Thursday, 9 April 2020

The Unfolding Pandemic - February


1 February 2020 — In China, confirmed cases now total 14,380 and the death toll rises above 300.
10th case is reported in Australia, another returning from Wuhan. Australia banned the entry of foreign nationals from mainland China and ordered Australian citizens returning from China to self quarantine for 14 days.
2 February 2020 — The first 2019-nCoV death outside China is reported in the Philippines. The patient was a 44-year-old Chinese male, and known companion of the 38-year-old woman who tested positive for 2019-nCoV on Jan. 30 and the first case in the Philippines. The country also imposes a travel ban for travellers coming from China, Hong Kong, and Macao, and a 14-day quarantine period for Philippine residents. In the epicentre, Hubei, the number of cases exceeds 11,000. Confirmed cases now at 17,205, bringing total global cases to 17,386, with 362 deaths.
2 more cases reported also returning from Wuhan.
3 February 2020 — China launches a clinical trial of Gilead’s antiviral drug remdesivir, previously tested in patients with Ebola, against the 2019-nCoV. Huoshenshan Hospital in Wuhan opens; the hospital was built in 10 days for the sole purpose of treating 2019-nCoV patients.
In Hong Kong cases total 20,438, bringing total confirmed cases globally to 20,625, and 426 deaths. Chinese officials call on the U.S. not to overreact and cause panic over 2019-nCoV. WHO meanwhile launches its own dashboard of 2019-nCoV confirmed cases in China and globally.
New Zealand Government announce that foreign travellers from China would be refused entry to New Zealand unless they had spent 14 days in another country en route. The Universities asked for exemptions for Chinese students but were refused.
4 February 2020 — Hong Kong reports its first death of a patient with 2019-nCoV. The 39-year-old man had travel history from Wuhan, the outbreak’s epicentre. This is the second death linked to the 2019-nCoV reported outside mainland China, after the Philippines. The total number of deaths from 2019-nCoV stands at 492, and confirmed cases globally over 24,000. Belgium reports its first case of 2019-nCoV; the patient was repatriated from Wuhan over the weekend.
Eleven New Zealanders understood to be on board the quarantined Diamond Princess in Japan.
5 February 2020 —Ten passengers from the Diamond Princess cruise ship currently docked in Yokohama, Japan, test positive for 2019-nCoV, bringing the total cases in Japan to 35, now the highest among countries with confirmed cases outside mainland China. Global cases total over 28,000, with 565 deaths, although the majority of cases are still in China. China state media Xinhua also reports a newborn has been infected with the virus, but the route of transmission is unknown. The Chinese central government has started penalising officials found to be neglectful in performing their duties in relation to infection prevention and control of the outbreak, amid increasing anecdotal reports of government officials’ slow response to the early days of the outbreak.
A chartered flight arrived in Auckland with Australian and New Zealand citizens and residents returning from Wuhan. The Australian citizens were transferred to an Australian flight, all remaining passengers were quarantined at Whenuapai for 14 days.
6 February 2020— Total cases in China now at 31,161, and 636 deaths. Outside mainland China, cases at 310, with 2 deaths.
The total number of cases in Australia had risen to 15.
7 February 2020 — Confirmed cases in Japan jump to 86, as the number of infected rises to 61 inside a cruise ship (Diamond Princess) docked in Yokohama. Patients include non-Japanese citizens. A local doctor in Wuhan, who tried to raise the alarm on the 2019-nCoV in December, dies. His death causes further angry sentiments in China, where he has been hailed a hero, with some calling for “freedom of speech” in the country where communication is tightly controlled by the government.
A dedicated COVID-19 Healthline set up
8 February 2020 — At a press conference the WHO Director-General criticises the levels of misinformation spreading around the virus. WHO is engaging with Facebook, Google, Tencent, Baidu, Twitter, TikTok, Weibo, Pinterest, and others to promote accurate information about 2019-nCoV.
9 February 2020 — The death toll of victims of the 2019-nCoV is now over 800, surpassing the death toll of the SARS epidemic in 2002 and 2003, which killed 773 people globally.
10 February 2020 — An advance team for the WHO-led 2019-nCoV international mission leaves for China. WHO states that instances of onward transmission from people with no travel history to China are concerning. The U.K.'s health department declares 2019-nCoV an “imminent threat” to public health, allowing the government to forcibly quarantine individuals. 168 labs around the world now have the capacity to diagnose the virus. The death count at 909 surpasses that associated with Middle East respiratory syndrome (MERS), which has claimed the lives of 858 people.
11 February 2020 — WHO assigns the novel coronavirus its official name: COVID-19. A global research and innovation forum starts in Geneva, aimed at creating a roadmap for identifying research priorities on COVID-19. WHO Director-General calls the outbreak a “very grave threat for the rest of the world” and they say a vaccine may not be available for 18 months. Death toll from the outbreak reaches over 1,000.
12 February 2020 — The number of countries outside China reporting cases has not changed since 4 February. A total of 175 people test positive for COVID-19 on the Diamond Princess cruise ship, which is quarantined in Japan. Cambodia agrees to accept a cruise ship that had been turned away from five ports, over fears that passengers might have COVID-19.
13 February 2020 — Overnight, China reports a spike in cases, with 14,840 cases in Hubei province. This coincided with the Chinese government changing its reporting strategy to include both laboratory-confirmed cases and clinically diagnosed cases. WHO is only reporting laboratory-confirmed cases as is the rest of the world. The third death from the virus outside of mainland China is confirmed in Japan. The previous deaths occurred in Hong Kong and the Philippines.
14 February 2020 — China reports that 1,716 health workers have contracted COVID-19 and that six of them have died.  This pattern had been seen previously with both SARS and MERS and the executive director of WHO Health Emergencies Programme said "Our understanding is that the cases amongst health workers peaked in the third and fourth week of January and that there has been a rapid fall-off in the number of cases that have occurred in health workers in the last two weeks."
15 February 2020 — France reports the first death from COVID-19 outside of Asia — an 80-year-old tourist from Hubei province.
16 February 2020 — An American woman who had been on a cruise ship that docked in Cambodia, tests positive for COVID-19 after flying to Malaysia. The ship originally set sail from Hong Kong on Feb.1, with 1,455 passengers and 802 members of its crew. Taiwan reports its first death from COVID-19, marking the fifth death from the virus outside of mainland China.
17 February 2020 — China publishes a paper with detailed information on more than 44,000 confirmed cases of COVID-19. The data appears to show that COVID-19 is not as deadly as other types of coronaviruses, including severe acute respiratory syndrome and MERS. The data shows that more than 80% of patients have mild disease; about 14% of cases lead to severe diseases, including pneumonia; about 5% of cases lead to critical diseases including respiratory failure, septic shock and multiorgan failure; and about 2% of reported cases lead to death. Mortality rates increase in older patients, with few cases among children. WHO switches methods for reporting confirmed COVID-19 cases, now aligning with Chinese government reporting which changed on 13 February. (WHO previously reported only laboratory-confirmed cases but now includes cases that are clinically confirmed via chest imaging.)
18 February 2020 — There are currently 92 documented cases in 12 countries other than China in which human-to-human transmission of the virus has occurred. Countries work to evacuate their citizens from the Diamond Princess cruise ship, which is quarantined in Japan, as the number of COVID-19 cases on the ship surpasses 450. The levels of community transmission was higher than had been expected.
19 February 2020 — The death toll from COVID-19 surpasses 2,000. China revokes the press credentials of three Wall Street Journal reporters. Their Foreign Ministry says the move was retribution for a recent opinion piece published by the media outlet.
20 February 2020 — South Korea sees a spike in cases, bringing its count to 104. The country now has the second-highest number of cases outside of mainland China. The new cases are concentrated in the city of Daegu and the surrounding North Gyeongsang province. Outside of China, there are 1,076 cases in 26 countries, with seven deaths. China again changed the way that it classifies confirmed cases, removing the category of "clinically diagnosed,” which includes the use of chest exams as some were found to be COVID-19-negative after laboratory testing.
Four New Zealand citizens on board the Diamond Princess tested positive and were being treated in Japan.
21 February 2020 — WHO says it is concerned about the rapid spread of COVID-19 in Iran, which has 18 cases and has seen four deaths in the past two days. The country reported its first cases on 19 February. Israel confirms its first case of COVID-19; a person who had been quarantined on the Diamond Princess cruise ship off Japan’s coast. WHO Director-General says that “We are concerned about the number of cases with no clear epidemiological link, such as travel history to China or contact with a confirmed case,” and says that the window of opportunity to contain the outbreak is “narrowing.” While the number of cases in China’s Hubei province the epicentre of the outbreak continues to decline, there is concern about an increase in cases in Shandong province. Over 500 new cases of COVID-19 are traced to four prisons in China.
22 February 2020 — WHO conducts a survey of African countries to assess their overall readiness for COVID-19 and finds the regional readiness level is at about 66%.
23 February 2020 — South Korean President Moon Jae-in announces the highest level of alert after the country surpasses 340 cases of COVID-19, the majority of which were discovered in the past few days. This empowers the government to take measures such as restricting public transportation and banning visitors from certain countries. Cases of COVID-19 in Italy continue to rise in what has become the largest outbreak outside of Asia. Neighbouring countries close their borders with Iran, fearing a spread of the outbreak.
24 February 2020 — WHO urges focus on containment while doing everything possible to prepare for a potential pandemic. Case numbers in China are falling, according to the team of external experts on a mission in China over the previous two weeks, from an average of 2,500 cases two weeks ago to 400 cases today. But they warned against complacency. They encouraged the world to prioritise studies that can stop the outbreak faster and can reduce morbidity and mortality. Currently only one drug, remdesivir, seems to be showing real efficacy against the disease. The host of COVID-19 remains unclear, say the National Health Commission Expert Team for the epidemic response in China. But according to currently available data, bats may be the host and pangolins intermediate hosts of the virus. Some evidence also points to virus transmission through oral-fecal route and aerosol transmission, but this needs further confirmation. It’s also still unclear whether asymptomatic carriers of the virus can spread the disease. The case fatality rate in China is between 3% and 4%, but less than 1% in cities and provinces outside Wuhan.
New Zealand Government extend the travel ban for China for a further eight days.
26 February 2020 — Cases of the virus have now been confirmed on every continent except Antarctica. For the first time since the outbreak began, there are more new cases reported outside China, 459, than in China, 412. The European Commission requests member states to review pandemic preparedness plans, and inform the commission of how they plan to implement them.
Diamond Princess Australian passengers were evacuated from Japan, some repatriated to their home state to quarantine and others quarantined in a facility near Darwin for 14 days.
27 February 2020 — The number of infections globally continues to grow. There are 3,474 cases of COVID-19 including 54 deaths outside of China in 44 countries. WHO state that we are at a decisive point and urges countries to move swiftly and aggressively to contain the virus.
Australian Government activate the Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19) prompted by the rapid spread outside China.
28 February 2020 — WHO raises the global risk of spread of COVID-19 from “high” to “very high.”
“This is a reality check for every government on the planet. Wake up. Get ready. This virus may be on its way, and you need to be ready,” says Dr. Michael Ryan, executive director of the WHO Health Emergencies Programme. In recent days, 24 new cases originating from Italy have been reported in 14 countries, and 97 cases originating in Iran have been reported in 11 countries. More than 20 vaccines are in development globally, and several therapeutics are in clinical trials, with results from those trials expected in a few weeks. WHO officials say it is not yet time to declare a pandemic, adding that once one is declared, efforts will move away from containment to mitigation. There are 36,117 people in China that have recovered from the disease, according to WHO. Thirty-eight countries reported to WHO that they have instituted travel restrictions, including travel bans of visitors from China or other countries reporting transmission of COVID-19, quarantine of foreigners, self-isolation of returning citizens and visa restrictions. There have been no trade restrictions. Panic buying takes hold all across the globe with severe shortages of essential items including toilet paper, flour, canned goods and cleaning supplies.
New Zealand report their first COVID-19 case a New Zealand citizen who had returned from Iran. The Government extended the travel restrictions to include travellers coming from Iran.
A new case in Australia in a passenger returning from Iran.
29 February 2020 — WHO continues to advise against travel or trade restrictions, it notes that in certain circumstances countries can use travel restrictions temporarily, such as in settings with few international connections and limited response capacities. It says that countries can only justify significant travel restrictions at the beginning of an outbreak to give a country time to implement preparedness measures for an outbreak. WHO also says that temperature screening alone at airports and borders is not an effective way to stop international spread because people may be in an incubation period and not showing symptoms or be using antipyretics to reduce fever. WHO also recommends that countries intensify surveillance for "unusual outbreaks of influenza-like illness and severe pneumonia and monitor carefully the evolution of COVID-19 outbreaks, reinforcing epidemiological surveillance."
Australian Government extend the enforced quarantine to passengers returning from Iran, requiring them to spend 14 days in a third country before being allowed into Australia.


Total cases globally as of 29 February 2020: 85,403 and 2924 deaths.
Total cases in Australia: 24
Total cases in New Zealand: 1
(figures from WHO)


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