2019-nCOV situation: 26 January 2020

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Pandemic Threats and Health Emergencies

2019-nCOV situation: 26 January 2020

Welcome to this special issue of the newsletter where we highlight latest research and policy news and literature on 2019-nCVO situation

Please send your feedback, articles and reports, or questions you would like to share to Dr. Chadia Wannous via email  cwannous@yahoo.com  

Wishing you useful reading!


2019-nCOV Outbreak Situation

Situation updates:
WHO situation report- 24 Jan 2020
WHO situation report- 25 Jan 2020
Statement on the meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)
see also
Novel Coronavirus – Republic of Korea (ex-China)
21 January 2020
Novel Coronavirus – Japan (ex-China)
17 January 2020
Novel Coronavirus – Japan (ex-China)
16 January 2020
Novel Coronavirus – Thailand (ex-China)
14 January 2020

CDC- 2019 Novel Coronavirus (2019-nCoV)
Factbox: Latest on the coronavirus spreading in China and beyond
Countries measures

Official: China is in a critical coronavirus control period
China has mobilized seven groups of 900 medical staff to aid Hubei Province and will send 12 more teams with 1,600 medical personnel in two days to Wuhan City, the center of the novel coronavirus outbreak, as part of the latest efforts to control the spread of the coronavirus, according to officials.
China postpones 14th National Winter Games in Inner Mongolia
New hospital in Wuhan for coronavirus to be completed on Feb. 1

Beijing, Shanghai and Other Cities Enact Highest Level Emergency in Response to Coronavirus
Beijing schools postpone their opening date amid coronavirus outbreak
Chinese President Xi Jinping: Control of new coronavirus is currently the primary task
Other countries
Paris cancels Lunar New Year parade over coronavirus
Hong Kong Disneyland and Ocean Park to be closed from Sunday to help prevent spread of virus - CCTV
Scientific publications and reports
WHO Collaborating Centre for Infectious Disease Modelling, MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, UK
Report 3: Transmissibility of 2019-nCoV (Download Report 3)
Natsuko Imai, Anne Cori, Ilaria Dorigatti, Marc Baguelin, Christl A. Donnelly, Steven Riley, Neil M. Ferguson
WHO Collaborating Centre for Infectious Disease Modelling, MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, UK
Correspondence: neil.ferguson@imperial.ac.uk
Note: This is an extended version of an analysis previously shared with WHO, governments and academic networks between 22/1/20-24/1/20
Summary Report 3
Self-sustaining human-to-human transmission of the novel coronavirus (2019-nCov) is the only plausible explanation of the scale of the outbreak in Wuhan. We estimate that, on average, each case infected 2.6 (uncertainty range: 1.5-3.5) other people up to 18th January 2020, based on an analysis combining our past estimates of the size of the outbreak in Wuhan with computational modelling of potential epidemic trajectories. This implies that control measures need to block well over 60% of transmission to be effective in controlling the outbreak. It is likely, based on the experience of SARS and MERS-CoV, that the number of secondary cases caused by a case of 2019-nCoV is highly variable – with many cases causing no secondary infections, and a few causing many. Whether transmission is continuing at the same rate currently depends on the effectiveness of current control measures implemented in China and the extent to which the populations of affected areas have adopted risk-reducing behaviours. In the absence of antiviral drugs or vaccines, control relies upon the prompt detection and isolation of symptomatic cases. It is unclear at the current time whether this outbreak can be contained within China; uncertainties include the severity spectrum of the disease caused by this virus and whether cases with relatively mild symptoms are able to transmit the virus efficiently. Identification and testing of potential cases need to be as extensive as is permitted by healthcare and diagnostic testing capacity – including the identification, testing and isolation of suspected cases with only mild to moderate disease (e.g. influenza-like illness), when logistically feasible.

22 January 2020 - Imperial College London‌
Report 2: Estimating the potential total number of novel Coronavirus cases in Wuhan City, China (Download Report 2)
Natsuko Imai, Ilaria Dorigatti, Anne Cori, Christl Donnelly, Steven Riley, Neil M. Ferguson
WHO Collaborating Centre for Infectious Disease Modelling
MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, UK
Correspondence: neil.ferguson@imperial.ac.uk
Summary Report 2
On January 16th we released estimates of the scale of the nCoV-19 outbreak in China based on an analysis of the number of cases detected outside mainland China. Since then, cumulative confirmed cases reported by the Chinese authorities have increased 10-fold, to 440 by January 22nd. The number of detected outside China with symptom onset by 18th January had increased to 7 in the same time.  Here we report updated estimates of the scale of the epidemic in Wuhan, based on an analysis of flight and population data from that city. Our estimate of the number of cases in Wuhan with symptoms onset by January 18th is now 4,000. The  uncertainty range is 1,000-9,700, reflecting the many continuing unknowns involved in deriving these estimates. Our central estimate of 4,000 is more than double our past estimates, a result of the increase of the number of cases detected outside mainland China from 3 to 7. Our estimates should not be interpreted as implying the outbreak has suddenly doubled in size in the period 12th January to 18th January – delays in confirming and reporting exported cases and incomplete information about dates of symptom onset together with the still very small numbers of exported cases mean we are unable to estimate the epidemic growth rate at the current time.
Our analysis suggests that the nCoV-19 outbreak has caused substantially more cases of moderate or severe respiratory illness in Wuhan than have currently been detected. However, recent rapid increases in officially reported confirmed case numbers in China suggest that case detection and reporting has been substantially enhanced in recent days. With further refinements and expansion of surveillance (for instance, to primary care providers) it is to be hoped that the differences between our estimates and official case numbers will lessen further. Given the increasing evidence for human-to-human transmission, enhancing rapid case detection will be essential if the outbreak is to be controlled.

17 January 2020 - Imperial College London‌
Report 1: Estimating the potential total number of novel Coronavirus (2019-nCoV) cases in Wuhan City, China (Download Report 1)
Natsuko Imai, Ilaria Dorigatti, Anne Cori, Steven Riley, Neil M. Ferguson
WHO Collaborating Centre for Infectious Disease Modelling
MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, UK
Correspondence: neil.ferguson@imperial.ac.uk
Summary Report 1
Many aspects of the novel Wuhan coronavirus outbreak are highly uncertain. However, the detection of three cases outside China (two in Thailand, one in Japan) is worrying. We calculate, based on flight and population data, that there is only a 1 in 574 chance that a person infected in Wuhan would travel overseas before they sought medical care. This implies there might have been over 1700 (3 x 574) cases in Wuhan so far. There are many unknowns, meaning the uncertainty range around this estimate goes from 190 cases to over 4000. But the magnitude of these numbers suggests that substantial human to human transmission cannot be ruled out. Heightened surveillance, prompt information sharing and enhanced preparedness are recommended.
Genomic analysis of nCoV spread. Situation report 2020-01-23.

Executive summary
Using 24 public shared novel coronavirus (nCoV) genomes, we examined genetic diversity to infer date of common ancestor and rate of spread. We find:

  • 24 sampled genomes are nearly identical, differing by 0-3 mutations
  • This lack of genetic diversity has a parsimonious explanation that the outbreak descends either from a single introduction into the human population or a small number of animal to human transmissions of very similar viruses.
  • This event most likely occurred in November or early December 2019.
  • There has been ongoing human-to-human spread since this point resulting in observed cases.
  • Using estimates of total case count from Imperial College London of several thousand cases, we infer a reproductive number between 1.5 and 3.5 indicating rapid growth in the Nov-Jan period.


Further Reading:

  • General information on coronaviruses on Wikipedia 2020-01-23
  • Material provided by the US CDC 2020-01-23
  • Organization and genome on ViralZone 2020-01-23

A Novel Coronavirus from Patients with Pneumonia in China, 2019
We report a novel CoV (2019-nCoV) that was identified in hospitalized patients in Wuhan, China, in December 2019 and January 2020. Evidence for the presence of this virus includes identification in bronchoalveolar-lavage fluid in three patients by whole-genome sequencing, direct PCR, and culture. The illness likely to have been caused by this CoV was named “novel coronavirus-infected pneumonia” (NCIP). Complete genomes were submitted to GASAID. Phylogenetic analysis revealed that 2019-nCoV falls into the genus betacoronavirus, which includes coronaviruses (SARS-CoV, bat SARS-like CoV, and others) discovered in humans, bats, and other wild animals. We report isolation of the virus and the initial description of its specific cytopathic effects and morphology.
WHO Technical guidance


Training course:

WHO “Emerging respiratory viruses, including nCoV: methods for detection, prevention, response and control” now available
You can access the course through the following link:https://openwho.org/courses/introduction-to-ncov
By the end of this course, participants should be able to:

  • Understand the fundamental principles of emerging respiratory viruses and how to effectively respond to an outbreak.

There are two modules, as follows:

  • Module A: Introduction to Emerging respiratory viruses, including nCoV
  • Module B: Detecting Emerging respiratory viruses, including nCoV: Surveillance and Laboratory investigation

The course will take approximately 1 hour to finish.
Web: https://openwho.org
•Technical interim guidance for novel coronavirus, WHO: https://www.who.int/health-topics/coronavirus
•WHO travel advice for international travel and trade in relation to the outbreak of pneumonia caused by a new coronavirus in China:
https://www.who.int/ith/2020-0901_outbreak_of_Pneumonia_caused_by_a_new_coronavirus_in_C/en/Pressstatementby KCDC (in Korean): https://www.cdc.go.kr/board/board.es?mid=a20501000000&bid=0015&list_no=365794&act=view#
•Second Press statement by KCDC (in Korean): https://www.cdc.go.kr/board/board.es?mid=a20501000000&bid=0015&list_no=365805&act=view#
•Wuhan Municipal Health Commission's briefing on the pneumonia epidemic situation, (in Chinese): http://wjw.wuhan.gov.cn/front/web/list2nd/no/710
•Disease outbreak news, Novel Coronavirus:https://www.who.int/csr/don/en/
•Thailand Ministry of Public Health situation update on novel coronavirus (in Thai):https://ddc.moph.go.th/viralpneumonia/index.html
•Press statement by Ministry of Health, Labour and Welfare, Japan on 16 January 2020 (in Japanese): https://www.mhlw.go.jp/stf/newpage_08906.html
•Press statement by Ministry of Health, Labour and Welfare, Japan on 6 January 2020 (in Japanese):https://www.mhlw.go.jp/stf/newpage_08767.html
•Notice sent out from Health and Food Safety Planning Division, Quarantine Station Operation Management Office (in Japanese):https://www.mhlw.go.jp/content/10900000/000582967.pdf
▪Situation report by WHO on Novel Coronavirus (2019-nCoV)https://www.who.int/emergencies/diseases/novel-coronavirus-2019
•Hong Kong SAR Department of Health, Press Releasehttps://www.info.gov.hk/gia/general/202001/23/P2020012300970.htm
•Epidemic Prevention Measures, Macau SAR Health Bureauhttps://www.ssm.gov.mo/apps1/PreventWuhanInfection/ch.aspx#clg17048•Pressrelease on 23 January 2020, Ministry of Health Singapore.https://www.moh.gov.sg/news-highlights/details/confirmed-imported-case-of-novel-coronavirus-infection-in-singapore-multi-ministry-taskforce-ramps-up-precautionary-measures



Knowledge Sharing

Thank you for reading. If you have thoughts, feedback, story ideas, or questions you would like to share or interested in partnering with us on a special event coverage, please send a note to Chadia Wannous via email cwannous@yahoo.com  


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