Novel Coronavirus (2019-nCoV) Update 1/26/20

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Novel Coronavirus (2019-nCoV) Update 1/26/20

IN THE NEWS

The 2019-nCoV situation is a rapidly changing one with almost constant news media reports, situation reports, revised information and guidelines, travel bans and recommendations, and more.  Reports of new cases, including where the case was identified (country, state, province, county, etc.), travel or other specific information associated with the new patient, and a running total of suspected cases, confirmed cases, deaths caused by the virus, and other case information is often published in one form or another.  This information, and other related data, is often quite different based on the reporting entity, often a governmental one but not always, and may or may not be accurate.

At FirstWatch, we will always attempt to include accurate information that can be relied upon, but may sometimes include information that cannot be readily validated, but will be presented so there is access to different sources.  An example of this is information that comes from the Chinese government or health authorities.  Other national agencies, including the CDC, PHAC, as well as the WHO and others, will investigate the information that comes from Mainland China but may not be able to provide immediate collaboration since there may not be enough data or proof to confirm the claim.  However, being aware of what is being offered is important and may prove valuable. It’s just as important to realize that when it is an emerging disease – and particularly a virus – the observations that China has made may well be true even if countries outside of Mainland China have yet to see the novel virus act in this same way.  Or, perhaps, no one else has enough cases to witness what they have amongst their thousands of patients.  You can be assured that the WHO and many government and health authorities are trying to decipher the 2019-nCoV ASAP and share it with their medical personnel and citizens as quickly as they can.

Here is a synopsis of updated information on the situation.  According to physicians within China who are keeping a running tally of the number of cases and other specific data, as of 1/26/20 @ 2211 Beijing time, there were 769 new cases, for a total of 2762 confirmed cases out of 5794 suspected ones.  There have been 80 deaths and 51 cases cured (their choice of words, which were translated by Google).  There has been less and less reporting of the number of severe cases and how many health care workers are infected, but the number of severe cases typically falls around 20-25% of the cases, when it is reported.  These numbers will have already changed by the time you see this and probably in the time it took to write this page.

The virus is spreading.  It is spreading rapidly in Mainland China, particularly in the Hubei Province where Wuhan is located.  Their Minister of Health, Ma Xigowei, stated that the virus is now spreading person to person more easily and that people are infectious (able to spread the virus) before they have any symptoms.  In fact, according to some in China, some patients never develop any symptoms but can pass it on (it has been reported in case details).  Furthermore, some of the symptoms have changed to include sneezing, sore throat and headache.  China has also reported repeated family clusters.

The Director-General of the WHO, Dr. Tedros Adhanom Ghebreyesus, tweeted today that he was on his way to meet with government and health authorities in Beijing, to support China with the novel coronavirus and understand the latest developments in the virus.  In response to questions about these reported changes in the virus behavior, the CDC’s Nancy Messonnier, MD, the Director of the National Center for Immunization and Respiratory Diseases, has said that she has heard the Chinese reports of more rapid person to person spread and the ability to spread the virus without symptoms, but does not believe that person to person transmission is occurring in the U.S. She went on to say, “For this reason, we continue to believe that the immediate health risks from the 2019 coronavirus to the general American public is low at this time.”  And then going on to say, “The threat is serious and the U.S. Public Health Response is aggressive.”  The Canadian Public Health Authorities have also deemed the risk to Canadians to be low at this time.

The good news is that, although the virus has infected people that are now in countries outside of China, the numbers are small and, except in one case, which had likely limited person to person contact between family members (2), the cases have all been related to travel from Wuhan.  There have now been 5 confirmed cases of 2019-nCoV in the U.S., the first in Seattle, then one in Chicago, then two in California, one each in Orange County and L.A., and one in Mariposa County, Arizona.  There are 100 suspected cases being investigated in 26 states; 25 of those have tested negative for the virus and the rest are pending. There has also been a confirmed case in Toronto, Canada.  There have been 8 cases each in Hong Kong and Thailand, 6 in Macau, 4 each in Taiwan, Singapore, Malaysia, Japan, and Australia, and 3 each in South Korea and France, Vietnam has 2 and Nepal has 1.

Globally, everyone must pay attention to the latest news, while waiting for confirmation from trusted sources.  Pre-hospital agencies should have made sure that there emerging disease/pandemic plan is up to date, operations and medical direction are discussing dispatch and scene awareness of suspect cases,  and that their personnel know the case definition of a person under (or should be under) investigation, what PPE to wear, how to put it on and take it off safety, and other items outlined in a previously published article on the Health Intel Page  (see Novel Coronavirus 2019-nCoV – What First Responders Can Do [1/24/20]).  Someone should be assigned to check for new information at least once a day until the situation stabilizes.  Reach out to those in your local health department so they know you and can immediately become real partners in the event it becomes necessary.

Recent Situation Reports and Case Data: 

CDC 2019-nCoV Situation Summary (1/26/20):
https://www.cdc.gov/coronavirus/2019-nCoV/summary.html

Public Health Agency of Canada (PHAC) Home Page for 2019 Coronavirus (1/26/20):
https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

WHO 2019-nCoV Situation Report #5 (1/25/20):
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

European CDC on the Risk Assessment of 2019-nCoV (1/26/0):
https://www.ecdc.europa.eu/en/publications-data/risk-assessment-outbreak-acute-respiratory-syndrome-associated-novel-0

Doctors within China (DYX) Provide Case Statistics & Information with Other Tabs for More Information – will translate after clicking on site (displays as current): 
http://3g.dxy.cn/newh5/view/pneumonia

The Center for Systems Science & Engineering at Johns Hopkins University GIS/Running Tally of Cases (shows update in last hour)
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 

Information, Guidelines and Tools from the CDC/PHAC (dates of the posts are in parentheses): 

CDC List of Frequently Asked Questions (FAQs) (1/24/20):
https://www.cdc.gov/coronavirus/2019-ncov/faq.html

CDC Explanation of Known Transmission (Spread) (1/26/20):
https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html

CDC Clinical Presentation (Symptoms) (1/26/20):
https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html

CDC Prevention & Treatment (1/26/20):
https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html

Public Health Agency of Canada (PHAC) 2019-nCoV Page for Health Care Professionals (1/26/20):
https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals.html#a3

These Tools Have Application for 1st Responders/Prehospital Personnel:

International Academies of Emergency Dispatch (IAED) Recommendations for Emergency Communication Centers:
https://www.emergencydispatch.org/coronavirus-2019-nCoV

CDC-Produced Preparedness Checklist for Health Care Personnel (1/25/20):
https://www.cdc.gov/coronavirus/2019-ncov/hcp/hcp-personnel-checklist.html

CDC-Produced Preparedness Checklist for Hospitals (1/25/20):
https://www.cdc.gov/coronavirus/2019-ncov/hcp/hcp-hospital-checklist.html 

 

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