COVID-19 Daily Update (3/4)
A daily update on the emerging coronavirus ("COVID-19") from a US perspective.
Global situation by the numbers
[Infections (Daily Increase) (%) ] [Fatalities (Daily increase) (%) ] [CFR %]
East Asia
🇨🇳Mainland China — 80,270 (+244) — 2,981 (+37) — 3.71% [CDC Level 3]
🇰🇷South Korea — 5,328 (+516) (10.7%) — 28 (+6) — 0.52% [CDC Level 3]
🇯🇵Japan — 1,000 (+20) — 12 — 1.2% [CDC Level 2]
🇭🇰Hong Kong— 100 — 2 — 2.0% [CDC Level 1]
🇸🇬Singapore — 110 (+2) — 0 — 0%
🇹🇼Taiwan — 42 (+1) — 1 — 2.38%
🇲🇴Macau — 10 — 0 — 0%
Southeast Asia / Australasia
🇹🇭Thailand — 43 — 1 — 2.38%
🇲🇾Malaysia — 36 (+7) — 0 — 0%
🇦🇺Australia — 39 (+8) — 1 —2.56%
🇻🇳Vietnam — 16 — 0 — 0%
🇵🇭Philippines — 3 — 1 — 33%
🇮🇩Indonesia — 2 — 0 — 0%
🇰🇭Cambodia — 1 — 0 — 0%
🇳🇿New Zealand —2 (+1) — 0 — 0%
South Asia
🇮🇳India — 6 (+1) — 0 — 0%
🇳🇵Nepal — 1 — 0 — 0%
🇱🇰Sri Lanka — 1 — 0 — 0%
Middle East
🇮🇷Iran — 2,336 (+835) (55.6%) — 77 (+11) — 3.29% [CDC Level 3]
🇰🇼Kuwait — 56 — 0 — 0%
🇧🇭Bahrain — 49 — 0 — 0%
🇦🇪United Arab Emirates — 27 (+6) — 0 — 0%
🇮🇶Iraq — 32 (+6) — 0 — 0%
🇮🇱Israel — 12 — 0 — 0%
🇱🇧Lebanon — 13 — 0 — 0%
🇴🇲Oman — 12 (+6) — 0 — 0%
🇵🇰Pakistan — 5 — 0 — 0%
🇦🇿Azerbaijan — 3 — 0 — 0%
🇦🇫Afghanistan — 1 — 0 — 0%
Saudi Arabia — 1 — 0 — 0%
Jordan — 1 — 0 — 0%
Europe
🇮🇹Italy — 2,502 (+466) (22.8%) — 79 (+27) (51.9%) — 3.15% [CDC Level 3]
🇫🇷France — 212 (+21) — 4 (+1) — 1.88%
🇩🇪Germany — 203 (+38) — 0 — 0%
🇪🇸Spain — 165 (+45) — 1 — 0.6%
🇬🇧UK — 51 (+11) — 0 — 0%
🇸🇪Sweden — 30 (+15) — 0 — 0%
🇨🇭Switzerland — 58 (+16) — 0 — 0%
🇳🇴Norway — 32 (+7) — 0 — 0%
🇭🇷Croatia — 9 (+2) — 0 — 0%
🇬🇷Greece — 7 — 0 — 0%
🇦🇹Austria — 24 (+6) — 0 — 0%
🇳🇱Netherlands — 24 (+6) — 0 — 0%
🇸🇲San Marino — 10 (+2) — 1 — 10%
🇮🇸Iceland — 14 (+5) — 0 — 0%
🇷🇴Romania — 4 (+1) — 0 — 0%
🇫🇮Finland — 6 — 0 — 0%
🇷🇺Russia — 3 (+1) — 0 — 0%
🇧🇪Belgium — 13 (+5) — 0 — 0%
🇬🇪Georgia — 3 — 0 — 0%
🇩🇰Denmark — 10 (+6) — 0 — 0%
🇨🇿Czech Republic — 5 (+1) — 0 — 0%
🇵🇹Portugal — 4 (+2) — 0 — 0%
🇲🇰North Macedonia — 1 — 0 — 0%
🇪🇪Estonia — 2 (+1) — 0 — 0%
🇧🇾Belarus — 1 — 0 — 0%
🇱🇹Lithuania — 1 — 0 — 0%
🇦🇲Armenia — 1 — 0 — 0%
🇱🇺Luxembourg — 1 — 0 — 0%
🇱🇮Liechtenstein — 1 — 0 — 0%
🇲🇨Monaco — 1 — 0 — 0%
🇱🇻Latvia — 1 — 0 — 0%
🇮🇪Ireland — 2 (+1) — 0 — 0%
🇦🇩Andorra — 1 — 0 — 0%
🇺🇦Ukraine — 1 — 0 — 0%
Africa
🇩🇿Algeria — 5 — 0 — 0%
🇪🇬Egypt — 2 — 0 — 0%
🇳🇬Nigeria — 1 — 0 — 0%
🇸🇳Senegal — 2 (+1) — 0 — 0%
🇲🇦Morocco — 1 — 0 — 0%
🇹🇳Tunisia — 1 — 0 — 0%
North America
🇨🇦Canada — 33 (+6) — 0 — 0%
🇲🇽Mexico — 5 — 0 — 0%
South America / Caribbean
🇧🇷Brazil — 2 — 0 — 0%
🇩🇴Dominican Republic — 1 — 0 — 0%
US situation by the numbers
🇺🇸United States — 125 (+20) (19.0%) — 9 (+3) — 7.2%
Note: 45 cases are people repatriated from Diamond Princess cruise ship in Japan.
State-by-state breakdown:
California — 40 (+3)
Nebraska — 13
Texas — 11
Washington — 30 (+7) — 9
Illinois — 4
Florida — 3 (+1)
New York — 2 (+1)
Wisconsin — 1
Utah — 1
Massachusetts — 2
Rhode Island — 2
Arizona — 2 (+1)
Oregon — 2
North Carolina — 1 (+1)
Georgia — 2 (+2)
New Hampshire — 2 (+2)
**Presumptive positive - pending confirmation by CDC lab test.
Latest developments in US
All nine deaths related to COVID-19 virus have occurred in Washington; state officials considering closing schools and moving to virtual teaching as additional cases are confirmed. Schools in the Seattle area mulled teaching students online in the event of prolonged closures over health concerns. The schools took the steps after researchers said the virus that causes the disease called COVID-19 may have been circulating for weeks undetected in the state. Experts said more cases will probably be reported soon. The Washington state Department of Health says there are 27 confirmed cases, all in the Seattle area. The nine cases include four tied to a suburban Seattle care facility that has reported multiple virus cases and deaths.
Among the newly reported deaths was a man in his 50s who had been a resident of Life Care Center in Kirkland, who died at Harborview Medical Center in Seattle on Feb. 26. Tests later determined he died of COVID-19. Hospital spokeswoman Susan Gregg said some hospital staff may have been exposed while treating the patient, but officials don’t believe other patients were exposed. The hospital staff are being monitored and screened daily.
Among the new cases reported Tuesday were two men in their 20s who were hospitalized in Issaquah. It wasn’t known how they were exposed. An Amazon employee who works in Seattle’s South Lake Union neighborhood tested positive for the new virus, The Seattle Times reported Tuesday afternoon, citing a message from the company.
A person who visited Kirkland, Washington long-term care facility tested positive for the virus in North Carolina. According to the North Carolina Department of Public Safety, the North Carolina person is from Wake County. Local health department officials are identifying close contacts to monitor symptoms and contain spread.
New COVID-19 cases confirmed in California (Los Angeles / Orange County). Kaiser Permanente announced that it was treating a patient on Tuesday evening. Only hours earlier, Orange County officials announced two “presumptive positive” COVID-19 cases, both of whom had recently traveled to high-risk countries. At least five Northern California counties reported new cases of COVID-19 on Monday. On Tuesday, the city of Berkeley reported its first case after an individual visited a country with an outbreak. Contra Costa County also reported a case.
Patient who tested positive for COVID-19 in New Hampshire defied quarantine orders by attending private event. The first coronavirus patient in New Hampshire — an employee of Dartmouth-Hitchcock Medical Center — defied instructions from public health officials to stay away from other people. In a statement, the state Department of Health and Human Services said the patient attended an invitation-only private event Friday "despite having been directed to self-isolate." New Hampshire reported Tuesday that a second person, a close contact of the first patient, has also tested positive for the coronavirus.
A synagogue in New Rochelle, NY was ordered to suspend all services indefinitely and approximately 600 people were ordered to self-quarantine until March 8. The temple is connected to the COVID-19 case announced by New York officials on Tuesday. The patient, a 50-year-old New Rochelle attorney who commutes to work in Manhattan, was in serious condition at New York-Presbyterian Hospital. The man's family includes a wife and four children, two of whom are in Israel. One of the children, a daughter, attends SAR Academy in Riverdale. It closed for the day. One son is in college, the name of which was not immediately released. The man's family is under self-quarantine in their home.
Firefighters who responded to a call at Washington nursing home are now experiencing flu-like symptoms. Twelve of 30 firefighters and police officers in Kirkland who have been quarantined after potential or direct exposure to the COVID-19 virus at the city's LifeCare facility are now showing "flu-like" symptoms, according to city of Kirkland officials. The 30 all had been quarantined after they had responded to calls at the LifeCare Facility in the days before and during an outbreak of COVID-19 that was discovered at the center. At least five patients connected to the center have died and more remain sickened.
Congress nearing agreement on $7.5 billion emergency spending bill to fund COVID-19 response. Lawmakers are finalizing a $7.5 billion emergency bill to fund the government’s response to the coronavirus outbreak, even as fear is growing that the rapid spread of the virus is a shock to the economy and will lead to significant disruption in people’s everyday lives. The $7.5 billion package would triple Trump’s request but is expected to enjoy support from both the White House and Republicans. The draft legislation would speed development and production of a coronavirus vaccine, finance preparedness and response efforts by state and local governments, help foreign countries battle the outbreak overseas, and seek to ensure affordability of any future vaccines.
Oregon’s governor requests 400,000 respirator masks, gowns and gloves, disposable protective suits and up to 100 ventilators. Following up on her request, Governor Kate Brown wrote to Vice President Mike Pence, describing what the state is doing to combat the spread amid three confirmed cases, and what its needs are. She asked for increased flexibility on criteria for testing for the COVID-19 virus “to better assess the burden of the disease in Oregon resulting from community spread within the state.” Oregon may now have 300 to 500 Oregonians who are or were unknowingly carrying the coronavirus, Dean Sidelinger, a health officer and epidemiologist with the Oregon Health Authority, told reporters Monday.
Trump admin response
The Office of Management and Budget (OMB) will be issuing new guidance directing all federal agencies to review internal travel policies. Vice President Pence said on Tuesday that the COVID-19 task force plans to meet with CEOs of several major airlines to “talk about greater cooperation”. This information was tweeted by New York Times correspondent, Katie Rogers, from a press briefing that explicitly prohibited both audio and video. The WSJ reported that the discussions would involve “contact-tracing data”.
Despite administration’s messaging, widespread testing for COVID-19 still likely weeks away. Doctors, hospitals and some public health labs say they aren’t set up yet to do the tests. FDA Commissioner Stephen Hahn said Monday that, by the end of the week, U.S. labs would have enough materials to perform close to 1 million tests. Public health experts say that figure is misleading because it is far larger than the number of samples that can be processed in labs in the coming weeks. The realistic estimate is now likely around 5,000 each day, according to a public health lab industry group.
Testing capacity in US
Per new CDC guidance, anyone can be tested for COVID-19 with no restrictions, subject to a doctor's orders. The announcement was made by Vice President Mike Pence in a briefing with reporters Tuesday evening. The CDC's previous guidance was limited to people who traveled to countries affected by the novel coronavirus outbreaks and came in contact with a diagnosed patient or showed severe symptoms. But Pence said several governors raised concerns that people with only mild symptoms wouldn't be tested.
FDA promises to expedite delivery of test kits to local health labs. The chief of the Food and Drug Administration, Dr. Stephen Hahn, said the FDA has been working with a private company to get as many as 2,500 test kits out to labs by the end of the week. Each kit should enable a lab to run about 500 tests, he said. One lab was already testing for coronavirus in Washington state and a second was scheduled to begin doing so Tuesday.
How other governments are responding
Iran. Iran’s supreme leader ordered the military to assist health officials in fighting the virus.
France. France’s president announced the government will take control of current and future stocks of face masks to ensure they could go to health workers and coronavirus patients, and the finance minister warned that binge-shopping for household essentials could trigger shortages.
South Korea. At drive-thru virus testing centers, workers dressed head-to-toe in white protective suits leaned into cars with mouth swabs to check for the virus. Troops sprayed disinfectant on streets and alleys across the city. Some 200 designated health centers across the country can test up to 15,000 people daily.
Japan. In Japan, questions continued to build about the fate of the Olympics.
The country’s Olympic minister, Seiko Hashimoto, said Japan is “making the utmost effort” to proceed with the games’ opening on July 24 in Tokyo.
What doctors / scientists / PH officials are saying
US has only a fraction of the medical supplies needed to combat widespread outbreak. Three hundred million respirators and face masks. That’s what the United States needs as soon as possible to protect health workers against the coronavirus threat. But the nation’s emergency stockpile has less than 15 percent of these supplies. Last week, US HHS Secretary Alex Azar testified before the Senate that the Strategic National Stockpile has just 30 million surgical masks and 12 million respirators in reserves. A study conducted five years ago by the CDC found that the US might need as many as seven billion respirators in the long run to combat a worst-case spread of a severe respiratory outbreak such as COVID-19.
Serious concerns over global availability of medical supplies for health care workers on front lines. "We’re concerned that countries’ abilities to respond are being compromised by the severe and increasing disruption to the global supply of personal protective equipment, caused by rising demand, hoarding, and misuse," Dr. Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing at the WHO headquarters in Geneva on Tuesday. "Prices of surgical masks have increased sixfold, and N95 respirators have more than tripled, and gowns cost twice as much."
In a repeat of Wuhan, Washington State risks seeing explosion in COVID-19 cases without dramatic action. The author of the analysis, a computational biologist named Trevor Bedford, said there are likely already at least 500 to 600 cases of Covid-19 in the greater Seattle area. He urged health authorities and the public to immediately begin adopting non-pharmaceutical interventions — imposing “social distancing” measures, telling the sick to isolate themselves, and limiting attendance at large gatherings. The genetic sequences of patients in the Seattle-King County region suggest the virus has been circulating there since about mid-January, when the first U.S. patient — a man who returned from Wuhan — was diagnosed. Bedford said Seattle faces a stark choice — take aggressive actions to slow down the spread of the new coronavirus now or face the type of outbreak that engulfed Wuhan’s health facilities and led to a lockdown of the city that remains in place six weeks later.
Quotable
Giovanni Rezza, director of the infectious-disease department at the Italian National Institute of Health on his country’s experience with COVID-19:
“The lesson is that you have to intervene very, very fast and in a very tough manner. Otherwise, you’ll have a high burden of disease that will jeopardize the health system. We cannot compromise.”
WHO Director Tedros Adhanom Ghebreyesus on global case fatality rate for COVID-19:
Finally, this from Jonathan Katz:
Indeed, Trump nominated Azar—corporate lackey that he is—precisely because he seemed like a reliably loyal and reliably corrupt replacement for his wildly corrupt predecessor at HHS, former Georgia Republican congressman Tom Price. Trump sat by while John Bolton dismantled the National Security Council team in charge of pandemic response, and boasted about cuts to the CDC and NIH budgets. Blaming Azar for botching the response is like blaming the dog for eating the box of cupcakes he left him alone to guard. What did he expect him to do?
Worthy of your time
One way to “flatten the epidemic curve”:
