COVID-19(02)(03) 中国，エジプト reporting criteria, WHO
● COVID-19(03) 中国，エジプト，インフルエンザ
PRO/AH/EDR> COVID-19 update (03): China, global, Egypt, influenza surveillance, WHO
Archive Number: 20200214.6991020
In this update:
[1] China: China National Health Commission 15 Feb 2020
[2] Global update: Johns Hopkins CSSE [accessed at 9:30 p.m. GMT-5]
[3] Egypt ex China, 1st confirmed case
[4] USA to use flu monitoring system
[5] Selected media reports of transmission outside of mainland China
[6] WHO situation report 25 (as of 14 Feb 2020*)
[1] 中国
Update on new coronavirus pneumonia epidemic as of 24:00 on 14 Feb [2020]
情報源 China National Health Commission [in Chinese] 2020年2月15日
At 04:00 on [14 Feb 2020], 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps reported 2641 newly diagnosed cases, 849 severe cases, and 143 death cases (139 in Hubei and 2 in Henan). ... 1373 new cases were cured and discharged, ...
As of 24:00 on [14 Feb 2020], according to reports from 31 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps, there were 56 873 confirmed cases (of which 11 053 were severe cases), a total of 8096 cases were cured and discharged, and 1523 died. A total of 66 492 confirmed cases have been reported, and 8969 suspected cases have been reported. A
2420 new cases were confirmed in Hubei 湖北省 (1923 in Wuhan 武漢市), ...
地図 A good map of China showing provinces
[2] Global update: Johns Hopkins CSSE
情報源 Johns Hopkins CSSE (Center for Systems Science and Engineering) 2020年2月14日
Confirmed cases
2 Feb 2020 / ... / 12 / 13 / 14 Feb 2020 / Country/Region
17 187 / ... / 59 789 / 63 842 / 66 343 / Mainland China
20 / ... / 28 / 28 / 29 / Japan
19 / ... / 33 / 33 / 33 / Thailand
18 / ... / 50 / 58 / 67 / Singapore
15 / ... / 50 / 53 / 56 / Hong Kong
15 / ... / 28 / 28 / 28 / South Korea
12 / ... / 15 / 15 / 15 / Australia
10 / ... / 16 / 16 / 16 / Germany
Data sources: WHO, CDC, ECDC, NHC, and DXY
[3] エジプト ex China, 1st confirmed case
情報源 El Balad news [in Arabic] 2020年2月14日
14日，エジプト保健当局 the Egyptian Ministry of Health and Population and the World Health Organization は，国内初となる外国人の感染例 the 1st positive case of coronavirus (SARS-CoV-2) emerging in the country in a "foreign" person が確認されたと発表した ... 感染の疑いがあるが症状のない症例について検査を行い，ウイルス陽性の結果を得たと明らかにした。救急車 a self-sterilized ambulance で病院に搬送されたが，特に症状は現れていないと説明されている ...
［Mod.MPP 注－他のメディアでは，患者は中国人で，14人のエジプト人とともに飛行機で到着したと伝えられている。患者には症状は認められていないが，検体が採取され，14人のエジプト人も検疫観察下に置かれている (see in Arabic for more details. ]
[4] 米国 to use flu monitoring system
CDC: Flu surveillance system enlisted in hunt for COVID-19 cases情報源 CIDRAP (Center for Infectious Disease Research and Policy) 2020年2月14日
As a way to spot any community COVID-19 activity early, federal health officials will use the nation's flu surveillance system to look for people who may be infected with the disease. ...
[5] Selected media reports of transmission outside of mainland China
A. Japanese cruise ship
情報源 Japan Times 2020年2月14日
Over the next 5 days, Japan faces the daunting task of testing thousands of passengers aboard a quarantined cruise ship, evacuating them and transporting those who test positive for the coronavirus -- or who may have come in contact with someone who has -- to medical facilities on shore.
With the health ministry yet to announce a plan to address these issues or to extend the quarantine, which is scheduled to end Wednesday [19 Feb 2020], the task of getting everyone off the Diamond Princess by the deadline grows increasingly improbable.
The whole situation is like "a game with no end in sight," said Koji Wada, a professor of public health at the International University of Health and Welfare. As the time limit gets closer, the question now is whether it's possible to send everyone home in time," he said. "It's entirely possible that not all passengers will be evacuated by the end of the quarantine period."
So far, those infected with COVID-19 start to show symptoms anywhere between 2 and 14 days after contracting the virus. Thus a 2-week quarantine was placed upon the cruise ship, which was carrying more than 3700 passengers and crew, after an 80-year-old man who left the ship in Hong Kong tested positive for the virus.
But if secondary infections are occurring on the ship, as many experts suspect, the 14-day quarantine -- which began on [5 Feb 2020] when the Diamond Princess arrived at Yokohama Bay -- will prove meaningless. Still, the health ministry has not officially changed its plan to end the quarantine on [19 Feb 2020] nor explained to the public what strategies it will take to contain the outbreak after the deadline.
"The cruise ship is almost completely infested," Wada said. "The world is watching Japan," he continued, adding that Japan is the only country in the world -- besides China -- that has had to deal with so many coronavirus patients all at once. He said that, depending on the outcome, Tokyo's response could serve as a model for other countries struggling to contain the outbreak.
The ship made port in Yokohama Bay last week following a 16-day cruise that included stops in Japan, Hong Kong, Viet Nam, and Taiwan. A total of 2666 passengers, including those staying in small, windowless rooms, were asked to stay inside their compartments to prevent transmission during the quarantine period. Since then, 218 passengers and crew members have tested positive, as well as one of the quarantine officers administering the tests.
On Friday [14 Feb 2020], high-risk passengers 80 or older who tested negative for COVID-19 were allowed to disembark amid growing concerns over the physical and mental conditions of those aboard. The elderly passengers were transported by bus to a government facility in Wako, Saitama prefecture.
The central government has called on doctors, academics, and other experts to help devise a plan to safely and securely evacuate the Diamond Princess. Wada is part of this collaborative effort. He raised the idea of using tents near Yokohama Bay as a preliminary testing ground for the passengers. Moving forward, he added, the government needs to put forth a plan that lays out how all passengers and crew will be evacuated, tested, and treated, all while containing the virus.
Further doubt was cast upon efforts to evacuate the Diamond Princess by Shigeru Omi, president of the Japan Community Healthcare Organization and former regional director of the World Health Organization's Western Pacific Regional Office, during a news conference on Thursday [13 Feb 2020]. Omi, who served as WHO regional director during the 2002-2003 outbreak of SARS, questioned the reliability of the test results and the ability of onshore medical facilities to accept coronavirus patients. "The tests aren't necessarily picking up the virus 100% of the time," he said. "And if coronavirus patients are taken to a local hospital, where should the patients who were already there go? How do we know the medical staff are prepared for these circumstances?"
The Diamond Princess was quarantined by the government in an attempt to contain the novel coronavirus and prevent a domestic epidemic. However, reports of new cases of infection aboard the ship continue to emerge almost daily, and passengers seem to be growing weary as the quarantine continues. Omi pointed out that quarantine periods typically reset every time an additional case is reported.
Health minister Katsunobu Kato said on Wednesday [12 Feb 2020] that he wants to test everyone aboard the ship, but the lack of testing kits and logistical difficulties are complicating matters. As of Wednesday [12 Feb 2020], 492 samples had been collected, but that figure includes specimens collected from the same people more than once. "Keeping the passengers in a place with such high risk of infection is questionable, not only from a virus prevention standpoint, but ethically as well," Omi said. "We need to move quickly to get them off the ship as soon as possible."
Meanwhile on Friday [14 Feb 2020], a female taxi driver in Okinawa was confirmed to be infected with the novel coronavirus, the 1st patient in the prefecture. She was among about 200 people in the prefecture being monitored by the Okinawa government who had close contact with passengers on the Diamond Princess when the ship made port in Naha during its trip.
On Friday [14 Feb 2020], at the request of the health ministry, SoftBank delivered iPhones preloaded with medical advice to passengers aboard the Diamond Princess.
［Mod.MPP 注－While there is much discussion about the passengers on the ship, the discussions re: the crew have been limited. To date there have been at least 10 cases confirmed among crew on the ship, individuals who sleep in dormitory-like quarters with multiple individuals in the same room. Many of these individuals have been interfacing with the passengers, potentially serving as 2-way transmission streams if use of PPE (personal protective equipment) isn't completely observed. Interestingly there have not been reports of additional cases confirmed in the past 24 hours, but is this a function of the volume of specimens tested, or does it reflect no newly confirmed cases?
As for the passengers with confirmed COVID-19, an age distribution of the passengers was provided by ProMED-mail Rapporteur Kunihiko Iizuka from media reports in Japanese:
20-29: 10
30-39: 7
40-49: 7
50-59: 20
60-69: 50
70-79: 73
80-89: 49
90-99: 2
79.8% are 60 years of age or older.]
B. 日本
情報源 NHK World 2020年2月14日
Japan saw several new cases of coronavirus infection reported on Friday [14 Feb 2020], leading health officials to try and establish just how they contracted the virus. The latest cases bring the number of infected people in Japan to 259, including 218 from a cruise ship. Two people are residents of Tokyo. They likely had contact with a taxi driver who was confirmed to be infected on Thursday [13 Feb 2020]. The driver's mother-in-law was the 1st infected person to die in Japan.
Another taxi driver in the southern prefecture of Okinawa also has the virus. She drove 4 passengers from the now-quarantined cruise ship, the Diamond Princess, when it made a stop earlier this month [February 2020]. The governor of Okinawa says officials there are responding to the latest developments. Governor Denny Tamaki said, "2679 people possibly disembarked in Okinawa. We've been checking up on about 200 people who may have come into contact with them. These checks will continue until Saturday [15 Feb 2020], to cover the incubation period."
A man in his 70s in the western prefecture of Wakayama has also tested positive. He had temporarily stayed at a hospital where a surgeon was confirmed to be infected on Thursday [13 Feb 2020].
The northern prefecture of Hokkaido reported its 2nd case.
A man in Aichi prefecture, central Japan, has now been confirmed to have the virus.
And a local government official in Kanagawa prefecture, bordering Tokyo, has tested positive. He was engaged in transporting infected people from the Diamond Princess to hospitals earlier this week.
Meanwhile, 11 infected people from the ship are in serious condition.
713 people on board have been checked for the virus, with 218 testing positive. They have either been taken to hospitals or are in the process of being transferred.
Roughly 3400 passengers and crew remain onboard. The health ministry is asking them to stay in their rooms until next Wednesday [19 Feb 2020], which will mark the end of a 2-week quarantine period.
[In the above description of cases, most can be connected to contact with persons previously confirmed as infected, or in the case of Okinawa, retrospectively confirmed passengers from the cruise ship currently in quarantine off Yokahama. The challenging cases for identifying the chain of transmission include the doctor in Wakayama, the cases in Hokkaido, and the man in Aichi prefecture. We await more information on results of epidemiologic investigations.
A good map showing the prefectures of Japan can be found at https://www.digi-joho.com/japan-maps.html. It does not include the Okinawa Islands, though.]
C. 日本, case ill while in Hawaii
情報源 KITV4 Island News 2020年2月14日
An adult male traveler that had been through Hawaii has now been confirmed to have the coronavirus. He was in Hawaii from [28 Jan 2020] through [7 Feb 2020]. When he returned to Japan, he was confirmed to have contracted the coronavirus. The state is in contact with the Japanese government.
The Department of Health (DOH) was notified this morning by the Centers for Disease Control and Prevention (CDC) that the visitor went to Maui before he traveled to O'ahu [3-7 Feb 2020].
During his time on Maui, [the traveler] showed no symptoms. However, during the time he spent on O'ahu, he had cold symptoms, with no fever.
The visitor stayed in Waikiki at the Hilton Grand Vacation with his wife. Officials believe he was infected while he was in Japan or while traveling.
The focus now is to try and understand who the Japanese visitor had close contact with. Once they can identify who those people are, they will monitor them or quarantine them.
[The challenge facing the global efforts to interrupt transmission of the SARS-CoV-2 is that the coronavirus infections frequently present clinically as a common cold, a presentation that doesn't lead to seeking out health services in the majority of times. If the symptoms remain mild, these individuals are out in the community and do not usually self-quarantine or isolate frequently. We await results of investigations into where this individual may have been exposed to the coronavirus. - Mod.MPP]
[6] WHO situation report 25 (as of 14 Feb 2020*)
情報源 World Health Organization 2020年2月14日
Highlights
- No new countries reported cases of COVID-19 in the past 24 hours. [See report on case identified in Egypt above in section [3].]
- The 2nd death has been reported outside of China, in Japan. This individual did not have known travel history to China.
- In China, healthcare workers account for 1716 confirmed cases of COVID-19 including 6 deaths.
Technical Focus: WHO Research & Development Blueprint
-----------------------------
The WHO R&D Blueprint is a global strategy and preparedness plan that allows the rapid activation of research and development activities during epidemics. Its aim is to fast-track the availability of effective tests, vaccines, and medicines that can be used to save lives and avert further crisis.
In view of the urgency of the COVID-19 outbreak, the international community is mobilizing to find ways to significantly accelerate the development of interventions including vaccines and therapeutics. Nearly 400 world scientists met at WHO's Geneva Headquarters from 11-12 Feb 2020 to assess the current level of knowledge about the new COVID-19 virus, agree on critical research questions that need to be answered urgently, and identify ways to work together to accelerate and fund priority research that can contribute to curtail this outbreak and prepare for future outbreaks. The meeting was organized by WHO, in collaboration with the Global Research Collaboration for Infectious Disease Preparedness.
Research topics discussed included: COVID-19 virus natural history, transmission and diagnostics; animal and environmental research on the virus origin; management measures at the human-animal interface; epidemiological studies; clinical characterization and management; infection prevention and control, including healthcare workers' protection; candidate therapeutics R&D; candidate vaccines R&D; ethical considerations for research; and integrating social sciences in the outbreak response.
Experts identified key knowledge gaps and research priorities, and shared scientific data on ongoing research, thereby accelerating the generation of critical scientific information to contribute to the control the COVID-19 outbreak. There was broad consensus on the need for research to focus on actions that can save lives now to ensure that those affected are promptly diagnosed and receive optimal care. 8 immediate research priorities were agreed as part of this forum:
1. Mobilize research on rapid point-of-care diagnostics for use at the community level;
2. Assess available data to learn what standard of care approaches from China and elsewhere are the most effective;
3. Evaluate as fast as possible the effect of adjunctive (given in addition to the main treatment) and supportive therapies;
4. Optimize the use of protective equipment and other infection prevention and control measures in healthcare and community settings;
5. Review all available evidence to identify animal host(s), prevent continued spill-over, and better understand virus transmissibility in different contexts over time, the severity of disease, and individuals more susceptible to infection;
6. Accelerate the evaluation of investigational therapeutics and vaccines by using "Master Protocols";
7. Maintain a high degree of communication and interaction among funders so that critical research is implemented; and
8. Broadly and rapidly share virus materials, clinical samples, and data for immediate public health purposes.
For further information and to view documents related to the forum, please visit https://www.who.int/blueprint/priority-diseases/key-action/novel-coronavirus/en/.
[The figures provided in the below report are the figures from the National Health Commission of China from 12 Feb 2020. The 14 Feb 2020 figures are included in section [1] above. They are usually posted at approximately 7 p.m. (GMT-5), which is 1 a.m. (GMT+1) in Geneva. - Mod.MPP]
Table 2. Countries, territories or areas with reported confirmed COVID-19 cases and deaths. Data as of [14 Feb 2020]
Excerpted to show confirmed cases outside mainland China:
WHO Region:
Country / Territory / Area: Total confirmed (new cases in past 24 hours)* / Total (new) with travel history to China / Total (new) cases with possible or confirmed transmission outside of China** / Total (new) case with site of transmission under investigation / Total (new) deaths
Western Pacific Region:
China***: Lab confirmed: 48 548 / Clinically diagnosed: 15 384 / total reported: 63 932 / / 1381 (268)
Japan: 33 (4) / 24 / 9 (4) / 0 / 1 (1)
Republic of Korea: 28 /13 / 12******** / 3 / 0
Viet Nam: 16 (1) / 8 / 8 (1) / 0 / 0
Singapore: 58 (8) / 22 / 36******* (8) / 0 / 0
Australia: 15 / 15 / 0 / 0 / 0
Malaysia: 19 (1) / 15 / 4********* (1)********** / 0 / 0
Cambodia: 1 / 1 / 0 / 0 / 0
Philippines: 3 / 3 / 0 / 1 / 1
South East Asia Region:
Thailand: 33 / 23 / 6********** / 4 / 0
Nepal: 1 / 1 / 0 / 0 / 0
Sri Lanka: 1 / 1 / 0 / 0 / 0
India: 3 / 3 / 0 / 0 / 0
Region of the Americas:
United States of America: 15 (1) / 13 (1) / 2 / 0 / 0
Canada: 7 / 6 / 0 / 1 / 0
European Region:
France: 11 / 5 / 6 / 0 / 0
Finland: 1 / 1 / 0 / 0 / 0
Germany: 16 / 2 / 14******* / 0 / 0
Italy: 3 / 3 / 0 / 0 / 0
Russian Federation: 2 / 2 / 0 / 0 / 0
Spain: 2 / 0 / 2***** / 0 / 0
Sweden: 1 / 1 / 0 / 0 / 0
United Kingdom: 9 / 2 / 7****** / 0 / 0
Belgium: 1 / 1 / 0 / 0 / 0
Eastern Mediterranean Region:
United Arab Emirates: 8 / 6 / 1 / 1 / 0
Other: Cases on an international conveyance (Japan): 218**** (44) / 0 / 0 / 218 (44) / 0
*Case classifications are based on WHO case definitions for COVID-19.
**Location of transmission is classified based on WHO analysis of available official data and may be subject to reclassification as additional data become available.
***Confirmed cases in China include cases confirmed in Hong Kong SAR (53 confirmed cases, 1 death), Macao SAR (10 confirmed cases) and Taipei and environs (18 confirmed cases).
****Cases identified on a cruise ship currently in Japanese territorial waters.
*****The exposure for 2 cases occurred outside of Spain.
******The exposure for 6 cases occurred outside of the United Kingdom.
*******The exposure for 4 cases occurred outside of Singapore.
********The exposure for 3 cases occurred outside of Republic of Korea.
*********The exposure for 1 case occurred outside of Malaysia.
**********This patient also had travel history to China, but exposure likely occurred after return to Malaysia.
[There are excellent graphs and a map available at the source URL, as well as strategic objectives and preparedness and response information.
- Figure 1. Countries, territories or areas with reported confirmed cases of COVID-19, 14 Feb 2020.
- Figure 2: Epidemic curve of COVID-19 cases (n =192) identified outside China, by date of onset of symptoms and travel history, 14 Feb 2020 (WHO has a note for Figure 2: Of the 505 cases reported outside China, 17 were detected while apparently asymptomatic. For the remaining 488 cases, information on date of onset is available only for the 192 cases presented in the epidemiologic curve).
- Figure 3: Epidemic curve of COVID-19 cases (n = 505) identified outside China, by date of reporting and travel history, 14 Feb 2020.
- Mod.MPP]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[[The number of countries reporting confirmed cases of COVID-19 with transmission occurring outside China remains 12 (Japan, Singapore, South Korea, Viet Nam, Malaysia, Thailand, USA, France, Germany, Spain, UK, and UAE). There has also been local transmission noted on the cruise ship quarantined in Japan related to a quarantine officer.
New confirmatory information contained in this update includes showing the number of laboratory-confirmed cases in China in addition to showing the clinically confirmed cases, in keeping with change in reporting criteria implemented in Hubei province. Thus, while the numbers of "confirmed cases" in China yesterday [13 Feb 2020] increased by an additional 15 384, the number of laboratory-confirmed cases increased by 1998 from that reported in the WHO update on 13 Feb 2020. Unfortunately, there isn't a delineation of fatalities to know how many of the newly reported fatalities were laboratory-confirmed cases.
Another piece of newly confirmed data includes information that there have been a total of 1716 laboratory-confirmed cases in healthcare workers including 6 fatalities in China. With a total number of laboratory-confirmed cases as of today, 14 Feb 2020, at 48 548, the proportion of cases among healthcare workers is 3.5%, significantly lower than seen with the SARS-CoV outbreak in 2002-2003, when there were 1725 cases among healthcare workers out of 8422 cases (20.5%). (Data from WHO SARS summary table, 15 Aug 2003 available at: https://www.who.int/csr/sars/country/country2003_08_15.pdf?ua=1). - Mod.MPP]
● COVID-19(03) 中国，エジプト，インフルエンザ
PRO/AH/EDR> COVID-19 update (03): China, global, Egypt, influenza surveillance, WHO
Archive Number: 20200214.6991020
In this update:
[1] China: China National Health Commission 15 Feb 2020
[2] Global update: Johns Hopkins CSSE [accessed at 9:30 p.m. GMT-5]
[3] Egypt ex China, 1st confirmed case
[4] USA to use flu monitoring system
[5] Selected media reports of transmission outside of mainland China
[6] WHO situation report 25 (as of 14 Feb 2020*)
[1] 中国
Update on new coronavirus pneumonia epidemic as of 24:00 on 14 Feb [2020]
情報源 China National Health Commission [in Chinese] 2020年2月15日
At 04:00 on [14 Feb 2020], 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps reported 2641 newly diagnosed cases, 849 severe cases, and 143 death cases (139 in Hubei and 2 in Henan). ... 1373 new cases were cured and discharged, ...
As of 24:00 on [14 Feb 2020], according to reports from 31 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps, there were 56 873 confirmed cases (of which 11 053 were severe cases), a total of 8096 cases were cured and discharged, and 1523 died. A total of 66 492 confirmed cases have been reported, and 8969 suspected cases have been reported. A
2420 new cases were confirmed in Hubei 湖北省 (1923 in Wuhan 武漢市), ...
地図 A good map of China showing provinces
[2] Global update: Johns Hopkins CSSE
情報源 Johns Hopkins CSSE (Center for Systems Science and Engineering) 2020年2月14日
Confirmed cases
2 Feb 2020 / ... / 12 / 13 / 14 Feb 2020 / Country/Region
17 187 / ... / 59 789 / 63 842 / 66 343 / Mainland China
20 / ... / 28 / 28 / 29 / Japan
19 / ... / 33 / 33 / 33 / Thailand
18 / ... / 50 / 58 / 67 / Singapore
15 / ... / 50 / 53 / 56 / Hong Kong
15 / ... / 28 / 28 / 28 / South Korea
12 / ... / 15 / 15 / 15 / Australia
10 / ... / 16 / 16 / 16 / Germany
Data sources: WHO, CDC, ECDC, NHC, and DXY
[3] エジプト ex China, 1st confirmed case
情報源 El Balad news [in Arabic] 2020年2月14日
14日，エジプト保健当局 the Egyptian Ministry of Health and Population and the World Health Organization は，国内初となる外国人の感染例 the 1st positive case of coronavirus (SARS-CoV-2) emerging in the country in a "foreign" person が確認されたと発表した ... 感染の疑いがあるが症状のない症例について検査を行い，ウイルス陽性の結果を得たと明らかにした。救急車 a self-sterilized ambulance で病院に搬送されたが，特に症状は現れていないと説明されている ...
［Mod.MPP 注－他のメディアでは，患者は中国人で，14人のエジプト人とともに飛行機で到着したと伝えられている。患者には症状は認められていないが，検体が採取され，14人のエジプト人も検疫観察下に置かれている (see in Arabic for more details. ]
[4] 米国 to use flu monitoring system
CDC: Flu surveillance system enlisted in hunt for COVID-19 cases情報源 CIDRAP (Center for Infectious Disease Research and Policy) 2020年2月14日
As a way to spot any community COVID-19 activity early, federal health officials will use the nation's flu surveillance system to look for people who may be infected with the disease. ...
[5] Selected media reports of transmission outside of mainland China
A. Japanese cruise ship
情報源 Japan Times 2020年2月14日
Over the next 5 days, Japan faces the daunting task of testing thousands of passengers aboard a quarantined cruise ship, evacuating them and transporting those who test positive for the coronavirus -- or who may have come in contact with someone who has -- to medical facilities on shore.
With the health ministry yet to announce a plan to address these issues or to extend the quarantine, which is scheduled to end Wednesday [19 Feb 2020], the task of getting everyone off the Diamond Princess by the deadline grows increasingly improbable.
The whole situation is like "a game with no end in sight," said Koji Wada, a professor of public health at the International University of Health and Welfare. As the time limit gets closer, the question now is whether it's possible to send everyone home in time," he said. "It's entirely possible that not all passengers will be evacuated by the end of the quarantine period."
So far, those infected with COVID-19 start to show symptoms anywhere between 2 and 14 days after contracting the virus. Thus a 2-week quarantine was placed upon the cruise ship, which was carrying more than 3700 passengers and crew, after an 80-year-old man who left the ship in Hong Kong tested positive for the virus.
But if secondary infections are occurring on the ship, as many experts suspect, the 14-day quarantine -- which began on [5 Feb 2020] when the Diamond Princess arrived at Yokohama Bay -- will prove meaningless. Still, the health ministry has not officially changed its plan to end the quarantine on [19 Feb 2020] nor explained to the public what strategies it will take to contain the outbreak after the deadline.
"The cruise ship is almost completely infested," Wada said. "The world is watching Japan," he continued, adding that Japan is the only country in the world -- besides China -- that has had to deal with so many coronavirus patients all at once. He said that, depending on the outcome, Tokyo's response could serve as a model for other countries struggling to contain the outbreak.
The ship made port in Yokohama Bay last week following a 16-day cruise that included stops in Japan, Hong Kong, Viet Nam, and Taiwan. A total of 2666 passengers, including those staying in small, windowless rooms, were asked to stay inside their compartments to prevent transmission during the quarantine period. Since then, 218 passengers and crew members have tested positive, as well as one of the quarantine officers administering the tests.
On Friday [14 Feb 2020], high-risk passengers 80 or older who tested negative for COVID-19 were allowed to disembark amid growing concerns over the physical and mental conditions of those aboard. The elderly passengers were transported by bus to a government facility in Wako, Saitama prefecture.
The central government has called on doctors, academics, and other experts to help devise a plan to safely and securely evacuate the Diamond Princess. Wada is part of this collaborative effort. He raised the idea of using tents near Yokohama Bay as a preliminary testing ground for the passengers. Moving forward, he added, the government needs to put forth a plan that lays out how all passengers and crew will be evacuated, tested, and treated, all while containing the virus.
Further doubt was cast upon efforts to evacuate the Diamond Princess by Shigeru Omi, president of the Japan Community Healthcare Organization and former regional director of the World Health Organization's Western Pacific Regional Office, during a news conference on Thursday [13 Feb 2020]. Omi, who served as WHO regional director during the 2002-2003 outbreak of SARS, questioned the reliability of the test results and the ability of onshore medical facilities to accept coronavirus patients. "The tests aren't necessarily picking up the virus 100% of the time," he said. "And if coronavirus patients are taken to a local hospital, where should the patients who were already there go? How do we know the medical staff are prepared for these circumstances?"
The Diamond Princess was quarantined by the government in an attempt to contain the novel coronavirus and prevent a domestic epidemic. However, reports of new cases of infection aboard the ship continue to emerge almost daily, and passengers seem to be growing weary as the quarantine continues. Omi pointed out that quarantine periods typically reset every time an additional case is reported.
Health minister Katsunobu Kato said on Wednesday [12 Feb 2020] that he wants to test everyone aboard the ship, but the lack of testing kits and logistical difficulties are complicating matters. As of Wednesday [12 Feb 2020], 492 samples had been collected, but that figure includes specimens collected from the same people more than once. "Keeping the passengers in a place with such high risk of infection is questionable, not only from a virus prevention standpoint, but ethically as well," Omi said. "We need to move quickly to get them off the ship as soon as possible."
Meanwhile on Friday [14 Feb 2020], a female taxi driver in Okinawa was confirmed to be infected with the novel coronavirus, the 1st patient in the prefecture. She was among about 200 people in the prefecture being monitored by the Okinawa government who had close contact with passengers on the Diamond Princess when the ship made port in Naha during its trip.
On Friday [14 Feb 2020], at the request of the health ministry, SoftBank delivered iPhones preloaded with medical advice to passengers aboard the Diamond Princess.
［Mod.MPP 注－While there is much discussion about the passengers on the ship, the discussions re: the crew have been limited. To date there have been at least 10 cases confirmed among crew on the ship, individuals who sleep in dormitory-like quarters with multiple individuals in the same room. Many of these individuals have been interfacing with the passengers, potentially serving as 2-way transmission streams if use of PPE (personal protective equipment) isn't completely observed. Interestingly there have not been reports of additional cases confirmed in the past 24 hours, but is this a function of the volume of specimens tested, or does it reflect no newly confirmed cases?
As for the passengers with confirmed COVID-19, an age distribution of the passengers was provided by ProMED-mail Rapporteur Kunihiko Iizuka from media reports in Japanese:
20-29: 10
30-39: 7
40-49: 7
50-59: 20
60-69: 50
70-79: 73
80-89: 49
90-99: 2
79.8% are 60 years of age or older.]
B. 日本
情報源 NHK World 2020年2月14日
Japan saw several new cases of coronavirus infection reported on Friday [14 Feb 2020], leading health officials to try and establish just how they contracted the virus. The latest cases bring the number of infected people in Japan to 259, including 218 from a cruise ship. Two people are residents of Tokyo. They likely had contact with a taxi driver who was confirmed to be infected on Thursday [13 Feb 2020]. The driver's mother-in-law was the 1st infected person to die in Japan.
Another taxi driver in the southern prefecture of Okinawa also has the virus. She drove 4 passengers from the now-quarantined cruise ship, the Diamond Princess, when it made a stop earlier this month [February 2020]. The governor of Okinawa says officials there are responding to the latest developments. Governor Denny Tamaki said, "2679 people possibly disembarked in Okinawa. We've been checking up on about 200 people who may have come into contact with them. These checks will continue until Saturday [15 Feb 2020], to cover the incubation period."
A man in his 70s in the western prefecture of Wakayama has also tested positive. He had temporarily stayed at a hospital where a surgeon was confirmed to be infected on Thursday [13 Feb 2020].
The northern prefecture of Hokkaido reported its 2nd case.
A man in Aichi prefecture, central Japan, has now been confirmed to have the virus.
And a local government official in Kanagawa prefecture, bordering Tokyo, has tested positive. He was engaged in transporting infected people from the Diamond Princess to hospitals earlier this week.
Meanwhile, 11 infected people from the ship are in serious condition.
713 people on board have been checked for the virus, with 218 testing positive. They have either been taken to hospitals or are in the process of being transferred.
Roughly 3400 passengers and crew remain onboard. The health ministry is asking them to stay in their rooms until next Wednesday [19 Feb 2020], which will mark the end of a 2-week quarantine period.
[In the above description of cases, most can be connected to contact with persons previously confirmed as infected, or in the case of Okinawa, retrospectively confirmed passengers from the cruise ship currently in quarantine off Yokahama. The challenging cases for identifying the chain of transmission include the doctor in Wakayama, the cases in Hokkaido, and the man in Aichi prefecture. We await more information on results of epidemiologic investigations.
A good map showing the prefectures of Japan can be found at https://www.digi-joho.com/japan-maps.html. It does not include the Okinawa Islands, though.]
C. 日本, case ill while in Hawaii
情報源 KITV4 Island News 2020年2月14日
An adult male traveler that had been through Hawaii has now been confirmed to have the coronavirus. He was in Hawaii from [28 Jan 2020] through [7 Feb 2020]. When he returned to Japan, he was confirmed to have contracted the coronavirus. The state is in contact with the Japanese government.
The Department of Health (DOH) was notified this morning by the Centers for Disease Control and Prevention (CDC) that the visitor went to Maui before he traveled to O'ahu [3-7 Feb 2020].
During his time on Maui, [the traveler] showed no symptoms. However, during the time he spent on O'ahu, he had cold symptoms, with no fever.
The visitor stayed in Waikiki at the Hilton Grand Vacation with his wife. Officials believe he was infected while he was in Japan or while traveling.
The focus now is to try and understand who the Japanese visitor had close contact with. Once they can identify who those people are, they will monitor them or quarantine them.
[The challenge facing the global efforts to interrupt transmission of the SARS-CoV-2 is that the coronavirus infections frequently present clinically as a common cold, a presentation that doesn't lead to seeking out health services in the majority of times. If the symptoms remain mild, these individuals are out in the community and do not usually self-quarantine or isolate frequently. We await results of investigations into where this individual may have been exposed to the coronavirus. - Mod.MPP]
[6] WHO situation report 25 (as of 14 Feb 2020*)
情報源 World Health Organization 2020年2月14日
Highlights
- No new countries reported cases of COVID-19 in the past 24 hours. [See report on case identified in Egypt above in section [3].]
- The 2nd death has been reported outside of China, in Japan. This individual did not have known travel history to China.
- In China, healthcare workers account for 1716 confirmed cases of COVID-19 including 6 deaths.
Technical Focus: WHO Research & Development Blueprint
-----------------------------
The WHO R&D Blueprint is a global strategy and preparedness plan that allows the rapid activation of research and development activities during epidemics. Its aim is to fast-track the availability of effective tests, vaccines, and medicines that can be used to save lives and avert further crisis.
In view of the urgency of the COVID-19 outbreak, the international community is mobilizing to find ways to significantly accelerate the development of interventions including vaccines and therapeutics. Nearly 400 world scientists met at WHO's Geneva Headquarters from 11-12 Feb 2020 to assess the current level of knowledge about the new COVID-19 virus, agree on critical research questions that need to be answered urgently, and identify ways to work together to accelerate and fund priority research that can contribute to curtail this outbreak and prepare for future outbreaks. The meeting was organized by WHO, in collaboration with the Global Research Collaboration for Infectious Disease Preparedness.
Research topics discussed included: COVID-19 virus natural history, transmission and diagnostics; animal and environmental research on the virus origin; management measures at the human-animal interface; epidemiological studies; clinical characterization and management; infection prevention and control, including healthcare workers' protection; candidate therapeutics R&D; candidate vaccines R&D; ethical considerations for research; and integrating social sciences in the outbreak response.
Experts identified key knowledge gaps and research priorities, and shared scientific data on ongoing research, thereby accelerating the generation of critical scientific information to contribute to the control the COVID-19 outbreak. There was broad consensus on the need for research to focus on actions that can save lives now to ensure that those affected are promptly diagnosed and receive optimal care. 8 immediate research priorities were agreed as part of this forum:
1. Mobilize research on rapid point-of-care diagnostics for use at the community level;
2. Assess available data to learn what standard of care approaches from China and elsewhere are the most effective;
3. Evaluate as fast as possible the effect of adjunctive (given in addition to the main treatment) and supportive therapies;
4. Optimize the use of protective equipment and other infection prevention and control measures in healthcare and community settings;
5. Review all available evidence to identify animal host(s), prevent continued spill-over, and better understand virus transmissibility in different contexts over time, the severity of disease, and individuals more susceptible to infection;
6. Accelerate the evaluation of investigational therapeutics and vaccines by using "Master Protocols";
7. Maintain a high degree of communication and interaction among funders so that critical research is implemented; and
8. Broadly and rapidly share virus materials, clinical samples, and data for immediate public health purposes.
For further information and to view documents related to the forum, please visit https://www.who.int/blueprint/priority-diseases/key-action/novel-coronavirus/en/.
[The figures provided in the below report are the figures from the National Health Commission of China from 12 Feb 2020. The 14 Feb 2020 figures are included in section [1] above. They are usually posted at approximately 7 p.m. (GMT-5), which is 1 a.m. (GMT+1) in Geneva. - Mod.MPP]
Table 2. Countries, territories or areas with reported confirmed COVID-19 cases and deaths. Data as of [14 Feb 2020]
Excerpted to show confirmed cases outside mainland China:
WHO Region:
Country / Territory / Area: Total confirmed (new cases in past 24 hours)* / Total (new) with travel history to China / Total (new) cases with possible or confirmed transmission outside of China** / Total (new) case with site of transmission under investigation / Total (new) deaths
Western Pacific Region:
China***: Lab confirmed: 48 548 / Clinically diagnosed: 15 384 / total reported: 63 932 / / 1381 (268)
Japan: 33 (4) / 24 / 9 (4) / 0 / 1 (1)
Republic of Korea: 28 /13 / 12******** / 3 / 0
Viet Nam: 16 (1) / 8 / 8 (1) / 0 / 0
Singapore: 58 (8) / 22 / 36******* (8) / 0 / 0
Australia: 15 / 15 / 0 / 0 / 0
Malaysia: 19 (1) / 15 / 4********* (1)********** / 0 / 0
Cambodia: 1 / 1 / 0 / 0 / 0
Philippines: 3 / 3 / 0 / 1 / 1
South East Asia Region:
Thailand: 33 / 23 / 6********** / 4 / 0
Nepal: 1 / 1 / 0 / 0 / 0
Sri Lanka: 1 / 1 / 0 / 0 / 0
India: 3 / 3 / 0 / 0 / 0
Region of the Americas:
United States of America: 15 (1) / 13 (1) / 2 / 0 / 0
Canada: 7 / 6 / 0 / 1 / 0
European Region:
France: 11 / 5 / 6 / 0 / 0
Finland: 1 / 1 / 0 / 0 / 0
Germany: 16 / 2 / 14******* / 0 / 0
Italy: 3 / 3 / 0 / 0 / 0
Russian Federation: 2 / 2 / 0 / 0 / 0
Spain: 2 / 0 / 2***** / 0 / 0
Sweden: 1 / 1 / 0 / 0 / 0
United Kingdom: 9 / 2 / 7****** / 0 / 0
Belgium: 1 / 1 / 0 / 0 / 0
Eastern Mediterranean Region:
United Arab Emirates: 8 / 6 / 1 / 1 / 0
Other: Cases on an international conveyance (Japan): 218**** (44) / 0 / 0 / 218 (44) / 0
*Case classifications are based on WHO case definitions for COVID-19.
**Location of transmission is classified based on WHO analysis of available official data and may be subject to reclassification as additional data become available.
***Confirmed cases in China include cases confirmed in Hong Kong SAR (53 confirmed cases, 1 death), Macao SAR (10 confirmed cases) and Taipei and environs (18 confirmed cases).
****Cases identified on a cruise ship currently in Japanese territorial waters.
*****The exposure for 2 cases occurred outside of Spain.
******The exposure for 6 cases occurred outside of the United Kingdom.
*******The exposure for 4 cases occurred outside of Singapore.
********The exposure for 3 cases occurred outside of Republic of Korea.
*********The exposure for 1 case occurred outside of Malaysia.
**********This patient also had travel history to China, but exposure likely occurred after return to Malaysia.
[There are excellent graphs and a map available at the source URL, as well as strategic objectives and preparedness and response information.
- Figure 1. Countries, territories or areas with reported confirmed cases of COVID-19, 14 Feb 2020.
- Figure 2: Epidemic curve of COVID-19 cases (n =192) identified outside China, by date of onset of symptoms and travel history, 14 Feb 2020 (WHO has a note for Figure 2: Of the 505 cases reported outside China, 17 were detected while apparently asymptomatic. For the remaining 488 cases, information on date of onset is available only for the 192 cases presented in the epidemiologic curve).
- Figure 3: Epidemic curve of COVID-19 cases (n = 505) identified outside China, by date of reporting and travel history, 14 Feb 2020.
- Mod.MPP]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[[The number of countries reporting confirmed cases of COVID-19 with transmission occurring outside China remains 12 (Japan, Singapore, South Korea, Viet Nam, Malaysia, Thailand, USA, France, Germany, Spain, UK, and UAE). There has also been local transmission noted on the cruise ship quarantined in Japan related to a quarantine officer.
New confirmatory information contained in this update includes showing the number of laboratory-confirmed cases in China in addition to showing the clinically confirmed cases, in keeping with change in reporting criteria implemented in Hubei province. Thus, while the numbers of "confirmed cases" in China yesterday [13 Feb 2020] increased by an additional 15 384, the number of laboratory-confirmed cases increased by 1998 from that reported in the WHO update on 13 Feb 2020. Unfortunately, there isn't a delineation of fatalities to know how many of the newly reported fatalities were laboratory-confirmed cases.
Another piece of newly confirmed data includes information that there have been a total of 1716 laboratory-confirmed cases in healthcare workers including 6 fatalities in China. With a total number of laboratory-confirmed cases as of today, 14 Feb 2020, at 48 548, the proportion of cases among healthcare workers is 3.5%, significantly lower than seen with the SARS-CoV outbreak in 2002-2003, when there were 1725 cases among healthcare workers out of 8422 cases (20.5%). (Data from WHO SARS summary table, 15 Aug 2003 available at: https://www.who.int/csr/sars/country/country2003_08_15.pdf?ua=1). - Mod.MPP]
● COVID-19(02) 中国 報告定義 WHO
PRO/AH/EDR> COVID-19 update (02): China, global, reporting criteria, WHO
Archive Number: 20200214.6987678
In this update:
[1] China: China National Health Commission 14 Feb 2020
[2] Global update: Johns Hopkins CSSE [accessed at 9:30 p.m. GMT-5]
[3] China (Wuhan): change in case reporting criteria
[4] Selected media reports of transmission outside of mainland China
[5] WHO situation report 24 (as of 13 Feb 2020*)
[1] 中国
Update on new coronavirus pneumonia situation as of 24:00 on [13 Feb 2020]
Update on new coronavirus pneumonia situation as of 24:00 on [13 Feb 2020]
情報源 China National Health Commission [ in Chinese]2020年2月14日
At 04:00 on [13 Feb 2020], 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps reported an increase of 5090 confirmed cases, 2174 severe cases, and 121 death cases (116 in Hubei, 2 in Heilongjiang). Deaths were also reported 1 each in Anhui, Henan, and Chongqing), with 2450 new suspected cases.
1081 new cases were cured and discharged on the same day, and 26 905 close contacts were lifted from medical observation.
As of 24:00 on [13 Feb 2020], according to reports from 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps, there were 55 748 confirmed cases (including 10 204 severe cases), and a total of 6723 discharged cases were cured (269 cases in Hubei Province). A total of 1380 deaths (108 cases in Hubei Province due to repeated statistics), a cumulative report of 63 851 confirmed cases (1043 cases in Hubei Province), and 10 109 suspected cases. A total of 493 067 close contacts were traced, and 177 984 close contacts were still under medical observation.
There were 4823 newly confirmed cases in Hubei (3910 in Wuhan), 690 newly cured cases (370 in Wuhan), 116 new deaths (88 in Wuhan), and 46 806 confirmed cases (32 959 in Wuhan). Among them, 9278 cases were severe cases (7492 cases in Wuhan). A total of 3862 discharged patients were cured (2016 in Wuhan), a total of 1318 deaths (1016 in Wuhan), and a total of 51 986 confirmed cases (35 991 in Wuhan). There were 1154 new suspected cases (473 in Wuhan) and 6169 suspected cases (2585 in Wuhan).
A total of 81 confirmed cases were reported from Hong Kong, Macao, and Taiwan: 53 in the Hong Kong Special Administrative Region (1 discharged, 1 died), 10 in the Macau Special Administrative Region (3 discharged), and 18 in Taiwan (1 discharged).
The data below are from the Hong Kong Centre for Health Protection
https://www.chp.gov.hk/files/pdf/statistics_of_the_cases_novel_coronavirus_infection_en.pdf
Province: 11 Feb 2020 Cases / 11 Feb 2020 Deaths // 12 Feb 2020 Cases / 12 Feb 2020 Deaths // 13 Feb 2020 Cases / 13 Feb 2020 Deaths
Hubei: 33 336 / 1068 // 48 206 / 1310 // 51 986 / 1426
Beijing: 342 / 3 // 352 / 3 // 366 / 3
Liaoning: 116 / 0 // 1116 / 1 // 117 / 1
Anhui: 889 / 4 // 889 / 4 // 910 / 5
Chongqing: 505 / 3 // 518 / 3 // 525 / 3
Shaanxi: 219 / 0 // 225 / 0 // 229 / 0
Tianjin: 106 / 2 // 112 / 2 // 119 / 3
Fujian: 272 / 0 // 272 / 0 // 279 / 0
Hunan: 912 / 2 // 946 / 2 // 968 / 2
Sichuan: 436 / 1 // 436 / 1 // 451 / 1
Gansu: 86 / 2 // 87 / 2 // 90 / 2
Heilongjiang: 378 / 8 // 395 / 9 // 418 / 11
Jiangxi: 804 / 1 // 844 / 1 // 872 / 1
Guangdong: 1219 / 1 // 1241 / 2 // 1261 / 2
Guizhou: 127 / 1 // 133 / 1 // 135 / 1
Shanghai: 306 / 1 // 313 / 1 // 318 / 1
Shandong: 487 / 1 // 497 / 2 // 519 / 2
Guangxi Zhuang Autonomous Region: 222 / 1 // 222 / 2 // 226 / 2
Yunnan: 153 / 0 // 154 / 0 // 156 / 0
Inner Mongolia Autonomous Region: 58 / 0 // 60 / 0 // 61 / 0
Zhejiang: 1117 / 0 // 1131 / 0 // 1145 / 0
Henan: 1135 / 8 // 1135 / 8 // 1169 / 10
Hebei: 251 / 2 // 265 / 3 // 283 / 3
Hainan: 151 / 3 // 157 / 4 // 157 / 4
Jilin: 83 / 1 // 84 / 1 // 86 / 1
Shanxi: 124 / 0 // 126 / 0 // 126 / 0
Ningxia Hui Autonomous Region: 53 / 0 // 58 / 0 // 64 / 0
Jiangsu: 515 / 0 // 543 / 0 // 570 / 0
Xinjiang Uygur Autonomous Region: 55 / 0 // 59 / 0 // 63 / 1
Qinghai: 18 / 0 // 18 / 0 // 18 / 0
Tibet Autonomous Region: 1 / 0 // 1 / 0 // 1 / 0
Total: 44 476 / 1113 // 60 595 / 1362 // 63 688 / 1485
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[This comment refers to the data coming from the Hong Kong CHP website table above. A total of 3093 newly confirmed cases have been reported by China in the past 24 hours. This brings the total number of reported confirmed cases to 63 688 cases. In addition, 123 deaths were reported in this time period, bringing the total number of reported deaths to 1485. In the past 24 hours, there have been 3 newly confirmed cases reported from Hong Kong.
A good map of China showing provinces can be found at https://www.chinadiscovery.com/china-maps/china-provincial-map.html and a HealthMap/ProMED-mail map can be seen at http://healthmap.org/promed/p/155. - Mod.MPP]
[2] Global update: Johns Hopkins CSSE [accessed at 9:30 p.m. GMT-5]
情報源 Johns Hopkins CSSE (Center for Systems Science and Engineering) 2020年2月13日
Confirmed cases
2 Feb 2020 / 3 Feb 2020 / 4 Feb 2020 (early) / 4 Feb 2020 (end of day) / 5 Feb 2020 / 6 Feb 2020 / 7 Feb 2020 / 8 Feb 2020 / 9 Feb 2020 early / 9 Feb 2020 late / 10 Feb 2020 / 11 Feb 2020 / 12 Feb 2020 / 13 Feb 2020 / Country/Region
2 Feb 2020 / 3 Feb 2020 / 4 Feb 2020 (early) / 4 Feb 2020 (end of day) / 5 Feb 2020 / 6 Feb 2020 / 7 Feb 2020 / 8 Feb 2020 / 9 Feb 2020 early / 9 Feb 2020 late / 10 Feb 2020 / 11 Feb 2020 / 12 Feb 2020 / 13 Feb 2020 / Country/Region
17 187 / 19 693 / 20 636 / 23 746 / 27 396 / 30 553 / 34 524 / 37 174 / 37 199 / 40 157 / 42 310 / 44 414 / 59 789 / 63 842 / Mainland China
20 / 20 / 20 / 22 / 22 / 45 / 25 / 25 / 26 / 26 / 26 / 26 / 26 / 28 / 28 / Japan
19 / 19 / 19 / 25 / 25 / 25 / 25 / 32 / 32 / 32 / 32 / 33 / 33 / 33 / Thailand
18 / 18 / 18 / 24 / 28 / 28 / 30 / 40 / 40 / 43 / 45 / 47 / 50 / 58 / Singapore
15 / 15 / 15 / 17 / 21 / 24 / 26 / 26 / 26 / 36 / 38 / 49 / 50 / 53 / Hong Kong
15 / 15 / 15 / 16 / 19 / 23 / 24 / 25 / 25 / 27 / 27 / 28 / 28 / 28 / South Korea
12 / 12 / 12/ 13 / 13 / 14 / 15 / 15 / 15 / 15 / 15 / 15 / 15 / 15 / Australia
10 / 12 / 12 / 12 / 12 / 12 / 13 / 13 / 15 / 14 / 14 / 16 / 16 / 16 / Germany
10 / 10 / 10 / 11 / 11 / 16 / 16 / 17 / 17 / 18 / 18 / 18 / 18 / 18 / Taiwan
11 / 11 / 11 / 11 / 12 / 12 / 12 / 12 / 12 / 12 / 12 / 13 / 13 / 15 / USA
8 / 8 / 10 / 10 / 10 / 10 / 10 / 10 / 10 / 10 / 10 / 10 / 10 / 10 / Macau
8 / 8 / 10 / 10 / 12 / 12 / 12 / 16 / 16 / 18 / 18 / 18 / 19 / Malaysia
6 / 6 / 6 / 6 / 6 / 6 / 6 / 11 / 11 / 11 / 11 / 11 / 11 / France
6 / 8 / 8 / 8 / 8 / 10 / 10 / 13 / 13 / 14 / 14 / 15 / 16 / Viet Nam
5 / 5 / 5 / 5 / 5 / 5 / 5 / 7 / 7 / 7 / 8 / 8 / 8 / 8 / United Arab Emirates
4 / 4 / 4 / 4 / 5 / 5 / 7 / 7 / 7 / 7 / 7 / 7 / 7 / 7 / Canada
2 / 2 / 2 / 2 / 2 / 2 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / Italy
2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / Russia
2 / 2 / 2 / 2 / 2 / 2 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / Philippines
2 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / India
2 / 2 / 2 / 2 / 2 / 2 / 3 / 3 / 3 / 3 / 8 / 8 / 9 / 9 / UK
1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / Nepal
1 / 1 / 1 / 1/ 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / Cambodia
1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 2 / 2 / 2 / 2 / 2 / Spain
1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1/ 1 / 1 / 1 / 1 / Finland
1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / Sweden
1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / Sri Lanka
0 / 0 / 0 / 1 / 1 / 1 / 1 / 1 / 1/ 1 / 1 / 1 / 1 / 1 / Belgium
0 / 0 / 0 / 10 / 20 / 41 / 61 / 64 / 64 / 135 / 135 / 175 / 218 / Others
Total reported deaths: 1491
Hubei, Mainland China: 1426 deaths
Guangdong, Mainland China: 2 deaths
Henan, Mainland China: 11 deaths
Hunan, Mainland China: 2 deaths
Anhui, Mainland China: 6 deaths
Jiangxi, Mainland China: 1 death
Chongqing, Mainland China: 4 deaths
Shandong, Mainland China: 2 deaths
Sichuan, Mainland China: 1 death
Beijing, Mainland China: 3 deaths
Heilongjiang, Mainland China: 11 deaths
Shanghai, Mainland China: 1 death
Hebei, Mainland China: 3 deaths
Guangxi, Mainland China: 2 deaths
Hainan, Mainland China: 4 deaths
Guizhou, Mainland China: 1 death
Tianjin, Mainland China: 3 deaths
Gansu, Mainland China: 2 deaths
Jilin, Mainland China: 1 death
Liaoning, Mainland China: 1 death
Xinjiang, Mainland China: 1 death
Hong Kong, Hong Kong: 1 death
Philippines: 1 death
Japan: 1 death
Data sources: WHO, CDC, ECDC, NHC, and DXY
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[As mentioned previously, this website is constantly updated as new information comes in, so it is likely that when you read this post, the numbers will not match the linked numbers because they will have been updated since the post was prepared.
There are now a total of 566 confirmed cases of COVID-19 reported from outside mainland China. During this period, no new countries were added to the list, 1 new fatality was reported outside China in Japan. With respect to fatalities, the total number of fatalities associated with COVID-19 is now at 1491, with 123 newly reported fatalities in the past 24 hours, all but 1 reported from mainland China (the other was reported by Japan). Of the 123 newly reported fatalities, 116 (94.3%) were reported from Hubei province. - Mod.MPP]
******
[3] 中国 (Wuhan) change in case reporting criteria
情報源 Chinese National Health Commission [in Chinese] 2020年2月12日
Update on the epidemic situation of new coronavirus pneumonia as of 24:00 on [12 Feb 2020]
--------------------------------------------------------------------------
At 04:00 on [12 Feb 2020], 31 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps reported 15 152 newly confirmed cases (including 13 332 clinical diagnosis cases in Hubei), 174 cases of severe cases were reduced, and 254 death cases were newly added. [Fatalities] (242 in Hubei, 2 in Henan, 1 each in Tianjin, Hebei, Liaoning, Heilongjiang, Anhui, Shandong, Guangdong, Guangxi, Hainan, and Xinjiang Production and Construction Corps), and 2807 suspected cases were added.
1171 new cases were cured and discharged on the same day, and 29 429 close contacts were lifted from medical observation.
As of 24:00 on [12 Feb 2020], according to reports from 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps, there were 52 526 confirmed cases (of which 8030 were severe cases), 5911 were cured and discharged, and 1367 [had died]. A total of 59 804 confirmed cases have been reported, with 13 435 suspected cases. A total of 471 531 close contacts were traced, and 181,386 close contacts were still in medical observation.
There were 14 840 newly confirmed cases in Hubei (13 436 in Wuhan), 802 cured cases (538 in Wuhan), 242 death cases (216 in Wuhan), and 43 455 confirmed cases (30 043 in Wuhan). Among them, 7084 cases were severe cases (5426 cases in Wuhan). A total of 3441 discharged patients (1915 in Wuhan) were cured, a total of 1310 deaths (1036 in Wuhan), and a total of 48 206 confirmed cases (32 994 in Wuhan). There were 1377 new suspected cases (620 in Wuhan) and 9028 suspected cases (4904 in Wuhan).
In order to do a good job of early diagnosis and early treatment of patients with new type of coronavirus pneumonia, and to implement the work of receivables and treatments of patients in Hubei, according to the "New Coronary Virus Pneumonia Diagnosis and Treatment Program (Trial 5th Revised Edition)", the diagnostic criteria for cases in other provinces other than Hubei Province have been differentiated. Hubei Province has added a "clinical diagnosis case" classification to identify suspected cases with pneumonia imaging features as clinical diagnosis cases so that patients can be accepted as soon as possible, in accordance with the relevant requirements of confirmed cases, standardize treatment, and further improve the success rate of treatment. At present, 13 332 clinically diagnosed cases reported by Hubei Province are included in the statistics of confirmed cases, and case treatment is being strengthened to reduce severe illness and mortality.
A total of 78 confirmed cases were reported in Hong Kong, Macao and Taiwan: 50 cases in the Hong Kong Special Administrative Region (1 death and 1 discharge), 10 cases in the Macau Special Administrative Region (2 discharges), and 18 cases in Taiwan (1 discharge).
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Yesterday's report of approximately 16 000 newly confirmed cases was eye opening, to say the least, and strongly suggested a change in reporting criteria. Unfortunately, this report was not available at the time of preparation of the ProMED-mail update to clarify what was transpiring. It appears as though to fast track individuals with pneumonia into treatment protocols aimed at preventing more serious disease, Hubei has moved to a clinical definition of pneumonia and these cases are being reported as clinical cases of COVID-19 in lieu of waiting for positive laboratory tests. Recognizing this change may result in false positive reports. From a clinical management standpoint, it will hopefully impact on outcomes, especially for those with false negative tests early on in the course of their illnesses. Somewhat ironic that the day I chose to present the change in diagnostic criteria of the government not to report asymptomatic infections as cases of COVID-19, is the day there is a change in reporting criteria to use a clinical definition, resulting in a major increase in reported cases in Wuhan. - Mod.MPP]
******
[4] Selected media reports of transmission outside of mainland China
A. Japanese cruise ship
Date: Thu 13 Feb 2020 11:19 AM JST
Source: No updates on newly confirmed cases as of 10:30 PM GMT-5
--
Communicated by:
ProMED-mail
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---
B. Japan: 4 newly confirmed cases, 1 fatal
Date: Thu 13 Feb 2020
Source: NHK World [edited]
https://www3.nhk.or.jp/nhkworld/en/news/20200214_15/
Japan's health ministry has confirmed that a woman infected with the new coronavirus has died. She was in her 80s and lived in Kanagawa prefecture, located just outside Tokyo. Her death marks the 1st virus-related death in the country.
Health minister Katsunobu Kato said: "She exhibited symptoms on [22 Jan 2020] and was admitted to a hospital in Kanagawa on [1 Feb 2020]. She was declared dead today [13 Feb 2020]. After that, tests confirmed that she had contracted the new coronavirus."
The health ministry added that the woman reportedly never traveled abroad. Her son-in-law, who is a taxi driver, was also found to be infected with the virus. Health ministry officials say the man says he didn't visit the Chinese provinces of Hubei or Zhejiang during the 2 weeks before he began exhibiting symptoms. They also say he denies driving any foreign customers during this period. [Although another media report mentions he may have had passengers from China [https://www3.nhk.or.jp/news/html/20200213/k10012284011000.html; in Japanese]
Another new case in Japan is a doctor in his 50s. He works at a hospital in western Japan. [Information from another media report: The doctor was hospitalized on 10 Feb 2020 and tested positive on 13 Feb 2020 for symptoms of pneumonia following fever and general malaise beginning on 31 Jan 2020. He continued working at the hospital while symptomatic until 5 Feb 2020. The physician is currently hospitalized in another medical facility, but has not traveled to China in the 14 days prior to onset and did not have any apparent contact with people from China. https://www3.nhk.or.jp/news/html/20200213/k10012284301000.html; in Japanese.]
A man in his 20s, who lives just outside Tokyo has also been infected. Health ministry officials are still investigating how they contracted the virus.
--
Communicated by:
ProMED-mail Rapporteur Kunihiko Iizuka
[If these individuals did not have any known contact with high risk individuals (contact with individuals coming from areas with known local transmission such as China or Singapore), then this is most likely due to local transmission ongoing in Japan, quite possibly "under the radarscope" -- mild cases, many of whom are not seeking help from the formal health sector. In contrast, a case in a doctor is disconcerting as he may have had contact with a case during his practice, and may have in turn transmitted the virus to other patients and hospital staff. - Mod.MPP]
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C. Japan (Wakayama) contact case with physician
Date: Fri 14 Feb 2020
Source: Mainichi Shimbun [edited[
https://mainichi.jp/english/articles/20200214/p2g/00m/0na/044000c
A man in his 70s has tested positive for the new coronavirus after contact with a doctor at a hospital in western Japan, a local government said [Fri 14 Feb 2020].
The surgeon in his 50s was confirmed [Thu 13 Feb 2020] to have become the 1st doctor in Japan to be infected with the new virus, which originated in China.
The man in his 70s has developed severe pneumonia, the Wakayama prefectural government said.
--
Communicated by:
ProMED-mail Rapporteur Kunihiko Iizuka
[HealthMap/ProMED-mail map of Japan: http://healthmap.org/promed/p/156]
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D. USA ex China
Date: Thu 13 Feb 2020
Source: Times Record [edited]
https://www.timesrecordnews.com/story/news/local/2020/02/13/first-texas-case-covid-2019-reported-san-antonio/4749631002/
Texas' 1st case of the new coronavirus (COVID-19) was confirmed [Thu 13 Feb 2020] at Lackland Air Force Base in San Antonio [Texas]. The infection was confirmed by laboratory testing Wednesday [12 Feb 2020] night. The individual was a United States evacuee that had come from China. The patient is said to be in stable condition and is being quarantined in isolation at a nearby hospital.
The case marked the 15th known case in the United States. 2 other cases found in evacuees from Wuhan, China, tested positive last week at Marine Corps Air Station Miramar, California.
In a statement released Thursday [13 Feb 2020] morning, the Centers for Disease Control and Prevention said:
"CDC today confirmed another infection with Coronavirus Disease (COVID-19) in the United States. The patient is among a group of people under a federal quarantine order at JBSA-Lackland in Texas because of their recent return to the U.S. on a State Department-chartered flight that arrived on [7 Feb 2020].
All people who lived or traveled in Hubei Province, China, are considered at high risk of having been exposed to this virus and are subject to a temporary 14-day quarantine upon entry into the United States. This is the 1st person under quarantine at JBSA-Lackland who had symptoms and tested positive for COVID-19. The individual is currently isolated and receiving medical care at a designated hospital nearby.
This brings the total number of COVID-19 cases in the United States to 15. There will likely be additional cases in the coming days and weeks, including among other people recently returned from Wuhan. While 195 people were discharged from quarantine on Tuesday [11 Feb 2020], more than 600 people who returned on chartered flights from Wuhan remain under federal quarantine and are being closely monitored to contain the spread of the virus."
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Communicated by:
ProMED-mail
<promed@promedmail.org>
[Another media report mentioned there were 91 individuals in this airlift group so one will not be surprised if there are more cases confirmed over the coming days. - Mod.MPP
HealthMap/ProMED-mail map of the United States: http://healthmap.org/promed/p/37151]
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E. Viet Nam
Date: Thu 13 Feb 2020
Source: Le Courier Vietnam [in French, trans. Corr.SB]
https://www.lecourrier.vn/covid-19-le-vietnam-confirme-le-16e-cas-contamine/662223.html
COVID-19: Viet Nam confirms the 16th case
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He is a Vietnamese, aged 50, and domiciled in Son Loi commune, Binh Xuyen district, northern province of Vinh Phuc which has so far registered 11 infected cases. He is the father of a coronavirus-positive patient who was 1 of 8 Vietnamese workers returned from the epicenter of the COVID-19 epidemic in Wuhan, China.
Earlier, after his 2 daughters and wife tested positive for the virus, the man was included in the list of people in close contact and quarantined for daily health surveillance.
The patient showed signs of fatigue on [Tue 11 Feb 2020]. His sample was sent to the National Institute of Hygiene and Epidemiology and tested positive for coronavirus. He is now in stable health condition and is isolated in a clinic in the district of Binh Xuyen.
To date, Viet Nam has detected 16 cases tested positive for COVID-19, of which 7 have been cured.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[It appears as though there is local transmission of the coronavirus ongoing in Vinh Phuc province, originally related to returning workers from Wuhan, China. - Mod.MPP
HealthMap/ProMED-mail map of Vietnam: http://healthmap.org/promed/p/65332]
******
[5] WHO situation report 24 (as of 13 Feb 2020*)
情報源 World Health Organization 2020年2月13日
Highlights
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- No new countries reported cases of COVID-19 in the past 24 hours.
- WHO has developed a database to collect the latest scientific findings and knowledge on Coronavirus disease. For more information, please see here.
- The 2-day global research and innovation forum regarding COVID-19 was convened in line with the WHO R&D Blueprint this week. Leading health experts from around the world met at WHO to assess the current level of knowledge about the new COVID-19 disease, identify gaps and work together to accelerate and fund priority research needed to help stop this outbreak and prepare for any future outbreaks. For more details, please see https://www.who.int/news-room/detail/12-02-2020-world-experts-and-funders-set-priorities-for-covid-19-research.
- Overnight 14 840 cases, including 13 332 clinically diagnosed cases were reported from Hubei. This is the 1st time China has reported clinically diagnosed cases in addition to laboratory-confirmed cases. For consistency, we report here only the number of laboratory-confirmed cases. WHO has formally requested additional information on the clinically diagnosed cases, in particular when these have occurred in the course of the outbreak and whether suspect cases were reclassified as clinically diagnosed cases.
Technical focus: investigation of COVID-19 cases outside of China
-----------------------------------------------------------------
As of 10am CET 13 Feb 2020, a total of 170 cases of COVID-19 who had a travel history to China have been reported outside of China. The vast majority of these (151, 89%) do not appear to lead to further transmission of the virus, while the remaining 19 have been associated with onward transmission within 12 distinct groups of epidemiologically linked cases (Fig 2 [at source URL]).
Among these, 4 groups have involved at least 9 individuals. The largest involves 20 individuals in 6 countries thus far -- United Kingdom (6), France (5), Malaysia (3), Singapore (3), Republic of Korea (2), Spain (1) -- and has been linked to a conference held in Singapore between [20 and 22 Jan 2020] and a subsequent ski trip to the French Alps (Table 1, Figure 2 [at source URL).
The next largest involves 15 cases and was linked to a conference in Bavaria, Germany. Among the attendees was an individual with an epidemiological link to confirmed cases in Wuhan, China. Additionally, one of the 15 cases was detected in, but did not involve transmission within, Spain.
16 cases have been reported in 4 countries for which there are no clearly established epidemiological links. For all these individuals, investigations are ongoing to establish the mechanism by which they were infected.
Table 1. Summary of 4 events with linked cases and transmission out of China with number of confirmed cases larger than 7, as of 10 am 13 Feb 2020
Event Number: Countries Reporting / Number of Confirmed Cases / Date of report to WHO of last case
1: France (5), Malaysia (3), Republic of Korea (2), Singapore (3), Spain (1), United Kingdom (6) / 20 / 10 Feb 2020
2: Germany (14), Spain (1) / 15 / 11 Feb 2020
3: Viet Nam (9) / 9 / 11 Feb 2020
4: Singapore (9) / 9 / 8 Feb 2020
Figure 2. Description of the known transmission chain of event originating in Singapore (Event Number 1, Table 1), as of 10 am 13 Feb 2020 [Available at the source URL and definitely worth looking at].
[The figures provided in the below report are the figures from the National Health Commission of China from 12 Feb 2020. The 13 Feb 2020 figures are included in Section [1] above. They are usually posted at approximately 7 p.m. (GMT-5), which is 1 a.m. (GMT+1) in Geneva. - Mod.MPP]
Table 2. Countries, territories or areas with reported confirmed COVID-19 cases and deaths. Data as of [13 Feb 2020]
Excerpted to show confirmed cases outside mainland China:
WHO Region:
Country / Territory / Area: Total confirmed (new cases in past 24 hours)* / Total (new) with travel history to China / Total (new) cases with possible or confirmed transmission outside of China** / Total (new) case with site of transmission under investigation / Total (new) deaths
Western Pacific Region:
China***: 46 550 (1820) / / / / 1113 (97)
Japan: 29 / 24 / 5 / 0 / 0
Republic of Korea: 28 /13 / 12******** / 3 / 0
Viet Nam: 16 (1) / 8 / 8 (1) / 0 / 0
Singapore: 50 (3) / 22 / 28******* (3) / 0 / 0
Australia: 15 / 15 / 0 / 0 / 0
Malaysia: 18 / 15 / 3********* / 0 / 0
Cambodia: 1 / 1 / 0 / 0 / 0
Philippines: 3 / 3 / 0 / 1 / 1
South East Asia Region:
Thailand: 33 / 23 / 6********** / 4 / 0
Nepal: 1 / 1 / 0 / 0 / 0
Sri Lanka: 1 / 1 / 0 / 0 / 0
India: 3 / 3 / 0 / 0 / 0
Region of the Americas:
United States of America: 14 (1) / 12 (1) / 2 / 0 / 0
Canada: 7 / 6 / 0 / 1 / 0
European Region:
France: 11 / 5 / 6 / 0 / 0
Finland: 1 / 1 / 0 / 0 / 0
Germany: 16 / 2 / 14******* / 0 / 0
Italy: 3 / 3 / 0 / 0 / 0
Russian Federation: 2 / 2 / 0 / 0 / 0
Spain: 2 / 0 / 2***** / 0 / 0
Sweden: 1 / 1 / 0 / 0 / 0
United Kingdom: 9 (1) / 2 (1) / 7****** / 0 / 0
Belgium: 1 / 1 / 0 / 0 / 0
Eastern Mediterranean Region:
United Arab Emirates: 8 / 6 / 1 / 1 / 0
Other: Cases on an international conveyance (Japan): 174**** / 0 / 0 / 174 / 0
*Case classifications are based on WHO case definitions for COVID-19.
**Location of transmission is classified based on WHO analysis of available official data and may be subject to reclassification as additional data become available.
***Confirmed cases in China include cases confirmed in Hong Kong SAR (49 confirmed cases, 1 death), Macao SAR (10 confirmed cases) and Taipei and environs (18 confirmed cases).
****Cases identified on a cruise ship currently in Japanese territorial waters.
*****The exposure for 2 cases occurred outside of Spain.
******The exposure for 6 cases occurred outside of the United Kingdom.
*******The exposure for 4 cases occurred outside of Singapore.
********The exposure for 3 cases occurred outside of Republic of Korea.
*********The exposure for 1 case occurred outside of Malaysia.
**********The exposure for 2 cases occurred outside of Thailand.
[There are excellent graphs and a map available at the source URL, as well as strategic objectives and preparedness and response information.
- Figure 1. Countries, territories or areas with reported confirmed cases of COVID-19, 13 Feb 2020.
- Figure 3: Epidemic curve of COVID-19 cases (n =172) identified outside China, by date of onset of symptoms and travel history, 13 Feb 2020 (WHO has a note for Figure 3: Of the 447 cases reported outside China, 16 were detected while apparently asymptomatic. For
the remaining 431 cases, information on date of onset is available only for the 172 cases presented in the epidemiologic curve
- Figure 4: Epidemic curve of COVID-19 cases (n = 447) identified outside China, by date of reporting and travel history, 13 Feb 2020.
- Mod.MPP]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The number of countries reporting confirmed cases of COVID-19 with transmission occurring outside China remains 12 (Japan, Singapore, South Korea, Viet Nam, Malaysia, Thailand, USA, France, Germany, Spain, UK, and UAE). There has also been local transmission noted on the cruise ship quarantined in Japan. - Mod.MPP]
関連項目
COVID-19 update (01): China, global, EVZD, reporting criteria, WHO 20200213.6984084