers from Wuhan at the five designated airports. This enhances entry screening serves two purposes. The first is to detect illness and rapidly respond to symptomatic people entering the country. The second purpose is critical to educate travelers about these symptoms of the virus and what to do if they develop symptoms. I expect our travel recommendations will change in the coming days. I can’t provide details on this yet but know we’re working on it.

Given the aggressive public health response we’re pursuing, there may be some disruptions experienced by some. CDC recommends travelers avoid all non-essential travel to Hubei Province china. Yesterday, we began recommend people traveling to all parts of china practice enhanced precautions including avoiding contact with people who are sick and discussing travel to china with your healthcare provider, especially if you are an older adult or have underlying health conditions. Returning travelers with symptoms and close contact of people confirmed with novel coronavirus may be asked to take precautionary measures.

We understand many people in the united states are worried about this virus here in the united states. However, currently in the U.S., this virus is not spreading in the community. For that reason, we continue to believe that the immediate health risk from the new virus to the general American public is low currently.

Every day we learn more and every day we assess to see if our guidance or our response can be improved. As this evolves CDC will continue our aggressive public health strategy, working to protect the health and safety of the American people. Thank you.

Paul Fulton: Thank you, Dr. Messonnier. We’re now ready to take questions.

Operator: Thank you. As a reminder if you want to ask a question please press star one, unmute your phone and record your name clearly when prompted. One moment, please. Once again to ask a question press star one. Our first question is from Michele Cortez from Bloomberg, news.

Michelle Cortez: Hi. Thanks, so much for taking the question. I wonder if you can give use some details on the screening, the flight screening now that we’re not having flights out of Wuhan directly any longer if you can tell how many patients were screened or how many travelers were screened and if there were detected that way, how many are we following with close contacts and how you think that’s going to change? I you know mentioned that in passing but I’m wondering if you’ll expand to all of china or shut it down. What are your thoughts on that? Thanks.

Dr. Messonnier: Sure. We’ve screened somewhere around 2400 people so far. And as you imagine, the number of people who are coming from Wuhan is declining with the aggressive closure of that city. I don’t have in front of may sort of the daily total from today or every the day before, but those number are, indeed, declining and we’re continuing the same posture with those five airports with the same screenings.

Two reasons to do the screening, one is to identify ill returning passengers so that they can be identified quickly, treated promptly, and so the we can keep transmission from going further and importantly education so that we can educate returning traveler about the signs and symptoms.

In terms of people identified through screening there’s a variety of people that are being tracked and I don’t think I’ll go in more detail. In terms of our forward-looking stance, as I said this outbreak is unfolding rapidly and we’re rapidly looking at how we should – how it impacts our posture at the border. We’re certainly considering broadening of that screening and that is something that I’ll be prepared to speak about as soon as we can decide on it.

Paul Fulton: Next question, please.

Operator: Thank you. Our next question is from Dan Vergano from Buzzfeed News.

Dan Vergano: Hi, thanks very much. I wonder if you could say something about the disputes over the weekend about the infectiousness of the disease, the subzero factor. Is there any way this usually plays out or there a stage at which you can definitively say how infectious this is?

Dr. Messionier: I wouldn’t say it’s a dispute. I would say its scientists from around the world are looking at the available data and trying to analyze it, to come up with information that will be helpful in response. So, different scientists are looking at the data slightly differently and our general interpretation at this point is that the incubation period is somewhere around two to 14 days.

I do think, again, it’s important that this outbreak is really unrolling in front of our eyes and when we have a definitive answer it may not be further on into an outbreak.

There’s some confusion about what this is that folks are talking about, it’s called an Arnot. It’s a reproductive number of how many infected people come from a single infected person. Several different groups looked at it. Most articles have had interpretation that the Arnot is somewhere 1.5 and 3. That’s not a dramatic difference. As a comparison, the Arnot for measles is somewhere around 12 to 18. That’s among the most contagious. In general, you want to get an Arnot below one. That’s how you get the disease controlled. I’ll stop there.

Paul Fulton: Next question, please.

Operator: Thank you. Our next question is from Evan Brown from Fox News.

Evan Brown: Hi, good morning. Could you talk a little bit more about the posting of the protocols for this test? Is this now sort of like an open source kind of test? Are your encouraging as many different health departments around the world to do this, to be able to have their own version of this test or am I not getting that right. Can you explain that more and tell me the best you can how helpful you think it would be to get this test out there as quickly as possible to as many different agencies?

Dr. Messonnier: I’ll start. I think — thank you for allowing us to clarify. We have put that protocol out. It’s a blueprint, Dr. Weldon will explain more about what the means. In general, at this stage of the investigation we are asking our clinical lab parters to send samples to CDC because we think that’s the most efficient way to – in order to ensure results are as accurate as possible.

I would point out that other countries as far as I know every other country is doing centralized testing. That is sort of how we typically stand up in this kind of response. Our most important priority is making sure that the tests is accurate. Speed is important but accuracy is probably a priority. Dr. Weldon, do you want to talk more about this?

Dr. Weldon: Yes. So, the protocol that was posted online, the intent was to use this as a blueprint. The hope is researcher can take this protocol and adapt it to their own labs so they can have this important tool available at their disposal for testing samples from suspected patients. The protocol itself is undergoing rigorous evaluation in our own labs and kits are being developed that will allow CDC to distribute to state and international labs so that they will have the important re-agency needed for the assay.

Paul Fulton: Next question, please.

Operator: Thank you. Our next question is from Kat Eschner from Popular Science.

Kat Eschner: Thank you for taking my question. I’m wondering if you can speak to the origins of the virus at all. Two articles suggest it may not have come from the Wuhan seafood market. Do we know anything more at this time?

Dr. Messonnier: So, I would also put this in the range of interesting science that’s coming out rapidly and at CDC we’re work to synthesize it. There are two different kinds of research that’s coming up in these articles. Some of its genetic sequencing analysis which is a comparison the sequencing of the strains from china with other coronaviruses including animal coronavirus and SARS and MERS.

There is epidemiology data in terms of the genetic sequencing data it looks somewhat like a bat coronavirus, but I think there’s a lot more to be done in terms of both the genetic sequencing as well as the analysis into the epidemiological researcher before we are all confident that we know how this started.

Yesterday the microphone may not have been on when I answered a question, so I’ll make sure I re-answer that. There was a question about there risk of novel coronavirus from packages of products shipped from china. So, there’s still a lot of unknown about the newly emerged 2019 coronavirus and how it spread.

But we know a lot about MERS and SARS, the other two coronavirus that are known to be infectious in people. The Novel coronavirus is genetically related more to SARS than MERS, which also have their origins in bats. We don’t know for sure if this virus will behave in the same way as far as MERS, we use information from those coronaviruses to guide us.

In general, because of the poor survivability of these coronaviruses on surfaces, that’s in the range of hours, there’s likely a very, very, very low if any risk of spread from products or packaging that is shipped over a period of days or weeks in ambient the temperatures.

So at this time we can’t fully evaluate the risks from different products that are shipped from china under different conditions, but coronaviruses have generally spread most often by respiratory droplets and there’s no evidence that supports transmission of this coronavirus is associated with imported goods and no cases in the U.S., associated with imported goods. More information will be posted as it becomes available on our website and I’m sure we’ll talk about it in upcoming media teleconferences.

Paul Fulton: Thank you. Next question?

Operator: Thank you. Our next question is from Dawn Kopecki from CNBC.

Dawn Kopecki: Hi. Last week you said there was no evidence that the coronavirus was infectious during the incubation period but china’s health minister this weekend said that there was evidence that it could be spread when people were asymptomatic. Do you have any additional information on this?

Dr. Messonnier: We have seen the reports out of china regarding the spread of the disease. We at CDC don’t have any clear evidence of patients being infectious before symptom on sets. However, with our states and local health department partners we are being very aggressive and very cautious in tracking of close contacts to determine if we can identify any close contacts who are, indeed ill.

So far, we’ve not seen any human-to-human transmission in the United States, but we’ll update you as more information becomes available from the U.S., as well as other countries.

Dawn Kopecki: Thank you.

Paul Fulton: Our next question, please?

Operator: Thank you. Our next question is from Melissa Jenco from APP News.

Melissa Jenco: Yes, thanks for taking my question. I just wondered if you could tell us if this virus had – what kind of impact this had on children both in the U.S., and what you know of the global cases?

Dr. Messonnier: So far, most of the information coming out of China which is certainly where most cases are is that the disease is by far majorly in adults with older adults in those underlying illnesses with higher risk. In the United States the five cases are all in adults.

There are a few reports of disease in children, and we’ll wait to learn more as more information becomes available. In the U.S., as you can imagine we’re also taking a cautious approach and certainly we’ll be very cautious about making sure that if there are children who are immunized and treated properly and monitoring any close contacts of cases that happen to be in children.

Paul Fulton: Next question, please.

Operator: Thank you. Our next question is from Mike Stobbe from the Associated Press.

Mike Stobbe: Hi. Thank you for taking my question. Doctor, could you say more – you said there were 110 people in the U.S., are being monitored. The samples have been taken from each of them and you’re awaiting results.

Could you be more specific about that is going on the evaluation of those 110 people? Can you say when the test kits are expected to be sent out? I’m sorry, you kind of alluded to a decision that I guess CDC is discussing about whether to change its recommendation. Anything else you can say are you thinking of doing screening for all Chinese passenger? You dangled something big in front of us and we’re all kind of wondering what you’re referring to. Thank you.

Dr. Messonnier: Sure. Let me take those in order. In term of PUIs, the process is like this. We identify somebody who potentially has exposure to Wuhan and has a fever and a respiratory illness. We would consider a PUI to be somebody who had contact with a confirmed case and had fever and respiratory illness.

Those patients are coming to attention in a variety of forums. Some have presented themselves to a health care provider. Others are being detected through vigilance at health departments, the airport and healthcare providers, so when those patients are identified that procured is set that the health department gets called first.

The health department calls CDC. We have folks here on site 24/7 through our emergency operation center. The CDC people who take the call discuss the case with the health department and clinician and based on the discussion decide whether that patient merits additional laboratory diagnostics. Specimens are taken and they are sent to CDC where they are tested.

The lag time between a patient — the decision that a patient needs further laboratory testing and a result somewhere around a day, depending on where that patient is being seen and how we can most efficiently ship it. That number of PUI’s is that general number and as you say, we’ll be working our way through the ones that will require additional laboratory testing and you’ll see patients identified as either being confirmed cases or hopefully rule out a confirmed case.

In terms of the lab kits what I would say is we’re working as fast as we can, and I am going to say one to two weeks. We’re doing everything we can to make it as fast as possible. We understand that for physicians, clinicians and health departments it’s important to have the kits as close as possible to the patients geographically so we can provide a result but it’s another week or two.

In terms of the last thing we are intermittently thinking about this decision. As you know there’s lots of new information coming out of china in terms of cases, in terms of what is going on here outside of Wuhan. There are other provinces. The case numbers. We’re trying to take that into account as we move quickly as we can towards any decisions.

I expect that there will be a decision and an announcement about that within the next day, but I can’t give you a time because we want to make sure that we’re being expedient and sensible about what kind of decisions and recommendations we’re making.

Paul Fulton: I think we have time for two more questions. Next question, please?

Operator: Our next question is from Lisa Irizarry from News Day.

Lisa Irizary: Hi, thanks for taking my question. I just want to make sure I understood, 110 persons under investigation, they were either themselves traveling in china and Wuhan or they had contact with somebody who had recently traveled, is that correct?

Dr. Messonnier: Generally, most of them, yes. As I said before we have a general guideline. However, because there is so much unknown, we are being cautious about testing and being responsive to concerns of the clinicians and the health department. The decision about whether that a patient gets tested is a joint decision between the clinician, the health department and CDC.

So, in general that is the correct definition, but around the edges there may be some additional testing and know hat this issue also, what we consider a PUI is something that we’re in active discussions out with our state and local partner.

In the definition of the PUI, also know that while the number is 110 — we’re prioritizing based on PUIs that might be at higher risk. For example, in general somebody who has a very close contact of a confirmed case and has respiratory symptoms might be a higher priority than somebody with a mild cough and traveled to Wuhan two weeks ago. Those are not real examples but just know that within 110 we are also prioritizing based on risk.

Lisa Irizarry: One quick follow up question, it’s 26 states. At some point will you release which states those are?

Paul Fulton: Last question please.

Operator: Our final question today is from Ronnie Koenig from the New York Times.

Ronnie Koenig: A couple of things. I want to get more clarity on this fight from Wuhan. I didn’t think there were flight from Wuhan. Your screening people who came from another city via Wuhan and are you able to get that information if they do present themselves at the airport? I’m not sure how that’s happening unless there are flights coming.

I just want to ask one more thing. You’re asking people to present themselves to come in for testing if they have been to Wuhan? I mean 110 out of — I mean we know there are so many people who have traveled recently from china. that is a very small number and we do see they are asymptomatic and not older with underlying conditions. So just a little confused about — are you — is there scarcity of testing?

Dr. Messonnier: There’s no scarcity of testing and I’m sorry if you could let me respond now.

Ronnie Koenig: Sure.

Dr. Messonnier: Thanks. So, again, as I said, fights from Wuhan, direct flights have certainly been stopped. But there are a variety of people who are called broken itineraries, they may be transiting from Wuhan through another country back to the United States. There are still individuals who are in the middle of one of those itineraries when I am talking about screening passengers from Wuhan, I’m talking about those people.

As I said earlier, I don’t have numbers from the past day, but we are gathering those people and they are still part of the same screening. In terms of the message to travelers, our focus is on returning travelers from Wuhan who have respiratory symptoms and fever.

This is something we’ve been trying to make sure, we’re being very clear about to returning travelers and one of the things that’s really important about the screening at the airport is that we’re not just identifying people who are sick, we’re passing out those messages so that people who returned from Wuhan who came back a week ago, for example, if they have a fever and respiratory infections, my message is to please call your health care provider. It’s important to get you analyzed and you may need to be tested.

As many of you know several of the confirmed patients in the United States were asymptomatic when they came back. Developed symptoms later. I want to compliment them because they were prompt in calling their health care provider and identified themselves as traveling to Wuhan.

Patients who are returning are an important part of this equation and I’m sorry I misspoke, travelers from Hubei not just from Wuhan. If you recently returned from Hubei and you have a fever and respiratory symptoms, please call your health care provider so you can be appropriately checked out and we want to make sure you get the best health care possible.

Paul Fulton: Thank you, Dr. Messonnier. Thank you all for joining us today for this briefing. Please remember to visit the 2019 Novel Coronavirus webpage for continued updates. If you have further questions, please call the CDC media line at 404-639-3286 or email media@cdc.gov.

Operator: Thank you. This does conclude today’s conference. You may disconnect at this time.

January 27: World Health Organization posted “Novel Coronavirus (2019-nCoV)

Highlights:

  • WHO Director-General Dr Tedros Adhanom Ghebreyesus and colleagues are in Beijing to meet with government and health experts supporting the response. The mission’s aim is to understand the latest developments and strengthen the partnership with China, in particular for the response.
  • Current estimates of the incubation period of the virus range from 2-10 days, and these estimates will be refined as more data becomes available. Understanding the time when infected patients may transmit the virus to others is critical for control efforts. Detailed epidemiological information from more people is needed to determine the infectious period of 2019-nCoV, in particular, whether transmission can occur from asymptomatic individuals or during the incubation period.
  • WHO is continually monitoring developments and on standby to reconvene the Emergency Committee on very short notice as needed. Committee members are regularly informed of developments.

Among the 37 cases identified outside of China, three were detected without the onset of symptoms, while among the remaining 34 patients, there is information on date and symptoms for 28 individuals…

The median age of cases detected outside of China is 45 years ranging from 2 to 74 years, 71% of cases were male (information was missing on age for 6 cases, and on sex for 4 cases.) Of the 27 for whom we have detailed information on the date of symptom onset and travel date from China, 8 cases had symptom onset in China, 5 had onset on the same day as travel, and 14 developed symptoms after leaving China.

36 cases had travel history to China, of whom 34 had travel history in Wuhan city, or had an epidemiological link to a confirmed case with travel history to Wuhan. For the remaining two, investigations into their travel histories are ongoing. One additional case was the result of human-to-human transmissions among close family in Viet Nam.

Countries, territories or areas with reported confirmed cases of 2019-nCoV, 27 January 2020:

  • China – including cases confirmed in Hong Kong SAR (8 confirmed cases), Macau SAR (5 confirmed cases) and Taipei (4 confirmed cases): 2761
  • Japan: 4
  • Republic of Korea: 4
  • Viet Nam: 2
  • Singapore: 4
  • Australia: 4
  • Malaysia: 4
  • Thailand: 5
  • Nepal: 1
  • United States of America: 5
  • Canada: 1
  • France: 3
  • TOTAL: 2,798

STRATEGIC OBJECTIVES

  • Limit human to human transmission including, reducing secondary infections among close contacts and health care workers, preventing transmission amplification events, and preventing further international spread from China*
  • Identify, isolate and care for patients early, including providing optimized care for infected patients;
  • Identify and reduce transmission from the animal source;
  • Address crucial unknowns and about clinical severity, extent of transmission and infection, treatment options, and accelerate the development of diagnostics, therapeutics and vaccines;
  • Communicate critical risk and event information to all communities and counter misinformation;
  • Minimize social and economic impact through multisectoral partnerships.

This can be achieved through a combination of public health measures, such as rapid identification, diagnosis and management of cases, identification and follow up of the contacts, infection prevention and control in healthcare settings, implementation of health measures for travelers, awareness raising in the population, risk communication.

PREPAREDNESS AND RESPONSE

  • WHO has been in regular and direct contact with Member States where cases have been reported. WHO is also informing other countries about the situation and providing support as requested.
  • Developed interim guidance for laboratory diagnostics, clinical management, infection prevention and control in health care settings, home care for patients with suspected novel coronavirus, risk communication and community engagement.
  • Provided recommendations to reduce risk of transmission from animals to humans.
  • WHO has published an update advice for international traffic in relation to the outbreak of the novel coronavirus 2019-nCoV.
  • Activation of R&D blueprint to accelerate diagnostics, vaccines, and therapeutics.
  • WHO is providing guidance on early investigations. The first protocol that is available is a: Household transmission investigation protocol for 2019-novel coronavirus (2019-nCoV) infection.
  • WHO has developed an online course to provide general introduction to emerging respiratory viruses, including novel coronavirus.
  • WHO is providing guidance on early investigations, which are critical to carry out early in an outbreak of a new virus. The data collected from the study protocols can be used to refine recommendations for surveillance and case definitions, to characterize the key epidemiological transmission features of 2019-nCoV, help understand spread, severity, spectrum of disease, impact on community and to inform operational models for implementation of countermeasures such as case isolation, contact tracing and isolation. The first protocol that is available is a: Household transmission investigation protocol for 2019-novel coronavirus (2019-nCoV) infection.
  • WHO is working with its networks of researchers and other experts to coordinate global work on surveillance, epidemiology, modelling, diagnostics, clinical care and treatment, and other ways to identify, manage the disease and limit onward transmission. WHO has issued interim guidance for countries, updated to take into account the current situation.
  • Utilizing global expert networks and partnerships for laboratory, infection prevention and control, clinical management and mathematical modelling.

RECOMMENDATIONS AND ADVICE

During previous outbreaks due to other coronaviruses (Middle-East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS)), human to human transmission occurred through droplets, contact and fomites, suggesting that the transmission mode of the 2019-nCoV can be similar. The basic principles to reduce the general risk of transmission of acute respiratory infections include the following:

  • Avoiding close contact with people suffering from acute respiratory infections.
  • Frequent hand-washing, especially after direct contact with ill people or their environment.
  • Avoiding unprotected contact with farm or wild animals.
  • People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover cogs and sneezes with disposable tissues or clothing, and wash hands.)
  • Within healthcare facilities, enhance standard infection prevention and control practices in hospitals, especially in emergency departments.

WHO does not recommend any specific health measures for travelers. In case of symptoms suggestive of respiratory illness either during or after travel, the travellers are encouraged to seek medical attention and share their travel history with their health care provider. Travel guidance was updated on 24 January.

January 27: American Academy of Pediatrics (AMA) posted “CDC: 5 US cases of coronavirus confirmed”.

Five cases of coronavirus have been confirmed in the U.S., and federal health officials are preparing diagnostic kits so states can perform their own testing.

Cases have been confirmed in Arizona, California, Illinois and Washington and all involved adults who traveled to Wuhan, China, the center of the outbreak, according to the Centers for Disease Control and Prevention (CDC).

“At this time in the U.S., this virus is not spreading in the community,” said Nancy Messonnier, M.D., director of the CDC’s National Center for Immunization and Respiratory Diseases. “For that reason, we continue to believe the immediate health risk from the new virus to the general American public is low at this time.”

Thirty-two people have tested negative, and 73 potential cases are still under investigation.

While the CDC has been handling testing, it has created a test to diagnose the new coronavirus in respiratory and serum samples and plans to send it to domestic and international partners in the next couple of weeks. It also has posted a testing protocol online, which Dr. Messionnier described as “essentially a blueprint to make the test.”

“We are doing everything we can to make it as fast as possible,” she said. “We understand that for patients, clinician and health departments, it is much preferable to have that kit as close as possible to the patient geographically so we can efficiently proved a result.”

China first reported cases in late December and linked the virus to a large market with seafood and live animals in Wuhan, a city of more than 11 million people and a major transportation hub. The pathogen is genetically similar to those that caused outbreaks of Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), and there is evidence of human-to-human spread.

The global case count has reached 2,886, and there have been 81 deaths, according to a tally by Johns Hopkins University. While most of the cases are in China, cases have been confirmed in about a dozen other countries, including Thailand, Australia, the U.S., Japan, South Korea and France.

The global case count has reached 2,886, and there have been 81 deaths, according to a tally by Johns Hopkins University. While most of the cases are in China, cases have been confirmed in about a dozen other countries, including Thailand, Australia, the U.S., Japan, South Korea and France.

“So far, most of the information coming out of China, which is certainly where the majority of cases are, s that the disease is by far, majorly in adults, with older adults and those with underlying illnesses at higher risk,” Dr. Messonnier said.

The CDC is continuing to screen passengers arriving from Wuhan at international airports in Las Angeles, New York City, San Francisco, Chicago and Atlanta and may expand screening in the coming days.

It recommends people avoid non-essential travel to Hubei Province, China. People traveling to other parts of China should discus their plans with their health care provider and take precautions.

Clinicians should be vigilant for people who have a fever and respiratory symptoms and who traveled Wuhan within 14 days of symptom onset or were in close contact with a confirmed or suspected coronavirus patient. If they suspect a case, they should take infection-control precautions and immediately contact their state or local health department to facilitate testing.

January 27: U.S. Food and Drug Administration (FDA) posted a news release title: “FDA Announces Key Actions to Advance Development of Novel Coronavirus Medical Countermeasures”.

Today, the U.S. Food and Drug Administration (FDA) announced critical actions to advance development of novel coronavirus medical countermeasures.

As with any emerging public health threat, the FDA will collaborate with interagency partners, product developers, International partners and global regulators to expedite the development and availability of medical products needed to diagnose, treat, mitigate and prevent such outbreaks.

“We have a vital mission to protect and promote public health and the FDA is closely collaborating with our domestic and international public health partners to mitigate the impact of the novel coronavirus that emerged in Wuhan, China,” said FDA Commissioner Stephen M. Hahn, M.D. “We are actively leveraging the vast breadth of the FDA’s expertise and have begun employing the full range of our public health authorities to facilitate the development and availability of investigational medical products to help address this urgent public health situation.”

As part of FDA’s ongoing commitment to prepare and respond to infectious disease outbreaks, the agency is sharing updates on processes in place to help developers understand the pathways, including Emergency Use Authorization (EUA), that may be available to more rapidly advance and make medical countermeasures available for this virus, including diagnostic tests.

The FDA is also issuing key information for the public to help support the timely development of medical products to respond to the current outbreak. In order to support efficient medical product development for novel coronavirus medical countermeasures, today the FDA is launching a landing page that provide key information to the public, including product developers, on the FDA’s efforts in response to this outbreak.

“We are committed to keeping the American people informed as we prepare and respond to emerging public health threats, including the novel coronavirus,” said FDA Deputy Commissioner of Policy, Legislation and International Affairs Anna Abram. “The agency is committed to ensuring safe and effective medical countermeasures are available as quickly as possible to protect public health.”

Being able to quickly and accurately diagnose patients infected with the novel coronavirus is an essential step in helping patients identify the need for care and mitigate the spread of the virus to additional individuals. Currently, there are no commercially available products that are authorized to detect novel coronavirus; however, the FDA is actively working to facilitate the development and availability to advance and share the reference materials necessary to facilitate diagnostic development.

The FDA is also requesting that diagnostic test sponsors interested in potential EUA for tests to detect 2019n-CoV contact CDRH-EUA-Templates@fda.hhs.gov for further information and templates.

Sponsors wishing to develop therapeutics for 2019-nCoV are encouraged to submit information and questions via the FDA’s Pre-IND Consultation program.

The FDA is an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency is also responsible for the safety and security of our nation’s supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

January 27: Billboard reported – Japanese rock group Suchmos canceled a slate of dates in China that were scheduled between Feb. 7-11. The group said they hoped to play dates in China as soon as possible.

January 27: CBC News (Canada) posted “Online claims that Chinese scientists stole coronavirus from Winnipeg lab have ‘no factual basis’ Karen Pauls and Jeff Yates reported

The Public Health Agency of Canada is denying any connection between the National Microbiology Lab in Winnipeg, two scientists who were escorted out of the building last summer, and the coronavirus outbreak in China.

Baseless stories claiming that the two scientists are Chinese spies and that they smuggled the coronavirus to China’s only Level 4 lab in Wuhan last year have been spreading on all social media platforms and on conspiracy theorists blogs. One article from a conspiracy blog was shared more than 6,000 times on Facebook on Monday.

The story even made its way on Chinese-owned social media app TikTok, where a video pushing these claims was watched more than 350,000 times.

“This is misinformation and there is no factual basis for claims being made on social media.” Eric Morrissette, chief of media relations for Health Canada and the Public Health Agency of Canada said in response by queries by CBC News.

The conspiracy theory seems to be based on a distorted reading of reporting from CBC News published last summer. One of the first mentions occurred Saturday on Twitter, where businessman Kyle Bass claims that “a husband and wife Chinese spy team were recently removed from a Level 4 Infectious Disease facility in Canada for sending pathogens to the Wuhan facility.”

In the tweet, which was shared over 12,000 times, he linked to a story CBS News broke in July, revealing that a researcher, her husband, and some of their graduate students were escorted out of the National Microbiology Lab (NML) in Winnipeg amid an RCMP investigation into what’s being describe as a possible “policy breach” and “administrative matter.”

The RCMP and Health Canada have both stressed that there was no danger for public safety.

CBC reporting never claimed the two scientists were spies, or that they brought any version of the coronavirus to the lab in Wuhan.

Experts say the disinformation is creating a “social panic” online.

“We’ve seen already Twitter and Reddit and other platforms that there have been calls to ban travellers from China from entering North American or Europe – that there have been individuals targeted to be supposedly pulled off flights of stopped at the Canadian border or the U.S. border,” Says Fuyuki Kurasawa, director of the Global Digital Citizen Lab at York University.

“The broader damage is that there grows a mistrust toward both government authorities, public health officials, the media, authoritative sources of media, and there there becomes a social media environment where speculation, rumour and conspiracy theories take over and wash out the factual information that is being promoted online.”

Kurasawa is already seeing that spread from the online world to the real world.

“Individuals will take it on themselves to become vigilantes, where they’ll try to spot someone who supposedly is either holding the truth about some hidden truth about the coronavirus or a person who may be a carrier or supposed carrier of the virus because they appear to have certain symptoms, and then they’ll ask the general public to take matters into own hands,” he says.

Kernels of truth in disinformation

Dr. Xiangguo Qiu is a medical doctor and virologist from Tianjin, China, who came to Canada for graduate studies in 1996. Qiu is still affiliated with the university. there and has brought in many students over the years to help with her work. She helped develop ZMapp, a treatment for the deadly Ebola virus which killed more than 11,000 people in West Africa between 2014-2016.

Her husband Keding Cheng works at the Winnipeg lab as a biologist. He has published research papers on HIV infections, severe acute respiratory syndrome (SARS), E. coli infections and Creutzfeldt-Jakob disease.

One month later, CBC discovered that scientists at the NML sent live Ebola and Henipah viruses to Beijing on an Air Canada flight March 31. The Public Health Agency of Canada says all federal policies were followed. PHAC will not confirm if the March 31 shipment is part of the RCMP investigation.

Contrary to posts on Twitter, the coronavirus was not part of this shipment. And there is no confirmation Qiu or Cheng were the scientists behind the shipment.

In another followup story using travel documents obtained in Access to Information requests, CBC reported that Qiu made at least five trips to China in 2017-18, including one to train scientists and technicians at China’s newly certified Level 4 lab.

She was invited to visit the Wuhan National Biosafety Laboratory of the Chinese Academy of Sciences twice a year for two years, for up to two weeks each time. The lab does research with the most deadly pathogens.

PHAC has denied any connection between RCMP investigation, Qiu’s visits to Wuhan or any Canadian research, with the coronavirus outbreak.

However, PHAC would not comment on the current status of Qiu and Cheng, citing privacy reasons.

Communicate more effectively

Heidi Tworek, assistant professor in international history at the University of British Columbia, says governments and public health authorities need to do a better job of communicating facts at times like this, including the languages of the communities impacted.

“It’s incredibly challenging during fast-moving outbreaks of any disease to balance between information to keep the public safe and prevent something from becoming a massive epidemic and also trying to provide truthful information and also providing enough so you don’t end up with a vacuum, which is were disinformation can flourish, Tworek says.

“We’ve seen in previous outbreaks it’s been difficult to get this right, but I’d emphasize this is actually a crucial element of what we need to be thinking about into the future – how do we actually communicate well and swiftly with general public with all types of health scares? This will not be the last time we face disinformation during a potential epidemic.”


January 28

January 28: World Health Organization (WHO) posted”WHO, China leaders discuss next steps in battle against coronavirus outbreak”

The Director-General of the World Health Organization (WHO), Dr Tedros Adhanom Ghebreyesus, today met President Xi Jinping of the People’s Republic of China in Beijing. They shared the latest information on the novel coronavirus 2019 (2019-n-CoV) outbreak and reiterated their commitment to bring it under control.

Dr. Tedros was joined by WHO Regional Director Dr. Takeshi Kasai and Executive Director of the WHO Health Emergencies Programme Dr Mike Ryan, and also met State Councilor and Minister of Foreign Affairs Wang Yi and Minister of Health Ma Xiaowei.

The National Health Commission presented China’s strong public health capacities and resources to respond and manage respiratory disease outbreaks. The discussions focused on continued collaboration on containment measures in Wuhan, public health measures in other cities and provinces, conducting further studies on the severity and transmissibility of the virus, continuing to share data, and for China to share biological material with WHO. These measures will advance scientific understanding of the virus and contribute to the development of medical countermeasures such as vaccines and treatments.

The two sides agreed that WHO will send international experts to visit China as soon as possible to work with Chinese counterparts on increasing understanding of the outbreak to guide global response efforts.

“Stopping the spread of this virus both in China and globally is WHO’s highest priority,” said Dr Tedros. “We appreciate the seriousness with which China is taking this outbreak, especially the commitment from top leadership, the transparency they have demonstrated, including sharing data and genetic sequence of the virus. WHO is working closely with the government on measures to understand the virus and limit transmission. WHO will keep working side-by-side with China and all other countries to protect health and keep people safe.”

The WHO mission comes as the number of people confirmed with the virus rose to over 4500 globally on 28 January, the greatest number being in China.

The WHO delegation highly appreciated the actions China has implemented in response to the outbreak, its speed in identifying the virus and openness to sharing information with WHO and other countries.

Much remains to be understood about 2019-nCoV. The source of the outbreak and the extent to which it has spread in China are not yet known. While the current understanding of the disease remains limited, most cases reported to date have been milder, with around 20% of those infected experiencing severe illness. Both WHO and China noted that the number of cases being reported, including those outside China noted that the number of cases being reported, including those outside China, is deeply concerning. Better understanding of the transmissibility and severity of the virus is urgently required to guide other countries on appropriate response measures.

WHO is continually monitoring developments and the Director-General can reconvene the International Health Regulations (2005) Emergency Committee on very short notice as needed. Committee members are on stand-by and are informed regularly of developments.

January 28: Reuters posted “Spain, Portugal work to repatriate nationals from coronavirus-hit Wuhan”

The governments of Spain and Portugal are working with China and the European Union to repatriate their nationals from the Wuhan area struck by the coronavirus, the two countries’ foreign ministers said Monday.

The coronavirus outbreak has killed 81 people in China and infected more than 2,800 globally, most of them in China.

“We’re working… with our consulate in Beijing, and officials in China and the European Union to repatriate around 20 Spaniards in Wuhan, Hubei, the epicenter of the coronavirus. We will continue to update on any advances,” Spanish Foreign Minister Arancha Gonzalez Laya wrote on Twitter.

She did not provide any futher details.

Portuguese Foreign Minister Augusto Santos Silva told state broadcaster RTP that the ministry was exploring whether Portuguese citizens in Wuhan could return on a civilian plane with citizens from other European countries.

“Unlike other countries such as the United States or France, who have large numbers of citizens in Wuhan and carry out their own repatriation programmes, it makes more sense for country like Portugal, which has only a few citizens there, to carry out coordinated operations, if possible,” he said.

January 28: The CDC reported the onset of 3 additional COVID-19 case in the United States.

January 28: President Trump tweeted: “Really pathetic how @FOXNews is trying to be so politically correct by loading the airwaves with Democrats like Chris Van Hollen, the no name Senator from Maryland. He has been on forever playing up the Impeachment Hoax. Dems wouldn’t even give Fox their low ratings debates…

For context, in the tweet above, President Trump was angry that Chris Van Hollen, a Democratic Senator from Michigan, discussed that Trump had been impeached. Trump is also angry that this happened on Fox News, a channel that had previously acted as state media and praised Trump.

In the above tweet, Trump is also pointing out that the Democrats did not want to hold any of their primary debates on Fox News. He is using that observation as an attack on Fox News. There is another tweet in this thread, but it is irrelevant.

January 28: President Trump tweeted: “It’s amazing what I’ve done, the most of any President in the first three years (by far), considering that for three years I’ve been under phony political investigations and the impeachment HOAX! KEEP AMERICA GREAT!”

January 28: President Trump tweeted: “Heading to New Jersey. Big Rally, in fact, Really Big Rally!”

January 28: President Trump tweeted: “Thank you Wildwood New Jersey! #KeepAmericaGreat”. The tweet included a periscope video of the rally in New Jersey.

January 28: NPR posted: “Starbucks Closes More Than 2,000 Stores In China Amid Coronavirus Outbreak”

Starbucks has temporarily closed more than half of its stores in mainland China as an outbreak of coronavirus has surged through the country, affecting thousands of people.

Starbucks executives on Tuesday called the viral outbreak a “very complex situation,” adding that the company closed its locations in China at the direction of local government officials as well as “proactively,” to limit the spread of the virus among workers and consumers.

“Our immediate focus is on two key priorities in China,” CEO Kevin Johnson told analysts on an earnings call. “First, caring for the health and well-being of our partners and customers in our stores. Second: playing a constructive role in supporting local health officials and government leaders as they work to contain the coronavirus.”

China is a key, fast-growing market for Starbucks and many other companies that are starting to see an impact from the outbreak and the measures that Chinese authorities have imposed in response, including a lockdown of multiple cities with tens of millions of residents.

Other chains such as McDonald’s and KFC have also been closing stores. McDonald’s is expected to share an update on Wednesday when it reports its quarterly earning. Apple CEO Tim Cook said on Tuesday that his company has closed one of its retail stores.

“Many of the stores that remain open have also reduced operating hours,” Cook said. “We’re taking additional precautions and frequently deep-cleaning our stores as well as conducting temperature checks for employees.”

Starbucks CEO Johnson said he had anticipated raising the company’s financial forecast for the year on Tuesday, but would not do so now “due to the dynamic situation unfolding with the coronavirus.” China is the second-largest market for Starbucks, which had almost 4,300 stores there at the end of 2019.

In a company earnings release on Tuesday, Starbucks said. “Currently, we have closed more than half of our stores in China and continue to monitor and modify the operating hours of all of our stores in the market in response to the outbreak of the coronavirus.”

Chinese authorities say that a surge in cases of the rapidly spreading coronavirus in recent weeks has sickened nearly 6,000 people as of Wednesday, with more than 130 deaths. Additional cases have been reported outside of China, including in Australia, France and Canada, and the U.S.

In the United States, five confirmed cases involve people who recently traveled to Wuhan, China, the epicenter of the outbreak. At a news conference Tuesday, top U.S. health officials reiterated that the disease — while serious — is not currently a threat to ordinary Americans.

January 28: World Health Organization (WHO) posted “WHO, China leaders discuss next steps in battle against coronavirus outbreak”

The Director-General of the World Health Organization (WHO), Dr. Tedros Adhanom Ghebreyesus, today met with President Xi Jinping of the People’s Republic of China in Beijing. They shared the latest information on the novel coronavirus 2019 (2019-nCoV) outbreak and reiterated their commitment to bring it under control.

Dr Tedros was joined by WHO Regional Director Dr. Takeshi Kasai and Executive Director of the WHO Health Emergencies Program Dr Mike Ryan, and also met State Councilor and Minister of Foreign Affairs Wang Yi and Minister of Health Ma Xaiowei.

The National Health Commission presented China’s strong public health capabilities and resources to respond and manage respiratory disease outbreaks. The discussions focused on continued collaboration on containment measures in Wuhan, public health measures in other cities and provinces, conducting further studies on the severity and transmissibility of the virus, continuing to share data, and for China to share biological material with the WHO. These measures will advance scientific understanding of the virus and contribute to the development of medical countermeasures such as vaccines and treatments.

The two sides agreed that WHO will send international experts to visit China as soon as possible to work with Chinese counterparts on increasing understanding of the outbreak to guide global response efforts.

“Stopping the spread of the virus both in China and globally is WHO’s highest priority,” said Dr. Tedros. “We appreciate the seriousness with which China is taking this outbreak, especially the commitment from top leadership, and the transparency they have demonstrated, including sharing data and genetic sequence of the virus. WHO is working closely with the government on measures to understand the virus and limit transmission. WHO will keep working side-by-side with China and all other countries to protect health and keep people safe.”

The WHO mission comes as the number of people confirmed with the virus rose to over 4500 globally on 28 January, the greatest number being in China.

The WHO delegation highly appreciated the actions China has implemented in response to the outbreak, its speed in identifying the virus and openness to sharing information with WHO and other countries.

Much remains to be understood about 2019-nCoV. The source of the outbreak and the extent to which it has spread in China are not yet known. While the current understanding of the disease remains limited, most cases reported to date have been milder, with around 20% of those infected experiencing severe illness. Both WHO and China noted that the number of cases being reported, including those outside China, is deeply concerning. Better understanding of the transmissibility and severity of the virus is urgently required to guide other countries on appropriate response measures.

WHO is continually monitoring developments and the Director-General can reconvene the International Health Regulations (2005) Emergency Committee on very short notice as needed. Committee members are on stand-by and are informed regularly of developments.

January 28: CNBC posted an article titled: “Facebook restricts employee travel to China as coronavirus spreads”. It was written by Annie Palmer. From the article:

Facebook has started restricting employee travel to China, joining a growing list of U.S. companies that have done the same amid a growing outbreak of the coronavirus.

“Out of an abundance of caution, we have taken steps to protect the health and safety of our employees,” Facebook spokesperson Anthony Harrison told CNBC in a statement.

The travel restrictions were announced on Monday. Facebook has banned all non-essential travel the country, but if employees must visit China, they have to receive approval first. The company has also told employees who work in China, or who have recently traveled there, to work from home, Facebook said.

Facebook is the first major U.S. technology company to ban all non-essential travel to the country. Other companies including Disney, McDonalds, Starbucks, and Ford Motor have either suspended operations or instituted travel restrictions there. Apple shares fell on Monday amid concerns the company, which has high revenue exposure in China, would be hurt by any impact the coronavirus might have on consumer spending.

More than 100 people have died from the disease, while total confirmed cases have risen to more than 4,600. The majority of cases have been reported in Wuhan, China, but within the last week, five cases have been confirmed in the U.S.

January 28: The European Centre for Disease Prevention and Control posted “ECDC statement following reported confirmed case of 2019-nCoV in Germany”.

German health authorities confirmed a case of 2019-nCoV in Bavaria on 27 January. This brings the cases reported in Europe to four. The cases in France had a direct link to Wuhan, China.

Based on current information, the infection in Germany followed a close contact with a visitor from China during a stay in Germany (diagnosed with 2019-nCoV after return to China) who had previously been visited by relatives from the Wuhan area. The German authorities are investing this case and taking the necessary steps to trace and inform any contracts.

At this stage of the on-going outbreak in the Hubei province in China, it is likely that there will be more imported cases in Europe. As a consequence, it could be expected to see (limited) local transmission in Europe. A single detected case in Europe does not change the overall picture for Europe, nor does it change the assessment that there is currently a moderate likelihood of importation of cases of 2019-nCoV to the EU/EEA. As more and more cases are reported globally, this also increases the probability of sporadically imported cases to EU/EEA countries.

Based on this, EU/EEA countries should ensure that timely and rigorous infection prevention and control measures (IPC) are applied around any detected nCoV cases in the EU/EEA, in order to prevent further spread in the community and healthcare settings. Healthcare workers in the EU/EEA need to be aware and vigilant in order to detect possible nCoV cases early and apply appropriate infection control measures when handling patients.

Right now, the focus still should be on the development of the outbreak in China and the related information on the characteristics of the virus.

The source of the infection is unknown and could be still active. Human-to-Human transmission has been confirmed but more information is needed to evaluate the full extent of this mode of transmission and understanding how the virus spreads. This is a rapidly evolving situation, ECDC is revising its risk assessment for Europe.

January 28: Kyodo News (News from Japan) posted “Japan classifies new virus as designated infectious disease”.

Japan on Tuesday classified pneumonia caused by a new deadly coronavirus that originated in the central Chinese city of Wuhan as a “designated infectious disease” that legally allows compulsory hospitalization amid a steep rise in overseas infections.

The designation approved by the Cabinet will also restrict infected patients from going to work and require disinfection of sites where the virus has been detected.

The government will use public money to pay for the medical treatment of those subject to forced hospitalization. About 400 specified medical institutions across Japan will be able to provide treatment.

An ordinance on the designation will be implemented on Feb. 7, according to Japanese officials. The government also said anyone who travelling who is suspected of having the virus must, under the quarantine law, have a medical checkup at their point of arrival in Japan.

Japan is stepping up quarantine and other preventative efforts to prevent the spread of the virus in the country, one of the major destinations for Chinese travelers during the Lunar New Year holiday.

The death toll from the new virus topped 100 in China, local media said Tuesday. Globally, the pneumonia-causing virus has infected more than 4,500, with four confirmed in Japan.

The designation, the fight of its kind and the first since the 2014 spread of Middle East respiratory syndrome, or MERS, also requires doctors report any patients confirmed in Japan.

“We will take all possible measures to prevent the spread of infections,” Chief Cabinet Secretary Yoshihide Suga said at a press conference.

The same emergency steps were also taken in the past for other infectious diseases designated by the government as Class II such as MERS and severe acute respiratory syndrome, or SARS. Under the law, infectious diseases are divided into five classes depending on their severity.

The government is also arranging charter flights for Japanese nationals who wish to return home from Wuhan, a city of 11 million that has been on a virtual lockdown since last week.

“We are ready to go if we can get approval from the Chinese authorities,” Suga said, adding that Tokyo is also considering sending necessary supplies to Wuhan such as masks and protective clothing.

Foreign Minister Toshimitsu Motegi said a charter plane will leave Japan on Tuesday night.

As of last week, about 710 Japanese were registered as staying in Hubei Province, whose capital is Wuhan. Japanese embassy officials have been trying to determine the number of Japanese citizens wishing to return home.

Once they board a charter plane, a doctor, two nurses and a quarantine office plan to conduct an in-flight check for symptoms such as fever and cough, according to the Japanese health ministry.

The passengers will be asked to monitor their health condition for two weeks after their return to Japan and report to the nearest public health center if they develop symptoms of the new coronavirus.

January 28: Ohio Department of Health posted a tweet: “There are no confirmed cases of the 2019 novel coronavirus (2019-nCoV) in Ohio. However, ODH is closely monitoring two possible cases reported by Miami University in Butler County.” This tweet was the start of a thread.

January 28: Ohio Department of Health posted a tweet: “Both students being monitored had recently returned from China. Neither individual is severely ill. They are currently in isolation pending test results.”

January 28: Ohio Department of Health posted a tweet: “The CDC is conducting the testing, and results are expected by the end of the week.”

January 28: Ohio Department of Health posted a tweet: “ODH has been working diligently with our health partners and local health districts across the state to ensure we are prepared if a case is confirmed in Ohio.”

January 28: Ohio Department of Health posted a tweet: “Five U.S. cases of 2019-nCoV have been confirmed by the CDC. Unless you have recently traveled from China or have been around someone ill with this new virus, your risk of getting sick is low.”

January 28: Ohio Department of Health posted a tweet: “Investigations are ongoing to learn more about transmission. There is no known person-to-person spread of 2019-nCoV in the U.S.”

January 28: Ohio Department of Health posted a tweet: “Symptoms include fever, cough, and difficulty breathing. Seek medical care if you are experiencing symptoms and traveled from Wuhan City, China, in the 14 days before you started feeling sick.”

January 28: Ohio Department of Health posted a tweet: “Also seek medical care if you are exhibiting symptoms and, in the 14 dasy before symptoms appeared, had close contact with a person who is under investigation for 2019-nCoV”.

January 28: Ohio Department of Health posted a tweet: “Just like other illnesses, it’s critical to protect yourself against the virus: wash hands often, follow appropriate cough and sneeze etiquette, don’t go to work or school when you feel ill; avoid exposure to others who are sick.”

January 28: New South Wales Health posted another Novel Coronavirus Statistics (as of 11:30 AM that day).

NSW – number of cases confirmed – 4

NSW – number of cases under investigation – 6

We will not be disclosing the hospital locations of patients under investigation for privacy reasons.

January 28: Centers for Disease Control and Prevention posted “HHS and CDC Supporting Safe, Expedient Departure of US Citizens”.

The U.S. Government is relocating approximately 210 U.S. citizens from Wuhan, China back to the United States. The Department of State has the lead for the safe and expedient ordered departure of citizens. The Department of Health and Human Services (HHS) and Centers for Disease Control and Prevention (CDC) are collaborating with the Department of State on the logistics of public health evaluations for every traveler on the flight. HHS and CDC are working with partners to ensure that any traveler who develops symptoms during their journey receives appropriate medical care.

Our primary objective is to facilitate the safe return of these Americans while protecting the public’s health. These individuals will be screened before they take off; monitored during the duration of the flight by medical personnel on board; screened again on landing to refuel in Anchorage, Alaska; monitored on the last leg of the flight by medical personnel on board; evaulated upon arrival at March Air Reserve Base in Riverside County, California; and then monitored for symptoms post-arrival.

January 28: World Health Organization South-East Asia posted “Thailand announced a total of 14 cases of Novel Coronavirus detected in country”.

On 28th January, the Ministry of Public Health, Thailand announced there have been a total of 14 cases of Novel Coronavirus 2019-nCoV detected in Thailand. 13 cases had travelled from Wuhan and 1 case from Chongqing. Five of the cases are from the same family.

A press release from the Ministry of Public Health (in Thai language) can be seen here

A WHO Situation Report on Novel Coronavirus 2019-nCoV for 27th January 2020 can be seen here.

Background

Beginning early December 2019, an upsurge of cases of pneumonia was detected in persons from Wuhan City in China. Cases have now also been detected in many other parts of China, and human-to-human transmission has been confirmed in the city of Wuhan. Chinese authorities identified a new coronavirus as the agent causing these cases. 14 imported cases have also been reported in Thailand: all in people that had traveled from Wuhan. Cases have also been reported from several other countries.

Coronaviruses are common – many cause less severe illness such as the common cold; other are known to cause more severe illness (SARS and Middle East Respiratory Syndrome, MERS)

At present, WHO does not recommend any specific health measures for travelers in relation to this event. WHO advises against the application of any travel or trade restrictions on China based on the information available. If travelers develop respiratory illness before, during or after travel, they should seek medical attention and share travel history with their health care provider.

The World Health Organization is working with Thailand and other countries to track further understand infections caused by this new coronavirus and to ensure that they are prevented and controlled. This includes,

  • Facilitating information sharing on this and other relevant health events between countries
  • In the longer term using the International Health Regulations to develop and strengthen the capacities of countries to detect and respond to infections like the new coronavirus.
  • Providing all countries with a technical package of interim guidance, including:
  • Surveillance and case definitions
  • Laboratory guidance
  • Clinical management for suspected novel coronavirus
  • Home care for patients with suspected novel coronavirus
  • Infection prevention and control
  • Risk communications
  • Readiness checklist
  • Disease commodity package
  • Reducing transmission from animals to humans

January 28: Nippon.com (News from Japan) posted “Toyota Bans Business Trips to China’s Hubei”

Toyota Motor Corp. <7203> has banned employees from going on business trips to China’s Hubei Province, due to an outbreak of pneumonia caused by a new coronavirus, company officials said Tuesday.

Previously, the Japanese automaker had told its employees to refrain from making nonessential business trips to the provincial capital, Wuhan, where the outbreak is believed to have started.

Currently, no Toyota workers are on business trips in Hubei, the officials said.

January 28: World Health Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report – 8”

Highlights:

  • A World Health Organization (WHO) senior leadership team, led by Director-General Dr Tedros Adhanom Ghebreyeus, today met President Xi Jinping of the People’s Republic of China in Beijing. They shared the latest information on the outbreak and reiterated their commitment to bring it under control.
  • The discussions focused on continued collaboration to improve containment measures in Wuhan, to strengthen public health measures in other cities and provinces, to conduct further studies and transmissibility of the virus to continue to share data, and for China to share biological material with WHO. These measures will advance scientific understanding of the virus and contribute to the development such has vaccines and treatments.
  • WHO is launching Global 2019-nCoV Clinical Data Platform to allow Member States to contribute anonymized clinical data in order to inform the public health clinical response
  • WHO is continually monitoring developments and the Director-General can reconvene the Emergency Committee on very short notice as needed. Committee members are regularly informed of developments.

TECHNICAL FOCUS: Clinical Management:

Patients with 2019-nCoV infection, are presenting with a wide range of symptoms. Most seem to have mild disease, and about 20% appear to progress to severe disease, including pneumonia, respiratory failure and in some cases death.

Clinical care of suspected patients with 2019-nCoV should focus on recognition, immediate isolation (separation), implementation of appropriate infection prevention and control (IPC) measures and provision of optimized supportive care. WHO is convening a bi-weekly call with clinical experts around the globe, to better understand, in real-time, the clinical presentation and treatment interventions.

WHO has published interim clinical care guidance for hospitalized patients and for mildly ill patients at home, and developed a standardized clinical case record form (CRF) that will be available via the website.

To facilitate the aggregation of standardize clinical data, WHO is launching a Global 2019-nCoV Clinical Data Platform to allow Member States to contribute anonymized clinical data in order to inform the public health clinical response.

As there is currently no known effective antiviral therapy for 2019-nCoV, the WHO R&D blueprint is conducting a systematic review to evaluate the potential therapeutics and develop master clinical protocols that are necessary to accelerate this globally.

WHO has also updated the Disease Commodity Package that includes an essential list of biomedical equipment, medicine and supplies to care for patients with 2019-nCoV.

In addition, a notification was sent out to the Emergency Medical Teams network requesting an expression of interest for clinical operations support teams to support triage, referral systems, clinical care and IPC.

SURVEILLANCE

Western Pacific

  • China4537
  • Japan – 6
  • Republic of Korea – 4
  • Viet Nam – 2
  • Singapore – 7
  • Australia – 5
  • Malaysia – 4
  • Cambodia 1

South-East Asia

  • Thailand – 14
  • Nepal – 1
  • Sri Lanka – 1

Region of the Americas

  • United States – 5
  • Canada – 2

European Region

  • France -3
  • Germany -1

STRATEGIC OBJECTIVES

WHO’s strategic objectives for this response are to:

  • Limit human-to-human transmission including reducing infections among close contacts and health care workers, preventing transmission amplification events, and preventing further international spread from China*
  • Identify, isolate and care for patients early, including providing optimized care for infected patients;
  • Identify and reduce transmission from the animal source;
  • Address crucial unknowns regarding clinical severity, extent of transmission and infection, treatment options, and accelerate the development of diagnostics, therapeutics and vaccines;
  • Communicate critical risk and event information to all communities and counter misinformation;
  • Minimize social and economic impact through multisectoral partnerships.
  • This can be achieved through a combination of public health measures, such as rapid identification, diagnosis and management of the cases, identification and follow up of the contacts, infection prevention and control in healthcare settings, implementation of health measures for travellers, awareness-raising in the population and risk communication.

PREPAREDNESS AND RESPONSE

  • WHO has been in regular contact with Member States where cases have been reported. WHO is also informing other countries about the situation and providing support as requested.
  • WHO has developed interim guidance for laboratory diagnostics, clinical management, infection prevention and control in healthcare settings, home care for patients with suspected novel coronavirus, risk communication and community engagement.
  • WHO has provided recommendations to reduce risk of transmission from animals to humans.
  • WHO has published an updated advice for international traffic in relation to the outbreak of the novel coronavirus 2019-nCoV.
  • Activation of R&D blueprint to accelerate diagnostics, vaccines, and therapeutics.
  • WHO has developed an online course to provide general introduction to emerging respiratory viruses, including novel coronaviruses.
  • WHO is providing guidance on early investigations, which are critical to carry out early in an outbreak of a new virus. The data collected from the study protocols can be used to refine recommendations for surveillance and case definitions, to characterize the key epidemiological transmission features of 2019-nCoV, help understand spread, severity, spectrum of disease, impact on the community and to inform operational models for implementation of countermeasures such as case isolation, contact tracing and isolation. The first protocol that is available is a: Household transmission investigation protocol for 2019-novel coronavirus (2019-nCoV) infection.
  • WHO is working with its networks of researchers and other experts to coordinate global work on surveillance, epidemiology, modelling, diagnostics, clinical care and treatment, and other ways to identify, manage the disease and limit onward transmission. WHO has issued interim guidance for countries, updated to take into account the current situation.
  • WHO is working with global health expert networks and partnerships for laboratory, infection prevention and control, clinical management and mathematical modelling.

RECOMMENDATIONS AND ADVICE

During previous outbreaks due to other coronaviruses (Middle-East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), human-to-human transmission occurred through droplets, contact and fomites, suggesting that the transition mode of the 2019-nCoV can be similar. The basic principles to reduce the general risk of transmission of acute respiratory infections include the following:

  • Avoid close contact with people suffering from acute respiratory infections.
  • Frequent hand-washing, especially after direct contact with ill people or their environment.
  • Avoiding unprotected contact with farm or wild animals.
  • People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands).
  • Within healthcare facilities, enhanced standard infection prevention and control practices in hospitals, especially in emergency departments.

WHO does not recommend any specific health measures for travellers. In case of symptoms suggestive of respiratory illness either during or after travel, travellers are encouraged to seek medical attention and share their travel history with their healthcare provider. Travel guidance was updated on 24 January.

January 28: WHO posted: “WHO, China leaders discuss next steps in battle against coronavirus outbreak

The Director-General of the World Health Organization (WHO), Dr Tedros Adhanom Ghebreyesus, today met President Xi Jinping of the People’s Republic of China in Beijing. They shared the latest information on the novel coronavirus 2019 (2019-nCoV) outbreak and reiterated their commitment to bring it under control.

Dr Tedros was joined by WHO Regional Director Dr Takeshi Kasai and Executive Director of the WHO Health Emergencies Programme Dr Mike Ryan, and also met State Councilor and Minister of Foreign Affairs Wang Yi and Minister of health Ma Xiaowei.

The National Health Commission presented China’s strong public health capacities and resources to respond and manage respiratory disease outbreaks. The discussions focused on continued collaboration on containment measures in Wuhan, public health measures in other cities and provinces, conducting further on the severity and transmissibility of the virus, continuing to share data, and for China to share biological material with WHO. These measures will advance scientific understanding of the virus and contribute to the development of medical countermeasures such as vaccines and treatments.

The two sides agreed that WHO will send international experts to visit China as soon as possible to work with Chinese counterparts on increasing understanding of the outbreak to guide global response efforts.

“Stopping the spread of this virus both in China and globally is WHO’s highest priority,” said Dr Tedros. “We appreciate the seriousness with which China is taking this outbreak, especially the commitment from top leadership, and the transparency they have demonstrated, including sharing data and genetic sequence of the virus. WHO is working closely with the government on measures to understand the virus and limit transmission. WHO will keep working side-by-side with China and all other countries to protect health and keep people safe.”

The WHO mission comes as the number of people confirmed with the virus rose to over 4500 globally on 28 January, the greatest number being in China.

The WHO delegation highly appreciates the actions China has implemented in response to the outbreak, its speed in identifying the virus and openness to sharing information with WHO and other countries.

Much remains to be understood about 2019-nCoV. The source of the outbreak and the extent to which it has spread in China are not yet known. While the current understanding of the disease remains limited, most cases reported to date have been milder, with around 20% of those infected experiencing severe illness. Both WHO and China noted that the number of cases being reported, including outside China, is deeply concerning. Better understanding of the transmissibility and severity of the virus is urgently required to guide other countries on appropriate response measures.

WHO is continually monitoring developments and the Director-General can reconvene the International Health Regulations (2005) Emergency Committee on very short notice as needed. Committee members are on stand-by and are informed regularly of developments

January 28: Nippon.com (News from Japan) posted “Japan Confirms 1st Coronavirus Infection without Visit to Wuhan”

A person in Japan has been confirmed infected with a new coronavirus despite not having visited the Chinese city of Wuhan at the center of the pneumonia outbreak, Japanese health minister Katsunobu Kato said Tuesday.

The infection marks the first time for the new virus to be confirmed in Japan from someone who did not travel to Wuhan, Hubei Province.

January 28: Australian Government Department of Health posted “Doorstop interview at the Peter MacCallum Cancer Centre”

GREG HUNT: Thank you very much. Okay, with the Chief Medical Officer Professor Murphy, we’ll give a quick update on coronavirus.

As of this morning, there are five confirmed cases in Australia of coronavirus. Other cases will continue to be tested by state health authorities and as results are known they will be made available publicly.

All of those five patients, we are advised, are stable, in isolation and under very high quality care.

Globally, on the latest figures available, 2800 patients have been confirmed and 80 deaths, but we expect that the Chinese and World Health Organization authorities will provide an update on those figures during the course of today.

Yesterday, the Prime Minister chaired a meeting of the National Security Committee to reaffirm all of the elements of our national preparedness.

The World Health Organization reviewed Australia’s preparedness two years ago as part of a global survey, and we were identified as being at the absolute global forefront of preparedness.

But all of those elements are being put in place now, and I will let Professor Murphy speak to those a little bit more.

In particular, the Australian Government, through the embassy, has also been in contact with Chinese authorities about Australians who are in Wuhan and the broader Hubei Province.

Significant progress, significant progress has been made overnight, and we are exploring all options with the Chinese authorities, both to ensure that there is support and care for Australians on the ground, and that there is a pathway to returning them home.

And the advice from the Foreign Minister shortly before coming to this event is that there has been significant progress.

So I want to thank the embassy and the Chinese authorities, and we will continue to ensure that we have strong broader protection, the highest quality medical care in the world, and action to protect and secure those Australians who are in Hubei Province in China. Brendan?

BRENDAN MURPHY: Thank you, Minister. So as the Minister said, given the update on the numbers, the main message that we’re trying to give still to the Australian public is that there is no cause for concern in the Australian public.

There is no human to human transmission of this virus. And it’s important to note because we had some media about masks today.

There is no need for the Australian public to wear masks. There is- the only people who should wear masks in relation to this virus are those who are unwell and have a relevant travel history.

Our most important thing now is for those who have come back from China in the last two weeks, whom developed flu-like symptoms, particularly if they’ve come from the Hubei Province of China, they need to call ahead to their GP or their emergency department, tell them of their travel history and get tested.

As the Minister said, we’re testing a large number of people across the country every day.

The vast majority of them are negative, as we always expected it to be, but we all do expect that it is likely we might find some more positives over the next few days, but we are extremely well prepared.

All of our state and territory health services have stood up teams to be prepared, their public health units have activated. We’ve got very, very good isolation facilities.

We now have very good diagnostic facilities; same day diagnostics- turn around in diagnosis in most parts of the country.

And we have also put up additional border measures that I outlined yesterday – in addition to every single flight from China, because this disease is now present in significant numbers in other parts of China, mainly from people who have come from the Hubei Province.

There’s no clear evidence that there’s human to human transmission in those other parts of China, but because people are appearing with the disease in other parts of China, every flight from China is being met and entered by border security officers and making sure that everyone on the flight gets information in English and Mandarin about the need to report their travel history, if they develop symptoms after they arrive, and obviously if they have any symptoms, they should declare themselves to a border security officer at the airport.

And we’ve had a three-fold increase in people reporting ill symptoms to border security officers. Mostly just trivial symptoms, but the message is getting out there.

So we are well prepared. We are still concerned about what is happening in China.

This outbreak is not under control. The Chinese authorities are doing a lot of things.

As we know, they’ve locked down the Hubei Province, very hard to get out of there. That’s the main focus of this infection at the moment, but we are reviewing things daily.

Yesterday, I convened the expert public Health Committees of the Commonwealth and states and territories to review all of our advice and all of the situations that are happening at the moment.

So I’ll leave it there, thanks Minister.

GREG HUNT: Yeah. Happy to take any questions.

JOURNALIST: When did you list coronavirus as a pandemic potential disease and (inaudible)?

BRENDAN MURPHY: So, we listed it as a listed human disease early last week, as soon as we received the data from the weekend before last that there was a very significant increase in numbers.

As you recall only 10 days ago, the Chinese were reporting only 50 cases and there’d been no new cases for a week. But over that following weekend, the numbers increased significantly.

Our concern was such that we knew we needed to have the capacity to make additional border measures. So I signed the determination to make the listed human disease early last week.

JOURNALIST: You’ve spoken about those enhanced border measures and people going (inaudible) boarding these flights, but would this also involve turning away flights from China?

GREG HUNT: Look, what I’ll do is speak to that very briefly. We will follow the medical advice without fear or favour. And so if the medical advice is that stronger action is needed, the Prime Minister, the Cabinet and the National Security Committee will adopt that immediately.

And so we continue to follow all of the advice.

I have to say, Professor Murphy listed this before the World Health Organization had declared it to be an epidemic of global significance, so he was ahead of the curve.

And again, to have people who are fearless in their advice and in their decision making is one of the great strengths of the Australian system, and I think that’s one of the reasons why the WHO recognized it.

JOURNALIST: (inaudible) to that point of having to turn away flights?

BRENDAN MURPHY: There – the Chinese are actually already, as I’ve said they’ve locked down the Hubei Province, which is the main epicentre. It’s impossible to get out of there.

They have already stopped organized tour groups leaving China. The Chinese are putting significant restrictions in.

Even if you stop all of the flights from China, there are ways to come from China via other ports.

So we are also putting in additional border measures for every flight that comes to Australia, putting out announcements and providing those printed materials for people that have come from other ports.

It’s essentially not practical to really close off all traffic in an international transmission of a virus. All of the cases that we’ve detected so far were- came here when there wasn’t major concern about the disease internationally.

They all came before that escalation, the weekend before last. All of them were perfectly well when they arrived. So the medical advice and the World Health Organization advice is that complete travel bans are not an effective additional measure.

GREG HUNT: Okay, thank you. I think there was one, or sorry there is one here.

JOURNALIST: There are five confirmed cases in Australia – without wanting to sound alarming, what are the chances there are going to be more?

GREG HUNT: Brendan?

BRENDAN MURPHY: My sense here is there will be more, but I wouldn’t be alarmed about that. Given the traffic of people before this escalated from that region of China to Australia, I would be reasonably confident that we’ll find some more cases over the coming days.

But we’re incredibly well prepared to test and isolate them when they appear.

JOURNALIST: Minister, there has been some (inaudible) that Australian health authorities had been slow to act behind the (inaudible), Singapore in terms announcing extreme measures. Do you think that that’s a fair assessment?

GREG HUNT: Well I think what you’ll see is that we’ve been helping to lead at the global level in relation to this.

The World Health Organization, as I say, has yet to declare this to be a pandemic of global significance.

The measure that we’ve taken has been in conjunction with the international organizations, in conjunction with the state health and territory authorities, and have come from constant engagement between Professor Murphy as the Chief Medical Officer of Australia and the medical community, as well as the state and territory communities.

JOURNALIST: The doctors, sorry, the (inaudible) practitioners are saying that they would like more masks in their practices, because of the brushfires, everyone is running low on masks, and if they have cases, they want to be able to protect against the spread.

They were under the impression that there’s a government stockpile of masks that’s going to be released. Is that something?

GREG HUNT: So there is a national medical stockpile of 12 million, in addition to those that were provided for brushfires where there is still significant reserves with the states and territories.

And Professor Murphy will say a little bit more in a second, but he’s been in contact with the College of General Practitioners and we’ll work to make sure that anybody who needs them, has them. Brendan.

BRENDAN MURPHY: Yes, thanks. I have spoken to the President of the RACCP this morning.

We’re investigating the supply situation to general practitioners. If it really is difficult and impossible for some of them to get them we’ll make sure they can get masks because we do want GP’s who sees someone with the relevant travel history is unwell to put a mask on the patient, and put a mask on the doctor and the staff when they’re assessing the patient — that is important advice.

So we need to be able to follow through what that, so we’re actively following that up with the college today.

JOURNALIST: You said that it might not be feasible to actually shut down flights but if need be would you also look at potentially quarantining people coming from China.

BRENDAN MURPHY: The expert advice is quarantining is not of practical public health value at the moment.

The advice of all the public health experts that convened yesterday remains the same – that people who have come from China should be treated like any normal member of the community unless they develop symptoms of fever, flu-like symptoms that could suggest this virus – and it probably won’t be.

But if they’re unwell, they must immediately wear a mask, ring forward to their GP or their emergency department.

But there is- most of the international advice — I know there’s been a bit of a story in the media about potentially some people being given slightly infectious before their symptoms — but all of the previous experience with these coronaviruses is that people are only infectious when they’re symptomatic.

So, our focus at the moment is identifying symptomatic people with that travel history and managing them and isolating them.

JOURNALIST: And after those initial symptoms, what will somebody with coronavirus experience (inaudible)?

BRENDAN MURPHY: We know that there are a very large number of mild cases. We suspect that in Hubei Province there are probably a large number of people who have never ever been diagnosed.

In Thailand, of the eight cases the have been exported to there, five have now gone home well.

The five people in Australia are in a very stable condition – in fact one of them is so well they’re long in hospital because of the quarantine requirements.

So, we know that 25 per cent of people reported from China do have a more severe illness with a pneumonia and we know there have been 80 deaths.

Now, the median age of those deaths is 71.5 years and the Chinese are reporting that many of them have elderly and have other comorbidities.

But the concerning development in that 25 percent is the development of a viral pneumonia and, obviously, there is no specific treatment for that other than respiratory support. But a lot of people do have mild disease.

JOURNALIST: Minister, we know there was a family in New South Wales who were tested yesterday morning for a coronavirus. Just confirming you’re (inaudible) with news about that this morning?

GREG HUNT: Yes. So, just before arriving here at Peter Mac we’ve had advice from both the New South Wales Minister for Health – Brad Hazzard — and the Department of Health that the family of four, they have all been tested and they’ve all received a clearance of a negative test.

So these are the preliminary results, but it’s good news so far.

JOURNALIST: Two questions, one quickly. Is there any other cases that are being likely to be confirmed at this stage?

GREG HUNT: Brendan.

BRENDAN MURPHY: Look, every day there are a number of cases who what we call meet the case definition. They have come from that part of China, they have relevant symptoms and they’re being tested.

But- so, there are potential positive cases every day. As I said, over the weekend, we only had one additional confirmed one after the reports on Saturday.

So, as I said, I expect to see more positives but there is nothing that we know of that’s a very strong likelihood at the moment.

GREG HUNT: Any – one more?

JOURNALIST: Sorry, I just want to ask when you said earlier that there’d been significant progress overnight about these Chinese in Wuhan. What’s that mean? Is that in terms of negotiating with the Chinese authorities? And will we be able to get them out?

GREG HUNT: Well, our work has been to provide support on the ground and then to provide a pathway home.

The Foreign Minister and the Embassy are working with the Chinese authorities and the advice I have from Foreign Minster Payne this morning, again just before coming here, is significant progress.

So, the Foreign Minister is working to ensure we have a pathway home for each and every one of those Australians. The timing is something that will be worked on with the Chinese authorities.

And this is part of a global challenge, but Australia has been working with countries such as the United States, the United Kingdom, and many others directly with the Chinese authorities.

And we are confident that given time we will get all of our Australians back and we are also working in the meantime to make sure that they have the best care, the best support on the ground.

JOURNALIST: Are we talking days or weeks?

GREG HUNT: I will leave that for the Foreign Minister.

JOURNALIST: The DFAT is compiling a list of people are currently in Wuhan.

GREG HUNT: Yes.

JOURNALIST: How many people have (inaudible) registered as being in that region?

GREG HUNT: So, again, the advice of the Foreign Minister just before coming here was approximately 400 calls have been received in terms of registration.

They are being crosscheck to ensure there is no double counting – because sometimes you will have, understandably, multiple family members report the same person.

So they are going through the process, but at this stage, approximately 400 registrations have been placed with Foreign Affairs.

JOURNALIST: Are you expecting an influx of Australians and nationals coming back from the Chinese New Year celebrations (inaudible) in terms of that?

GREG HUNT: Well we have the border protection measure in place. One of the things which the Prime Minister has ordered and instructed is to ensure that all planes coming from China are boarded by biosecurity officials, and that’s, I think, an extremely important measure.

So each and every passenger is met with and by biosecurity officials and that not only are they provided with information, but there is a review of their symptoms and situation.

JOURNALIST: Minister, I have been sent a text from one of the producers back in the office that they heard further ten student have been quarantines at a Queensland private school. Do you know anything on that?

GREG HUNT: No, I’m sorry. I don’t have any information on that.

JOURNALIST: Is Australia playing any broad role in patient diagnosis (inaudible)?

BRENDAN MURPHY: So we are very actively involved in the World Health Organization emergency response. We also have researchers at the University of Queensland who are actively involved in vaccine development, and we have staff in the WHO.

We have also offered to the WHO any assistance. We have assistance, medical assistance, teams and experts — obviously that’s a matter for the Chinese whether they take that up.

So, we have epidemiology experts who are participating nightly in modelling teleconferences with the WHO. So we are very actively involved. Okay.

GREG HUNT: Thank you very much.

JOURNALIST: And if I can ask you another couple of quick questions, Minister. Just given the scathing Auditor-General’s report into Bridget McKenzie and the fact that there’s now an investigation into her by the Secretary of the PM&C, how can she remain in the Minister?

GREG HUNT: Look, obviously the Prime Minister’s referred that to the Secretary of PM&C so I won’t (inaudible).

JOURNALIST: And did you have any knowledge of Senator McKenzie supplementing Sport Australia’s list of recommended clubs for funding within her – by herself given that it was being run from your department.

GREG HUNT: No, that was a process conducted by the Minister.

UNIDENTIFIED SPEAKER: Thanks everyone.

January 28: Nippon.com (News from Japan) posted “Chinese Buying Masks in Bulk in Japan amid Coronavirus Crisis”

Sales of face masks and other hygiene products have been surging in Japan amid the spread of pneumonia caused by a new type of coronavirus, with people from China, where the outbreak started, massively buying masks in particular.

“Chinese people living in Japan have bought 10 to 20 boxes of masks at once,” the manager of a drug store in Tokyo’s Chiyoda Ward said. As masks sell out as soon as they come back in stock, the store started on Tuesday to allow one customer to buy only one box.

At a different drug store, a Chinese woman in her 30s, who lives in Saitama Prefecture, north of Tokyo, said that she has already sent more than 100 boxes of masks to her family in Shanghai and will buy more because they are not available in the city.

At drug stores run by Weicia Holdings Co. <3141>, sales of masks in the latest week doubled from the preceding week.

A public relations official of the company said that masks are in high demand among both Japanese and Chinese people. Sales of antibacterial sprays and had sanitizers are also growing, the official said.

January 28: Football Federation Australia (FFA) posted “Women’s Olympic Football Tournament Qualifiers Update”

Football Federation Australia (FFA) was this afternoon notified of the latest advice from Australia’s Chief Medical Officer, Professor Brendan Murphy, regarding the coronavirus. The updated advice follows a meeting of the Australian Health Protection Principal Committee on Wednesday afternoon. This major new development confirmed that health experts believe the coronavirus is contagious before people show symptoms, and contacts of any confirmed cases must now be isolated following exposure.

The health and wellbeing of all players, staff and spectators is of paramount importance to both FFA and the Asian Football Confederation (AFC).

FFA is working with the Australian Government and AFC to explore ramifications of this advice and how it may affect the staging of the Women’s Olympic Football Tournament Qualifiers.

As a result of these developments, which came to light following today’s match schedule announcements, FFA will not be going on sale tomorrow with tickets for the tournament.

FFA will provide a further update as soon as possible.

January 28: New York State website posted “Governor Cuomo Issues Update on Novel Coronavirus as One More New Yorker is Identified for Testing Bringing Total to 10”

Governor Andrew M. Cuomo today announced an update on the status of testing for the novel coronavirus in New York State. As of today, the New York State Department of Health has sent samples for 10 individuals to the CDC for testing with seven found to be negative and three more still pending. So far, there are no confirmed cases in New York State.

“While we continue to closely monitor the spread of this novel coronavirus, I have directed our Department of Health to continue communicating with and providing updates to our local communities, healthcare providers, colleges, universities, and New York companies with locations or business interests in China,” Governor Cuomo said. “My message to New Yorkers is: takte this coronavirus seriously, take proper precautions, stay informed, but also feel confident that our Health Department and this administration are prepared and ready.”

The Department of Health continues to provide guidance to New York’s colleges and universities, many of which have international students from China, on how to identify the virus, update students, and promote prevention measures.

More information about the novel coronavirus is available here.

New York State Health Commissioner Dr. Howard Zucker said, “We encourage all New Yorkers to take normal precautions against sickness, such as regular hand washing and avoiding close contact with people who are sick. We will continue to work with our partners at the CDC and around the State as we assist in any way necessary to ensure the health of all New Yorkers.”

Symptoms of the novel coronavirus may include:

  • Cough
  • Sore Throat
  • Fever

While there is currently no vaccine for this novel coronavirus, everyday preventative actions can help stop the spread of this and other respiratory viruses, including:

  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.
  • Individuals who are experiencing symptoms and may have traveled to areas of concern, or have been in contact with somebody who has traveled to these areas, should call ahead to their healthcare provider before presenting for treatment.

January 28: U.S. Centers for Disease Control and Prevention (CDC) posted “CDC Advises Travelers to Avoid All Nonessential Travel to China”

On January 27, the Centers for Disease Control and Prevention (CDC) issued updated travel guidance for China, recommending that travelers avoid all nonessential travel to all of the country (Level 3 Health Notice). This warning is in response to an ongoing outbreak of respiratory illness caused by a novel (new) coronavirus (2019-nCoV) spreadking between people in many parts of that country.

Chinese health officials have reported thousands of 2019-nCoV cases in China, as well as severe illness including deaths. Sustained person-to-person community spread with this virus is reportedly occuring in China.

A number of travel-associated cases of 2019-nCoV infection have also been identified in other locations, including in the United States. In other parts of Asia, some limited person-to-person spread has been detected among close contacts of travelers returning from Wuhan, China, the epicenter of the outbreak, however, community spread with this virus has not been reported in locations outside China.

In the United States, there have been 5 cases of 2019-nCoV detected in travelers returning from Wuhan. No person-to-person spread has been detected in the United States at this time and this virus is NOT spreading in the community.

While it’s possible that some person-to-person spread with this virus may be detected in the United States, the goal of the ongoing U.S. public health response is to contain this outbreak and prevent sustained spread in this country.

Based on the current information, the immediate health risk from 2019-nCoV to the general American public is considered low at this time. However, risk is dependent on exposure and some people will have greater risk of infection, for example, healthcare workers caring for 2019-nCoV and other close contacts. CDC is aggressively responding to this serious public health situation to help protect the health of Americans. This response may cause disruptions in some people’s daily lives. This is unfortunate, but necessary to protect the health of Americans.

January 28: CBC News (Canadian Broadcasting Corporation) tweeted: “Death toll from the coronavirus in China now stands at 131, as health authorities confirm 25 new deaths in Hubei.”

January 28: CBC News posted an article titled: “Coronavirus deaths in China rise to 132 with confirmed cases nearing 6,000.” From the article:

Coronavirus: The latest

  • At least 132 deaths, all in China, according to China’s National Health Commission.
  • One death in Beijing, the rest in Hubei province, which includes the city of Wuhan.
  • 5,974 confirmed cases in China.
  • More than 50 million people locked down in containment efforts in China.
  • Most cases are in mainland China.
  • Eight cases in Hong Kong and five in Macao.
  • Other confirmed cases in: Taiwan, Australia, Cambodia, France, Germany, Japan, Malaysia, Nepal, Sri Lanka, Singapore, South Korea, Thailand, Vietnam, the United States and Canada.
  • Health officials in B.C. are ‘confident’ that first case of the virus has been found there.
  • The first American and Japanese chartered planes containing evacuees from Wuhan departed early Wednesday local time.
  • The European Union and Mongolia are also planning evacuations. Canada still working on its plan.

The death toll from the coronavirus outbreak in China rose to 132 early Wednesday local time, according to China’s National Health Commission, with the total number of confirmed cases across the country hitting nearly 6,000.

The news came as several foreign governments – including the European Union and Japan – were preparing to fly their citizens out of Wuhan, the locked-down city at the centre of the outbreak.

The updated death toll followed word from officials in Hubei province, where the first illnesses from the newly identified coronavirus occurred in December, that another 25 people had died there as of end-of-day Tuesday.

The National Health Commission said 1,459 new cases have been confirmed, bringing the total to 5,974.

The growing number of cases and deaths come as foreign governments began flying their citizens out of the affected area. A Japanese chartered flight carrying 206 evacuees landed at Tokyo’s Haneda International Airport Wednesday, not long after U.S. officials confirmed a flight of evacuees took off in the early morning hours.

Scientists grow virus

As news of the virus rise in cases, a team of scientists in Australia said on Wednesday they have successfully developed a lab-grown version of coronavirus, the first to be recreated outside China, in a breakthrough that could help combat the global spread of the illness.

The researchers at the Peter Doherty Institute for Infection and Immunity in Melbourne said they would share the sample, which was grown from an infected patient, with the World Health Organization and laboratories around the world.

“Having the real virus means we now have the ability to actually validate and verify all test methods, and compare their sensitivities and specificities,” said Julian Druce, the head of the institute’s virus identification laboratory, in a statement.

China’s increasingly drastic containment efforts began with the suspension of plane, train and bus links to Wuhan, a city of 11 million people. That lockdown has expanded to 17 cities with more than 50 million people in the most far-reaching disease-control measures ever imposed.

Hong Kong’s leader has announced that all rail links to mainland China will be cut starting Friday as fears grow about the spread of the coronavirus. Both the high-speed rail station and the regular train station will be closed, Hong Kong chief executive Carrie Lam said Tuesday. Ferry service will also be curtailed.

The EU is set to dispatch a second flight to get healthy European citizens from Wuhan, according to a statement by the European Commission. The disaster response was initiated at France’s request.

More than 100 EU citizens will travel on the second flight.

France’s government had already announced that it would organize return flights for both healthy citizens and those with virus symptoms, and that it would hold them in quarantine for 14 days after their arrival in France.

Mongolia and other governments were also planning evacuations for citizens in Wuhan.

On Tuesday afternoon, Foreign Affairs Minister Francois-Phillppe Champaigne said Canada is still working on its plans to get Canadians out of the affected area. He said 250 Canadians living there have registered online with Global Affairs Canada, with about 126 requesting consular assistance to get home.

China extended the Lunar New Year holiday by three days to Sunday to reduce the risk of infection by keeping offices and other factories nationwide closed and the public at home. The government of Shanghai, a global business centre and home to 25 million people, extended the holiday in that city by an additional week to Feb. 9.

The government has sent 6,000 extra medical workers to Wuhan from across China, including 1,800 who were due to arrive Tuesday, a commission official, Jiao Yahui, said at a news conference.

Wuhan is building two hospitals, one with 1,500 beds and another with 1,000 for the growing number of patients. the first is scheduled to be finished next week.

Global Affairs Canada has advised Canadians to avoid all travel to Hubei province, including the cities of Wuhan, Huanggang and Ezhou.

U.S. health officials expanded their recommendations for people to avoid non-essential travel to any part of China, rather than just Hubei province.

Air Canada said Tuesday it’s canceling “select flights to China to better match capacity with expected demand.”

“Air Canada currently operates 33 flights a week to China, and the resulting capacity reduction is relatively small,” airline spokesperson Pascale Déry told CBC News in an email. “Those customers who are affected will be notified and provided with alternate travel options. We continue to monitor the situation closely and will adjust accordingly.”

Mongolia closed its vast border with China, and North Korea said it was strengthening quarantine measures. Hong Kong and Malaysia are barring visitors from Hubei. Chinese travel agencies were ordered to cancel group tours nationwide.

Also Tuesday, the Education Ministry cancelled English-proficiency and other tests for students to apply to foreign universities. The ministry said the new semester for public schools and universities following the Lunar New Year was postponed until further notice.

In addition to the transportation restrictions with mainland China, Hong Kong officials announced some government offices would remain closed until at least Monday, and non-essential public employees were allowed to work from home.

Beijing’s official response has “vastly improved” since the 2002-03 SARS outbreak, which also originated in China, but “fears of a global contagion are not put to bed,” said Vishnu Varathan at Mizuho Bank in Singapore.

Scientists are concerned about the new virus because it is closely related to other diseases including SARS, which killed nearly 800 people.

So far, the new coronavirus doesn’t seem to spread as easily among people as SARS or influenza. Most of the cases that spread between people were of family members and health workers who had contact with patients. That suggests the new virus isn’t well adapted to infect people.

Countries with confirmed cases

China has reported eight cases in Hong Kong and five in Macao, and more than 45 cases have been confirmed elsewhere in the world. Almost all involve mainland Chinese tourists or people who visited Wuhan.

According to the U.S. Centers for Disease Control and Prevention (CDC), coronavirus cases have been confirmed in Taiwan, Australia, Cambodia, France, Germany, Japan, Malaysia, Nepal, Sri Lanka, South Korea, Thailand, Vietnam, the United States and Canada.

Three new cases of coronavirus have been reported in Canada, two in Toronto and one newly announced in British Columbia. The Toronto cases are a 50-year-old man and his wife who traveled to Wuhan. The husband, whose case has been confirmed by Canada’s National Microbiology lab, is considered “presumptive” pending confirmation by the lab, was at home in isolation and was “asymptomatic”as of Monday, according to health officials in Toronto.

In B.C., health officials announced Tuesday they are “confident” they have the first case of the coronavirus in the province. A man in his 40s who regularly travels to China for work tested positive late Monday. He lives in the Vancouver Coastal Health region and is in isolation at home. His case is also “presumptive” pending conformation of the test results from the National Microbiology Lab.

Five American cases — two in Southern California and one each in Washington state, Chicago, and Arizona, — are people who had recently arrived from central China. Health officials said they had no evidence the virus was spreading in the U.S., and they believe the risk to Americans remains low.

In Germany, Vietnam, Taiwan and Japan, the virus has spread person-to-person, rather than from a traveller arriving from China, heightening concerns.

During the SARS outbreak, Chinese authorities were criticized for reacting slowly and failing to disclose information. The government has responded more aggressively to the latest outbreak.

The coronavirus family includes the common cold but also more severe illnesses, such as SARS, and Middle East Respiratory Syndrome. The new virus causes cold- and flu-like symptoms, including cough and fever, and in more severe cases, shortness of breath and pneumonia.

The virus is thought to have spread to people from wild animals sold a Wuhan market. China on Sunday banned trade in wild animals and urged people to stop eating meat from them.

January 28: Billboard reported – Cantopop singer Leon Lai postponed his two shows in Macau, China. Lai’s Leon Metro Live 2.0 concerts were originally slated for Jan. 31 and Feb. 1 at Studio City Event Centre.

Promoter Live Nation announced the postponement of Miriam Yeung’s Feb. 8 concert in Singapore. The show, which was slated to take place at the Singapore Indoor Stadium, is postponed indefinitely, due to the travel and freight conditions in China.

American rock band X Ambassadors took to social media to announce that their Feb. 14 and 15 shows in Shanghai and Chengdu, respectively, were canceled.

January 28: ACLU posted “What You Need To Know About the Coronavirus Outbreak: A Civil Liberties Perspective” It was written by Senior Policy Analyst, ACLU Speech, Privacy and Technology Project – Jay Stanley

The World is watching anxiously to see what happens with the coronavirus that originated in Wuhan, China. As scientists and public health officials in the United States learn more about the virus, and as we all see how bad the outbreak turns out to be, it is important that public policymaking remain firmly centered around science.

Unfortunately our history of reactions to infectious disease outbreaks suggests that if this outbreak becomes severe, we’re likely to see strong pressure to the contrary. In particular, we can expect three things:

We can expect some to panic.

Unfortunately, there tends to be disproportionate hysteria and exaggerated fear around infectious diseases – especially when they are new. In 2009, the appearance of the H1N1 (aka “swine flu”) virus prompted some to call for measures like closing the U.S.-Mexico border, and enormously disruptive measure that, among other things, would have led to billions of dollars in lost economic activity. The H1N1 turned out to be no worse Ethan a normal strain of the seasonal flu virus.

In late 2014, many panicked over the Ebola outbreak ravaging West Africa, including a number of U.S. governors who imposed politically motivated quarantines on health care workers and others returning from West Africa. Those quarantines were completely unjustified by science. (In 2015 the ACLU, the Yale School of Public Health, and Yale Law School released a major report analyzing the response to Ebola.)

Every disease is different and merits different public health responses. A person infected with Ebola, for example, is not contagious until after fever and other symptoms begin. That appears not to be the case with the coronavirus, and scientists’ recommendations will no doubt differ as a result. But no matter how bad any disease outbreak may get, responding in ways that are not supported by science is never the right thing to do.

We can expect pressure for counterproductive responses.

Most panicky responses to disease outbreaks, according to epidemiologists and other experts, only make things worse. In particular, law enforcement-type approaches to stopping the spread of communicable disease such as forced treatment and large-scale quarantine are, as three preeminent public health experts put it, “generally acknowledged by experts to be either completely ineffective or only potentially marginally effective” in slowing the spread of disease.

Public panic will predictably spark calls for “tough,” even draconian measures that treat the problem like a law enforcement or national security issue rather than a public health matter. We at the ACLU have always acknowledged that civil liberties must sometimes give way when it comes to fighting a communicable disease – but only in ways that are scientifically justified.

And the public health community has learned over time that treating sick people like potential enemies only spurs them to “go underground” and avoid the authorities, which exacerbates the spread of disease. The evidence is clear that travel bans and quarantines are not the solution. Also counterproductive are the targeting and stigmatization of vulnerable populations, another historically frequent response to frightening epidemics.

We can expect that Trump will lead the panic, not calm it.

In previous disease scares, Donald Trump has been among the most panicky and scientifically undergrounded public voices in the United States. During the West African Ebola outbreak in 2014-15, he opposed allowing American doctors infected with the diseases to be airlifted back to the United States for lifesaving treatment (tweeting “KEEP THEM OUT OF HERE”). He also called for blocking all air traffic from West Africa.

As one expert advised in 2015, “Officials should avoid unrealistic reassurances or taking unnecessarily stringent measures so as to appear decisive.” Even in the earliest stages of the present outbreak, President Trump managed to violate the first half of that guidance, rashly and unrealistically telling the nation of the Wuhan virus, “We have it totally under control.” If things get worse, history suggests he’ll violate the second half as well and react with theatrical, counterproductive “toughness.”

The job of our political leaders is to solicit and follow the guidance of public health experts in crafting calm and rationale response to an outbreak, to help the public understand the scientific facts of this disease, and to present an honest and mature appraisal of risk and the limits of human power curb nature. Unfortunately, Trump and his administration have a terrible record when it comes to listening to scientists.

We don’t know how bad this outbreak will be. If this one is not severe, another one probably will be in the future. And the more dangerous an actual outbreak, the more important it is that our authorities respond with cool heads and based on science, and not intrude any more than strictly necessary on people’s civil liberties.

January 28: New South Wales posted “Save the Date to Vaccinate” app keeps kids safe

NSW Health is urging parents and carers to ensure children are vaccinated on time and has warned vaccinations shouldn’t be delayed even if a child has a minor illness.

Dr Jeremy McAnulty, Executive Director, Health Protection NSW encouraged parents and carers to download the Save the Date to Vaccinate app to ensure their children receive vital vaccinations in time for the start of school.

“On-time vaccination are the most effective way to protect children from life-threatening diseases,” Dr. McAnulty said.

“The free Save the Date to Vaccinate app reminds parents and carers what vaccinations their child needs and when they’re due, in like with the NSW Immunisation Schedule.

“If a child has a runny nose or a slight cold, they can still get vaccinated. Delaying vaccinations can leave children exposed to serious illnesses at a time when they are the most vulnerable.”

Dr McAnulty said the recent measles outbreak in Samoa, which has killed at least 83 people, is a salient reminder of just how dangerous vaccine preventable disease can be when immunisations rates are low.

Mother of two Lisa Smith, from Sydney’s north, said the Save the Date to Vaccinate app is a helpful reminder in a hectic schedule.

“I’ve never missed a vaccination with my first child but once I had my second child, I found it hard to stay on top of the key dates as I was just so busy with work and looking after two children,” Ms Smith said.

“The Save The Date to Vaccinate app sends automatic reminders to my phone, it’s made it so much easier to schedule immunisation appointments, not forget them and have a record to hand all of the vaccinations my children have received.

On-time vaccination and overall participation in childhood immunisation programs continues to improve in NSW, with 94.5 per cent of children fully vaccinated by five years of age in the past 12 months compared with 90.8 per cent in 2012.

Protecting children from potentially deadly diseases is a key priority for the NSW Government, which has invested approximately $130 million in the 2019-20 Immunisation Program budget, including Commonwealth and state vaccines.


January 29

January 29: Senator Elizabeth Warren (who was running for President) shared her “Preventing, Containing, and Treating Infectious Disease Outbreaks At Home and Abroad” plan.

PREVENTING TRANSMISSION AND PREPARING FOR OUTBREAKS

The best way to beat a pandemic is to prevent it from starting in the first place. As President, I will work to build the foundations that help us catch infectious diseases before they spread.

Build strong public health systems at home and abroad. Combating infectious diseases requires building health infrastructure that enables us to handle epidemics whenever and wherever they strike. Diseases do not recognize borders — we need a global approach to a global problem. To build strong systems we must:

  • Fund agencies that prevent and manage outbreaks. President Trump has repeatedly proposed billions in cuts to the agencies responsible for fighting and preventing pandemics, a devastating blow that would put lives at risk. Some of the deepest proposed cuts were to the Centers for Disease Control and Prevention (CDC), which runs essential pandemic prevention and response programs. As President, I will fully fund this work, ensuring that key agencies like the Department of Health and Human Services (HHS), the State Department, and the U.S. Agency for International Development (USAID) have the support they need to do their jobs.
  • Prepare health departments, health care providers and hospitals, and other facilities and frontline staff. We must increase funding for the Public Health Emergency Preparedness (PHEP) cooperative agreement that supports the critical work of health departments across the country to prepare for outbreaks, natural disasters, and more. Similarily, we must continue to support the Hospital Preparedness Program (HPP), which ensures we equip facilities and train staff on the front lines.
  • Fully Fund the Global Health Security Agenda (GHSA). Designed to build capacity in nearly 50 countries, the GHSA funds work in partnership with other countries to strengthen their public health infrastructure and combat outbreaks before they start. And in a few short years, it is clear that investment has paid off. Under President Trump, some of this work has ramped down, but we know that the ability to stop an outbreak requires consistent investment and support. As President, I’ll provide it.
  • Reduce transmission of infectious diseases at home. By reducing the transmission of communicable diseases like HIV and Hepatitis C, we keep families healthy and safe and strengthen our health system’s ability to respond to global pandemics. That’s why I have a plan to invest $100 billion to end the opioid epidemic, and why I’ve committed to end the domestic HIV epidemic by 2025 and ensure that patients can afford drugs like PreP and Hepatitis C treatments by acting on Day One of my presidency to lower drug prices.
  • Move to Medicare for All. When people can’t access basic health care, infectious diseases are more likley to spread and cause severe, lasting health effects — as we saw in the recent Indiana HIV outbreak. This is especially true in underserved communities, who experience the effects of outbreaks more severely. Under Medicare for All, everyone will have high quality health care they can afford, removing financial barriers for patients who may be contagious and need to seek care. We all benefit when we stop the spread of infectious disease faster.
  • Fully Fund critical existing global health work. U.S. investments in global health, including programs that combat HIV and AIDS, tuberculosis, and malaria help build capacity in countries around the world that enables them to better handle epidemics when they strike. As President, I will push to expand funding for the President’s Emergency Plan for AIDS Relief, which funds vital services for individuals with HIV or AIDS overseas and its a pillar of U.S. global health programs. I’ll also repeal the Trump administration’s heartless Global Gag Rule, which makes organizations that conduct or refer patients for abortion ineligible for global health funds — harming patients and reducing the capacity of other nations’ health systems.

Fight climate change. A changing climate means infectious diseases will spread to new places, and it’s already happening. In 2016, the Zika virus threatened more of the U.S. because changing climates mean the mosquitos that carry it now thrive further and further north. And Lyme disease is expected to increase by 20% in the next decade due to climate change. West Nile is projected to more than double by 2050 due to warming, costing upwards of $1 billion annually. Our health depends on fighting climate change. And I have a lot of plans for that.

  • Recommit to the Paris Agreement and invest in the Green Climate Fund. On Day One of my administration, I’ll commit the United States to rejoin the Paris Agreement, including meeting Obama era commitments to the Green Climate Fund — a critical funding stream to prevent the spread of climate fueled pandemics — and backfilling the contribution that the Trump administration failed to deliver.
  • Recognize interconnectedness of human, animal, and environmental health. When it comes to pandemics, we must think about how animal, human, and environmental factors interact. Last year the Trump administration shut down the Predict program to test animals for dangerous pathogens that could cross over to humans. As President, I would restore this essential work. And I will support new scientific research to help understand and predict the impact of warmer temperatures on disease emergence and transmission.
  • Invest in CDC’s Climate and Health Program. This essential program invests in adaptation for the effects of climate change on our nation’s health, but its budget only allows for programs that cover roughly half our population. Rather than follow President Trump’s attempts to kill this program, I will expand it to cover very American so no community is left behind.

Prioritize effective federal management. As President, I’ll take key steps to ensure that the agencies who handle outbreaks have clear leadership, responsibility, and support.

  • Restore White House leadership position for health security. President Obama created this position in response to the Ebola epidemic. In 2018, the Trump administration eliminated it – and I demanded answers. As President, I will bring it back, with a formal senior lead in my White House who focuses solely on global health security and oversees this work across the entire federal government.
  • Rebuild the State Department and USAID. American security and health depend on robust diplomacy and development assistance, but the Trump administration has declared war on the State Department and USAID. We must reverse the trend of declining American diplomacy and development aid by creating a 21st century foreign service and corps of development specialists. My plan to rebuild the State Department ensure that we have the diplomats we need leading our engagement with the world to help effectively manage outbreaks.
  • Build on the CDC’s legacy as the world and domestic leader in public health. The Strategic National Stockpile (SNS) holds our nation’s largest supply of medial countermeasures and medical supplies. Historically, CDC has managed SNS because it has the public health expertise to stock the right medical countermeasures and ensure they get to communities who need them during an emergency. In 2018, the Trump administration removed the SNS from CDC management in an ill-advised attempt to streamline response activities that could make it easier for drug companies to lobby for their products to be included. As President, I will move it back to optimize public health while ensuring coordination with other agencies.
  • Strengthen the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE). PHEMCE coordinates the federal government’s efforts to prepare for potential chemical, biological, radiological and nuclear threats, as well as from emerging infectious diseases. We must ensure the PHEMCE fully utilizes expertise from across agencies and reinvigorate its ability to prepare for and respond to emergencies.

Develop vaccines for infections diseases. The United States should join its peer countries and invest in the Coalition for Epidemic Preparedness Innovations (CEPI), a public/private global alliance focused on vaccine development, and actively participate in global coalitions working toward vaccine development. I have pushed the CDC to prepare for pandemic influenza, which must include the development of a universal flu vaccine — a necessity if we want to effectively fight the next strain of pandemic influenza…

January 29: Victoria State Government (Australia) posted “Second novel coronavirus case in Victoria”.

Victoria’s Department of Health and Human Services confirmed a second Victorian case of the 2019 novel coronavirus.

The man in his 60s, a Victoria resident, is isolated and recovering at home. He was confirmed as positive this morning following a series of tests after experiencing a respiratory illness.

After the positive result, the man was seen by doctors at the Monash Medical Centre in accordance with infection control procedures and was assessed as well enough to stay at home.

The Victorian man had traveled to Wuhan City, Hubei Province, China. The man first became unwell more than two days after returning from China. There is no current evidence that passengers or crew on the flight that the man took to return to Melbourne are at risk.

The department is monitoring five close contacts who live with the man. Two of the contacts are children who have been excluded from school…

January 29: The CDC reported the onset of 1 additional COVID-19 case in the United States.

January 29: World Health Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report – 9”

Highlights:

  • Four confirmed cases reported in United Arab Emirates, in individuals traveling from Wuhan City.
  • The World Health Organization (WHO), in collaboration with the World Economic Forum, has set up a public private collaboration called “The Pandemic Supply Chain Network (PSCN)” It is a Market Network that seeks to provide a platform for data sharing, market visibility and operational coordination and connecting.
  • Today, PSCN is launching the first of several teleconference calls with over 350 private sector organizations and 10 multilateral organizations to develop a market capacity and risk assessment for personal protective equipment (PPE). This assessment will be used as the basis to match the global demand for PPE with the global supply. The market and risk assessment of PPE is expected to be completed by 5 February 2020.
  • The Emergency Committee on the novel coronavirus (2019-nCoV) under the International Health Regulation (IHR 2005) is re-convened by the World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus on 30 January.

TECHNICAL FOCUS: Travel advice:

WHO has published travel advice for international traffic on 27 January. This document includes advice for individual travelers on general measures to reduce the risk of acute respiratory infection, as well as advice on health measures related to international traffic. Exit screening is advised for areas with ongoing transmission of the novel coronavirus 2019-nCoV (currently in People’s Republic of China).

Exit screening includes checking for signs and symptoms (fever above 38°, cough), interview of passengers with respiratory infection symptoms leaving the affected areas with regards to potential exposure to high-risk contacts or to the presumed animal source, directing symptomatic travelers to further medical examination, followed by testing for 2019-nCoV, and keeping confirmed cases under isolation and treatment.

The evidence from the past outbreaks shows that effectiveness of entry screening is uncertain, but it may support risk communication strategy by providing information to travellers from affected countries/areas to reduce the general risk of acute respiratory infections, and to seek medical attention early if they develop symptoms with the infection.

During the current outbreak with the novel coronavirus 2019-nCoV, a number of exported cases were detected through entry screening implemented by some countries. Symptomatic cases may be detected though temperature screening at Point of Entry, for whom medical examination and laboratory tests will be conducted for confirmation.

Temperature screening to detect potential suspect cases at Point of Entry may miss travellers incubating the disease or travellers concealing fever during travel and may require substantial investments. A focused approach targeting direct flights from affected areas could be more effective and less resource demanding.

If entry screening is implemented, temperature screening should always be accompanied by dissemination of risk communication messages at Points of Entry. This can be done through posters, leaflets or electronic bulletin aiming at raising awareness among travellers about signs and symptoms of the disease, and encouragement of health care seeking behavior, including when to seek medical care, and reporting of their travel history.

When implementing temperature screening, countries should take into account national policy and capacity considerations. Countries implementing temperature screening are encouraged to establish proper mechanism for data collection and analysis such as number of travellers screened and confirmed cases out of screened passengers, and method of screening.

WHO advises against the application of any restrictions of international travel based on the information currently available on this event.

Countries, territories or areas with reported cases of 2019-nCoV, 29 January 2020:

SURVEILANCE

  • China: 5997 (cases include cases confirmed in Hong Kong (8 confirmed cases), Macau SAR (7 confirmed cases) and Taipei (8 confirmed cases).
  • Japan: 7
  • Republic of Korea: 4
  • Viet Nam: 2
  • Singapore: 7
  • Australia: 7
  • Malaysia: 4
  • Cambodia: 1
  • Thailand: 14
  • Nepal: 1
  • Sri Lanka: 1
  • United States of America: 5
  • Canada: 3
  • France: 4
  • Germany: 4
  • United Arab Emirates: 4
  • TOTAL: 6065

Four confirmed cases reported in United Arab Emirates, in individuals travelling from Wuhan City.

PREPAREDNESS AND RESPONSE

  • WHO has been in regular and direct contact with Member States where cases have been reported. WHO is also informing other countries about the situation and providing support as requested.
  • WHO has developed interim guidance for laboratory diagnosis, clinical management, infection prevention and control in health care settings, home care for patients with suspected novel coronavirus, risk communication and community engagement.
  • Prepared disease commodity package that includes an essential list of biomedical equipment, medicines and supplies necessary to care for patients with 2019-nCoV.
  • WHO has provided recommendations to reduce the risk of transmission from animals to humans.
  • WHO has published an updated advice for international traffic in relation to the outbreak of the novel coronavirus 2019-nCoV.
  • Activation of R&D blueprint to accelerate diagnostics, vaccines, and therapeutics.
  • WHO has developed an online course to provide general introduction to emerging respiratory viruses including novel coronaviruses.
  • WHO is providing guidance on early investigations, which are critical to carry out early in an outbreak of a new virus. The data collected from the study protocols can be used to refine recommendations for surveillance and case definitions, to characterize the key epidemiological transmission features of 2019-nCoV, help understand spread, severity, spectrum of disease, impact on the community and to inform operational models for implementation of countermeasures such as case isolation, contact tracing and isolation. The first protocol that is available is a: Household transmission investigation protocol for 2019-novel coronavirus (2019-nCoV) infection.
  • WHO is working with its networks of researchers and other experts to coordinate global work on surveillance, epidemiology, modelling, diagnostics, clinical care and treatment, and other ways to identify, mange the disease and limit onward transmission. WHO has issued interim guidance for countries, updated to take into account the current situation.
  • WHO is working with global expert networks and partnerships for laboratory, infection prevention and control, clinical management and mathematical modelling.

RECOMMENDATIONS AND ADVICE

During previous outbreaks due to the coronavirus (Middle-East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), human-to-human transmission occurred through droplets, contact and fomites, suggesting that the transmission mode of the 2019-nCoV can be similar. The basic principles to reduce the general risk of transmission of acute respiratory infections include the following:

  • Avoiding close contact with people suffering from acute respiratory infections.
  • Frequent hand-washing, especially after direct contact with ill people or their environment.
  • Avoiding unprotected contact with farm or wild animals/
  • People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands.)
  • Within healthcare facilities, enhance standard infection prevention and control practices in hospitals, especially in emergency departments.

WHO does not recommend any specific health measures for travellers. In case of symptoms, suggestive of respiratory illness either during or after travel, travellers are encouraged to seek medical attention and share their travel history with their healthcare provider.

January 29: President Donald Trump tweeted: “Just received a briefing on the Coronavirus in China from all of our GREAT agencies, who are also working closely with China. We will continue to monitor the ongoing developments. We have the best experts anywhere in the world, and they are on top of it 24/7!”

January 29: Centers for Disease Control and Prevention (CDC) posted “Transcript of 2019 Novel Coronavirus (2019-nCoV) Response”

Operator: Welcome and thank you for standing by. Today’s conference is being recorded. If you have any objections you may disconnect at this time. All participants are in a listen-only mode and to the question and answer session of today’s presentation. To ask a question at that time, pleas press start one. I would like to turn the call over to your host Benjamin Haynes, thank you.

Haynes: Thank you, Michelle, and thank you for joining us for today’s briefing, I am joined by Dr. Nancy Messonnier, director of CDC’s national center for immunization and respiratory diseases, who will provide opening remarks before taking your questions. I would now like to turn the call over to Dr. Messonnier.

Messonnier: Thank you for joining us today. I’m pleased to give an update on the ongoing 2019 novel coronavirus situation in the united states. As promised, we updated our web site earlier today with our lab results. This morning, we have 165 persons under investigation or PUIS with 68 persons testing negative and only 5 confirmed positive.  The remainder are samples in transit or being processed at CDC for testing. 

We have uploaded the full genetic sequence for all five viruses detected in the united states to date, and we’re working quickly through the process to get the CDC -developed test into the hands of public health partners in the united states and internationally. 

CDC is expanding entry screening to 20 U.S. Ports of Entry where CDC have quarantine stations.  Also, in collaboration with customs and border protection, CDC is expanding distribution of travel health education materials to all travelers from china.  350,000 travel education cards are ready for distribution. 

The good news here is that despite an aggressive public health investigation to find new cases, we have not.  The situation in china is concerning. However, we are looking hard here in the united states. We will continue to be proactive. I still expect that we will find additional cases. 

Another development today, the federal government was able to successfully return a plane full of U.S. Citizens living in Wuhan, china to this country. We have taken every precaution to ensure their safety while also continuing to protect the health of our nation and the people around them. 195 passengers have been screened, monitored and evaluated by medical personnel every step of the way, including before takeoff, during the flight, during a refueling in Anchorage, Alaska, and again in California.  Twenty CDC staff are present to help manage this process. 

All of the 195 passengers are without the symptoms associated with novel coronavirus. And all have been given assigned living quarters at the air force base. All of the 195 have agreed to remain on base voluntarily. CDC has now begun a second stage of further screening and information gathering from the passengers. The passengers will be offered testing as part of this thorough risk assessment. And samples will be sent to CDC.  We will be processing them with the appropriate speed. 

I want to thank everyone who worked so hard over these past few days to bring these Americans home.  I heard that the people on board cheered loudly when the plane touched down safely in anchorage.  I want to thank those now safely returned from Wuhan for their cooperation and patience as we safeguard their health and the health of all Americans. 

I understand that many people in the united states are worried about this virus and whether it will affect them. Outbreaks like this are always concerning. Particularly when a new virus is emerging, but we are well prepared and working closely with federal, state and local partners to protect our communities and others nationwide from this new public health threat.  At this time, we continue to believe that the immediate health risk from this new virus and the general American public is low.

Haynes: Thank you, Dr. Messonnier, Michelle, we are ready to take questions.

Operator: Our first question will come from mike stobbe with ap, your like is now open.

Stobbe: Hi, thank you for taking my call. Yeah, thank you, doctor. I wanted to ask you, there was a press event from Riverside, and it was a little confusing. First of all, you used the number 195. The number 201 has been used earlier. Are you saying it was actually 195 people on the flight?

And the people who, from the flight, could you tells us exactly what the restrictions are for those folks at the base? You have already said that they’ve all agreed, but there was supposed to be a three-day period, and there was some confusion about whether if someone decided they wanted to leave before three days even if there isn’t a federal quarantine order, are they allowed to do that?

And why three days? How did you all arrive at three days if the incubation period is up to 14 days according to a paper in the “New England journal today” is five days, and the flight was supposed to go to the Ontario airport. Whose decision was it to divert it to the Air Force base and why was that decision made? Thank you.

Messionnier: Sure. So, I know that the numbers have been confusing and as you know, we pride ourselves on precision. Some of it is the desire to communicate quickly. So, the correct number is 195 passengers. It’s 195 passengers who have been screened.

Thanks also for the opportunity to clarify around what the status of the travelers are. You know, quarantine is a regulatory authority. It’s used to isolate someone because they post a threat to the health of their family or their community. In this instance, we have 194 travelers who are willingly undergoing isolation for the purpose of medical evaluation and investigation of their risk assessment. These passengers are happy to be back in the United States. We at CDC are happy to help them return to their communities at the completion of their risk assessment.

All of the parties are committed to reducing the spread of this illness, so the 72 hours, you know, we hope that we will be able to assess their risk more quickly than that, get these patients through the process after giving them perhaps a little time to rest and recuperate and we’re trying to make sure that we can get them on their way as quickly as possible, knowing that it may take a little while to fully assess their risk, which is something we’re doing jointly with these passengers, so we’re hoping to give them and us a little time to make sure we take our time to do this risk assessment fully, but also mindful of the stress that these passengers have been under. We also want to recuperate before we ask them the detailed set of questions that we think will help us help them make the appropriate risk assessment.

Haynes: Next question, please.

Operator: Next question will come from Eden David with ABC news medical unit; your line is now open.

David: Hi, thanks for taking the time to update us, so I understand that you are isolating these particular 195 passengers but what about the commercial flights that are still coming in from china? You’re not isolating them or why the extra precautions for this specific – this specific subset of passengers and what would be your comment on why you’re not taking the same initiative for the commercial fights coming in?

Messonnier: Thanks for the opportunity to clarify. These are passengers from Wuhan, and the number of travelers coming from commercial airlines from Wuhan has drastically dropped in the past days since the airport at Wuhan was closed. So, the numbers of passengers directly coming from Wuhan drastically dropped.

We are still doing active screening of any passenger who was coming from Wuhan in the five airports where we initially set that up, and the kind of screening we’re doing is in the same category as this screening. It is a similar risk assessment where we’re understanding where they’ve been, who they’ve been in contact with. Of course, looking for any medical illness and quantifying their risk into the set of categories that help us define the next steps.

These passengers are undergoing something similar. It is more detailed, partly because of what’s been going on in Wuhan the past few days. And because of their situation, we thought that out of the desire to make sure that they have time to rest and recuperate before they’re getting asked those questions, we wanted to make sure that they had a place where they could safely do that. And this offers us that place. It is in the same kind of setting that we’re offering risk assessment for other passengers coming back from Wuhan as well as anybody in the united states.

For example, the individuals who have been identified as close contacts of the confirmed patients were also stratifying their risk as well, and our guidance for those individuals differs based on their risk. For example, somebody who was directly in close contact of a coughing patient with Wuhan would have a higher risk of somebody for example who passed them on the street a week before they became ill. But all of those people are at risk, but the risk is different, and in these returning travelers, these 195 people, we want to take our time to make sue we fully assess their risk, and that we have worked with the people to do it.

Again, I want to compliment them. I also want to thank the folks from Alaska as well as California who have been with us every step of the way. We appreciate their patience. As we said before, the cooperation of the patients with this novel coronavirus as well as their close contacts, as well as their – these other travelers are essential for us to be able to protect the health of these people, the health of their families and the health of the communities.

Haynes: Next question, please.

Operator: Next question will come from Eben Brown with FOX News, your line is open.

Brown: Thank you, Dr. Messonnier, for doing the call this afternoon. It’s been mentioned that the screening is being done at 20 airports or at 20 metro areas where the CDC has their standing quarantine stations but is it just only airports or will there or are there screening stations underway at sea ports or land-based border crossings? I mean, it’s always possible someone could have flown from china to Cancun, got on a cruise ship and came to Miami. Is that something that’s being addressed or what would be the criteria to start addressing those types of scenarios?

Messionnier: Sure. Thank you. So, I actually think it’s a great opportunity to differentiate the active enhanced screening that we were doing a the five airports for folks coming out from Wuhan from what we’re doing to enhance the screening at these 20 quarantine stations.

So as part of our regular business at those 20 quarantine stations we look at work with customs and border protection to identify people who are returning to the United States with illness. That is part of our regular business and at these 20 quarantine stations, what we’re actually doing is enhancing the staffing at those airports so we can do more of that illness detection. It’s called a standard illness protocol. Part of our normal business, but we’re enhancing those activities.

There are two of the 18 airports actually include two land borders that are also quarantine stations and also searching for illness response. Detecting people that come into the United States ill is part of our normal business, and it’s relevant here, but we should remember that some of our five cases weren’t ill when they crossed back into the United States. They became ill later.

So it’s equally important to use that opportunity and for CDC to work with cbp to provide all of these returning passengers educational materials, those educational materials specifically point out what the signs and symptoms of novel coronavirus are and we tell them if they have a fever and they have respiratory symptoms, specifically a cough they need to contact their health care provider. This is part of the method we use in a layered approach to try and protect all of us from any such illness that comes into the United States.

Haynes: Next question, please.

Operator: Our next question will come from Richard Harris from npr. Your line is now open.

Harris: Thanks, I’ve got two quick questions, one of which is, if these folks get screened with the CDC’s pcr test, and they call come back negative is there any biological reason to continue to 14-day surveillance of them or is that just, is that belts and suspenders up because it would seem like everyone’s negative for carrying the virus, that would be end of story. And the second question is about WHO. Which today said CDC would not be part of their new scientific efforts to go into china and learn more, and I was wondering if the CDC has any progress to report on getting a CDC team into china. Thanks.

Messonnier: Sure. The answer to the first question is we’re being appropriately cautious as one should be when there is a new virus with which we only have limited experience, and so we really make sure that there’s appropriate monitoring. As we’re doing for all of the — as we’re doing for all of the close contacts of the confirmed cases in the United States, and so I think it’s — I wouldn’t call it belts and suspender, I would call it an appropriate degree of caution for a new disease.

As we learn more about the disease from investigations here in CDC, as well as around the world, our procedures may change but right now we’re taking what we consider to be an appropriately proactive and cautious approach around potential contacts as well as around travelers.

In terms of the — in terms of the WHO, I don’t know that that’s a confirmed report, and actually, we expect that we will be invited to be part of the this WHO expert group, so we actually will, as I understand it, we are working with WHO to put together a team to go to china as soon as possible and we’ll provide an update on the team’s departure as well as activities when more information becomes available.

Haynes: Next question, please.

Operator: Next question will come from Erica Edwards from NBC, your line is open.

Edwards: Hey, thank you. I have two quick things. One is just to clarify something that was said earlier. I know that the number of passengers changed from 201 to 195. Can we assume that the other six were crew members? And also, I’m wondering if you can say anything more about the close contacts in the confirmed cases here in the U.S., particularly that patient in Washington state? I believe we’re at or near the end of the 14 days since he arrived back in the U.S. Is that person still hospitalized and if so, why?

Messionnier: Yeah, so the 195 is the correct number. The other people on the plane were state department employees, medical officers and pilots. In terms of clinical status of the patient in Washington state, as I said before, you would really need to direct that question to the state heath department, but just know that we are actively engaged with these patients and their clinical care making recommendations to their clinicians and the health department as to how long they need to stay in hospital. I think that as you can imagine, with a new disease, we are being cautious and I think their clinicians in their health departments are being cautious as we learn more, but those decisions will be coming from the state health department, local decision, not from CDC. over.

Haynes: Next question, please.

Operator: Our next question will come from Nathan Weixel from The Hill, your line is now open.

Weixel: Thanks for taking my question. I just wanted to clarify, just about whether CDC is actually going to be part of this WHO Group, you don’t know that you’re a part of it yet or you don’t know that you’re going to china, you just expect that?

Messionnier: So, the information that I have right now is that we are invited to be part of the WHO mission and that we are working with WHO through the particulars of that team. I think there are logistic questions and such about this, but again, my understanding is that there has been preliminary outreach and that CDC at this point, the plans are to include CDC as part of that team.

Haynes: Michelle, we have time for two more questions.

Operator: Our next question will come from Lisa Krieger from San Jose Mercury News, your line is open.

Krieger: Yes, hi, thank you very much. Granted that the travel to Wuhan is the single greatest risk factor, I wonder if you could answer a reader’s question about how do I tell the difference between, you know, symptomatically between a cold, the flu and a new coronavirus?

Mesionnier: I actually think that’s a really important question for the American public because the symptoms of this disease early are over and cough and respiratory disease, and as I think your readers astutely pointed out, that is similar wi what we say as the early symptoms of influenza as well as other viral respiratory diseases.

That’s why it’s really important for Americans to know right now that the risk factor that we have identified in the United States are travel to Wuhan, but he second group of people that we’re especially concerned about are people who are close contacts of people who are traveling to — who have traveled to Wuhan, and that’s why the health department is working with CDC, have been —

I’m sorry, it’s Hubei province. You said Wuhan so I said Wuhan, but the answer is people who have traveled to Hubei province, and other countries that already identified cases among those groups that have had close contact with people who have traveled and that’s why we have been working with our state health departments to be very proactive and aggressive in identifying potential contact of confirmed patients and monitoring them closely. That is, you know, we expect to see additional cases in the United States.

We think there could be travelers returning from Hubei Province, but we also think that it’s likely we may have cases among close contacts of patients that, but right now, there is no sign in the United States that we have broader community transmission, and that’s why people who are not in one of those groups either traveling themselves or having close contact with a confirmed case, we don’t think those Americans need be especially concerned, because we judged the risk in the general American public to be low.

Haynes: Last question, please.

Operator: and our last question will come form Issam Ahmed with AFP, your line is now open.

Ahmed: Hi, Nancy, just another clarifying question, so it’s the volunteer isolation period is 72 hours, and then what was the 14 days for, and I’m sorry, and will everybody have to submit a specimen or is that also voluntary, which will be tested at CDC?

Messonnier: I’m sorry if some of this got confusing as we tried to work quickly through a complex problem. We said it might take up to three days because we thought it might take up to that long for us to do a full risk assessment with these returning travelers and built in there some time to make sure that they also had enough time to rest and recuperate after what sounds like a difficult ordeal.

So, we said up to three days because we thought that gave us a little room to make sure that had enough time to do all the things we needed to do. It’s not a specific time line. It is a period of time for our medical officers who evaluate each patient. Each passenger in giving the passengers time to work things through with us as quickly as possible.

What I can say in general is that we are working with — we at CDC are working as quickly as we can to return our fellow Americans to their lives but we also want to make sure we’re doing it in a way that no one represents a risk to themselves or their families or their communities and right now, 195 of these travelers are willing and eager to cooperate because they also want to make sure that they’re taking care of their own health, the health of their families and the health of their communities.

So, they are voluntarily cooperating with us, and in these kind of situations, that’s in general how our fellow Americans react. They want to make sure that they’re protecting themselves and their communities and we want to compliment them on their eagerness to help, and we have full expectation that we’ll continue to have that kind of cooperation.

Haynes: Thank you, Dr. Messonnier, and thank you all for joining us for today’s update. Please visit the 2019 novel coronavirus web page for continued updates and if you have further questions, please contact the main media line at 404-639-3286 or by e-mail at media@cdc.gov. Thank you.

Operator: This concludes today’s conference, all participants may disconnect at this time. Please disconnect at this time. Thank you.

January 29: Reuters posted: “Japan plane evacuating citizens arrives Tokyo from virus-hit Wuhan”

A chartered plane carrying 206 Japanese nationals evacuated from Wuhan the epicenter of China’s coronavirus outbreak, arrives at Tokyo’s Haneda airport on Wednesday, as the death toll from the new strain rose to 132.

Japanese Foreign Minister Toshimitsu Motegi said on Tuesday that 650 Japanese citizens were hoping to come home, and the government was making arrangements for additional flights.

Prime Minister Shinzo Abe has stressed that the government will explore all possible measures to bring back all those citizens who want to return to Japan.

January 29: Nippon.com (News from Japan) posted: “Chartered Plane Arrives in Wuhan to Bring Japanese Home”

An All Nippon Airways plane chartered by the Japanese government arrived at an airport in Wuhan late Tuesday night local time on a mission to bring home Japanese nationals from the city in China’s Hubei Province following the outbreak of pneumonia caused by a new type of deadly coronavirus in the country.

The airplane operated by the major Japanese carrier will ferry some 200 people, who will be the first group of Japanese to be evacuated from the Chinese city at the center of the outbreak using government-charted aircraft.

The ANA plane will depart from the Wuhan airport in several hours and arrive back at Haneda on Wednesday morning. Returning in the first group will be mainly people with high risks of infection, including those living near the outbreak epicenter.

For the first round of airlifting operations, the plane left Haneda for Wuhan on Tuesday night, also carrying relief goods, such as face masks and protective suits, for supply to the Chinese side.

As of Tuesday, some 650 Japanese nationals in Hubei said they wish to return to Japan, according to the government.

January 29: New South Wales Health posted “Novel Coronavirus Statistics -10am

The situation is continually evolving.

NSW – number of cases confirmed – 4

NSW – number of cases under investigation – 6

We will not be disclosing the hospital locations of patients under investigation for privacy reasons.

January 29: AP News posted: “Japanese evacuation flight brings back workers from Wuhan”

The first group of Japanese evacuees from a virus-hit Chinese city arrived in Tokyo on Wednesday, a dozen of them with cough and fever including two who were later diagnosed with pneumonia.

Five of the 206 evacuees were taken to designated Tokyo hospitals specializing in treating infectious diseases, Prime Minister Shinzo Abe told a parliamentary session, adding that they were still checking if any passengers were ill with the virus.

Two who had pneumonia were not yet linked to the new coronavirus, Tokyo city officials said. All five patients, being treated at two Tokyo hospitals, were stable, hospital officials said.

Later Wednesday, seven other evacuees who cleared an earlier screening on board were also found to have coughs and fever in a secondary screening and were hospitalized, the Ministry of Health, Labor and Welfare said in a statement. The remaining evacuees who had no symptoms were taken to a hotel where they will be quarantined.

Officials said about 650 Japanese citizens and their families in Wuhan and elsewhere in Hebei province had sought to return home. Aoyama said there are more than 400 others still in Wuhan, including those working for a Japanese supermarket chain that has stayed open to serve customers who need food and other necessities and supplies.

He said it was important to step up preventative measures in Japan, but “I hope we can also provide support for the Chinese people, while we also help Japanese people who are still there.”

Another evacuee, Takayuki Katy, said that all those wishing to leave Wuhan had submitted their health inquiry form and had their temperature taken before departure. While on board, a doctor came to each passenger to take temperature again and check their condition, he said.

Kato said he did not panic as he was able to monitor the news online and via local media, but “I was shocked when all transportation systems were suspended. That’s when the situation drastically changed.”

Aoyama and Kato, along with the rest of the evacuees who were not showing immediate signs of infection, were expected to be taken to the National Center for Global Health and Medicine for further checks and a virus test.

Health officials said the evacuees will be sent home on chartered buses to keep them from using public transportation and stay home for about two weeks until their virus test results are out, though it’s not legally binding. Others who need to travel long distance home are asked to stay at designated hotels.

Abe’s Cabinet designated the new coronavirus as an infectious disease Tuesday, allowing hospitalization and treatment of the patients compulsory, but the measure is taking effect Feb. 7 because of the required 10-day notification period, causing concerns that it may be too late.

Former Defense Minister Gen Nakatani told a ruling party meeting that “if you abide by law and people die, it’s useless,” Kyodo News quoted him as saying.

Foreign Minister Toshimitsu Motegi told the parliamentary session Wednesday that the government would have to send two more flights to evacuate the rest of the people wishing to return home.

Japan’s government said it will send another chartered flight to evacuate the others later Wednesday.

January 29: PolitiFact posted: The White House forms a coronavirus response task force, initially led by Health and Human Services Secretary Alex Azar.

January 29: Nippon.com (News from Japan) posted “Toyota to Keep China Plants Closed until Feb. 9”

Toyota Motor Corp. <7203> will keep its plants in China closed until at least Feb. 9, in response to the spread of a new coronavirus in the country, company officials said Wednesday.

Whether to reopen the plants on Feb. 10 depends on the situation, one of the officials said.

Toyota has four auto assembly plants in China.

Previously, the company planned to reopen a plant in Tianjin on Monday, and a plant in Guangzhou on Tuesday after suspensions during the Lunar New Year holiday.

Toyota said that it will donate 10 million yuan to the Red Cross Society of China to help finance its purchases of medical supplies such as masks.

January 29: Australian Government Department of Health posted “Australian Health Protection Principal Committee (AHPPC) statement on novel coronavirus on 29 January 2020.”

AHPPC provides the following advice to the Australian community following advice from the Communicable Diseases Network Australia.

AHPPC is aware of:

  • very recent cases of novel coronavirus who are asymptomatic or minimally symptomatic and
  • reports of one case of probable transmission from a pre-symptomatic case to other people, two days prior to the onset of symptoms.

These data are very limited and preliminary and AHPPC still believes that most infections are transmitted by people with symptomatic disease. However, AHPPC believes that we should take a highly precautionary approach and is making the following new recommendations:

  1. People who have been in contact with any confirmed novel coronavirus cases must be isolated in their home for 14 days following exposure;
  2. Returned travellers who have been in Hubei Province of China must be isolated in their home for 14 days after leaving Hubei Province, other than for seeking individual medical care.

Given the lower number of cases in China reported outside Hubei province, we do not currently recommend self-isolation for travellers from other parts of China or other countries. We are closely monitoring the development of cases outside of Hubei province and will update this advice if necessary.

AHPPC recognises that the evidence for pre-symptomatic transmission is currently limited, and this policy is highly precautionary. At this time, the aim of this policy is containment of novel coronavirus and the prevention of person to person transmission within Australia.

Further details of the extent of pre-symptomatic transmission is being monitored, and may result in changes to policy.

Summary of evidence to support the revised advice

New international evidence suggest that asymptomatic or minimally symptomatic infection can occur, and that pre-symptomatic transmission has occurred in at least one case cluster.

1. German case cluster: It has been reported that participants at a workshop in Munich had contact with a woman on 21 January. This woman, who had been in Wuhan, became symptomatic on 23 January and diagnosed following return to China. Four workshop attendees, with no travel history to China, have been confirmed with nCoV and several more are under investigation.

2. A 10 year old child reported in a case series was noted as having no fever; although it is likely that this case may have had a cough sufficient to produce PCR positive sputum.

3. A Japanese person reported as a case was a bus driver who transported Chinese passengers from Wuhan. The Japanese person had no history of travel outside Japan. None of the passengers were known cases.

4. Several Chinese language media reports have detailed transmission from pre-symptomatic cases, but no confirmatory evidence has been published.

5. WHO Sitrep (#8) states that 3 of 58 cases diagnosed outside China were asymptomatic.

January 29: Nippon.com (News from Japan) posted “More Aircraft May Fly to China Soon to Evacuate Japanese”

The Japanese government is in the final stages of arrangements to send additional chartered aircraft on Wednesday night to evacuate expatriates from China’s Hubei Provence, at the center of the outbreak of a new strain of coronavirus that has caused pneumonia among a number of people.

The cabinet of Japanese Prime Minister Shinzo Abe will decide on Thursday to set up a task force to be headed by him to stop the new coronavirus from spreading further in the country.

According to the government, some 650 Japanese nationals in China province are wishing to return home via government-chartered flights. Of them, 206 returned on the first such flight on Wednesday morning.

“We’ll continue to take every possible measure to bring home all of the people hoping to come back to Japan,” Abe said at a meeting of the Budget Committee of the House of Councillors, the upper chamber of the Diet, Japan’s parliment, on Wednesday. The government will also work on preventing the spread of the virus in Japan, he added.

In Japan, seven people, including one Japanese, were confirmed to be infected with the new virus.

January 29: The Desert Sun posted: “Over 200 US evacuees from coronavirus epicenter begin 72-hour evaluation period at March Air Reserve Base”. It was written by Colin Atagi.

As more than 200 U.S. evacuees from the epicenter of the coronavirus outbreak in China began a sequestered, 72-hour evaluation period at March Air Reserve Base on Wednesday, health officials assured the public that the risk of a similar outbreak in the United States is “very low”.

“There’s a lot about this virus that we don’t know. But, something that we also have to keep in mind is that these folks need to come home… The risk to the public remains low and we aim to keep it that way,” said Dr. Cameron Kaiser, Riverside County’s public health officer.

A contingent of federal, state and county health experts took questions from reporters Wednesday after a chartered plane filled with U.S. diplomats, their families, and other U.S. citizens who were in Wuhan, China, landed at the air force base near Morano Valley.

Authorities said the 210 passengers passed numerous screening tests to determine if they were exhibiting symptoms of the illness before being allowed on the plane, which stopped briefly in Anchorage, Alaska, where another series of screening tests were administered before continuing on to the Southern California air base.

Government officials made the decision to bring the passengers to Riverside County, although none of the passengers are from the county.

“The coronavirus is spreading rapidly, we think, in China and we think it is appropriate that our citizens who are in the epicenter of that outbreak in Wuhan be repatriated home for their own safety,” said Dr. Chris Braden, deputy director of the National Center for Emerging and Zoonotic Infectious Diseases with the U.S. Centers for Disease Control and Prevention.

The illness has sickened at least 5,500 people and is responsible for 132 deaths around the world.

Health officials said there are 60 cases in 13 other countries outside of China, including five in the United States. None of the five are in Riverside County.

Authorities said the evacuees are isolated from military personnel on base. For at least the next three days, they will be monitored twice a day for fever and other symptoms.

“There (will) be no interaction between those people on the base in the military and these passengers. There is a cordon that is there that we have established for the passengers. There are federal marshals there to keep everyone safe,” Braden said.

“At the end of three days, we think we’ll have enough information to know their status and their risk,” he added.

Officials said the passengers who don’t exhibit symptoms in those first 72 hours will be able to travel to their home states and on to their families or residences. They will, however, continue to be monitored for a maximum of 14 days.

“When they leave and go to their home states, at least twice a day someone from public health will contact them and say, ‘Do you have any of these symptoms?’ ‘Tell me your temperature?’ or ‘I’m going to take your temperature,” Braden said.

“We are going to monitor them for the full extent of their incubation period,” he said. adding that every passenger has “agreed to do that. If they want to go to their home stay we will pass that information on to the health officials in that state so they can handle that there.”

Officials said there is no danger to anyone who lives near the base or to any personnel on the base.

Coronavirus has similar symptoms to the flu, however, anyone who’s feeling sick should not immediately assume they have been infected.

“If you have these symptoms and you haven’t been to China, you don’t have coronavirus. It’s that simple.” said Kaiser.

Authorities were quick to say that the passengers were not under a federal quarantine order.

“A quarantine order would be forced,” said Rear Admiral Dr. Nancy Knight, director of the Division of Global Health Protection at the CDC. “In this 72-hour period we are respecting the rights of individuals and … they can leave. However, they are sitting in the middle of a military base. Any discussion around departure would be just that — a discussion … If someone demands to leave right now that is where all of the (medical) partners… would come together and talk about what needs to be done. This would be discussed up to the highest levels of the U.S. government and we would ensure we were making the right decision for the American people.

The plane was charted by the U.S. State Department after it issued an evacuation order for U.S. diplomats and their families, officials said, adding that the flight was large enough to accommodate more people than the State Department diplomats and their families.

“They were able to offer seats to other American citizens and their families if they wanted to evacuate Wuhan,” Knight said.

Because of this it was initially thought that more than 210 people would be aboard the plane.

However, “a number of people did not have the right documentation to enter the United States. Some others … did not show up. There was one person who had a fever who was not allowed to board,” Braden said.

During the 72-hour observation period, passengers will undergo “checks every 12 hours for symptoms and temperatures. … The hospital provided a mobile health care unit near where people are being housed. And laboratory testing is being offered to these individuals and our desire is to turnaround those results as quickly as possible.” Knight said.

The CDC lab in Atlanta will be testing samples from the passengers and authorities believe these checks will be completed within 72 hours.

Kaiser reiterated: “The risk for the general communities in the United Staes from this infection is very low.”

“We have five confirmed cases in the United States. All were identified very early in their illness. They were isolated very early,” Braden added. “There is no indication of transmission from those cases.”

Coronaviruses are a large family of viruses that cause illness ranging from the common cold to pneumonia to Middle East respiratory syndrome, known as MERS, and severe acute respiratory syndrome, or SARS.

Common signs of infection include fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause a high fever, kidney failure, and death.

Eisenhower Health Infection Preventionist Michael Connors said people can prevent the spread of illness by washing hands and covering their nose and mouth when sneezing and coughing.

“If a person has traveled to affected areas, they should follow public health directions and notify heath care providers via phone before coming in for an appointment,” he said.

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January 29: Nippon.com (News from Japan) posted: “5 Japanese Returnees Test Negative for Wuhan Coronavirus”.

Five of the 206 Japanese nationals brought back on a government-chartered plane from the Chinese city of Wuhan, the epicenter of the outbreak of pneumonia blamed on a new strain of coronavirus, have tested negative for the virus, it was learned.

Feeling unwell, the five were sent to two hospitals designated as institutions to deal with specific infectious diseases following the All Nippon Airways flight’s arrival at Tokyo International Airport at Haneda.

Two of them were diagnosed with pneumonia. But they and the other three were all confirmed not to have the new coronavirus later. Three of the five are men in their 30s to 50s and two are women in their 50s.

According to the Tokyo metropolitian government, four of the five people were admitted to Ebara Hospital in Tokyo’s Ota Ward. Two of them – a man in his 40s and a man in his 50s – who complained of such symptoms as a cough and a fever were initially diagnosed with pneumonia following computed topography scan tests.

One of the two women was admitted to Komagome Hospital in Tokyo’s Bunkyo Ward.

January 29: The Honorable Scott Morrison Prime Minister of Australia posted: “Assisted Departure and Strict Quarantine For Australians From Wuhan/Hubei”

The Australian Government is working across agencies to assist the departure of isolated and vulnerable Australians from Wuhan and to put strict quarantine arrangements in place.

Australian diplomatic and consular staff have been working very closely with the Chinese authorities and with other partner countries to develop options for the departure of Australians in Wuhan and Hubei Province, in what continues to be a difficult and complex situation.

The Australian Embassy in Beijing is now seeking formal approval from the Chinese Government to send a plane to Wuhan to assist the departure of Australians from Hubei Province.

We thank the Chinese Government for the cooperative way they have dealt with Australian counterpart and those of the countries who have citizens in Wuhan and Hubei province.

Australians departing on any flight arranged by the Australian Government will be flown to Christmas Island to undertake a period of quarantine of up to 14 days based on current medical advice, as a condition of their assisted departure.

They will also be required to commit to making a contribution to the cost, consistent with normal arrangements in these circumstances.

This will ensure we are also prioritizing public health in Australia.

A consular team is positioned to support an assisted departure. A temporary Consular office is being set up in Wuhan to work with local authorities to help give effect to this plan. We do not have a permanent consular presence in Wuhan.

An Australian Medical Assistance Team (AUSMAT) will provide medical support and expert advice to returning to Australians upon arrival at Christmas Island.

There are just over 600 Australian citizens currently registered with the Department of Foreign Affairs and Trade. We will seek to speak with each of them in relation to the Goverment’s announcement. Our focus and priority is on vulnerable and isolated citizens.

We are endeavoring to make further contact with those people who have provided us their details. Contact can be difficult due to high demand on phone lines in China. We request that those who have registered their detail contact DFAT again if they have not spoken to Australian consular officials in the past 24 hours. The DFAT emergency number is +61 2 6261 3305 from overseas or 1300 555 135 if you are calling from Australia on behalf of a family member.

We also thank Qantas, which has offered to support Australians out of Wuhan if the authority to proceed is provided.

We understand this is a very stressful time for this impacted. We encourage people to make contact with family and friends, stay in touch with travel providers and contact your insurers. Australians should continue to follow all health precautions which are available on the Smart Traveler website – www.smarttraveller.gov.au.

We advise that Australians do not travel to Hubei Province and reconsider their need to travel to China overall.

January 29: Reuters reported that Mondelez International Inc. maker of Oreos and Chips Ahoy cookies, said it expects its first-quarter revenue will be impacted by the coronavirus spreading across China, and it has temporarily closed two factories.

The company reported quarterly revenue that beat estimates, helped by higher demand for its snacks in developing markets. Shares in Mondelez were up 2.6% after the bell.

January 29: China Daily tweeted: “At 4:30 pm on Tuesday, about 10 million people were watching the ongoing construction of the Huoshenshan and Leishenshan hospitals – two makeshift hospitals for novel coronavirus patients in suburban #Wuhan”. The tweet included a link to a the China Daily website, where a livestream was available.

January 29: Reuters reported Sweden’s IKEA said on Thursday that it has temporarily closed all its stores in China because of the new coronavirus.

The decision to close all of its 30 stores follows an announcement from the world’s biggest furniture retailer on Wednesday that it was closing around half of its stores and shortening the opening hours.

The total number of confirmed deaths from the coronavirus in China has risen by 38 to 170 as of Wednesday, as the number of infected patients rose by more than 1,700.

January 29: People’s Daily, China, The largest newspaper in China, tweeted: “China is expected to resume its maks production with normal capacity on Feb 3 and produce 180m masks per day by the end of Feb. The domestic production, together with imported masks, will ease the gap between supply and demand, according to PLA Daily.”

June 29: Twitter posted on its blog: “Helping the world find credible information about novel #coronavirus”. It was written by Jun Chu and Jennifer McDonald.

As the global conversation continue around the spread of novel #coronavirus, we want to share the work we’re doing to surface the right informatio, to promote constructive engagement, and to highlight credible information on this emerging issue. We’ve seen over 15 million Tweets on this topic in the past four weeks and that trend looks set to continue.

Preventing platform manipulation

At present, we’re not seeing significant coordinated attempts to spread disinformation at scale about this issue. However, we will remain vigilant and have invested significantly in our proactive abilities to ensure trends, saerch, and other common areas of the services are protected from malicious behaviors. As ever, those who engage in these practicies will be removed from our service. We do not permit platform manipulation and we encourage people to think before sharing or engaging in deliberate attempts to undermine the public conversation.

Expanding search prompt

Given the rapidly evolving nature of the issue and the growing international response, we’ve launched a new dedicated search prompt to ensure that when you come to the service for information about the #coronavirus, you’re met with credible, authoratiative information first. In addition, we’re halting any auto-suggest results that are likely to direct individuals to non-credible content on Twitter. This is an expansion of our #KnowTheFacts prompt, which we specifically put in place for the public to find clear, credible information on immunization and vaccination health.

Our official #coronavirus partnerships are now in palce in Australia, Belgium, Brazil, Canada, Denmark, France, Germamy, Hong Kong, India, Ireland, Italy, Japan, Malaysia, New Zealand, Netherlands, Norway, Philippines, Singapore, South Korea, Spain, Sweden, Taiwan, Thailand, US, UK, and Vietnam. We will continue to expand as the need rises.

Direct engagement

Finally, our Global Public Policy team is proactively seeking ways to integrate the product with organizations involved in the effort to contain the threat. Experts, NGO’s and governments play a pivotal public service role, using Twitter to reach people with the right information when they need it. We’re committed to playing our part to amplify authoritative, official content across the globe.

January 29: NPR posted “Face Masks: What Doctors Say About Their Role in Containing Coronavirus”. It was written by Maria Godoy.

As the coronavirus continues to spread, officials in China are urging citizens to wear masks in public to stop the spread of the virus – and cities in China as well as other parts of Asia are reportedly running out of face masks.

But can a mask really keep you from catching the virus?

To answer that question, it helps to clarify what kinds of masks we’re talking about.

Because experts don’t yet know exactly how the virus is transmitted, the Centers for Disease Control and Prevention is recommending that health care workers treat it like an airborne pathogen – germs that can travel in particles or droplets in the air. That means health care workers interacting with a coronavirus patient should wear a heavy-duty mask called an N96 respirator. These respirators are designed to fit tightly around the nose and mouth, and, when worn correctly, block out at least 95% of small airborne particles, according to the CDC.

But wearing an N95 respirator is serious business, says Dr. Williman Schaffner of Vanderbuilt University Medical Center. Health care workers who use these respirators are required to undergo an annual fit test – a check to make sure that mask forms a tight seal on the wearer’s face so that contaminated air can’t leak in. Although N95s are disposable, workers must also demonstrate that they know how to put on and wear the model that they are using.

This type of maks is “difficult to wear” because it’s uncomfortable, Schaffner says. Some people find it harder to breathe when wearing the N95. But “that’s the kind of protection that really works.”

While N95 respirators are available for the public to purchase, there’s no recommendation from health agencies for the general public to wear them.

By contrast, surgical masks – those cheap, disposable, gauzy masks that often come in blue or green, — are less uncomfortable. But Shaffner says the scientific evidence that “there might be a benefit for people in the community wearing [surgical] face masks is very, very meager. The general sense is perhaps, but they’re certainly not an absolute protection.” In other words, they do provide some benefit but they’re far from foolproof.

Surgical masks are just a physical barrier that will protect you against “a visible splash or spray of fluid or large droplets,” explains Raina MacIntyre, an infectious disease researcher and professor of global biosecurity at the University of New South Wales in Sydney who has studies the efficacy of face masks. These masks fit loosely on the face around the edges, so they don’t completely keep out germs, and small airborne particles can still get through.

MacIntyre’s research has shown that N95 respirators offer far superior protection. But in one study, she did find that family member who wore surgical masks when carrying for a sick chid at home had a lower risk of getting infected. But the benefit only occurred if people wore masks “all the time when you are in the same room as the infected person,” MacIntyre says — something many families in the study found difficult to do. “But if they did wear it, yes, they got protection.”

MacIntyre notes that cloth masks, — which people wash and reuse — are also common in Asian countries. She says there’s no evidence to show they have any benefit, and her research suggest they “may actually be harmful,” because frequent washing and moisture retention can make cloth masks a breeding ground for pathogens.

January 29: U.S. Centers for Disease Control and Prevention (CDC) posted “UPDATE: HHS and CDC Receive Flight Carrying Repatriated US Citizens”.

This morning, the Department of Health and Human Services (HHS) and Centers for Disease Control and Prevention (CDC) in collaboration with the Department of State recieved the flight carrying approximately 210 U.S. citizens from Wuhan at March Air Reserve Base in California.

The plane was met by a team of CDC medical officers deployed there to assess the health of the passengers. The passengers have been screened, monitored and evaluated by medical personnel every step of the way, including before takeoff, during the flight, during a refuling in Anchorage, Alaska, and now post-arrival. CDC and staff have conducted risk assessments to ensure the health of each traveler, including temperature checks and observing for respiratory symptoms.

CDC will work with the California Department of Public Health and Riverside County Public Health to transport any passenger exhibiting symptoms to a hospital for further evaluation. Passengers not exhibiting symptoms of exposure, will be asked to stay on the base in housing to allow CDC medical officers to perform more thorough screening and to better understand each individual’s exposure.

CDC is committed to protecting the heatlth and safety of Americans. At this time, we continue to believe the risk of coronavirus exposure to the general public is low. CDC is taking these measures to assess and care for these returning Americans to protect them, their loved ones, and their communities.

January 29: The New York Times Editorial Board wrote “Is the World Ready for the Coronavirus?”

The coronavirus outbreak, which began in early December in the Chinese city of Wuhan, had as of Wednesday sickened more than 6,000 people across at least 15 countries and claimed more than 130 lives, all of them in China. Experts don’t yet know how contagious, or how deadly, this new virus is. But the growing crisis has inspired panic. Cities around the world are bracing for a potential wave of infections. Stock and oil prices are tumbling. And experts in just about every global industry are fretting over the many supply chains that could be disrupted — from prescription drugs and surgical masks to rare earth metals — if the outbreak grows into an even wider epidemic.

Given the scope of these anxieties, it’s a wonder more hasn’t been done to prepare for an outbreak like this one. The Centers for Disease Control and Prevention have long warned that the rate at which new pathogens emerge is increasing (partly as a result of global warming). The agency identifies new ones every year, and disease outbreaks — especially those involving viruses that leap from animals to humans, as the coronavirus did — are hardly surprising.

China, the center of the current outbreak, appears to have learned at least some lessons from the last such crisis it confronted. In 2002, when SARS first emerged, the country’s leaders waited roughly three months before notifying the World Health Organization. By then, the virus was on its way to reaching more than a dozen countries. (SARS is also caused by a coronavirus, variants of which are fairly common around the world but rarely affect humans. When they do, they generally cause upper-respiratory infections.)

Chinese officials appear to have moved much faster this time around. They alerted the W.H.O. within a month of detecting the first coronavirus cases and moved quickly to sequence the new virus and to contain it: Some 56 million people, including the entire city of Wuhan, have been placed under quarantine.

But global health experts say that over all, the country’s response still leaves much to be desired. Officials appear to have withheld crucial information — including that the virus was spreading between humans and that cases were not confined to the elderly or to people who visited the market believed to be at the outbreak’s epicenter — for weeks. They have also rebuffed initial offers of help from the C.D.C. and failed to share samples of the virus with the scientific community.

Global health experts are already cautioning other countries to prepare for China’s containment efforts to fail. Part of the problem is that a quarantine of this size is inherently difficult to maintain. Another major issue is a lack of public trust: Control measures work only if people abide by them. And people are much less likely to follow orders when they don’t trust that the authorities issuing them have their best interests at heart. In Wuhan and elsewhere in China, trust in officials is running low, as some citizens suspect that the government is more concerned with containing bad press than with defeating the virus…

January 29: CBC posted “Canada prepares charter flight to bring home Canadians in China affected by coronavirus outbreak”. It was written by Kathleen Harris.

Canada has secured a charter aircraft to bring home Canadians stranded in the coronavirus-affected region of China – but people who are already infected will not be allowed to board.

Canada’s Chief Public Health Officer Theresa Tam said Chinese authorities will not allow anyone who may be infected to get on the plane.

“No cases, and no sick people, will be leaving that city,” Tam said during an appearance before the House of Commons health committee Wednesday.

Tam said China has diagnostic tools to determine if someone is infected. Because the incubation period is anywhere from one to 14 days, she said there are “meticulous” measures in place to isolate individuals from other passengers if they develop symptoms during the flight.

Asked if Canada is considering asking people on the flight to self-isolate upon their return to Canada as a precaution, Tam said it’s crucial to secure the public’s full cooperation with measures to contain the virus. That means avoiding stigmatization and any measures that go beyond scientifically sound measures to protect public safety, she said.

Saying public health authorities have to strike a balance between public safety and individual liberty, Tam said “restricting someone’s freedom, essentially to be moving about in a community, after return … I think that is not something we would take lightly.”

Tam and Health Minister Patty Hajdu have maintained the risk to Canadians remains low. Tam said that assessment is based on the small number of cases that have been exported from China, and the fact that the most severe illnesses or deaths resulting from the novel coronavirus have involved older patients with underlying conditions.

Foreign Affairs Minister François-Philippe Champagne announced today the government has chartered an aircraft to repatriate Canadians and is now working on the diplomatic front to organize the flight — work which could take several days because the affected region is in a “lockdown.”

He said 160 Canadians have requested consular services to date.

“We have to work with the Chinese authorities to deal with the logistical side of things,” he said, adding that Canada is coordinating with other countries on the process.

Facing criticism from some stranded Canadians about a lack of consular assistance, Champaigne insisted that Canada is at the “forefront” of the response.

Air Canada announced today it was suspending direct flights to Beijing and Shanghai until Feb. 29.

Champagne said he could not confirm whether any of the Canadians requesting repatriation are sick, or or are showing symptoms of the virus.

Hajdu said she could not state yet if returning Canadians might be required to go into quarantine. She said the government will take steps to protect the health and safety of Canadians at home and abroad, but could not specify what those measures will involve.

“Part of the process now is figuring out exactly what our protocols will be when we return Canadians that wish to come home,” she said.

“We’re working very closely with our U.S. counterparts, who obviously have some experience in this and have set up some best practices, and we’ll be following their lead very closely and we’ll have more to says as those processes unfold.”

Hadju said not every Canadian in China requesting consular services wants to come home. Some need help with getting to other regions of China or securing supplies, she said.

Canada is cutting the number of consular staff in China due to the coronavirus outbreak.

Global Affairs Canada announced the reduced staffing at its diplomatic missions in China on Twitter, and in Chinese on the Beijing embassy’s social media pages on Wednesday. Canadians who need emergency consular assistance are being told to contact the emergency watch and response centre in Ottawa.

More than 6,000 cases of the novel coronavirus have been reported globally — the vast majority of them in China – with 133 related deaths.

Some Canadians trapped in Wuhan, China, due to strict travel restrictions, say they’re safe but feeling abandoned by their consular officials.

Consular offices were closed Saturday through Tuesday due to the Chinese New Year.

Today, Prime Minister Justin Trudeau said the government is looking at ways to help Canadians stuck in China.

“We are working very closely with our consular officials in China. We’re listening and concerned about the Canadians who are right now in the affected zone,” he said.

Application centres closed

“We will do what we can do. There are many countries looking at different ways to help out. It is a complex situation, but we’re doing everything we can to support Canadians.”

Patterson Wu, a Vancouver-based Canadian citizen now in Wuhan, said he tried without success for days to reach a consular official. When he finally made contact, the official told him there was no evacuation plan at the moment, and referred him to a Chinese website listing various hospitals.

“I tried to phone them for many days now, but they were on holiday while we were stuck in the city with the epidemic happening in the country,” he told CBC News Network.

“It kind of felt like finally I got something, but at the same time, I kind of felt like, ‘This is all I got?”

Another Canadian from Toronto said he is frustrated with the lack of government help in brining home his 15-month-old daughter, who is visiting grandparents in Wuhan.

“I’m certainly scared, worried, frustrated with the lack of response that I hear. I feel helpless. There’s not much I can do,” Richard Fabic told CBC Toronto on Tuesday. “I missed her before, but now I miss her more.”

All visa application centres in mainland China are temporarily closed, and consular offices will be providing only basic services (such as passport renewals) and emergency services such as medical assistance, emergency benefits and missing persons.

According to the embassy’s post, the immigration service will continue to provide services and prioritize the processing of travel documents for customers and permanent residents “who need to travel urgently to Canada for humanitarian and compassionate reasons.”

Global Affairs Canada’s emergency response centre can be reach by phone at 612-996-8885 or by email sos@international.g.c.ca.

The government has launched a website dedicated to the coronavirus and has set up an information hotline.

The World Health Organization announced Wednesday it will convene the International Health Regulations Emergency Committee tomorrow to determine whether the current outbreak constitutes a public health emergency of international concern.

During a news conference in Geneva Tuesday, Michael Ryan, executive director of the World Health Organization’s (WHO) Health Emergencies Program, praised the Chinese government’s “laser focus” and committed efforts to control the outbreak and protect public health.

“The challenge is great, but the response has been massive,” he said.

There’s a lot of misinformation to there about the virus’s origins and how it spreads.

Ryan acknowledged the challenge media outlets face in communicating accurate risk information and holding authorities and institutions to account.

All of the 15 countries that have imported cases, which include Canada, must be at “full alert,” he said.

Asked if countries evacuating their citizens from the affected regions could spread the virus further, WHO Director General Tedros Adhanom Ghebreyesys said every county can make its own decisions but must prepare for the arrival of new cases. Those countries need to have a “through understanding” of their actions, he said.

Several countries have started repatriating their citizens from the affected region in China.

A Japanese flight carrying 206 evacuees home included four people with coughs and fevers. The three men and one woman were taken to a Tokyo hospital on separate ambulances for treatment and further medical checks.

A chartered flight also landed in California today carrying 200 Americans from China.

Stephen Lucas, the deputy health minister and Public Health Agency of Canada President Tina Namiesniowski also took questions the committee meeting.

January 29: Stephen McDonell (China Correspondent for the BBC) tweeted: “Already more people infected with the #Wuhan #Coronavirus in #China that throughout the entire SARS epidemic which went on for around 7 months. More human movement now than in 2002/3 but this virus also seems much more infectious. More infectious but (for the moment) not as deadly.”

January 29: Overwatch League (An e-Sports league for Blizzard Entertainment’s Overwatch video game) tweeted a statement. The statement was in the form of a graphic with words on it, and it included the Overwatch League logo.

We have decided to cancel our February and March matches in China in order to protect the health and safety of our players, fans, and staff. We hope to have a safe and happy Lunar New Year, and remain incredibly excited to play Overwatch League matches in China later this season.

We’ll share more information about when and where the matches will take place at a later date.

Thank you for your support and understanding!


January 30

January 30: The World Health Organization (WHO) posted “Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)”.

The second meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding the outbreak of the novel coronavirus 2019 in the People’s Republic of China, with exportations to other countries, took place on Thursday, 30 January 2020, from 13:30 to 18:35 Geneva time (CEST). The Committee’s role is to give advice to the Director-General, who makes the final decision on the determination of a Public Health Emergency of International Concern (PHEIC). The Committee also provides public health advice or suggests formal Temporary Recommendations as appropriate.

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference.

The Director-General welcomed the Committee and thanked them for their support. He turned the meeting over to the Chair, Professor Didier Houssin.

Professor Houssin also welcomed the Committee and gave the floor to the Secretariat.

A representative of the department of compliance, risk management, and ethics briefed the Committee members on their roles and responsibilities.

Committee members were reminded of their duty of confidentiality and their responsibility to disclose personal, financial, or professional connections that might be seen to constitute a conflict of interest. Each member who was present was surveyed and no conflicts of interest were judged to be relevant to the meeting. There were no changes since the previous meeting.

The Chair then reviewed the the agenda for the meeting and introduced the presenters.

Representatives of the Ministry of Health of the People’s Republic of China reported on the current situation and the public health measures being taken. There are now 7711 confirmed and 12167 suspected cases throughout the country. Of the confirmed cases, 1370 are severe and 170 people have died. 124 people have recovered and been discharged from the hospital.

The WHO Secretariat provided an overview of the situation in other countries. There are now 83 cases in 18 countries. Of these, only 7 had no history of travel in China. There has been human-to-human transmission in 3 countries outside China. One of these cases is severe and there have been no deaths.

At its first meeting, the Committee expressed divergent views on whether this event constitutes a PHEIC or not. At that time, the advice was that the event did not constitute a PHEIC, but the Committee members agreed on the urgency of the situation and suggested that the Committee should continue its meeting on the next day, when it reached the same conclusion.

This second meeting takes place in view of significant increases in numbers of cases and additional countries reporting confirmed cases.

Conclusions and advice

The Committee welcomed the leadership and political commitment of the very highest levels of Chinese government, their commitment to transparency, and the efforts made to investigate and contain the current outbreak. China quickly identified the virus and shared its sequence, so that other countries could diagnose it quickly and protect themselves, which has resulted in rapid development of diagnostic tools.

The very strong measures the country has taken includes daily contact with WHO and comprehensive multi sectoral approaches to prevent further spread. It has also taken public health measures in other cities and provinces; is conducting studies on the severity and transmissibility of the virus, and sharing data and biological material. The country has also agreed to work with other countries who need their support. The measures China has taken are good not only for that country but also for the rest of the world.

The Committee acknowledged the leading role of WHO and its partners.

The Committee also acknowledged that there are still many unknowns, cases have now been reported in five WHO regions in one month, and human-to-human transmission has occurred outside Wuhan and outside China.

The Committee believes that it is still possible to interrupt the virus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk. It is important to note that as the situation continues to evolve, so will the strategic goals and measures commensurate with the risk. It is important to note that as the situation continues to evolve, so will the strategic goals and measures to prevent and reduce the spread of the infection. The Committee agreed that the outbreak now meets the criteria for a Public Health Emergency of International Concern and proposed the following advice to be issued as Temporary Recommendations.

The Committee emphasized that the declaration of a PHEIC should be seen in the spirit of support and appreciation for China, its people, and the actions China has taken on the front lines of this outbreak, with transparency, and, it is to be hoped, with success. In line with the need for global solidarity, the Committee felt that a global coordinated effort is needed to enhance preparedness in other regions of the world that may need additional support for that.

Advice to WHO

The Committee welcomed a forthcoming WHO multidisciplinary technical mission to China, including national and local experts. The mission should review and support efforts to investigate the animal source of the outbreak, the clinical spectrum of the disease and its severity, the extent of human-to-human transmission in the community and in healthcare facilities, and efforts to control the outbreak. This mission will provide information to the international community to aid in understanding the situation and its impact and enable sharing of experience and successful measure.

The Committee wished to re-emphasize the importance of studying the possible source, to rule out hidden transmission and to inform risk management measures.

The Committee also emphasized the importance of studying the possible source, to rule out hidden transmission and to inform risk management measures.

The Committee also emphasized the need for enhanced surveillance in regions outside Hubei, including pathogen genomic sequencing, to understand whether local cycles of transmission are occurring.

WHO should continue to use its networks of technical experts to assess how best this outbreak can be contained globally.

WHO should provide intensified support for preparation and response, especially in vulnerable countries and regions.

Measures to ensure rapid development and access to potential vaccines, diagnostics, antiviral medicines, and other therapeutics for low- and middle-income countries should be developed.

WHO should continue to provide all necessary technical and operational support to respond to this outbreak, including with its extensive networks of partners and collaborating institutions, to implement a comprehensive risk communication strategy, and to allow for the advancement of research and scientific developments in relation to this novel coronavirus.

WHO should continue to explore the advisability of creating an intermediate level of alert between the binary possibilities of PHEIC or no PHEIC, in a way that does not require reopening negotiations on the text of the IHR (2005).

WHO should timely review the situation with transparency and update its evidence-based recommendations.

The Committee does not recommend any travel or trade restriction based on the current information available.

The Director-General declared that the outbreak of 2019-nCoV constitutes a PHEIC and accepted the Committee’s advice and issued this advice as Temporary Recommendation under the IHR.

To the People’s Republic of China

Continue to:

  • Implement a comprehensive risk communication strategy to regularly inform the population on the evolution of the outbreak, the prevention and protection measures for the population, and the response measures taken for its containment.
  • Enhance public health measures for containment of the current outbreak.
  • Ensure the resilience of the health system and protect the health workforce.
  • Enhance surveillance and active case finding across China.
  • Collaborate with WHO and partners to conduct investigations to understand the epidemiology and the evolution of this outbreak and measures to contain it.
  • Share relevant data on human cases.
  • Continue to identify the zoonotic source of the outbreak, and particularly the potential for circulation with WHO as soon as it becomes available.
  • Conduct exit screening at international airports and ports, with the aim of early detection of symptomatic travellers for further evaluation and treatment, while minimizing interference with international traffic.

To all countries

It is expected that further international exportation of cases may appear in any country. Thus, all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contract tracing and prevention of onward spread of 2019-nCoVinfection, and to share full data with WHO. Technical advice is available on the WHO website.

Countries are reminded that they are legally required to share information with WHO under the IHR.

Any detection of 2019-nCoV in an animal (including information about the species, diagnostic tests, and relevant epidemiological information) should be reported to the World Organization for Animal Health (OIE) as an emerging disease.

Countries should place particular emphasis on reducing human infection, prevention of secondary transmission and international spread, and contributing to the international response through multisectoral communication and active participation in increasing knowledge on the virus and the disease, as well as advancing research.

The Committee does not recommend any travel or trade restriction based on the current information available.

Countries must inform WHO about travel measures taken, as required by the IHR. Countries are cautioned against the actions that promote stigma or discrimination, in line with the principles of Article 3 of the IHR.

The Committee asked the Director-General to provide further advice on these matters and, if necessary, to make new case-by-case recommendations, in view of this rapidly evolving situation.

To the global community

As this is a new coronavirus, and it has been previously shown that similar coronavirus required substantial efforts to enable regular information sharing and research, the global community should continue to demonstrate solidarity and cooperation, in compliance with Article 44 of the IHR (2005), in supporting each other on the identification of the source of this new virus, its full potential for human-to-human transmission, preparedness for potential importation of cases, and research for developing necessary treatment.

Provide support to low- and middle-income countries to enable their response to this event, as well as to facilitate access to diagnostics, potential vaccines and therapeutics.

Under Article 43 of the IHR, States Parties implementing additional health measures that significantly interfere with international traffic (refusal of entry or departure of international travellers, baggage, cargo, containers, conveyances, goods, and the like, or their delay, for more than 24 hours) are obliged to send to WHO the public health rationale and justification within 48 hours of their implementation. WHO will review the justification and may request countries to reconsider their measures. WHO is require to share with other States Parties the information about measures and the justification received.

The Emergency Committee will be reconvened within three months or earlier, at the discretion of the Director-General.

The Director-General thanked the Committee for its work.

January 30: New South Wales Health posted “Novel coronavirus statistics – 9:30am”

NSW – number of cases confirmed – 4

NSW – number of cases under investigation – 7

NSW – number of cases tested negative – 50

We will not be disclosing the hospital locations of patients under investigation for privacy reasons.

January 30: France24 posted: “France confirms sixth case of coronavirus infection as its citizens evacuate Wuhan”

France has confirmed a sixth case of infection by the new coronavirus from China, a French health official said on Thursday.

Meanwhile, a jet carrying around 200 French citizen flew out of the virus-hit Chinese city of Wuhan on Friday, according to the AFP journalists on board the flight.

The French military aircraft is bound for southern France, where the passengers will undergo a 14-day quarantine, in case they are carrying the new coronavirus.

The United States and Japan have already carried out airlifts from Wuhan for their citizens. A second US flight is planned in the coming days.

Britain also plans to evacuate around 200 of its citizens on Friday and Australia and New Zealand are among others organizing similar operations.

The European Commission has said it is planning a flight to evacuate more European nationals.

Beijing has taken extreme steps to stop the spread of the virus, effectively quarantining more than 50 million people in Wuhan and surrounding Hubei province, including thousands of foreigners.

The World Health Organization on Thursday declared a global emergency over the virus, which has also spread to more than 15 other countries.

China’s death toll from the virus rose to 212 on Friday as hardest-hit Hubei province reported 42 new fatalities.

January 30: Illinois Department of Public Health posted “Second Illinois 2019 Novel Coronavirus Case Identified”.

The Illinois Department of Public Health (IDPH), Chicago Department of Public Health (CDPH), and Cook County Department of Public Health (CCDPH), along with the Centers for Disease Control and Prevention (CDC), are reporting the second confirmed case of 2019 novel coronavirus (2019-nCov) in Illinois. The individual is a man in his 60s and is the spouse of the first confirmed travel-related case in Illinois. He had not traveled overseas but interacted with his wife upon her return from China. This is the first person-to-person spread of the virus in the United States.

“I want to emphasize that the risk of this novel coronavirus to the general public in Illinois remains low. Local, state, and federal health officials are working to identify those who have had close contact with the individual I order to take protective measures to minimize further spread of the virus,” said IDPH Director Dr. Ngozi Ezike. “We will continue to keep the public fully informed as additional information becomes available.”

On Friday, January 24, 2020, CDC, IDPH, and CDPH announced the first confirmed Illinois case of 2019-nCoV in a Chicago resident, a woman in her 60s who returned from Wuhan, China on January 13, 2020.  The woman remains in the hospital in stable condition and is doing well.  The second patient is also hospitalized in stable condition.

“We know coronaviruses are most likely to spread through close personal contact, and we know this second patient had close contact with his wife after she began to develop symptoms, so it’s not totally unexpected that he acquired the virus,” said Allison Arwady, MD, MPH, Commissioner of CDPH. “This is exactly why the public health has been monitoring him closely, and why we monitor any close contacts of confirmed cases. This does not change our guidance that the risk to the general public remains low at this time. People in the community do not need to change their behavior based on this news; for example, they don’t need to cancel events, avoid mass gatherings, or wear gloves and masks in public.”

Public health officials are investigating locations where this second patient has visited in the last two weeks and any close contacts who were possibly exposed. Public health and medical professionals are taking an aggressive approach in identifying and actively monitoring individuals who were in contact with both confirmed cases in an effort to reduce the risk of additional transmission. A CDC team continues to be deployed to Illinois to support these efforts. 

“If you have traveled to China or come into contact with a confirmed case and are experiencing fever, cough, or shortness of breath, contact your healthcare provider,” said Cook County Department of Public Health Chief Operating Officer Dr. Terry Mason. “We encourage everyone to practice the same germ prevention as with flu, which last year caused 35 million illnesses and just over 34,000 deaths.”

CDC is closely monitoring the outbreak of respiratory illness caused by 2019-nCoV that was first detected in Wuhan City, Hubei Province, China and which continues to expand. There have been hundreds of cases worldwide, including two in Illinois, and more than 50 deaths.  Symptoms reported among patients with 2019-nCoVhave included mild to severe respiratory illness with fever, cough, and difficulty breathing.

Although this is the first person-to-person transmission in the U.S., it is still not yet clear how easily 2019-nCoV spreads from one person to another. With MERS and SARS, also novel coronaviruses, the virus was thought to have spread mainly through sneezing and coughing, similar to the flu. In general, it was spread between close contacts. 

There is currently no vaccine to prevent 2019-nCoV infection. Right now, 2019-nCoV has not been found to be spreading widely in the United States, so there are no additional precautions recommended for the general public to take.

However, the following everyday preventive actions can help prevent the spread of several viruses, including seasonal flu.

January 30: New South Wales Health posted “Novel coronavirus statistics – 4pm”

NSW – number of cases confirmed – 4 (see below)

NSW – number of cases under investigation – 20

NSW – number of cases cleared – 50

Of the four confirmed cases, two patients have been discharged, a 53 year old male and a 35 year old male.

Two patients remain in hospital, a 21 year old female and a 43 year old male.

We will not be disclosing the hospital locations of patients under investigation for privacy reasons.

January 30: Australian Medical Association (AMA) posted “Dr.Tony Bartone – Today – Coronavirus and Christmas Island”

ALLISON LANGDON: Let’s get a medical perspective on this with Dr Tony Bartone from the Australian Medical Association. Very good morning to you, thanks for coming in.

TONY BARTONE: Good morning.

ALLISON LANGDON: We’ve seen another two cases confirmed in Australia overnight. How do you think we’re handling this?

TONY BARTONE: So right from the outset, it’s been handled according to best practice international guidelines and processes. We’ve been prepared. We’ve been rated previously as being equal best when it comes to preparedness to deal with this kind of outbreak. And we’ve been really focused on isolation, and contact tracing of those who have been exposed and the fact that more than a week on we’ve got such a relatively small number of cases confirmed is a real sign of the success thus far of the measures that have been implemented.

KARL STEFANOVIC: So the World Health Organization has advised Governments not to transport or evacuate their citizens from China. The solution from the Australian Government is let’s take them to Christmas Island. What are your thoughts on that?

TONY BARTONE: So, I can understand why the Australian Government has put that process in place. It’s important to recognize that we’ve got a group of vulnerable Australians who, through no fault of their own, found themselves at the epicenter of a significant outbreak. And they must be under a lot of stress and fear and concern.

Despite WHO’s recommendation, we feel that the repatriation to Christmas Island, to a place where has been previously the focus of populations under enormous mental and physical trauma and anguish, is not a really appropriate solution. We’ll be calling on the PM and the relevant Ministers to find a much more humane solution to dealing with a group of very vulnerable and concerned Australians.

ALLISON LANGDON: But doctor, they’re not going there indefinitely. They’re going there for the two-week quarantine period. It’s not a long time to keep the rest of Australia safe.

TONY BARTONE: I agree with the principle, but we can find a better set of facilities to deal with that, to manage that staged return to the community. We can protect the Australian community and also be much more humane to those Australians who, as I said, through no fault of their own, find themselves the focus of this epicentre.

KARL STEFANOVIC: It’s like nuclear waste. I mean, what are you going to do with it? I mean, where – what are you going to do with these people at this point? I mean, these people are coming out from China, it’s an infected area. What area of Australia are you going to put them where they’re safe?

TONY BARTONE: Well, it’s not up to me to suggest the exact area but the Government has at its disposal a number of facilities, everything from, you know, defense sites or other sites, quarantine facilities, which it could ramp up to meet this demand. Remember, AUSMAT teams are going into Christmas Island to provide the necessary solutions. It’s not like Christmas Island has got the solution. You know, they’re ramping up their facilities and their resources with the teams coming in. So, we can do that in a number of other places much more humanely.

ALLISON LANGDON: We’re now hearing that coronavirus is spreading between people before symptoms actually appear; that an Australian lab has recently been able to re-create the virus. So how close are we, considering that this seems – it does seem to be mutating, how close are we to finding a vaccine to treat it?

TONY BARTONE: Up ’til yesterday we didn’t have a copy of the virus outside of China. China hadn’t shared it with the rest of the world. We’d only had the genetic code. The fact that we’ve now got a virus where we can actually test a vaccine is a really significant positive step into developing a vaccine. It’s fantastic work by Australian scientists to get that far. Now, of course, we’re still, you know, months away from a vaccine but we’re a significant way closer than we were two days ago.

KARL STEFANOVIC: You’re going to run into problems here because a lot of Australians are going to say, hang on a second, these people need to be evacuated, they want to be evacuated, otherwise they say where they are. But if they want to be evacuated, then they can’t come into our cities, they can’t come into our towns, they have to make sure that they’re okay before they come in. And isn’t Christmas Island a viable option?

TONY BARTONE: But, Karl, you remember, at the heart of this is that the infectivity, as long as we follow proper process and procedures and we know that we’re dealing with a specific group, we can keep them isolated from the rest of the community in much, much better facilities because it’s really – you know, the droplet spread of this infection and can be managed and contained.

ALLISON LANGDON: Is the Government consulting you on in issue?

TONY BARTONE: We’re in constant dialogue with the Chief Health Officer on various matters. On this issue, we were not consulted.

KARL STEFANOVIC: Yeah okay. Appreciate it.

January 30: The CDC reported the onset of 1 additional COVID-19 case in the United States.

January 30: World Health Organization (WHO) posted “Novel Coronavirus (2019-nCoV) Situation Report – 10”

Highlights

  • The Emergency Committee on the novel coronavirus (2019-nCoV) under the International Health Regulations (IHR 2005) is meeting today to discuss whether the outbreak constitutes a public health emergency of international concern.
  • First confirmed cases of 2019-nCoV acute respiratory disease in Finland, India and Philippines; all had travel history to Wuhan City.
  • On 29 January, WHO held its third press briefing to provide update on the situation.
  • WHO recommends that the interim name of the disease causing the current outbreak should be “2019-nCoV acute respiratory disease” (where the ‘n’ is for novel and “CoV” is for coronavirus). The name complies with the WHO Best Practices for Naming of New Infectious Diseases, which were developed through a consultative process among partner agencies. Endorsement for the interim name is being sought from WHO’s partner agencies, World Organiztion for Animal Health (OIE) and Food and Agriculture Organization (FAO). The final name of the disease will be provided by the International Classification of Diseases (ICD). WHO is also proposing ‘2019-nCoV” as an interim name of the virus. The final decision of the official name of the virus will be made by the International Committee on Taxonomy of Viruses.

TECHNICAL FOCUS: Laboratory detection:

WHO published interim laboratory guidance for detection of the novel coronavirus on 9 January and has updated that advice twice. This guidance includes advice on biosafety, patient sampling, and pathogen detection and characterization.

Like the epidemiological situation, the diagnostic landscape is changing quickly. The first 2019-nCoV cases were detected using metagenomic sequencing. Within days of obtaining the sequence data public-sector groups, including China Center for Disease Control and Prevention (CDC), have designed assays targeting areas of the genome detecting sequences specific for the novel virus (2019-nCoV) and have made them publicly available.

One of WHO’s main aims is to strengthen global diagnostics capacity for 2019-nCov detection to improve surveillance, early detection and track the spread of disease. To date, human-to-human transmission outside of China has been limited, and public health efforts are targeted at limiting further transmission in countries with imported cases which depends critically on the ability to detect the pathogen.

WHO has taken a three-pronged approach to enhance diagnostic capacity for 2019-nCoV:

  1. Forming a network of specialized referral laboratories with demonstrated expertise in the molecular detection of coronaviruses. These international labs can support national labs to confirm 2019-nCoV cases and troubleshoot their molecular assays;
  2. Strengthening national capacity for detection of 2019-nCoV so that diagnostic testing can be preformed rapidly without the need for overseas shipping. One way this has been achieved is through working with existing global networks for detection of respiratory pathogens such as, notably, the National Influenza Centers that support the Global Influenza Surveillance and Response System;
  3. Ensuring test availability. This has involved a) screening of 2019-nCoV PCR protocols from academic laboratories for validation data (e.g. limits of detection, specificity), b) looking for sequence alignment of established commercial coronaviruses assays (e.g. SARS) to see if any were likely to be able to detect 2019-nCoV with high sensitivity, and c) working with commercial and non-commercial agencies with capacity to manufacture and distribute newly-developed 2019-nCoV PCR assays. WHO will begin supporting its regional and country offices to make these tests available the first week of February 2020.

SURVEILLANCE

Western Pacific:

  • China – 7736 (confirmed cases)
  • Japan 11
  • Republic of Korea – 4
  • Viet Nam – 2
  • Singapore – 10
  • Australia – 7
  • Malaysia – 7
  • Cambodia – 1
  • Philippines – 1

South-East Asia:

  • Thailand – 14
  • Nepal – 1
  • Sri Lanka – 1
  • India – 1

Region of the Americas

  • United States of America – 5
  • Canada – 3

European Region

  • France – 5
  • Finland – 1
  • Germany – 4

Eastern Mediterranean

  • United Arab Emirates – 4

PREPAREDNESS AND RESPONSE

  • WHO has developed a protocol for the investigation of early cases (the “First Few X (FFX) Cases and contact investigation protocol for 2019-novel coronavirus (2019-nCoV) infection”). The protocol is designed to gain early understanding of the key clinical, epidemiological and virological characteristics of the first cases of 2019-nCoV infection detected in any country, to inform the development and updating of public health guidance to manage cases and reduce potential spread and impact of infection.
  • WHO has been in regular and direct contact with Member States where cases have been reported. WHO is also informing other countries about the situation and providing support as requested.
  • WHO has developed interim guidance for laboratory diagnosis, advice on the use of masks during home care and in health care settings in the context of the novel coronavirus outbreak, clinical management, infection prevention and control in health care settings, home care for patients with suspected novel coronavirus, risk communication and community engagement.
  • Prepared disease commodity package that includes an essential list of biomedical equipment, medicines and supplies necessary to care for patients with 2019-nCoV.
  • WHO has provided recommendations to reduce risk of transmission from animals to humans.
  • WHO has published updated advice for international traffic relation to the outbreak of the novel coronavirus 2019-nCoV.
  • Activation of R&D blueprint to provide diagnostics, vaccines and therapeutics.
  • WHO has developed an online course to provide general introduction to emerging respiratory viruses, including novel coronavirus.
  • WHO is providing guidance on early investigations, which are critical to carry out early in an outbreak of a new virus. The data collected from the protocols can be used to refine recommendations for surveillance and case definitions, spectrum of disease, impact on the community and to inform operational models for implementation of countermeasures such as case isolation, contact tracing and isolation. The first protocol that is available is a: Household transmission investigation protocol for 2019-novel coronavirus (2019-nCoV) infection.
  • WHO is working with its networks of researchers and other experts to coordinate global work on surveillance, epidemiology, modelling, diagnostics, clinical care and treatment, and other ways to identify, manage the disease and limit onward transmission. WHO has issued interim guidance for countries, updated to take into account the current situation.
  • WHO is working with global expert networks and partnerships for laboratory, infection prevention and control, clinical management and mathematical modelling.

RECOMMENDATIONS AND ADVICE

During previous outbreaks due to coronavirus (Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), human-to-human transmission occurred through droplets, contact and fomites, suggesting that the transmission mode of the 2019-nCoV can be similar. The basic principles to reduce the general risk of transmission of acute respiratory infections include the following:

  • Avoid close contact with people suffering from acute respiratory infections.
  • Frequent hand-washing, especially after direct contact with ill people or their environment.
  • Avoiding unprotected contact with farm or wild animals.
  • People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissue or clothing, and wash hands.)
  • Within healthcare facilities, enhance standard infection prevention and control practices in hospitals, especially in emergency departments.

WHO does not recommend any specific health measures for travellers. In case of symptoms suggestive of respiratory illness either during or after travel, travellers are encouraged to seek medical attention and share their travel history with their healthcare provider.

January 30: President Trump tweeted: “Great photos from a SOUTHERN BORDER WALL Briefing with Secretary of Defense, Mark @EsperDod!”

The tweet was the start of a five tweet thread. Each tweet had four photos of the wall that Trump promised in his 2016 campaign. This thread was meant to attract Trump’s supporters, in the hopes they will vote for him again in 2020.

January 30: President Trump tweeted: “Just landed in Michigan. Car companies, and many others, are building and expanding here. Great to see!”

January 30: President Trump tweeted: “Leaving Michigan now, great visit, heading for Iowa. Big Rally!

January 30: President Donald Trump tweeted: “Working closely with China and others on Coronavirus outbreak. Only 5 people in U.S., all in good recovery.”

January 30: World Health Organization Philippines tweeted: “Today, the Department of Health announced the first confirmed case of 2019 novel #coronavirus in the Philippines. The patient is 38 years old from China.”

January 30: World Health Organization Phillippines tweeted: “The announcement was done today by @SecDuque in a press briefing, after results were recieved from the confimatory test done at the reference laboratory in Australia.”

January 30: World Health Organization tweeted photos of the @DOHgov press release. From the press release:

DOH CONFIRMS FIRST 2019-NCOV CASE IN THE COUNTRY; ASSURES PUBLIC OF INTENSIFIED CONTAINMENT MEASURES

The Department of Health (DOH) today confirmed that a 38-year-old female Chinese patient under investigation (PUI) is positive for the novel coronavirus (2019-nCoV) after her laboratory results arrived today from Victorian Infectious Disease Reference Library in Melbourne, Australia. DOH, however, continues to guarantee the public that all necessary precautionary measures are being taken to halt the spread of the virus.

The confirmed case arrived in the Philippines from Wuhan, China via Hong Kong last January 21, 2020. The patient sought consult and was admitted in one of the country’s government hospitals last January 25 after experiencing mild cough. She is currently aysmptomatic.

“I assure the public that the Department of Health is on top of this evolving situation. We were able to detect the first confirmed case becaues of our strong surveillance system, close coordination with World Health Organization and other national agencies, and the utilization of DOH’s decision tool. We are working closely with the hospital where the patient is admitted and have activated the Incident Command System of the said hospital for appropriate management, specifically on infection control, case management and containment. We are also implementing measures to protect the health staff providing care to these patients,” Health Secretary Francisco T. Duque III said.

DOH is also in close coordination with the Intre-agency Task Force on Emerging Infectious Diseases (EID) which includes representatives of the Departments of Foreign Affairs (DFA), Interior and Local Government (DILG), Justice (DOJ), Labor and Employment (DOLE), Tourism (DOT), Transportation (DOTr), and Information and Communications Technology (DICT). The Task Force will convene a high-level meeting tomorrow, January 31, 2020, to discuss the first confirmed case and developments arising from this health issue.

The Bureau of Quarantine remains on high alert and is in constant coordination with authorities from all ports of entry for stricter border surveillance. DOH assures that its health facilities are equipped and prepared to recieve and care for PUI’s and confirmed 2019-nCoV cases.

DOH has recorded a total of twenty-nine (29) PUI’s – eighteen (18) in Metro Manila, four (4) in Central Visayas, three (3) in Western Visayas, one (1) in MMAROPA, one (1) in Eastern Visayas, one (1) in Northern Mindano, and one (1) in Davao. Twenty-three (23) PUI’s are currently admittedand five (5) have been discharged but are still under strict monitoring. DOH also reported one PUI mortality.

“I urge the public to stay calm and remain vigilant at all times. Let us continue to practice good personal hygiene and adopt healthy lifestyles,” the Health Secretary concluded.

January 30: Victoria State Government (Australia) posted “Third Novel Coronavirus case in Victoria”.

Victoria’s Department of Health and Human Services confirmed a third case of Novel Coronavirus in Victoria.

The total number of confirmed cases of Novel Coronavirus in Victoria now is three. There are currently eight pending results and a total of 71 negative results.

The latest case a woman in her 40s, a visitor from Hubei Province in China, is in a stable condition with the respiratory illness. She has been confirmed positive today following a series of tests.

The patient is in isolation in the Royal Melbourne Hospital in accordance with recommended infection control procedures.

The woman attended a GP and was referred to the hospital immediately. Two close contacts are being provided support and education and monitored closely for signs and symptoms of illness…

January 30: Ohio Department of Health tweeted: “ODH, CDC, CCBH determined that the sixth U.S. confirmed coronavirus case was not infectious during his day trip to Cleveland. It is important to remember the U.S. is still low risk for nCoV. There are no additional PUIs related to this case on OH.”

January 30: Nippon.com (News from Japan) posted “New Coronavirus Detected in 3 Japanese Returnees from Wuhan”

A new coronavirus originating in Wuhan has been detected in three of the 206 Japanese nationals who returned home aboard a government-chartered flight Wednesday, a government official said Thursday.

The three are among the 12 returnees hospitalized after returning from the Chinese city, according to the health minister Katsuobu Kato.

Of the 12, five tested negative for the virus, he told parliament.

January 30, 2020: UK Department of Health and Social Care posted “Statement from the 4 UK Chief Medical Officers on novel coronavirus”.

The Chief Medical Officers were:

Chief Medical Officer for England, Professor Chris Whitty

Chief Medical Officer for Wales, Dr. Frank Atherton

Chief Medical Officer for Scotland, Dr. Catherine Calterwood

Chief Medical Officer for Northern Ireland, Dr. Michael McBride

We have been working in close collaboration with international colleagues and the World Health Organization to monitor the situation in China and around the world.

In light of the increasing number of cases in China and using existing and widely tested models, the 4 UK Chief Medical Officers consider it prudent for our governments to escalate planning and preperation in case of a more widespread outbreak.

For that reason, we are advising an increase of the UK risk level from low to moderate. This does not mean we think to risk to individual in the UK has changed at this stage, but that government should plan for all eventualities.

As we have previously said, it is likely there will be individual cases and we are confident in the ability of the NHS in England, Scotland, and Wales and HSC in Northern Ireland to manage these in a way that protects the public and provides high quality care.

January 30: Nippon.com (News from Japan) posted “Human-to-Human Spread of Coronavirus Confirmed in Japan”

Human-to-human transmission of a new strain of coronavirus that caused a pneumonia outbreak in China was confirmed in Japan, the health ministry said Thursday.

The ministry called on not only people who have visited the Chinese city of Wuhan, the epicenter of the coronavirus crisis, but also those who developed symptoms such as coughing after contracting people with records of staying in Wuhan, to go see a doctor after making an advance call.

Following the confirmation of the human-to-human spread of the virus, the ministry expanded the scope of people who are required to call medical institutions in advance to newly include those who had secondary contacts.

In Japan, a driver of a bus that carried 60 tourists from Wuhan and a guide on the same bus have been confirmed to be infected with the virus.

The ministry called on people not to worry more than necessary, saying that “the virus has not become widespread at the moment”. It advised people to take steps similar to those for avoiding the flu, such as wearing masks and washing hands.

January 30: New South Wales Health posted “Novel Coronavirus Statistics – 9.30am.

NSW – number of cases confirmed – 4

NSW – number of cases under investigation – 7

NSW – number of cases tested negative – 50

We will not be disclosing the hospital locations of patients under investigation for privacy reasons.

January 30: PolitiFact posted: Trump blocked travel from China.

That same night, he holds a campaign rally in Iowa.

“We think we have it very well under control. We have very little problem in this country at this moment five … we think it’s going to have a very good ending for it.”, Trump said.

January 30: Nippon.com (News from Japan) posted: “Abe Regrets 2 Returnees’ Refusal of Virus Tests”.

Prime Minister Shinzo Abe said Thursday that it is “very regrettable” that two Japanese returnees from Wuhan, the epicenter of the coronavirus outbreak, refused to have virus tests.

Officials “tried for a long time” to persuade them to accept virus tests as the government has no legal grounds to forcibly conduct such tests, Abe told a House of Councillors committee meeting.

The two were among the first batch of Japanese nationals brought back home on a government-chartered plane on Tuesday.

The prime minister said the government is now asking Japanese citizens still in the locked-down Chinese city and surrounding areas, before they board additional charter flights to return home, to agree to undergo virus tests.

During the Upper House committee meeting, Abe agreed to the view expressed by an opposition lawmaker that it is problematic that Taiwan was not invited to an emergency meeting of the World Health Organization on the coronavirus outbreak.

January 30: Nippon.com (News from Japan) posted “Japan to Do Follow-Up Survey on People Who Have Stayed in Wuhan”

Japan’s government on Thursday decided to conduct a follow-up survey on all people entering the country who have been to China’s Wuhan, the epicenter of the pneumonia outbreake caused by a new coronavirus.

The decision was made at the first meeting of a task force headed by Prime Minister Shinzo Abe, set up to prevent the spread of the virus.

Under the plan, the government will obtain information on the places of stay of such people, including foreigners, in Japan and conduct the follow-up survey, which will include medical checks.

Meanwhile, a third government-chartered flight left Tokyo International Airport at Hanada for Wuhan, the capital of the Hubei Province, on Thursday night to bring back more Japanese nationals.

“We’ll implement thorough health management, including viral tests, regardless of whether (people) display symptoms,” Abe said at the task force meeting. He instructed his cabinet members to work as one to implement necessary measures without hesitation while putting top priority on protecting the lives and health of the Japanese people.

January 30: Director-General of the World Health Organization, Tedros Adhanom Ghebreyesus tweeted: “I am declaring a public health emergency of international concern over the global outbreak of #2019nCoV, not because of what is happening in #China, but because of what is happening in other countries.” The tweet included a link to Periscope.

January 30: The World Health Organization (WHO) posted “Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)”.

The second meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding the outbreak of novel coronavirus 2019 in the People’s Republic of China, with exportations to other countries, took place on Thursday January 2020, from 13:30 to 18:35 Geneva time (CEST). The Committee’s role is to give advice to the Director-General, who makes the final decision on the determination of a Public Health Emergency of International Concern (PHEIC). The Committee also provides public health advice or suggests formal Temporary Recommendations as appropriate.

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference.

The Director-General welcomed the Committee and thanked them for their support. He turned the meeting over to the Chair, Professor Didier Houssin.

A representative of the department of compliance, risk management, and ethics briefed the Committee members on their roles and responsibilities.

Committee members were reminded of their duty of confidentiality and their responsibility to disclose personal, financial, or professional connections that might be seen to constitute a conflict of interest. Each member who was present was surveyed and no conflicts of interest were judged to be relevant to the meeting. There were no changes since the previous meeting.

The Chair then reviewed the agenda for the meeting and introduced the presenters.

Representatives of the Ministry of Health of the People’s Republic of China reported on the current situation and the public health measures being taken. There are now 7711 confirmed and 12167 suspected cases throughout the country. Of the confirmed cases, 1370 are severe and 170 people have died. 124 people have recovered and been discharged from hospital.

The WHO Secretariat provided an overview of the situation in other countries. There are now 83 cases in 18 countries. Of these, only 7 had no history of travel in China. There has been human-to-human transmission in 3 countries outside China. One of these cases is severe and there have been no deaths.

At its first meeting, the Committee expressed divergent views on whether this event constitutes a PHEIC or not. At that time, the advice was that the event did not constitute a PHEIC, but the Committee members agreed on the urgency of the situation and suggested the Committee should continue its meeting on the next day, when it reached the same conclusion.

The second meeting takes place in view of significant increases in numbers of cases and additional countries reporting confirmed cases.

Conclusions and advice

The Committee welcomed the leadership and political commitment of the very highest levels of Chinese government, their commitment to transparency, and the efforts made to investigate and contain the current outbreak. China quickly identified the virus and shared its sequence, so that other countries could diagnose it quickly and protect themselves, which as resulted in the rapid deployment of diagnostic tools.

The very strong measures the country has taken include daily contact with WHO and comprehensive multisectoral approaches to prevent further spread. It has also taken health measures in other cities and provinces; is conducting studies on the severity and transmissibility of the virus, and sharing data and biological material. The country has also agreed to work with other countries who need their support. The measures China has taken are good not only for that country but also for the rest of the world.

The Committee acknowledged the leading role of WHO and its partners.

The Committee also acknowledged that there are still many unknowns, cases have now been reported in five WHO regions in one month, and human-to-human transmission has occurred outside Wuhan and outside China.

The Committee believes that it is still possible to interrupt virus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk. It is important to note that as the situation continues to evolve, so distancing measures commensurate with the risk.

It is important to note that as the situation continues to evolve, so will the strategic goals and measures to prevent the reduce of spread of the infection. The Committee agreed that the outbreak now meets criteria for a Public Health Emergency of International Concern and proposed the following advice to be issued as Temporary Recommendations.

The Committee emphasized that the declaration of a PHEIC should be seen in the spirit of support and appreciation for China, its people, and the actions China has taken on the front lines of this outbreak, with transparency, and, it is to be hoped, with success. In line with the need for global solidarity, the Committee felt that a global coordinated effort is needed to enhance preparedness in other regions of the world that may need additional support for that.

Advice to WHO

The Committee welcomed a forthcoming WHO multidisciplinary technical mission to China, including national and local experts. The mission should review and support efforts to investigate the animal source of the outbreak, the clinical spectrum of the disease and its severity, the extent of human-to-human transmission in the community and in healthcare facilities, and efforts to control the outbreak. This mission will provide information to the international community to aid in understanding the situation and its impact and enable sharing of experience and successful measures.

The Committee wished to re-emphasize the importance of studying the possible source, to rule out hidden transmission and to inform risk management measures.

The Committee also emphasized the need for enhanced surveillance in regions outside Hubei, including pathogen genomic sequencing, to understand whether local cycles of transmission are occurring.

WHO should continue to use its networks of technical experts to assess how best this outbreak can be contained globally.

WHO should provide intensified support for preparation and response, especially in vulnerable countries and regions.

Measures to ensure rapid development and access to potential vaccines, diagnostics, antiviral medicines and other therapeutics for low- and middle-income countries should be developed.

WHO should continue to provide all necessary technical and operational support to respond to this outbreak, including with its extensive networks of partners and collaborating institutions, to implement a comprehensive risk communication strategy, and to allow for the advancement of research and scientific developments in this relation to this novel coronavirus.

WHO should continue to explore the advisability of creating an intermediate level of alert between the binary possibilities of PHEIC or no PHEIC, in a way that does not require reopening negotiations on the text of the IHR (2005).

WHO should timely review the situation with transparency and update its evidence-based recommendations.

The Committee does not recommend any travel or trade restriction based on the current information available.

The Director-General declared that the outbreak of 2019-nCoV constitutes PHEIC and accepted the Committee’s advice and issued this advice as Temporary Recommendations under the IHR.

To the People’s Republic of China

Continue to:

  • Implement a comprehensive risk communication strategy to regularly inform the population on the evolution of the outbreak, the prevention and protection measures for the population, and the response measures taken for its containment
  • Enhance public health measures for containment of the current outbreak.
  • Ensure the resilience of the health system and protect the health workforce.
  • Enhance surveillance and active case finding across China.
  • Collaborate with WHO and partners to conduct investigations to understand the epidemiology and the evolution of this outbreak and measures to contain it.
  • Share relevant data on human cases.
  • Continue to identify the zoonotic source of the outbreak, and particularly the potential for circulation with WHO as soon as it becomes available.
  • Conduct exit screening at international airports and ports, with the aim of early detection of symptomatic travellers for further evaluation and treatment, while minimizing interference with international traffic.

To all countries

It is expected that further international exportation of cases may appear in any country. Thus, all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of 2019-nCoV infection, and to share the full data with WHO. Technical advice is available on the WHO website.

Countries are reminded that they are legally required to share information with WHO under IHR.

Any detection of 2019-nCoV in an animal (including information about the species, diagnostic tests, and relevant epidemiological information) should be reported to the World Organization for Animal Health (OIE) as an emerging disease.

Countries should place particular emphasis on reducing human infection, prevention of secondary transmission and international spread, and contributing to the international response through multisectoral communication and collaboration and active participation in increasing knowledge on the virus and the disease, as well as advancing research.

The Committee does not recommend any travel or trade restrictions based on the current information available.

Countries must inform WHO about travel measures taken, as required by the IHR. Countries are cautioned against actions that promote stigma or discrimination, in like with the principles of Article 3 of the IHR.

The Committee asked the Director-General to provide further advice on these matters and, if necessary, to make new case-by-case recommendations, in view of this rapidly evolving situation.

To the global community

As this is a new coronavirus, and it has been previously shown that similar coronaviruses required substantial efforts to enable regular information sharing and research, the global community should continue to demonstrate solidarity and cooperation, in compliance with Article 44 of the IHR (2005), in supporting each other on the identification of the source of this new virus, its full potential for human-to-human transmission, preparedness for potential importation of cases, and research for developing necessary treatment.

Provide support to low- and middle-income countries to enable their response to this event, as well as to facilitate access to diagnostics, potential vaccines and therapeutics.

Under article 43 of the IHR, States Parties implementing additional health measures that significantly interfere with international traffic (refusal of entry or departure of international travellers, baggage, cargo, containers, conveyances, goods and the like, or their delay for more than 24 hours) are obliged to send to WHO the public health rationale and justification within 48 hours of their implementation. WHO will review the justification and may request consider their measures. WHO is required to share with other State’s Parties the information about measures and the justification received.

The Emergency Committee will be reconvened within three months or earlier, at the discretion of the Director-General.

The Director-General thanked the Committee for its work.

January 30: World Health Organization Western Pacific tweeted: “The total number of confirmed cases of the 2019 novel #coronavirus reported from mainland China to date is 9,692. This includes 1,527 severe cases and 213 people who have died. #nCoV #nCoV2019 #2019nCoV” This was the start of a thread.

January 30: World Health Organization Western Pacific tweeted: Hong Kong SAR has reported a total of 12 cases, Macao SAR has reported 7 cases, and Taiwan, China has reported 9 cases. #coronavirus, #nCoV #nCoV2019 #2019nCoV.”

January 30: World Health Organization Western Pacific tweeted: “Other countries in @WHO Western Pacific Region: Singapore has reported 13 cases, Japan 12 cases, Australia 9 cases, Malaysia 8 cases, Republic of Korea 6 cases, Viet Nam 2 cases, Cambodia & Philippines 1 case each #coronavirus #nCoV #nCoV2019 #2019nCoV”

January 30: World Health Organization Western Pacific tweeted: “It is important to note that the case numbers reflect date reported, not date of illness onset. #coronavirus #nCoV #nCoV2019 #2019nCoV” This was the last tweet in the thread.

January 30: Financial Post posted “ANA Sees China Flight Bookings Plunging amid Coronavirus Spread”.

ANA Holdings said on Thursday its bookings for flights leaving China fell by half in February from a year earlier as a new virus spread.

The Japanese airline also said its bookings to China from Japan plunged 60% in the same period.

“The concern is of the impact that the situation could have on China’s economy and the knock on that will have on things like air cargo,” said ANA Executive Vice President Ichiro Fukuzawa said at a news conference in Tokyo after it released its earnings for the three months ended Dec. 31.

He said China accounted for around a tenth of ANA’s passenger flights.

January 30: The Guardian posted “Coronavirus: Britons to be quarantined in Wirral after arriving from Wuhan”. It was written by Simon Murphy and Dan Sabbagh.

Around 120 Britons will fly from the Chinese city at the centre of the coronavirus outbreak overnight and land in the UK on Friday morning where they will be taken to Wirral for a fortnight’s quarantine.

It news came shortly before the risk level from the virus in the UK was raised from low to moderate and the World Health Organization declared it a global health emergency.

Dominic Raab, the foreign secretary, announced that the emergency flight, which was delayed by 24 hours, would be taking off from Wuhan and was due to land at RAF Brize Norton in Oxfordshire at around 9am.

Military doctors will be onboard the chartered plane in case immediate treatment is necessary, although any passengers displaying symptoms of the virus – which can include a sore throat, fever and breathing difficulties – will be barred from boarding.

It is understood there will be a quarantine area in the plane incase somebody falls ill during the flight.

The returnees will be bussed to Arrowe Park hospital in Wirral, where they will be monitored and treated if any symptoms develop. They will be staying in an accommodation block usually designated for NHS staff. Margaret Greenwood, the Labor MP for Wirral West, said she had spoken to the health secretary, Matt Hancock, who told her that experts believed it was unlikely that those quarantined had the virus.

Passengers were asked to sign contracts agreeing to the 14-day quarantine as a condition of getting the flight home. A further 50 EU nationals will also be on the chartered flight, which will fly on to Spain where it will complete its journey.

Raab said: “We are pleased to have confirmation from the Chinese authorities that the evacuation flight from Wuhan airport to the UK can depart at 0500 local time on Friday 31 January. The safety and security of British nationals is our top priority. Our embassy in Beijing and consular teams remain in close contact with British nationals in the region to ensure they have the latest information they need.”

Some Britons with family members who hold a Chinese passport have decided to remain in Wuhan because they faced being separated if they had chosen to travel.

Matt Raw and his 75-year-old mother, Hazel, were entitled to a place on the flight but are staying in Wuhan as Matt’s wife, Ying, a Chinese national, was not allowed to board because of strict rules imposed by the Chinese government.

“I would have for anything to happen to [my mother] and I would much rather be somewhere where the virus isn’t,” said Raw. “Half of the British people here that wanted to leave are still trapped. The government’s only done half the job.”

The death toll from the virus, has spread to at least 16 countries, has reached 170, and there are more than 7,700 confirmed cases in China. A total of 161 British nationals have so far tested negative for the virus.

Scotland’s chief medical officer, Dr Catherine Calderwood, said it was “highly likely” there would be a positive case in the UK in the coming days.

On Thursday night the four chief medical officers of the UK increased the risk level of coronavirus from low to moderate. They said they “do not think the risk to individuals in the UK has changed” but that the government should “plan for all eventualities.”

The WHO said its decision to declare it a global emergency was no criticism of China but was designed to provide support for countries with “weaker health systems which are ill prepared to deal with [the coronavirus]”.

A British woman in Wuhan who claimed she was told she would have to leave her three-year-old son behind if she flew out because he had a Chinese passport said the Foreign Office was in discussions with counterparts in the county about her situation.

Natalie Francis, originally from York, said on Wednesday that Foreign Office staff in London told he she could leave on a flight but that her son Jamie must stay. She said she was told “nothing can be done.”

“He suffered from pneumonia last year and the only advice they can give is for me to leave him behind? One again, thank you for nothing [Foreign Office] and Beijing embassy,” she wrote in a Facebook post.

However, Francis suggested in an update on Thursday morning that there might have been some progress on the matter, writing: “Been in touch with the [Foreign Office], Jamie and I are on the lists but they are still discussing with the Chinese government. Flight has been delayed by may be [leaving on] Friday with quarantine in the north-west for 14 days.”

The first US case of person-to-person transmission of the coronavirus has been confirmed by health officials. The individual is married to a Chicago woman who was diagnosed with the virus after she returned from a trip to Wuhan.

Elsewhere, an Italian cruise ship carrying 6,000 passengers was held at a port near Rome after two Chinese passengers fell ill with suspected coronavirus.

The couple boarded the Costa Smeralda on 25 January and later came down with fevers and breathing problems. However, local reports suggested they had tested negative.

An apartment-hotel in Yorkshire was put on lockdown after a man believed to be a Chinese national was taken to hospital on Wednesday evening by paramedics clad in quarantine suits.

York’s Staycity Hotel confirmed that the apartment where the may was staying had been sealed off and would undergo “a thorough environmental clean and disinfection.”

British Airways announces it would suspend flights to and from China to the end of February, one of a number of carriers stopping or reducing services to the affected country.

Russia closed its border with China and moved to stop issuing electronic visas to Chinese nationals. The prime minister, Mikhail Mishutin, pledged: “We have to do everything to protect our people.”

As China reported the biggest single-day jump in coronavirus deaths, the country’s football association cancelled all domestic games.

January 30: Centers for Disease Control and Prevention (CDC) posted “CDC Confirms Person-to-Person Spread of New Coronavirus in the United States”.

The Centers for Disease Control and Prevention (CDC) today confirmed that the 2019 Novel Coronavirus (2019-nCoV) has spread between two people in the United States, representing the first instance of person-to-person spread with this new virus here.

Previously, all confirmed U.S. cases had been associated with travel to Wuhan, China, where an outbreak of respiratory illness caused by this novel coronavirus has been ongoing since December 2019. However, this latest 2019-nCoV patient has no history of travel to Wuhan, but shared a household with the patient diagnosed with 2019-nCoV infection on January 21, 2020.

Recognizing early on that the 2019-nCoV could potentially spread between people, CDC has been working closely with state and local partners to identify close contacts of confirmed 2019-nCoV cases. Public health officials identified this Illinois resident through contact tracing. Both patients are in stable condition.

Given what we’ve seen in China and other countries with the novel coronavirus, CDC experts have expected some person-to-person spread in the US,” said CDC Director Robert R. Redfield, M.D. “We understand that this may be concerning, but based on what we know now, we still believe the immediate risk to the American public is low.”

Limited person-to-person spread with 2019-nCoV has been seen among close contacts of infected travelers in other countries where imported cases from China have been detected. The full picture of how easily and sustainably the 2019-nCoV spreads is still unclear. Person-to-person spread can happen on a continuum, with some viruses being highly contagious (like measles) and other viruses being less so.

MERS and SARS, the other two known coronaviruses that have emerged to cause serious illness in people, have been known to cause some person-to-person spread. With both those viruses, person-to–person spread most often occurred between close contacts, such as healthcare workers and those caring for or living with an infected person. CDC has been proactively preparing for the introduction of 2019-nCoV in the U.S. for weeks, including:

  • First alerting clinicians on January 8 to be on the look-out for patients with respiratory symptoms and a history of travel to Wuhan, China.
  • Developing guidance for preventing 2019 novel coronavirus (2019-nCoV) from spreading to others in homes and communities.
  • Developing guidance for clinicians for testing and management of 2019-nCoV as well as guidance for infection control of patients hospitalized or being evaluated by a health care provider.

CDC is working closely with Illinois health officials and other local partners. A CDC team has been on the ground since the first 2019-nCoV-positive case was identified and is supporting an ongoing investigation to determine whether further spread with this virus has occured.

It is likely there will be more cases of 2019-nCoV reported in the U.S. in the coming days and weeks, including more person-to-person spread. CDC will continue to update the public as we learn more about his coronavirus. The best way to prevent infection is to avoid being exposed to this virus. Right now, 2019-nCoV has not been found to be spreading widely in the United States, so CDC deems the immediate risk from this virus to the general public to be low. However, risk is dependent on exposure, and people who are in contact with people with 2019-nCoV are likely to be at greater risk of infection and should take the precautions outlined in CDC’s guidance for preventing spread in homes and communities.

For the general public, no additional precautions are recommended at this time beyond the simple daily precautions that everyone should always take. It is currently flu and respiratory disease season, and CDC recommends getting vaccinated, taking everyday preventative actions to stop the spread of germs, and taking flu antivirals if prescribed. Right now, CDC recommends travelers avoid all nonessential travel to China.

January 30: The Guardian posted “Coronavirus deaths leap in China as countries struggle to evacuate citizens”. It was written by Sarah Boseley and Justin McCurry. From the article:

China has reported its biggest single-day jump in coronavirus deaths, as countries struggled to evacuate citizens still trapped in the city where the outbreak began and Russia closed it long border with its southern neighbour.

The death toll rose to 170 on Thursday – up from 132 the previous day, a rise of 29%. The number of confirmed cases in China now stands at 7,736, up from 5,974 a day ago. The actual death rate has not risen, and is now at 2.2%

The number of global cases is 7,818.

It is understood that 162 of the deaths – or 95% – are in Hubei province where Wuhan, the city where the outbreak began, is located. Of the new deaths, 37 were in Hubei province and one in south-western province of Sichuan.

The health chief of Huanggang city, which has reported 500 cases, second only to Wuhan, was summarily sacked by the Chinese government following public anger over her inability to answer questions about the outbreak on state television.

Tang Zhihong floundered under questioning from a central government inspection team together with a reporter. Asked how many sick people there were in one of the hospitals, she replied: “I don’t know, I’m unclear. I only know how many beds there are. Don’t ask me how many people are being treated.”

Her TV appearance generated more than half a million comments on the Weibo account of state television’s news channel, most of them in a very angry tone. A few hours after the programme aired, the city’s health department said in a terse and brief statement that Tang had been removed. It gave no other details.

The World Health Organization’s emergency committee is meeting on Thursday to decide whether to declare a global health emergency. On Wednesday, it warned all governments to be “on alert.”

The WHO director general Dr Tedros Adhanom Ghebreyesus has praised China for its efforts to contain the virus but said that the few cases of human to human transmission outside of China, in Japan, Germany, Canada and Vietnam were cause for real concern.

In Moscow, the Russian prime minister Mikhail Mishustin issued a decree ordering the temporary closure of the country’s border with China, which extend for 2,600 miles (4,200 kms). The border had been de facto closed because of the lunar new year holiday, but authorities said the closure would be extended until 1 March. In addition, all train traffic between the two countries, except for one train connecting Moscow and Beijing, was stopped on Thursday.

Meanwhile, the US and South Korea confirmed their first cases of person-to-person spread of the virus. The man in the US is married to a 60-year-old Chicago woman who got sick from the virus after she returned from a trip to Wuhan. The case in South Korea was 56-year-old man who had contact with a patient who was previously diagnosed with the virus.

The first British flight to evacuate citizens will carry about 150 British nationals and 50 others, mainly from the EU. A Spanish chartered flight is scheduled to leave Wuhan at 5am local time on Friday for RAF Brize Norton in Oxfordshire. From there it is understood that the British passengers will be taken to a former NHS facility in the north-west of England.

Australia is yet to gain permission from the Chinese government to evacuate hundreds of its citizens and New Zealand has launched a separate rescue mission, through a timeline remains unclear.

France, South Korea and other countries are also pulling out their citizens or making plans to do so. About 250 French citizens and 100 other Europeans are scheduled to be flown out of Wuhan onboard two French planes this week.

In Italy, a cruise ship’s 6,000 passengers were kept on board while tests were held on two Chinese travellers.

Businesses are beginning to feel the impact of the outbreak. Several airlines have suspended services to China, while Toyota, Ikea, Foxconn, Starbucks, Tesla and McDonald’s were among major companies to temporarily freeze production or close large numbers of outlets in China. The Chinese Football Association has postponed all domestic games.

In Huahe, a town in Hubei province, authorities were investigating the case of a 17-year-old boy with cerebral palsy who died after his father, who cared for him, was taken into quarantine for five days.

Almost 200 US citizens evacuated from Wuhan on Wednesday were undergoing three days of testing and monitoring at a Southern California military base to ensure they did not show signs of the virus.

In Japan, three of the 206 people repatriated on Wednesday had tested positive for the coronavirus, bringing the number of confirmed cases in the country to 11. A second group of 210 Japanese nationals arrived in Tokyo on Thursday morning.

Officials defended the decision not to forcibly quarantine all Japanese nationals arriving from Wuhan, in contrast to Australia, South Korea, Singapore and New Zealand, which will quarantine all evacuees for at least two weeks regardless of whether they show symptoms.

January 30: NBC News posted “Cruise with 6,000 people stuck on board due to coronavirus scare gets clean bill of health”. It was written by Claudio Lavanga and David K. Li.

Thousands of passengers, including more than 100 Americans, were stuck on their Italian cruise ship for much of Thursday after a passenger showed symptoms of the coronavirus, officials said.

But by late Thursday night, all 6,000 passengers and 1,000 crew had been given the medical OK to come and go from the Costa Smeralda, officials said.

Earlier in the day, the cruise line operator announced that everyone had to stay on board after one traveler appeared to fall ill.

It turns out the sickened female guest, a 54-year-old Chinese national, was “diagnosed…with the common flu,” according to a statement Thursday night from Costa Crociere.

“While we appreciate the inconvenience caused, the procedures in force and our cooperation with the Health Authorities were effective in managing this situation and were intended to ensure the maximum safety for all our guests, crew, and the community as a whole,” the cruise company statement said.

Of those travelers, 114 are American, cruise line spokesperson Davide Barbano said.

The ship has 1,143 passengers who were scheduled Thursday to end their cruise in Civitaecchia, a port city about 50 miles northwest of Rome.

Health officials with the maritime authority in Civitavecchia had given those travelers permission to leave the ship earlier in the day – but that city’s mayor asked for that disembarkment to be delayed until the results of all medical tests were known.

The maritime authority agreed to that delay, according to Patrick Vignola, a spokesman for the mayor.

“The mayor himself does not have the authority to overrule decisions by the port authority,” Vignola told NBC News earlier on Thursday.

“Nevertheless, once we learned that more than a thousand passengers were going to be allowed to disembark, he sent a request to the health ministry, the port authority and health authority to keep all passengers on board until the result of the tests clears the suspicion of coronavirus.”

Vignolia added: “He did that because as a mayor he is responsible for the well-being of his citizens, and worried port workers were asking him, ‘How do we know we are safe? We are glad the authorities listened to our plea.”

Then hours later, the entire ship was cleared.

More than 7,800 people in China have been infected by the virus that emerged in the central city of Wuhan. China has reported 170 deaths.

January 30: Nippon.com (News from Japan) posted “Honda Decides to Put Off Restart of Wuhan Plans”

Honda Motor Co. <7267> said Thursday that it has decided to keep its automobile plants in Wuhan, China, the epicenter of the outbreak of a new coronavirus, closed until Feb. 13.

The Japanese automaker earlier planned to keep facilities offline through next Sunday in line with the Lunar New Year holiday in China.

Meanwhile, Mitsubishi Motors Corp. <7211> plans to extend the period of closure for its two facilities in Shanghai, including a research and development base, by seven days until Feb. 9, sources in the company said.

Japanese companies are scrambling to deal with the spread of the coronavirus, as prolonged effects of the outbreak are feared to disrupt supply chains for their branches in China…

January 30: The New Zealand Goverment posted “Government charters Air NZ flight to assist Wuhan departure”. It was posted by RT Honorable Winston Peters the Deputy Prime Minister of Foreign Affairs.

The Government has agreed with Air New Zealand to charter an aircraft to assist New Zealanders leaving Wuhan, Foreign Minister Winston Peters has announced.

The aircraft will have the capacity for around 300 passengers and will fly from Wuhan to New Zealand. Officials will be working through operational requirements with Air New Zealand and Chinese authorities.

New Zealanders in the Hubei region who are registered on Safetravel have been emailed by the Ministry of Foreign Affairs and Trade to register interest in the flight, which is subject to Chinese Government approval.

“We are pleased to have been able to offer this assistance to New Zealanders in a challenging situation,” Mr Peter said.

“We courage all New Zealanders in the Hubei region to register on Safetravel and ensure all their details are accurate and up to date. This will give us a better understanding of the level of demand for this flight.”

“New Zealand will be offering any additional seats to Pacific Island and Australian citizens as a matter or priority.”

“This is a complex operation as we work through all the necessary requirements but we are working to have the aircraft depart as soon as possible.”

Consular teams will be working with health officials to ensure that the risks of transmission of the Coronavirus to New Zealand are carefully managed throughout the evacuation process.

Officials are currently developing procedures for: pre-departure health screening of passengers, infection control inflight, and isolation of all passengers arriving in New Zealand for up to two weeks.

Those who do take a seat on the plan will be required to pay a nominal fee, however the government will absorb most of the cost of the charter flight.

“The New Zealand Government would like to thank Air New Zealand for its support in assisting to bring New Zealanders home,” Mr Peters said.

January 30: Human Rights Watch posted “China: Respect Rights in Coronavirus Response”. From the article:

The Chinese government should ensure that human rights are protected while responding to the coronavirus outbreak, Human Rights Watch said today. As of January 29, 2020, confirmed cases of the infection, formally known as 2019-nCov, globally stood at 6,065, and the death toll at 132.

The Chinese government’s response to the coronavirus outbreak was initially delayed by withholding information from the public, underreporting cases of infection, downplaying the severity of the infection, and dismissing the likelihood of transmission between humans. Since mid-January, authorities have taken a more aggressive approach, quarantining 50 million people in an effort to limit transmission from the city of Wuhan in Hubei province, where the virus originated, to the rest of China. In addition, authorities have detained people for “rumor-mongering,” censored online discussions of the epidemic, curbed media reporting, and failed to ensure appropriate access to medical care for those with virus symptoms and others with medical needs.

“The coronavirus outbreak requires a swift and comprehensive response that respect human rights,” said Yaqui Want, China researcher. “Authorities should recognize that censorship only fuels public distrust, and instead encourage civil society engagement and media reporting on this public health crisis.

The first patient with onset symptoms was identified in Wuhan on December 1, 2019. Nearly a month later, on December 31, Wuhan authorities announced there were 27 cases of an unknown type of pneumonia and alerted the World Health Organization; they identified the new virus, 2019-nCoV, a week later. The first death was announced on January 11. By January 29, 2019-nCoV cases had been reported in 15 countries.

Internet and Media Censorship

Since mid-December, the Chinese government has tried to control the flow of information regarding the epidemic. There is considerable misinformation on Chinese social media and authorities have legitimate to counter false information that can cause public panic. But rather than rebutting false information and disseminating reliable facts, the authorities in some instances have appeared more concerned with silencing criticism.

Chines police have detained or harassed people for allegedly “spreading rumors.” On January 1, police in Wuhan announced that they had summoned eight people for questioning for “publishing and spreading untrue information online” related to cases of pneumonia. One was a doctor at a hospital where infected patients were being treated.

On December 30, he sent messages in a private WeChat group alerting them about the unknown illness. Hospital officials later warned him not to “spread rumors,” and the police forced him to sign a document stating that he would stop illegal activities and abide by the law. On January 12, the doctors as admitted to the hospital for pneumonia symptoms after treating patients, and is now in critical condition.

In recent weeks, police across China have detained dozens of people for their online posts related to the virus. On January 25, Tianjin police detained a man for 10 days for “maliciously publishing aggressive, insulting speech against medical personnel.”

Authorities have censored numerous articles and social media posts about the epidemic, including those posted by families of infected people seeking help, by people living in cordoned cities documenting their daily life, by the netizens critical of the government’s handling of the crisis. Women’s rights activist Gus Jing said she had trouble posting on Weibo and WeChat blogs on her life in cordoned Wuhan.

Authorities in various locations ordered medical personnel treating infected patients not to speak to the media. They also blocked some journalists from reporting. Government personnel escorted BBC journalists way from Henan province. Police claimed that there were “no problems” in the area and “so no need for [the journalists] to stay.”

Restrictions and Movement in Wuhan and Surrounding Areas

Since January 23, authorities have imposed travel lockdowns on Wuhan and nearby cities, effectively fencing in 56 million people. Wuhan authorities also suspended all vehicle traffic, with some exceptions, in the city center. Many residents in Wuhan expressed difficulties about access to medical care and other life necessities.

A man on Weibo said that his HIV medicine was running out but that he could not get it refilled due to the roadblocks. He sought help from the local police. Instead of helping get the new medicine, the police informed his parents of his HIV status, which he had chosen to be kept private. A man with cancer in Huanggang, a city near Wuhan also under cordon, said he was unable to purchase life-saving medicine. A pregnant woman reported that the only way she could get to see her gynecologist was by walking a long distance.

International human rights law, notably the International Covenant on Civil and Political Rights (ICCPR), which China has signed but not ratified, requires that restrictions on human rights in the name of public health or a public health emergency meet requirements of legality, evidence-based necessity, and proportionality. Restrictions such as quarantine or isolation of symptomatic people must, at a minimum, be provided for and carried out in accordance with the law. They must be strictly necessary to achieve a legitimate objective, the least intrusive and restrictive available to reach the objective, based on scientific evidence, neither arbitrary nor discriminatory in application, of limited duration, respectful of human dignity and subject to review…

January 30: Boston Globe posted “BSO cancels tour of East Asia due to coronavirus concerns”

The Boston Symphony Orchestra has canceled plans for a tour of East Asia, responding to the threat of the rapidly spreading coronavirus. The ensemble’s eight-concert tour under music director Andris Nelsons, with piano soloist Yefim Bronfman, was to take place from Feb. 6-16.

“On behalf of Andris Nelsons and the musicians of the Boston Symphony Orchestra, we are all deeply disappointed that we will not be able to perform for the wonderful audiences in Seoul, Taipei, Hong Kong, and Shanghai,” BSO president and CEO Mark Volpe said in a statement released by the orchestra Thursday morning.

As of Thursday, China had reported more than 7,500 cases of coronavirus, and the US State Department had posted warnings to all Americans to “reconsider travel” to China and to avoid all travel to Hubei Province, where the virus was first identified. Earlier this week, the State Department evacuated 195 Americans from the city of Wuhan, where the outbreak began.

In Hong Kong, all government-administered performance venues, including the Hong Kong Cultural Centre – where the BSO was scheduled to perform – have been closed since Jan. 29.

According to the BSO’s statement, the orchestra is considering scheduling some new Boston concerts for the period it was due overseas, including a free community program.

Changes to BSO tour itineraries are rare in the orchestra’s history, but not unprecedented. In 1960, a planned appearance in Seoul under the baton of Charles Munch was canceled after South Korea was engulfed in what came to be known as the April Resolution. The orchestra has not traveled there since, so its upcoming visit would have been a first in BSO history.

Geopolitical events also intervened in 1999, when the United States bombed the Chinese embassy in Yugoslavia while the orchestra was again touring East Asia, this time led by Siege Ozawa. The episode prompted widespread outrage in China. As rock-throwing protesters in Beijing trapped then-US ambassador Jim Sasser and his staff inside the American Embassy, the BSO chose to forgo its scheduled appearance in Beijing.

January 30: France 24 posted “France confirms sixth case of coronavirus infection as its citizens evacuate Wuhan”

France has confirmed its first three cases of the Wuhan coronavirus on Friday, a fourth case on Tuesday, and a fifth case on Wednesday.

Meanwhile, a jet carrying around 200 French citizens flew out of the virus-hit Chinese city of Wuhan on Froday, according to AFP journalists on board the flight.

The French military aircraft is bound for southern France, where the passengers will undergo a 14-day quarantine, in case they are carrying the new coronavirus.

The United States and Japan have already carried out airlifts from Wuhan for their citizens. A second US flight is planned in the coming days.

Britian also plans to evacuate around 200 of its citizens on Friday and Australia and new Zealand are among others organizing similar operations.

The European Commission has said it is planning a flight to evacuate more European nationals.

Beijing has taken extreme steps to stop the spread of the virus, effectively quarantining more than 50 million people in Wuhan and surrounding Hubei province, including thousands of foreigners.

The World Health Organization on Thursdays declared a global emergency over the virus, which has also spread to more than 15 other countries.

China’s death toll from the virus rose to 212 on Friday as hardest-hit Hubei province reported 42 new fatalities.

January 30: Reuters posted “Two first coronavirus cases confirmed in Italy: prime minister”.

Italian Prime Minister Guiseppe Conte on Thursday said there were two confirmed cases of coronavirus in Italy, the first two in the country since the emergency exploded.

Conte said Italy had closed air traffic to and from China.

“We have two confirmed cases of coronavirus in Italy,” the prime minister told a news conference, adding two Chinese tourists from China had contracted the virus.

On Thursday, the World Health Organization declared that the coronavirus epidemic in China now constitutes a global public health emergency.

January 30: American Academy of Pediatrics (AAP) posted “1st person-to-person spread of coronavirus in U.S. reported; WHO declares public health emergency.”

A novel coronavirus has spread from person-to-person in the U.S. for the first time, according to federal health officials.

The World Health Organization (WHO) also declared the outbreak a public health emergency of international concern, due to the increasing cases and countries affected.

A man in his 60s from Chicago appears to have caught the virus from his wife who caught it while traveling to China. The man, who is the sixth confirmed case in the U.S. had not traveled.

Health officials from the Centers for Disease Control and Prevention (CDC) emphasized the two had been in close contact, and they are monitoring other potential contacts.

“We understand this may be concerning, but based on what we know now, our assessment remains the immediate risk to the American public is low,” said CDC Director Robert R. Redfield, M.D.

Globally, there have been 7,834 cases of the respiratory virus and 170 deaths, according to the WHO. Most cases are in China, but they also have been reported in 18 other countries.

In the U.S., 92 people are awaiting test results.

“The only way we will defeat this outbreak is for all countries to work together in a spirit of solidarity and cooperation,” said WHO Director-General Tedros Adhanom Ghebreyesys, Ph.D., M.S.c. “We are all in this together and can only stop it together. This is the time for facts, not fear. This is the time for science, not rumors. This is the time for solidarity, not stigma.”

WHO officials said they did not see a need for restrictions on travel or trade. They called for support for counties with weak health systems; quick development of vaccines, therapeutics and diagnostics; data-sharing and combating misinformation.

It is unclear whether the recommendations will change CDC’s level 3 travel advisory warning against unnecessary travel to China or the U.S. State Department’s level 4 warning not to travel to Hubei province, the center of the outbreak.

Health care providers should be vigilant for patients who have traveled to China and have a fever and respiratory symptoms…

…In addition to the warnings about travel, officials recommended the general public avoid respiratory illnesses by washing their hands, covering their mouths when coughing and staying home when they are sick. Buying masks is not necessary.

January 30: Reuters posted “Germany identifies fifth case of coronavirus”

German health officials said on Thursday they had identified the country’s fifth case of the coronavirus in an employee working at the same firm as the other four infected individuals in the northern state of Bavaria.

“This concerns an employee at the company in Starnberg at which the other four known cases work,” said Bavaria’s health ministry in a statement, adding further details would be made available on Friday.

January 30: Executive Director of Human Rights Watch, Kenneth Roth, tweeted: “Are Americans safe from the coronavirus? In only 3 years, Trump has eliminated the office of pandemic response, drastically scaled back the CDC’s overseas outbreak prevention efforts & discontinued a surveillance program meant to detect new viral threats.”

January 30: China correspondant for the BBC, Stephen McDonell, tweeted: #Coronavirus official figures update: 213 dead; 9720 infected; 15,238 suspected to have been infected; 179 recovered and discharged. Hubei alone 5806 infected and 204 dead. Wuhan city 2639 infected and 159 dead. #China.” This was the start of a short thread.

January 30: China correspondant for the BBC, Stephen McDonell, tweeted: “The number of those who’ve recovered and released does seem small. It can only mean that either they’re keeping people in hospital longer to make sure they’re OK and won’t pass the #coronavirus on or not monitoring that statistic very closely. #China” This was the end of a short thread.

January 30: Kenya Airways tweeted a screenshot of a statement:

SUSPENSION OF SERVICE TO GUANGZHOU, CHINA

Further to our prior communications regarding the current Coronavirus outbreak, we have temporarily suspended all flights to and from Guangzhou starting Friday 31st January 2020, until further notice. We however, clarify that our service between Nairobi and Bangkok remains operational.

Our consultation with the Ministries of Health and Foreign Affairs will continue and we will provide updates as the situation develops.

We apologizes to all customers for the inconvenience and reaffirm that the safety of our customers and staff remains our highest priority.

January 30: Monash University tweeted: “We’ve had to make some difficult decisions for the safety and wellbeing of our staff, students and the wider community due to the novel coronavirus, which has been declared a global health emergency by the World Health Organization.” This tweet was the start of a thread.

January 30: Monash University tweeted: “Among the difficult decisions made, all exams scheduled for February and the commencement of semseter one have been postponed.”

January 30: Monash University tweeted: “We’re continuing to monitor the rapidly evolving novel coronavirus situation acting accordingly with the advice from the Department of Human Services. For more information, see our fact sheet.” The tweet included a link to their fact sheet. This tweet was the end of the thread.

January 30: Reuters posted an article titled: “Spain to repatriate nationals from Wuhan in cooperation with UK”. From the article:

A group of Spanish citizens will fly back from the Chinese city of Wuhan in the coming hours as part of a joine repatriation operation with the United Kingdom amid concerns over coronavirus, Spain’s ministry said on Thursday.

Spain’s Health Minister Salvador Illa said earlier that the group of around 20 Spaniards will spend 14 days in quarantine when they return to the country.

January 30: Reuters posted “Factbox: Airlines suspend China flights over coronavirus”

Airlines have started suspending flights to China in the wake of a new coronavirus outbreak, which as of Thursday had killed 170 people and infected almost 8,000.

  • Air Canada said on Jan. 28 it was canceling select flights to Canada
  • Air France said on Jan. 30 it suspended all scheduled flights to and from mainland China until Feb. 9
  • Air India said it was cancelling its Mumbai-Dehli -Shanghai flight from Jan. 31 to Feb 14.
  • Air Seoul … said on Jan. 28 it had suspended all flights to China.
  • Air Tanzania – Tanzania’s state-owned carrier said it would postpone its maiden flights to China. It had planned to begin charter flights to China in February.
  • American Airlines said it would suspend flights from Los Angeles to Beijing and Shanghai from Feb. 9 to March 27.
  • British Airways said on Jan. 30 it has cancelled all flights to mainland China for a month.
  • Cathay Pacific Airways (Hong Kong) said it would progressively reduce capacity to and from mainland China by 50% or more from Jan. 30 to the end of March.
  • Delta Air Lines said on Jan. 29 it was reducing flights to China to 21 per week from 42 starting Feb. 6 through April 30.
  • Egyptair said on Jan. 30 it would suspend all flights to and from China starting Feb. 1.
  • Ethiopian Airlines on Jan. 30 denied reports it had suspended all flights to China. The airline’s statement contradicted its passenger call centre, which told Reuters earlier in the day that flights to China had been suspended.
  • Finnair (Finland) said on Jan. 28 it would suspend its flights to Nanjing and Beijing until the end of March after China suspended international group travel from the country. Finnair will suspend its three weekly flights between Helsinki and Beijing Daxing between Feb. 5 and March 29 and its two weekly flights between Helsinki and Nanjing between Feb. 8 and March 20.
  • Lion Air (Indonesia) said on Jan. 29 it would suspend all flights to China from February. The airline has suspended six flights from several Indonesian cities to China so far and will suspend the rest next month.
  • Lufthansa (Germany) said on Jan. 29 it was suspending Lufthansa, Swiss and Austrian Airlines flights to and from China until Feb. 9. The airline continues to fly to Hong Kong, but it will stop taking bookings for flights to mainland China until the end of February.
  • SAS said on Jan. 30 it has decided to suspend all fights to and from Shanghai and Beijing from Jan. 31 until Feb. 9.
  • Turkish Airlines (Turkey) said on Jan. 30 it would decrease frequency on scheduled flights to Beijing, Guangzhou, Shanghai, and Xian between Feb. 5 and Feb. 29.
  • United Airlines (Chicago-based) said it would implement a second phase of flight cancellations between its hub cities in the United States and Beijing, Hong Kong and Shanghai, resulting in 332 additional roundtrips being called off through March 28. The cancellations will reduce the carrier’s daily departures for mainland China and Hong Kong to four daily depatures from 12. United had previously suspended 24 U.S. flights to Beijing, Hong Kong and Shanghai between Feb. 1 and Feb. 8 because of a significant drop in demand.
  • United Parcel Service Inc. (UPS) has cancelled 22 China flights as a result of the Wuhan quarantines and normal manufacturing closures due to the Lunar New Year holiday, UPS Chief Executive David Abney said on Jan. 30. He did not specify how may flight cancellations were due to the virus.
  • Virgin Atlantic said on Jan. 30 it would suspend its daily operations to Shanghai for two weeks from Feb. 2. It cited declining demand for flights and the safety of its customers and staff.

January 30: Forbes posted “Mammoth Biosciences Raises $45 Million For Crispr Diagnostics – And Its Tech Is Already Being Used Against Coronavirus”. It was written by Leah Rosenbaum.

Mammoth Biosciences, a company that uses gene-editing technology Crispr for disease testing, said Thursday that it had raised $45 million in Series B funding to expand into treatments. The round, led by Dechung Capital and including new investor Verily, brings total funding to over $70 million.

The South San Francisco-based company, founded in 2017 by Forbes Under 30 honorees Trevor Martin, Janice Chen, Lucas Harrington and Crispr pioneer Jennifer Doudna, uses Crispr as a genetic “search engine” to find disease markers and alert researchers of their presence. They’ve already partners with others, such as gene-editing company Horizon Discovery and a UC San Francisco researcher who is creating a rapid diagnostic test to identify people infected with the new coronavirus.

“The company has been one of the most prolific innovators in the overall Crispr ecosystem,” says Ursheet Parikh, an investor at the Maryfield Fund, which also participated in the round.

The new capital will allow Mammoth to expand into more traditional gene editing, which can be used to treat diseases. The company also plans to double in size, [Trevor] Martin [One of the founders of Mammoth Biosciences] says. Mammoth already moved into a new lab space on the South San Francisco campus of Verily, Alphabet’s life sciences company.

Crispr gene editing emerged in the 2010’s as a tool that could quickly and precisely snip, repair or insert genes into DNA, giving rise to companies including eGenesis, Caribou Biosciences and Sherlock Biosciences. Most biotech companies in the gene-editing space use Crispr system with Cas9, a large protein that can cut DNA.

Mammoth focuses on a different one, Cas14. Martin refers to this protien as “nano-can,” because it’s smaller and more precise than the popular Cas9 protein. It’s “more of a scalpel than a sledgehammer,” he says. In a diagnostic test, the Cas protein is programmed to find a specific target.

Once it finds this target, I breaks apart a “reporter molecule,” which can then change the color of the solution, indicating a positive or negative test result. Cas14 is particularly useful in diagnostics, Martin says, because of its size and its ability to quickly generate a signal once it finds DNA evidence of disease.

The technology has big implications for diagnostics, Martin says. One of Mammoth’s current partnerships is with UCSF researcher Charles Chiu, who also sits on Mammoth’s scientific advisory board, to create a rapid diagnostic test for the new coronavirus that has sickened more than 6,100 people globally and killed 132.

Right now, suspected coronavirus samples are shipped to the Centers for Disease Control and Prevention, where it can take six or more hours for the test to complete. The new test will work by taking a sample from a nasal swab, putting it into a tube with the Crispr-Cas system and other chemicals, and then dipping in a color-changing strip of paper to determine whether the test result is positive or negative.

The whole thing should take two hours, Chiu says, and be done in a doctor’s clinic or an emergency room. His lab was already working on a similar diagnostic test quickly to the new coronavirus. Chiu says the only thing holding it back is a lack of human samples with which to test the diagnostic accuracy.

Chiu credits Mammoth’s platform for helping them create a better, faster test. “There are very few if any technologies that you could use that would have the same speed, turnaround, and accuracy,” he says.

January 30: New York State website posted “Governor Cuomo Provides Update on Novel Coronavirus While Reminding New Yorkers Flu is Still Prevalent”.

Governor Andrew Cuomo today advised New Yorkers that State and local health departments and healthcare partners are remaining vigilant and have a high state of readiness to protect New Yorkers from novel coronavirus. He also advised New Yorkers of ongoing risk for seasonal flu and urges them to take recommended precautions to prevent both. As of today, the New York State Department of Health has sent samples from 11 individuals to the CDC for testing for the novel coronavirus, with seven found to be negative and four more still pending. There are no confirmed cases in New York State.

Regarding flu however, the number of laboratory-confirmed flu cases and hospitalizations has increased every week since flu season began in October. Flu season occurs primarily from October through May, and the 2019-20 season has yet to peak.

“New York does not have one single confirmed case of novel coronavirus, but we are taking every necessary precaution to protect against its spread into our state. We have been here before, and I want to remind New Yorkers that it is much more likely that they will be exposted to the influenza virus than the coronavirus,” Governor Cuomo said. “I am urging New Yorkers to take basic precautions against the flu, such as regular hand washing and avoiding close contact with people who are sick. These measures will also help people avoid coming in contact with the novel coronavirus.”

The latest influenza surveillance report shows seasonal flu activity continues to increase in across New York State. Last week, 2,015 New Yorkers were hospitalized with lab-confirmed influenza, up eight percent from the previous week. This season, there have been 11,539 flu-related hospitalizations. In addition, last week, 15,012 laboratory-confirmed flu cases were reported to the State Department of Health, an 11 percent increase in cases from the week prior. There has been a total of 72,385 lab-confirmed cases reported this season, with three flu-associated pediatric deaths.

Influenza activity data is available on the New York State Flu Tracker. The Flu Tracker is a dashboard on the New York State Health Connector that provides timely information about local, regional and statewide influenza activity.

On January 3, the State Department of Health issued a statewide health advisory alerting healthcare providers to the dramatic increase in flu activity across New York State. The advisory also encourages providers to promote the effectiveness of patients getting vaccinated to help prevent the spread of influenza. While the effectiveness of the flu vaccine can vary, this year’s flu vaccine is likely to be more effective against the types of flu viruses that are circulating this season.

Department of Health Commissioner Dr. Howard Zucker said, “As flu is considered widespread in New York State, taking everyday preventive steps such as washing hands often, covering a cough or sneeze and staying home with experiencing flu-like symptoms will help prevent the spread of the flu. These same actions will help protect New Yorkers against the novel coronavirus.”

The latest increase in lab-confirmed flu hospitalizations comes after Dr. Zucker declared flu prevalent in December throughout New York State. The announcement put into effect a regulation requiring that healthcare workers who are not vaccinated against influenza wear surgical or procedure masks in areas where patients are typically present.

The State Health Department recommends and urges that everyone six months of age or older receive an influenza vaccination. The vaccine is especially important for people at high risk for complications from influenza, including children under age 2, pregnant women and adults over age 65. People with pre-existing conditions, such as asthma and heart disease, are also at greater risk, as are individuals with weakened immune systems due to disease or medications such as chemotherapy or chronic steroid use. Since influenza virus can spread easily by coughing or sneezing, it is also important that family members and people in regular contact with high risk individuals get an influenza vaccine.

While there is currently no vaccine for novel coronavirus, the same simple preventative measures for influenza can help stop the spread.

Last week the Department of Health issued guidance to healthcare providers, healthcare facilities, clinical laboratories, colleges and local health departments to provide updated information about the outbreak, and ensure the proper protocols are in place if a patient is experiencing symptoms consistent with the novel coronavirus, had a travel history to Wuhan, China, or had come in contact with an individual who was under investigation for this novel coronavirus.

Additionally, the Department has hosted a series of informational webinars for hospitals, colleges and local healthcare providers. The Department of Health is also working closely with the Centers for Disease Control to receive daily updates.

January 30: New Hampshire Governor Chris Sununu posted “Governor Chris Sununu Statement Following NH DHHS Announcement of Two Negative Test Results for the 2019 Novel Coronavirus”.

Today, Governor Chris Sununu issued the following statement after the U.S. Centers for Disease Control and Prevention confirmed that two individuals who had traveled to Wuhan City, China, have tested negatively for the Coronavirus:

“We are pleased the patients are doing well. It is important to note that the State of NH followed all CDC guidelines in assessing these potential cases and had a plan in place to stop potential spread of this virus. Our state remains vigilant in monitoring any potential cases and are well prepared for any future potential incidents. For future updates on the situation, visit the New Hampshire Department of Health and Human Services website.”

Note: For additional information, a copy of the New Hampshire Department of Health and Human Services’s press release is below.

NH DHHS Announces Two Negative Test Results for the 2019 Novel Coronavirus (2019-nCoV)

The New Hampshire Department of Health and Human Services (DHHS), Division of Public Health Services (DPHS) announces that two individuals in New Hampshire with recent travel to Wuhan City, China, have tested negative for the 2019 novel coronavirus. The U.S. Centers for Disease Control and Prevention (CDC) has confirmed the negative tests and both patients have fully recovered. DHHS will continue to monitor for new suspect cases of this new coronavirus for individuals who develop fever or respiratory symptoms after traveling to the affected areas in China.

“We have not yet identified any individuals infected with this novel coronavirus in New Hampshire, but we continue to work closely with healthcare providers and the CDC to protect the health of our communities,” said New Hampshire State Epidemiologist Dr. Benjamin Chan. “Rapid identification and testing of individuals is critical in preventing the spread of this novel coronavirus. We will continue to work with healthcare providers to monitor for any additional suspect cases that may occur in New Hampshire and test as appropriate based on a person’s symptoms and travel to affected areas in China. The risk to our communities remains low.”

“We are pleased the patients are doing well,” said Governor Chris Sununu. “It is important to note that the State of NH followed all CDC guidelines in assessing these potential cases and had a plan in place to stop the potential spread of this virus. Our state remains vigilant in monitoring any potential cases and are well prepared for any future potential incidents.”

More than 7,000 cases of novel coronavirus have been identified in more than fifteen countries, including the U.S., where the total number of cases remains at five. DHHS has asked New Hampshire healthcare providers to alert DPHS if they identify patients with travel to Hubei Province, China, who become ill with fever or respiratory symptoms within 14 days of travel so that DPHS can help assess risk, assist with testing, and ensure isolation of the ill patients to prevent the potential spread of novel coronavirus.

While the risk of contracting coronavirus remains low in the US, there are protective measures people can take to reduce their risk of illness. While we are still learning about how easily this novel coronavirus is spread, most coronaviruses of this type are transmitted through the spread of respiratory droplets, and people can take precautions similar to those taken during flu season to prevent the spread of illness; frequent handwashing with soap and water, avoiding close contact with sick people, staying home if you are sick, covering your nose and mouth when sneezing or coughing, and cleaning and disinfecting surfaces and objects that may be contaminated with germs.

Reported symptoms of illness have primarily included fever, cough, and difficulty breathing. There are currently no vaccines available to protect against the novel coronavirus. CDC now recommends avoiding all nonessential travel to China. For the most updated travel recommendations, people planning a trip to China or surrounding areas should check the CDC website for any updated travel restrictions and recommendations. Residents who have recently traveled to Hubei Province, China and are feeling sick should call their health care provider and let them know of their travel and symptoms before presenting to a provider office.

January 30: CNBC posted “Russia closes border with China to prevent spread of the coronavirus”. It was written by Holly Ellyatt.

Russia is to close its border with China as a measure to prevent the spread of the coronavirus, according to the country’s state media.

Russian Prime Minister Mikhail Mishustin said Thursday morning that he had signed an instruction to close the state border in the Far East, Russian news agency TASS reported.

“A corresponding instruction was signed today. Work on it is already in progress. We will inform all those concerned properly about the measures to close the border in the Far Eastern region and other steps the government has taken (to prevent the spread of coronavirus in Russia)” the news agency quoted him as telling a cabinet meeting on Thursday.

Sixteen out of the 25 crossings along the Russian-Chinese border will be closed as of midnight January 31, the decree said, according to the Moscow Times. Russia’s Foreign Ministry said Thursday that it had temporarily suspended the issuing of electronic visas to Chinese nationals.

The move by Russia comes as the pneumonia-like virus, first identified in the Chinese city of Wuhan at the end of December, continues to spread.

China’s health authorities say the number of cases has now exceeded 7,711 and the death toll stands at 170.

Most of the cases are in China but the virus has also been found in France, Germany, Cambodia, South Korea, Singapore, the U.S., Thailand, Sri Lanka and Japan. The Philippines and India have confirmed their first cases on Thursday too.

So far, there have been no reported cases of the virus in Russia. The World Health Organization is to decide later Thursday whether to declare a global health emergency over the outbreak.

January 30: Boston.com posted “‘We need to put the health and well-being of our musicians first’: Boston Symphony Orchestra cancels East Asia tour”. It was written by Ainsile Cromar.

The Boston Symphony Orchestra’s East Asia tour has been cancelled as growing concerns loom over the spread of the deadly new coronavirus.

While the Centers for Disease Control and Prevention reported that the health risk in the U.S. is still low, on Jan. 27, they issued a level three travel health notice, which recommends all travelers avoid nonessential travel to China.

The symphony’s four-city tour led by director Andris Nelsons would have traveled from Feb. 6 to Feb. 16, according to a BSO press release, but after discussion between Shanghai Oriental Art Center — which has made cancellations in its own upcoming performances — and the tour’s other presenters, they’ve decided to prioritize their musicians’ health. 

“We are all deeply disappointed that we will not be able to perform for the wonderful audiences in Seoul, Taipei, Hong Kong, and Shanghai,” BSO President and CEO Mark Volpe wrote in the release. “At this time of grave concern over the spread of the new coronavirus, our thoughts continue to be with those most directly affected by this serious public health crisis.”

The orchestra has only cancelled two other international performances in the past: once in 1960, during the Asia-Australasia tour which skipped an appearance in Seoul, South Korea because of political unrest, and again in Beijing after the Chinese embassy in former Yugoslavia was accidentally bombed in 1999.  

The 2020 trip would have been the BSO’s 29th international tour since the orchestra was founded in 1881, and its first appearance in Seoul.

“We greatly appreciate everyone’s understanding that we need to put health and well-being of our musicians first and foremost,” BSO Music Director Andris Nelsons said. “Please know the we are all passionately committed to a future visit to East Asia soon.”

Nelsons expressed his thanks to everyone involved in making the tour possible, his regret to anyone impacted by the virus.

“We all feel deep gratitude to the many wonderful people who worked so hard at every level to organize and support this tour,” he said. “Most importantly, our hearts and prayers are with everyone who has been affected by the coronavirus.”

January 30: Billboard reported NCT Dream’s promoter One Production announced the cancellation of the group’s two shows in Macau, China, on Feb. 7 and 8 and their Feb. 15 concert in Singapore.

The Boston Symphony Orchestra announced the cancellation of its Asia tour. The orchestra had been scheduled to go on a four-city tour that included Seoul in South Korea, Taipei in Taiwan and Shanghai and Hong Kong in China from Feb. 6-16.


January 31

January 31: World Health Organization (WHO) posted: “Novel Coronavirus (2019-nCoV) Situation Report – 11”

Highlights:

  • The Emergency Committee on the novel coronavirus (2019-nCoV) under the International Health Regulations (HR 2005) was reconvened on 30 January. WHO declared the outbreak to be a public health emergency of international concern. The Emergency Committee has provided advice to WHO, to the People’s Republic of China, to all countries, and to the global community, on measures to control this outbreak. The Committee believes that it is still possible to interrupt virus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk.
  • Today, the first two confirmed cases of 2019-nCoV acute respiratory disease were reported in Italy; both had history to Wuhan City.
  • WHO’s Risk Communication Team has launched a new information platform called WHO Information Network for Epidemics (EPI-WIN). EPI-WIN will use a series of amplifiers to share tailored information for specific target groups. EPI-WIN began this week to establish connections to health care and travel and tourism sectors and will work with food and agriculture and business/employer sectors next week.

TECHNICAL FOCUS

As part of WHO’s response to the outbreak, the R&D Blueprint has been activated to accelerate evaluation of the diagnostics, vaccines and therapeutics for this novel coronavirus.

The global imperative for research is to maintain a high-level discussion platform which enables consensus on strategic directions, nurtures scientific collaborations and, supports optimal and rapid research to address crucial gaps, without duplication of efforts.

Understanding the disease, its reservoirs, its transmission, its clinical severity and developing effective counter measures including therapeutics and vaccines is critical for control of the outbreak, the reduction of related mortality and minimization of economic impact.

Countries, territories or areas with repeated confirmed cases of 2019-nCoV, 31 January 2020:

  • China (including cases confirmed in Hong Kong SAR (12 confirmed cases), Macau (7 confirmed cases) and Taipei (9 confirmed cases): 9720
  • Japan: 14
  • Republic of Korea: 11
  • Viet Nam: 5
  • Singapore: 13
  • Australia: 9
  • Malaysia: 8
  • Cambodia: 1
  • Philippines: 1
  • Thailand: 14
  • Nepal: 1
  • Sri Lanka: 1
  • India: 1
  • United States of America: 6
  • Canada: 3
  • France: 6
  • Finland: 1
  • Germany: 5
  • Italy: 2
  • United Arab Emirates: 4
  • TOTAL: 9826

PREPAREDNESS AND RESPONSE

  • WHO has actively sought misinformation and responded to rumors through ‘myth busting’ on WHO’s social media and website.
  • WHO has developed a protocol for the investigation of early cases (the “First Few X (FFX) Cases and contact investigation protocol for the (2019-nCoV) infection”). The protocol is designed to gain an early understanding of the key clinical, epidemiological and virological characteristics of the first cases of 2019-nCoV infection detected in any individual country, to inform the development and updating of public health guidance to manage cases and reduce potential spread and impact of infection.
  • WHO has been in regular interim guidance for laboratory diagnosis, advice on the use of masks during home care and in health setting in the context of the novel coronavirus (2019-nCoV) outbreak, clinical management, infection prevention and control in health care settings, home care for patients with suspected novel coronavirus, risk communication and community engagement.
  • Prepared disease commodity package that includes an essential lis of biomedical equipment, medicines and supplies necessary to care for patients with 2019-nCoV.
  • WHO has provided recommendations to reduce risk of transmission from animals to humans.
  • Activation of R&D blueprint to accelerate diagnostics, vaccines, and therapeutics.
  • WHO is providing guidance on early investigations, which are critical to carry out early in an outbreak of a new virus. The data collected from the protocols can be used to refine recommendations for surveillance and case definitions, to characterize the key epidemiological transmission features of 2019-nCoV, help understand spread, severity, spectrum of disease, impact on the community and to inform operational models for implementation of countermeasures such as case location, contact tracing and isolation. The first protocol available is a: Household transmission investigation protocol for 2019-novel coronavirus (2019-nCoV) infection.
  • WHO is working with its networks of researchers and other experts to coordinate global work on surveillance, epidemiology, modelling, diagnostics, clinical care and treatment, and other ways to identify, manage the disease and limit onward transmission. WHO has issued interim guidance for countries, updated to take into account the current situation.
  • WHO is working with global expert networks and partnerships for laboratory, infection prevention and control, clinical management and mathematical modelling.

RECOMMENDATIONS AND ADVICE FOR THE PUBLIC

During previous outbreaks due to other coronavirus (Middle-East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), human-to-human transmission occurred through droplets, contact and fomites, suggesting that the transmission mode of the 2019-nCoV can be similar. The basic principles to reduce the general risk of transmission of acute respiratory infections include the following:

  • Avoiding close contact with people suffering from acute respiratory infections.
  • Frequent hand-washing, especially after direct contact with ill people or their environment.
  • Avoiding unprotected contact with farm or wild animals.
  • People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands).
  • Within healthcare facilities, enhance standard infection prevention and control practices in hospitals, especially in emergency departments.

WHO does not recommend any specific health measures for travelers. In case of symptoms suggestive of respiratory illnesses either during or after travel, travelers are encouraged to seek medical attention and share their travel history with their healthcare provider.

January 31: President Donald Trump tweeted: “The Radical Left, Do Nothing Democrats keep chanting “fairness”, when they put on the most unfair Witch Hunt in the history of the U.S. Congress. They had 17 Witnesses, we were allowed ZERO, and no lawyers. They didn’t do their job and had no case. The Dems are scamming America!”

January 31: President Donald Trump tweeted: “Democrats = 17 Witnesses. Republicans = 0 Witnesses”.

For context, President Trump was intensely focused on complaining about his impeachment hearing.

January 31: CBS News posted “Global airlines suspend flights to China on virus fears”.

Airlines around the world are canceling or suspending flights to China amid the growing coronavirus outbreak and a sharp drop in demand for travel to the country. Among the airlines scaling back or cancelling flights are United Airlines, Air Canada, British Airways and Delta Airlines.

By Thursday morning, the flu-like virus had killed at least 170 people, all of them in China. More than 9,000 others have been infected in more than a dozen countries, including six confirmed cases in the United States.

Texas Republican Senator Ted Cruz, chairman of the subcommittee on Aviation and Space, called Friday for the U.S. government to implement a total travel ban on China as the virus continued to spread. Secretary of State Mike Pompeo said earlier in the week that the Trump Administration was considering it, but no decisions have been announced.

As demand for travel drops to China because of the outbreak, airlines including United, Finnair, Hong Kong-based Cathay Pacific and Singapore-based Jetstar Asia have said they are cutting back on flights.

On Thursday, United said it would extend its suspended flights to China through March 28, cutting to just four daily departures its typical daily departures from the U.S. mainland China. United had said earlier the flight cutbacks would end on February 8.

Delta said Friday that all flights to and from China would stop operating from February 6, with the airline flying reduced schedules before then “to ensure customers looking to exit China have options to do so.” Delta said the last flight from China to the U.S. would leave on February 5.

British Airways said Wednesday that it is immediately suspending all flights to and from mainland China after the U.K. government warned against unnecessary travel to China amid a virus outbreak.

In the U.S., Secretary of State Mike Pompeo said a complete ban on travel to and from China is among the options the Trump administration is considering as it tries to address the rapid spread of the deadly new coronavirus.

French flagship carrier Air France announced Thursday it was suspending all normal scheduled flights to and from mainland China in a bid to help stem the spread of the new coronavirus. There were five confirmed cases of the virus in France as of Thursday.

Delta on Wednesday said it would temporarily reduce its weekly flights between the U.S. and China because of “significantly reduced customer demand.” Its flights will be cut from 42 weekly flights to 21 weekly flights, it said.

China has cut off access to the central city of Wuhan, epicenter of the outbreak, and 16 other cities to prevent people from leaving and spreading the virus further. Hong Kong airlines are cutting the number of their flights to the mainland by about half through the end of March in response to government virus-control efforts.

The first Americans evacuated on a U.S. government flight from the Chinese city at the center of the outbreak were likely facing at least a couple more days of isolation at a military base in Southern California, as the U.S. government planned more evacuation flights in the coming days. The first evacuees cleared initial health checks in China and then again during a stopover in Alaska on the way to the California base.

List of flight cancelations

  • Air Canada – on Wednesday said it’s suspending all direct flights to Beijing and Shanghai effective January 30 until February 29.
  • Lufthansa – said Wednesday that it’s suspending direct flights on Lufthansa, Swiss and Austrian Airline fleets to or from mainland China until 9 February.
  • Air Seoul – a budget airline, became the first South Korean airline to suspend its flights to mainland Chinese destinations apart from Wuhan, stopping its flights to the cities of Zhangjiajie and Linyi.
  • Indonesia’s Lion Air said it canceled more than 50 fights to China well into February. The flights are from five international airports in Manado, Surabaya, Jakarta, Batam and from Denpasar, in Bali, to 15 airports in China. Lion Group’s spokesman Dana Mandala Prihantor said the suspension would be phased in gradually and would continue until further notice.
  • Cathay Pacific Group said flights to 24 mainland destinations would be reduced to 240 weekly. The company owns Cathay Pacific Airways, cargo carrier Air Hong Kong, Cathay Dragon and Hong Kong Express.
  • Helsinki, Finland-based Finnair, which has actively promoted its position linking Asian and Western destinations, said it was canceling three weekly flights to Beijing Daxing International Airport through late March, as well as its twice-weekly flights to Nanjing. It will continue operating flights to four other mainland Chinese destinations, including Beijing Capital Airport.
  • Jetstar Asia said it will temporarily suspend flights to the Chinese cities of Hefei, Guiyang and Xuzhou starting Thursday through the end of March due to drop in demand.
  • South Korea’s second-largest carrier, Asiana Airlines, said it will temporarily suspend flights to the Chinese cities of Guilin, Changsha and Haikou starting next month.
  • Taiwan’s Eva Air announced a partial cancellation of flights to and from mainland China for two weeks starting Feb. 2. In addition, the airline has stopped providing towels, magazines, table clothes, and is limiting use of blankets and pillows on its flights.
  • Kazakhstan, which shares a long border with far western China, announced Wednesday that it plans to suspend all flights, train and bus traffic and to halt issuing visas to Chinese nationals.

January 31: HHS posted: “Secretary Azar Declares Public Health Emergency For United States for 2019 Novel Coronavirus”

Health and Human Services Secretary Alex M. Azar II declared a public health emergency for the entire United States to aid the nation’s healthcare community in responding to 2019 novel coronavirus.

“While this virus poses a serious public health threat, the risk to the American public remains low at this time, and we are working to keep this risk low,” Secretary Azar said. “We are committed to protecting the health and safety of all Americans, and this public health emergency declaration is the latest in the series of steps the Trump Administration has taken to protect our country.”

The emergency declaration give state, tribal, and local health departments more flexibility to request that HHS authorize them to temporarily reassign state, local and tribal personnel to respond to 2019-nCoV if their salaries normally are funded in whole or in part by Public Health Service Act programs. These personnel could assist with public health information campaigns and other response activities.

The Centers for Disease Control and Prevention is working closely with state health departments on disease surveillance, contact tracing, and providing interim guidance for clinicians on identifying and treating coronavirus infections. HHS is working with the Department of State to assist in bringing home Americans who had been living in affected areas of mainland China. HHS divisions are also collaborating with industry to detect, prevent, and treat 2019-nCoV infections.

In declaring the public health emergency, Secretary Azar acted within his authority under the Public Health Service Act. This declaration is retroactive to January 27, 2020.

This U.S. public health emergency declaration follows a declaration by the World Health Organization that spread of the virus constituted a public health emergency of international concern.

January 31: The European Centre for Disease Prevention and Control posted: “Risk assessment: Outbreak of acute respiratory syndrome associated with a novel coronavirus, China: first local transmission in the EU/EEA – third update”.

On 31 December 2019, a cluster of pneumonia cases of unknown aetiology was reported in Wuhan, Hubei Province, China. On 9 January 2020, China CDC reported a novel coronavirus (2019-n-CoV) as the causative agent of this outbreak, which is phylogenetically in the SARS-CoV clade.

As of 30 January 2020 09:00, more than 7,000 laboratory-confirmed 2019-n-CoV cases had been reported worldwide, mainly in China, but also with more than 70 imported cases from other countries around the world. Details on the epidemiological update for 2019-nCoV can be found on ECDC’s website.

So far, one hundred and seventy deaths associated with this virus have been reported. On 20 January, Chinese health authorities confirmed human-to-human transmission outside of Hubei province. Sixteen healthcare workers are reported to have been infected.

On 24 January 2020, the first three cases of 2019-n-CoV imported into the EU/EEA were identified in France and one additional case was reported in 29 January 2020. On 28 January, a cluster of four locally-acquired cases, with indirect links to Wuhan, was reported in Germany. On 29 January, Finland reported an imported case from Wuhan.

China CDC assesses the transmissibility of this virus to be sufficient for sustained community transmission without unprecedented control measures. Further cases and deaths in China are expected in the coming days and weeks. Further cases or clusters are also expected among travelers from China, mainly Hubei province. Therefore, health authorities in the EU/EEA Member States should remain vigilant and strengthen their capacity to respond to such an event.

There are considerable uncertainties in assessing the risk of this event, due to lack of detailed epidemiological analyses.

On the basis of the information currently available, ECDC considers that:

  • The potential impact of 2019-nCoV outbreaks is high;
  • The likelihood of infection for EU/EEA citizens residing in or visiting Hubei Provence is estimated to be high;
  • The likelihood of infection for EU/EEA citizens in other Chinese Provences is moderate and will increase;
  • There is a moderate-to-high likelihood of additional imported cases in the EU/EEA;
  • The likelihood of observing further limited human-to-human transmission within the EU/EEA is estimated as very low to low if cases are detected early and appropriate infection prevention and control (IPC) practices are implemented, particularly in healthcare settings and EU/EEA countries;
  • Assuming that cases in EU/EEA are detected in a timely manner and that rigorous IPC measures are applied, the likelihood of sustained human-to-human transmission within the EU/EEA is currently very low to low;
  • The late detection of an imported case in an EU/EEA country without the application of appropriate infection prevention and control measures would result in the high likelihood of human-to-human transmission, therefore in such as scenario the risk of secondary transmission in the community setting is estimated to be high.

January 31: Nippon.com (News from Japan) posted “Japan to Add New Pneumonia to Specified Disease List Sat.”

The Japanese government decided Friday to designate pneumonia caused by the new strain of coronavirus raging in China as a specified infectious disease Saturday, a week earlier than initially scheduled.

The government is considering covering the airfares for chartered flights it dispatched to Wuhan, the epicentr of the coronavirus crisis, to help Japanese nationals return home.

Prime Minister Shinzo Abe announced these matters at the Budget Committee of the House of Representatives, the lower chamber of parliment said.

The government “will reject the entry into Japan of anybody infected who try to enter the country,” Abe told the committee.

The government is also considering what can be done to tighten immigration controls in order to limit the entry into Japan of those suspected but not confirmed to be infected, he added.

January 31: Massachusetts.gov posted “Massachusetts state officials announce Coronavirus preparation measures”

Today, the Department of Public Health and Massport detailed ongoing steps being taken to ensure the Commonwealth is prepared to respond to the 2019 novel coronavirus. The U.S. Centers for Disease Control and Prevention (CDC) has identified Boston Logan International Airport as one of 20 additional airports that will have enhanced screening for passengers arriving from China, beginning in the coming days. To date, there have been no confirmed cases of 2019 novel coronavirus in Massachusetts and the risk to residents remains low.

The novel coronavirus has resulted in thousands of confirmed human infections in more than 20 countries, with more than 99 percent of cases in China. To date, six cases have been confirmed in the US, two individuals in California, two individuals in Illinois and one individual each in Washington State and Arizona. Again, to date, there have been no confirmed cases in Massachusetts.

On Friday, US Health and Human Services Secretary Alex Azar declared the 2019 novel coronavirus public health emergency and ordered any US citizens returning from the center of the outbreak in China to be quarantined for two weeks. This followed a declaration Thursday by the World Health Organization that the coronavirus out break is a Public Health Emergency of International Concern. Also that day the CDC reported the first case of person-to-person transmission in Illinois. Massachusetts state health officials, in conjunction with Massport and local health departments, have responded to prevent the spread of the virus.

Among the steps taken by the Department of Public Health:

  • Established an Incident Command Structure to facilitate the dissemination of information from federal and state partners to statewide stakeholders regularly.
  • Launched a new website that provides up-to-date information on the status of novel coronavirus for all residents: www.mass.gov/2019coronavirus
  • Developed and disseminated clinical advisories to all Massachusetts health care providers and issue guidance to hospitals, health-systems and Emergency Medical Services.
  • Scheduled calls with other key health care partners including local boards of health.

“Our priority is protecting public health as we work with our state and federal partners to provide the most up to date information and guidance to our residents,” said Public Health Commissioner Monica Bharel, MD, MPH. “We understand that this new virus is causing public concern, but I want to reassure people that at this time, the risk to Massachusetts residents remains low.”

As announced earlier this week, the CDC will start to screen international passengers for symptoms and signs of novel coronavirus. This is in addition to the 5 airports where enhanced screening is already underway. Logan International Airport has three daily non-stop flights from China; Beijing, Shanghai and Hong Kong. Logan Airport does not have any flights originating in Wuhan, China or Hubei Province.

With the US government’s declaration Friday of a public heath emergency, which includes limiting arrivals from China to just a handful of airports, starting Sunday, Feb. 2, the plans for Logan International Airport could change.

Coronaviruses are respiratory viruses and are generally spread through respiratory secretions (droplets from coughs and sneezes) of an infected person to another person. Symptoms of novel coronavirus include: fever, cough and shortness of breath, and in severe cases, pneumonia (fluid in the lungs). Information about how this novel coronavirus spreads is still limited.

Although the risk of the coronavirus to Massachusetts residents remains low, people are advised to take many of the same steps they do to help prevent colds and the flu, including:

  • Wash hands often with soap and warm water for at least 20 seconds.
  • Cover coughs and sneezes.
  • Stay home when feeling sick…

January 31: New South Wales Health posted “Novel Coronavirus Statistics” – 10.30 am”

NSW – number of cases confirmed – 4 (see below)

NSW – number of cases under investigation – 9

NSW – number of cases cleared – 67

Of the four confirmed cases, two patients have been discharged, a 53 year old male and a 35 year old male.

Two patients remain in hospital, a 21 year old female and 43 year old male.

We will not be disclosing the hospital locations of patients under investigation for privacy reasons.

January 31: Nippon.com (News from Japan) posted “3rd Evacuation Flight Brings Home Japanese from Wuhan”. From the article:

The third charter jet sent to Wuhan by the Japanese government arrived at Tokyo International Airport at Hanada on Friday, bringing home 149 Japanese nationals from the Chinese city mired in the coronavirus crisis.

Some of the people are complaining of ill health, officials said.

Returnees who show no symptoms after taking medical checks will be transferred to designated facilities to monitor their health condition for a while.

A total of 565 Japanese nationals were brought back to Japan aboard three government-chartered planes to Wuhan to evacuate all Japanese nationals who want to return home during the outbreak of pneumonia caused by the deadly virus.

According to the health ministry, three people in their 40s to 50s who were aboard the first flight, which arrived in Japan Wednesday, tested positive for the virus. Two of them did not show symptoms of the coronavirus-caused pneumonia.

January 31: ABC News Australia posted “Chinese women’s soccer team quarantined in Brisbane hotel as state confirms first coronavirus case”. It was written by Talissa Siganto. From the article:

Queensland health officials have revealed the Chinse women’s national soccer team is being quarantined in Brisbane over concerns about the possible spread of coronavirus.

The announcement came shortly before the state’s chief officer, Jeannette Young, confirmed Queensland’s first case of the illness.

“A 44-year-old Chinese national, who is currently isolated in the Gold Coast University Hospital, has been confirmed to have novel coronavirus,” Dr. Young said in a statement on Wednesday night.

“The man, who is from the city of Wuhan (Hubei Province) is stable.”

It came as Victorian authorities confirmed that state’s second case, bringing the total number of cases nationally to seven.

The virus has infected more than 6,000 people around the world, most of them in China, where the death toll stands at 133.

Dr Young earlier said 32 people in the Chinese women’s soccer squad – including players and staff – travelled through the city of Wuhan one week ago, where the outbreak is believed to have begun.

In light of this, Dr Young said they had been placed in a Brisbane hotel until February 5.

The group were checked by border officials after arriving in Brisbane on a flight from Shanghai on Wednesday morning before being placed in isolation at a hotel.

Dr. Young said authorities were working with the team and the hotel’s management to ensure the visitors remained separated from staff and other guests.

She said no-one from the group had shown any symptoms of the virus and the team had been traveling with their own doctor.

“There is absolutely no risk to anyone else in that hotel or to the staff in the hotel, these people are all well,” she said.

“They’ve been extremely cooperative, as has the Chinese consulate, and they will work with us, and the hotel has been fantastic as well.

“If any of these footballers develop any symptoms we will of course be taking them immediately to one of our hospitals … to be immediately assessed and tested and isolated.”

In a statement, Football Federation Australia (FFA) said the health and wellbeing of all players, staff and spectators was “of paramount importance to both FFA and the Asian Football Confederation (AFC)”.

“FFA is working with the Australian Government and AFC to explore the ramifications of this advice and how it may affect the staging of the Women’ Olympic Football Tournament Qualifiers,” the FFA said.

As a result of these developments … FAA will not be going on sale [on Thursday] with tickets for the tournament.”

The Asian Football Confederation (AFC) has also changed the order of home matches to be played by Chinese clubs in the AFC Champions League group stage due to the coronavirus, Asian soccer’s governing body has confirmed.

The move follows consultation with the Chinese Football Association (CFA) and means that home games of the four Chinese clubs on the first three match days will be rescheduled and played away by swapping the order with their opponents.

“The decision, which was also made in conjunction with the competing clubs from the respective groups, is a precautionary measure to ensure the safety and wellbeing of all participating players and teams,” the AFC said in a statement.

According to the revised schedule, Beijing Guoan will open their campaign at FC Seoul on February 11 and visit Melbourne Victory on March 3.

Students back from China urged to stay home

Meanwhile, the Queensland Education Department has also issued new advice for any students or staff who have traveled to China in the past 14 days to keep themselves isolated and not return to school for 14 days.

Queensland Health Minister Steven Miles said the advice given to schools would be updated in line with the changes to the national advice.

“We are updating the advice to schools to ask them to isolate all students who have travelled to China in the last 14 days until they have been returned 14 days without symptoms,” he said.

Mr. Miles said authorities were continuing to work together across all levels of government and with other states to “keep Queenslanders safe.”

Education Minister Grace said the department would alert schools about the change in advice immediately.

“This is a precaution, but we ask of course to ack is there are any symptoms … self-isolate immediately,” she said.

Brisbane’s Stuartholme School which had earlier this week planned to isolate 10 of its boarding students from mainland China but still allow them to attend classes said it would not keep them from classes for 14 days.

January 31: World Health Organization Western Pacific tweeted: “The total number of confirmed cases of the 2019 novel #coronavirus reported from mainland China to date is 11,791. This includes 1,795 severe cases and 259 people who have died. #nCoV #nCoV2019 #2019nCov” This tweet was the start of a thread.

January 31: World Health Organization Western Pacific tweeted: “Hong Kong SAR has reported a total of 13 cases, Macao SAR has reported 7 cases, and Taiwan, China has reported 10 cases #coronavirus #nCoV #nCoV2019 #2019nCoV”.

January 31: World Health Organization Western Pacific tweeted: “Other countries in the @WHO Western Pacific Region: Singapore has reported 16 cases, Japan 13 cases, Rep of Korea 12 cases, Australia 9 cases, Malaysia 8 cases, Viet Nam 5 cases, Camboria & Philippines 1 case each #coronavirus #nCoV #nCoV2019 #2019nCoV”

January 31: World Health Organization Western Pacific tweeted: “It is importan to note that case numbers reflect date reported, not date of illness onset. #coronavirus #nCoV #nCoV2019 #2019nCoV”. This was the last tweet in the thread.

January 31: Nippon.com (News from Japan) “Japan Travel Agencies Hit by Cancellations of China Tours”.

Massive cancellations of China-bound package tours from Japan are hitting Japanese travel agencies in the wake of the outbreak of pneumonia blamed on a new strain of coronavirus spreading from Wuhan, the capital of China’s Hubei Province.

As the outbreak spread throughout the world, the Japanese tourism industry is concerned that the coronavirus crisis may affect overall demand for travel abroad, sources familiar with the situation said.

The outbreak is also causing travel agencies to suspend China-bound package tours not including visists to Hubei, because major tourism spots outside the province, such as the Palace Museum in Beijing and the Great Wall of China, have been closed amid the crisis.

In an unusual move, JTB Corp. and H.I.S. Co <9603> have decided to give full refunds to customers for tours anywhere in China, excluding Hong Kong and Macau, without collectin cancellation fees, even if they cancel their tours just before departure.

JTB, Club Tourism International Inc. and Hankyu Travel International Co. have halted tours to Wuhan after Japan’s Foreign Ministry raised its travel alert related to infectious diseases. JTB plans to continue the suspension until the advisory is lowered to Level One from the current Level 3, which calls for avoiding travel to designated areas.

January 31: UK Department of Health and Social Care posted “CMO confirms cases of coronavirus in England”. It is a statement from Chief Medical Officer, Professor Chris Whitty, about cases of novel coronavirus in England.

We can confirm that 2 patients in England, who are members of the same family, have tested positive for coronavirus. The patients are receiving specialist NHS care, and we are using tried and tested infection control procedures to prevent further spread of the virus.

The NHS is extremely well-prepared and used to managing infections and we are already working rapidly to identify any contacts the patients had, to prevent further spread.

We have been preparing for UK cases of novel coronavirus and we have robust infection control measures in place to respond immediately. We are continuing to work closely with the World Health Organization and the international community as the outbreak in China develops to ensure we are ready for all eventualities.

January 31: Billboard posted “Cancellations Announced in January”

Three stops on GOT7’s world tour “Keep Spinning” tour were postponed including their concerts in Bangkok planned for Feb. 15 and 16 at Rajamangala National Stadium and a concert in Singapore planned for Feb. 22.

K-pop group TWICE‘s Tokyo fan signing events to be held on Feb. 1 and 2 were canceled.

The inaugural C.E.A. (Charming Eastern Awakening) Fest in Joy Park in Chengdu in China scheduled for April 18-19 is canceled. The event was set to headlining performances from Martin Garrix and Dimitri Vegas & Like Mike.

January 31: Nippon.com (News from Japan) posted “Nara Puts Off Accomodation Tax amid Coronavirus Outbreak”.

The western Japan city of Nara will put off its plan to introduce the accommodation tax during fiscal year 2020, to limit damage on the city’s tourism industry amid the outbreak of a new coronavirus, its mayor said Friday.

Mayor Motonobu Nakgawa told a press conference that the city will take various factors into consideration and decide when to introduce the tax after monitoring the situation concerning the virus.

A city survey of 13 large hotels with 100 rooms or more each showed that reservations for 3,156 guests, mainly on group tours from China, had been cancelled as of Thursday, according to the city.

On Tuesday, the health ministry said that a Japanese male bus driver in Nara Prefecture has been confirmed as infected with the virus. He drove tourists from the Chinese city of Wuhan, the center of the outbreak.

“It has been confirmed that their is obious damage (to tourism). We need to stop for now to see how things go.” Nakagawa said.

January 31: Nippon.com (News from Japan) posted “Japan Confirms 2 More Symptomless Returnees with New Coronavirus”.

Two Japanese nationals who returned from Wuhan on Thursday aboard the second government-chartered flight have been found to be infected with the new coronavirus that spread from the Chinese city and has caused an outbreak of pneumonia, the Japanese health ministry said Friday.

A man in his 30s and another man in his 50s tested positive for the virus, but have no symptoms. The number of returnees who are infected with the coronavirus but have no symptoms now stands at four. The other people returned to Japan on Wednesday aboard the first chartered flight.

A total of 210 Japanese nationals returned home on the second chartered plane. The first flight brought home 206 people, with three of them, including the two symptomless people, found to have the coronavirus.

The third flight chartered by the Japanese government for the evaucation operations arrived at Tokyo International Airport in Haneda on Friday moring with 149 passengers from Wuhan, bringing the total number of Japanese people brought back from the city and other parts of Hubei Province to 565.

Twenty-five of the 149 passengers complained of symptoms such as coughing and were admitted to hospitals in Tokyo. The remaining passengers were sent to the National Institute of Public Health in Wako, Saitama Prefecture, north of Tokyo, or the Customs Training Institute in Kasiwa, Chiba Prefecture, east of the Japanese capital, for monitoring

January 31: CDC tweeted: “The CDC, under statutory authority of the Health and Human Services (HHS) Secretary, has issued federal quarantine orders to all 195 United States citizens who repatriated to the U.S. on January 29, 2020. The quarantine will last 14 days from when the plane left Wuhan, China.” This tweet was the start of a thread.

January 31: CDC tweeted: “This action is a precautionary and preventative step to maximize the containment of the virus in the interest of the health of the American public. The current epidemic in Mainland China has demonstrated the #2019nCoV’s capacity to spread globally.”

January 31: CDC tweeted: “This legal order is part of a public health response that is necessary to prevent the transmission and spread of this virus in the U.S. This federal quarantine will protect the health of the repatriated US citizens, their families, and their communities. #2019nCoV”

January 31: CDC tweeted: “CDC is committed to protecting the health & safety of all Americans. We continue to believe the immediate risk to the larger American public is low at this time. The #2019nCoV outbreak investigation is ongoing. For updates:” The tweet included a link to the CDC website. This was the last tweet in the thread.

January 31: The Desert Sun posted “‘A whole different ballgame’: Wuhan flight passengers at March Air Reserve Base under quarantine; evacuee shares experience”. It was written by Marie McCain and wires.

Officials with the Centers for Disease Control and Prevention on Friday ordered the quarantine of all 195 U.S. evacuees from Wuhan, China, who are being screened for symptoms of the coronavirus at March Air Reserve Base near Moreno Valley.

So far, none of them have exhibited symptoms of the virus, a Riverside County spokeswoman said Friday. Nevertheless, the quarantine order means they will have to remain on base for the full 14-day incubation period.

“This action is a precautionary and preventative step to maximize the containment of the virus in the interest of the health of the American public” the CDC said in announcing the quarantine.

“This legal order will protect the health of repatriated citizens, their families, and their communities. These individuals will continue to be housed at the March Air Reserve Base. Medical staff will continue to monitor the health of each traveler, including temperature checks and observation for respiratory symptoms,” the agency added.

“If an individual presents symptoms, medical care will be readily available. Even if a screening test comes back negative from CDC’s laboratory results, it does not conclusively mean an individual is at no risk of developing the disease over the likely 14-day incubation period.

U.S. emergency declared, travel restricted

Federal officials said the CDC quarantine in Southern California was one of the reasons the coronavirus outbreak was declared a public health emergency in the United States.

Health and Human Services Secretary Alex Azar, on Friday, made that announcement along with another that President Donald Trump will temporarily bar entry to the U.S. of foreign nationals believed to be at risk of transmitting the virus. The new restrictions begin Sunday afternoon.

“The risk of infection for Americans remains low and with these and our previous actions we are working to keep the risk low,” Azar said.

Americans returning from Hubei province, the center of the outbreak, will be required to undergo 14 days of quarantine. Others returning from elsewhere in China will be allowed to self-monitor their condition for a similar period.

The public health announcement came hours after the State Department issued a level 4 “Do Not Travel” advisory, the highest grade of warning, and told Americans in China to consider departing using commercial means.

“Travelers should be prepared for travel restrictions to be put into effect with little or no advance notice,” the advisory said.

Friday’s order quarantining U.S. evacuees at March Air Reserve Base is the first time a federal quarantine has been ordered since the 1960s, when one was instituted over concern about potential spread of smallpox, the CDC said.

A day earlier, Riverside County health officials ordered the quarantine of one of the evacuees after that person attempted to leave the base hours after the group arrived.

“We understand this action may seem drastic,” the CDC’s Dr. Nancy Messonnier said. “We would rather be remembered for over-reacting than under-reacting.”

A morbid accounting

China, as of Friday morning, counted 9,692 confirmed coronavirus cases with a death toll of 213, including 43 new fatalities. The vast majority of the cases have been in Hubei province and its provincial capital, Wuhan, where the first illnesses were detected in December. No deaths have been reported outside China.

The National Health Commission reported 171 cases have been “cured and discharged from the hospital.” The World Health Organization has said that most people who got the illness had milder cases, though 20% experienced severe symptoms.

The virus can cause fever, coughing, wheezing and pneumonia. Health officials think it spread mainly from droplets when an infected person coughs of sneezes, similar to how the flu spreads.

That almost 10,000 people globally have fallen in in just two months is a troublesome sign of the virus’ spread, according to the WHO, which has declared the outbreak a global emergency.

There are six U.S. cases, with one each in Los Angeles and Orange counties, as well as in Chicago, Arizona, and Washington state. Five of the six people who have contracted the virus involve visitors to China.

The first case of a person-to-person transmission in the U.S. involved the husband of a Chicago woman who returned from China on Jan. 13. Both are hospitalized.

In Southern California, authorities described the 195 evacuees as U.S. citizens. Most of them are State Department diplomats and their families. None of them are from Riverside County.

They were screened twice before departing Wuhan and had another evaluation during a stopover in Anchorage, Alaska, before landing Wednesday morning at the air base, officials said.

Their plane was bound for Ontario International Airport before being diverted.

Dr. Chris Braden, deputy director of the CDC’s National Center for Emerging an Zoonotic Infectious Diseases, has said the decision to monitor the passenger at the air base was made “at a high level of government.”

Wuhan ‘turned into chaos’

Late Thursday, one of the evacuees shared his experiences in a telephone interview with the Associated Press.

Jarred Evans is a professional football player in China. He is used to wearing a helmet and shoulder pads. But in the wake of a deadly viral outbreak, he’s switched to a mask and medical gloves.

“When you’re dealing with life and death, it’s a whole different ballgame,” he said.

The evacuees, including children ranging from around a year old to about 13, are staying at the sprawling base where they received a battery of blood tests and were given nose, throat and mouth swabs, Evans, 27, said. Some test results won’t be back for a week, he added.

While the surroundings are fairly comfortable, Evans said Thursday that he and others are still being cautious about mingling.

“I’m still wearing my mask and I’m still wearing my gloves,” he said in a telephone interview. “We’re still not knowing who has it. I’m still taking major precautions. You don’t know whether you’re in the clear.”

“Today, a lot of kids were enjoying the weather,” he said, and the base provided scooters, bikes, footballs and soccer balls for them to play with.

But at dinnertime, Evans added, “everyone’s getting their food and going right back to their rooms.”

Those being held at the base 60 miles (96 kilometers) east of Los Angeles arrived Wednesday morning.

Evans said he would remain until testing shows he is free of the virus.

He is a professional quarterback who moved to Wuhan several years ago to play in a Chinese football league.

The city of 11 million people felt joyful, he said, with residents getting ready for the Lunar New Year.

Then, in a matter of days, “it turned into chaos” as news broke of the rapidly expanding coronavirus outbreak. Suddenly, Evans said, people were swarming pharmacies and stores to get masks and disinfectant spray.

Friends translated the news for Evans, who speaks no Chinese.

“I stocked up on rice, noodles, water, anything that could help me survive for a week or two,” Evans said.

From New York City to ghost town

The Chinese government shut dow the city. Busses, trains, taxis, and personal cars were banned. The military patrolled some streets.

“That’s when people, honestly, stayed locked in their homes,” Evans said.

He compared the deserted city to an Old West ghost town.

“I’ve never experienced anything like this before,” he said. “Imagine New York City being shut down. I was completely scared at first, because I didn’t know exactly what was going to happen. I don’t speak the language, and my family is so far away.”

Evans holed up in his home for a week and a half until he received news that the U.S. Embassy was evacuating its diplomats and their families and other U.S. citizens.

He was notified that a chartered flight was carrying some of the 1,000 or so Americans in Wuhan back to the United States. The flight was coming in the next day.

Evans said he was told, “If you can make it there, you’re on the flight.”

“It was a race against time,” he said.

Evans found an acquaintance who drove him to the airport. The embassy notified Chinese authorities of the license plate number so he could pass through the guarded streets.

Evans said he was No. 171 out of 195 people permitted on board.

On the plane were two men in full hazardous material suits, who warned them about the seriousness of the outbreak. Nobody appeared sick but all of the passengers decided to wear masks throughout the flight, Evans said.

The plane flew to Anchorage, where passengers had health screenings, and then landed at March Reserve Air Base on Wednesday morning. The U.S. arrival was joyful, Evans said.

“We were clapping, smiling, laughing … there were cheers,” he said.

One he is cleared, Evans says he intends to visit his family. Then it’s on to Switzerland, where he is signed to pay with the Bern Grizzlies this year. But he would like to return to Wuhan when the coronavirus outbreak recedes.

January 31: Nippon.com (News from Japan) “Japan to Bar Foreigners with Recent Stays in Hubei”

Japan’s government decided Friday to impose a temporary ban on entry by all foreigners with recent histories of staying in China’s Hubei Province, including its capital, Wuhan, the epicenter of the outbreak of a new coronavirus.

The entry ban will be in place “for the time being” from Saturday, Prime Minister Shinzo Abe said at a meeting on the day of the government’s headquarters for responding to the ongoing spread of the new coronavirus.

The move comes after the World Health Organization declared a public health emergency on Thursday, in the face of the spread of the coronavirus that has caused numerous people to develop pneumonia in China and other parts of the world.

It will be the first time for the Japanese government to impose an entry ban tha specifies a certain area.

Specifically, the govenrment will not accept entry applications form foreigners with histories of being in Hubei within the past 14 days and holders of Chinese passports issued by the province, regardless of whether they have been confirmed to have the virus or not. “We can’t deal with this unprecedented crisis if we stick to precedents,” the prime minister stressed, instructing cabinet ministers to respond flexibly.

January 31: Nippon.com (News from Japan) “Japanese Institute Succeeds in Isolating Wuhan Coronavirus”.

Japan’s National Institute of Infectious Diseases said Friday that it has succeeded in cultivating and isolating the new coronavirus, first reported in the Chinese city of Wuhan, from a person in Japan who has been confirmed to have the virus.

Using the isolated virus, the institute will start work to develop a vaccine and a drug for the coronavirus, as well as a test kit capable of quick diagnosis. It will also offer the isolated virus to researchers and companies, while trying to discover the infection mechanism and promoting research on the toxicity of the virus.

The isolated virus’ gene sequences 99.9 pct matched those released by the Chinese government, according to the Japanese institute.

In the isolated virus, there was no gene mutation leading to higher infectiousness or toxicity, the institute said.

January 31: The White House posted “Press Briefing by Members of the President’s Coronavirus Task Force”.

Secretary Azar: Well, good afternoon, everyone. I’m Alex Azar, Secretary of Health and Human Services, and Chairman of the President’s Task Force on the Novel Coronavirus.

I’m going to start by turning things over to Dr. Robert Redfield, the Director of the Centers for Disease Control and Prevention, to discuss the current situation on the novel coronavirus. Dr. Redfield.

Dr. Redfield: Thank you, Mr. Secretary, Let me give you an update on the current situation of the novel coronavirus. First though, I want to emphasize that this is a serious health situation in China, but I want to emphasize that the risk to the American public currently is low. Our goal is to do all we can to keep it that way.

Second, I want to recognize the concern that the American public may have. And I want to reiterate what I just said: Currently, the risk of the American public is low.

As of today, there are nearly 9,700 cases in China, with more than 200 deaths. Additionally, currently there are another 23 countries that have confirmed, totally, 132 cases. This also includes 12 individuals who have been confirmed in six countries who did not travel to China.

CDC has launched an aggressive public health response focused on early case recognition, isolation of those cases identified, and contact tracing around those individuals. This response is a layered response, which includes both targeted airport screening, as well as heightened education and awareness of the American healthcare community to be vigilant in ascertaining the possibility of recent travel to China when they are evaluating patients with upper respiratory tract infection.

To date, we have confirmed six cases of the novel virus in the United States. The most recent case had no travel history to China, but was a close personal contact of one of the previous cases that we had identified through our aggressive contact tracing. In addition, there are currently 191 individuals that are under investigation.

Once again, I want to emphasize that this is a significant global situation, and it continues to evolve. But I also want to emphasize that the risk at this time to the American public is low.

Mr. Secretary.

Secretary Azar: Thank you, Dr. Redfield. I would now like to invite Dr. Anthony Fauci, the Director of the National Institute of Allergy and Infectious Disease, to discuss the underlying rational for the actions that I will be discussing after he concludes. Dr. Fauci.

Dr. Fauci: Thank you very much, Mr. Secretary. The concept that’s underlying the action that you’ll hear about shortly is the issue of the unknown aspects of this particular outbreak. So let me enumerate just a few of these.

I can start off by putting it into perspective by telling you I often get asked – we have an influenza outbreak here. We have about 8,000 deaths already. We have about 100,000 hospitalizations. Why are we paying such attention? And why are we doing the kinds of things we’re doing here right now?

Well, the reason is, despite the morbidity and mortality with influenza, there’s a certainty, for example, of seasonal flu. I can tell you all, guaranteed, that as we get into March and April, the flu cases are going to go down. You could predict pretty accurately what the range of mortality is and the hospitalizations, as we’ve done over the years.

The issue now with this is there’s a lot of unknowns. As you can see just from the media, the number of cases steeply inclined each and every day. You know that, in the beginning, we were not sure if there were asymptomatic infection, which would make it a much broader outbreak than what we’re seeing. Now, we know for sure that there are.

It was not clear whether an asymptomatic person could transmit it to someone while they were asymptomatic. Now we know from a recent report from Germany that is absolutely the case.

There are a number of countries outside China that have travel-related cases. And now what we’re seeing is that there are secondary cases from them, and, as Bob mentioned, we also have that in this country. The WHO has issued, as you know, a Public Health Emergency of International Concern declaration.

If you put all of these things together, I underscore what Bob said: We still have a low risk to the American public, but we want to keep it at a low risk. And because there are so many unknowns here, we’re going to take the action that the Secretary will describe, in a temporary way, to make sure we mitigate, as best as we possibly can, this risk. Thank you.

Secretary Azar: Thank you, Dr. Fauci. Today, President Trump took decisive action to minimize the risk of the novel coronavirus in the United States. Since taking office, President Trump has been clear: His top priority is the safety of the American people. In addition to the steps that the doctors have outlined, we continue to operationalize a multi-layered, cross-agency, public health response.

Following the World Health Organization’s decision to declare the 2019 novel coronavirus a Public Health Emergency of International Concern, I have today declared that the coronavirus presents a public health emergency in the United States. The actions we have taken and continue to take complement — complement the work of China and the World Health Organization to contain the outbreak within China.

In accordance with the declaration, beginning at 5:00 p.m., Eastern Standard Time; Sunday, February the 2nd, the United States government will implement temporary measures to increase our abilities to detect and contain the coronavirus proactively and aggressively. Any U.S. citizen returning to the United States who has been in Hubei Province in the previous 14 days will be subject to up to 14 days of mandatory quarantine to ensure that are they are provided proper medical care and health screening.

To be clear, this applies only to U.S. citizens who have been in Hubei Province in the past 14 days prior to their attempted entry into the United States.

Any U.S citizen returning to the United States who has been in the rest of Mainland China within the previous 14 ays will undergo proactive entry health screening at a select number of ports of entry and up to 14 days of monitored self-quarantine to ensure they’ve not contracted the virus and do not pose a public health risk.

Additionally, the President has signed a presidential proclamation, using his authority pursuant to Section 212(f) of the Immigration and Nationality Act, temporarily suspending the entry into the United States of foreign nationals who pose a risk of transmitting the 2019 novel coronavirus.

As a result, foreign nationals, other than immediate family of U.S. citizens and permanent residents, who have traveled in China within the last 14 days will be denied entry into the United States for this time.

One again, these actions will become effective at 5:00 p.m., Eastern Standard Time; Sunday, February 2nd. These prudent, targeted, and temporary actions will decrease the pressure on public health officials screening incoming travelers, expedite the processing of U.S. citizens and permanent residents returning from China, and ensure resources are focused on the health and safety of the American people.

I want to stress: The risk of infection for Americans remains low. And with these and our previous actions, we are working to keep the risk low. All agencies are working aggressively to monitor this continually evolving situation and to keep the public informed in a constantly transparent way.

The United States appreciates China’s efforts and coordination with public health officials across the globe, and continues to encourage the highest levels of transparency.

It is likely that we will continue to see more cases in the United States in the coming days and weeks, including some limited person-to-person transmission. The American public can be assured the full weight of the U.S. government is working to safeguard the health and safety of the American people.

I’d now like to invite Deputy Secretary of State Steve Biegun for an update.

Deputy Secretary Beigun: Good afternoon. And thank you, Secretary Azar. My name is Steve Biegun, and I am the Deputy Secretary of State, and I represent the State Department on the President’s Novel Coronavirus Task Force.

Let me describe briefly the role of the Department of State in the proceedings of this task force and our contributions. Our first responsibility is to monitor events on the ground in China where we have the presence of U.S. diplomats, and to give clear and accurate advice to American citizens, and, in particular, American travelers considering visiting or staying in China.

In this particular case, this includes identifying any health or safety risks to which they may be subjected, but also, very importantly, identifying their access to essential services such as healthcare in parts of China the are affected by this coronavirus.

China has an excellent healthcare system, but, in parts of the country it is simply overwhelmed and the accessibility to that healthcare for any reason — including potential infection, but also any other type of accident in need of medical care — may be compromised during the Chines government’s own treatment of the consequences of this virus.

Finally, we also make our judgements based on any obstacles, particularly obstacles to movement that American citizens might face in the country. And in China, we have seen barriers to travel, both within and without China, as well as between the United States and China. And so we’ve given prudent advice, over the course of the week, to American citizens in order for them — to allow them to make the best possible choices for themselves.

Our second responsibility is to assist U.S. citizens in the affected areas as much as possible. Because we have a presence on the ground, we can provide advice and, in some cases, we can make other arrangements. But I want to emphasize this as “as possible,” and we will continue to review what we can do in certain circumstances.

Finally, and very importantly, the core mission of the Department of State is to work closely with our international partners. And in this case, we are working very closely with the Chinese government in order to address a number of related matters.

But let me start, on behalf of the President and the Secretary of State, by extending our deepest compassion to the people of China. This has been a very difficult time for the Chinese people. It came at a point of their peak holiday season. Many are affected. Many have lost loved ones or are enduring the illness of loved ones. And I want the Chinese people to know that they have the deepest sympathies of the United States of America.

Let me also say and echo what Secretary Azar said, which is we are deeply appreciative of the close cooperation we have with the Chinese government as we work together to try to find appropriate ways to address any risks and challenges from this virus.

And finally, the United States will continue to cooperate with China in ways that we could potentially provide assistance, including technical assistance, and also, to the extent possible, any critical supplies that the Chinese need in order to address this virus. And we are working very hard to find donors and make arrangements so that we can — we can undertake a robust effort to help the Chinese people get their arms around this outbreak.

Thank you.

Secretary Azar: Thank you, Secretary Biegun. Let me — let me invite the Acting Deputy Secretary of the Department of Homeland Security Ken Cuccinelli to take the podium for some comments.

Acting Deputy Secretary Cuccinelli: Thank you, Mr. Secretary. I am Ken Cuccinelli. I’m the Acting Deputy Secretary at the Department of Homeland Security, and I’m the Department’s representative on the task force led by Secretary Azar.

Several elements of the Department of Homeland Security are engaged in implementing the medical strategy you heard described here, including Customs and Border Protection, which stands at our land ports, seaports, and airports — and I’ll come back to the airports in a moment — particularly the Office of Field Operations personnel who see when you come back into the country from your travels. They’re the first line of defense when you land and come to the country.

Additionally engaged is TSA — the security and the engagement with the airlines. Our chief medical officer in the department is in CWMD and they’re — we were providing medical support at the airports.

So we’re using contract authority that we have to backfill the CDC personnel, so they can be freed up for other missions at the airports where medical screening is being focused.

FEMA continues to prepare and support HHS preparations themselves. And then the United States Coast Guard, of cours