Updated on 20 February 2020
As of Friday, 21 February, there are over 76,700 confirmed COVID-19 cases worldwide and 2,250 deaths. Thirteen deaths have been reported outside of mainland China in Philippines, Hong Kong, Japan, Taiwan, France, Iran, South Korea and off the Diamond Princess cruise ship moored in Japan.
New Cases Reported Per Day in Mainland China
The number of new cases reported in China changed significantly as adjustments to the reporting criteria were changed three times over an eight-day span by the Chinese government.
Friday (14 February) – 5,090* First change to reporting criteria
Saturday (15 February) – 2,641
Sunday (16 February) – 2,009
Monday (17 February) – 2,048
Tuesday (18 February) – 1,886
Wednesday (19 February) – 1,749
Thursday (20 February) – 394* Second change to reporting criteria
Friday (21 February) – 1,109* Third change to reporting criteria
A spike in cases at two hospitals in Beijing are causing some concern. Fuxing Hospital reported at least 36 cases while Peking University Hospital reported 3. Both hospitals were placed under quarantine.
South Korea Case Spike
The total number of cases in South Korea saw a significant increase as clusters were identified in two southern cities: Daegu and Cheongdo – both have been declared “special case zones”.
100 cases were reported on Friday with 86 in Daegu and nearly all of those linked to a church, which has over 400 members showing symptoms. Tests are ongoing.
Two deaths were reported this week out of South Korea. Both fatalities were patients at the same mental hospital in Cheongdo. Another 15 patients there have also tested positive.
Number of Confirmed Cases by Country: 76,789
These are TOTAL number of cases reported during the Covid-19 outbreak. These numbers do not reflect the number of patients who have since recovered. Statistics are expected to change rapidly as the exact impact of the virus is still under investigation and hospitals are increasingly overwhelmed by the current demands.
Mainland China: 75,467 (varying number being reported as some include Hong Kong and Macau)
Hong Kong: 68
South Korea: 204
Sri Lanka: 1
Diamond Princess Cruise Ship: 634
Diamond Princess cruise ship: 2
Hong Kong: 2
South Korea: 2
The largest study of Covid-19 cases done by researchers at the Chinese Center for Disease Control and Prevention (CCDC) analyzed 44,672 confirmed cases in China reported between 31 December 2019 and 11 February 2020:
With 1,023 deaths, the overall mortality rate was 2.3%
Mortality Rate Variance by Location:
In Hubei Province = 2.9%
Rest of China = 0.4%
Mortality Rate Variance by Age:
80+ = 14.8%
70-79 = 8.0%
60-69 = 3.6%
50-59 = 1.3%
40-49 = 0.4%
10-39 = 0.2%
No deaths reported in children from birth – 9 years of age
From CCDC report this week ending 21 February mortality rate variance by sex:
Men = 2.8%
Women = 1.7%
Other significant factors for consideration:
Experts estimated the actual number of cases could be much higher than what is being officially recorded and reported. If that is true, the mortality rate could be much lower.
Men were also disproportionately affected during MERS and SARS outbreaks.
Women, in general, have a stronger immune response than men.
China accounts for nearly a third of the world’s smokers with more than half of the men smoking compared to just over 2% of China’s women smoking.
Comparison to U.S. Influenza Season 2019-20
Compared to the U.S. flu season (according to CDC data):
The flu caused an estimated 26 million illnesses, 250,000 hospitalizations and 14,000 deaths this season
Current flu season mortality rate: 0.05%
“Typical” flu season mortality rate: 0.1%
Many countries have urged citizens to reconsider travel or avoid nonessential travel to China and avoid all travel to Hubei.
Airlines around the world suspended services to all or some of China
Several countries banned foreigners who recently traveled to China and/or are Chinese passport holders and increased health screening measure at ports of entry
Chinese nationals restricted from booking international flights out of the country
The Chinese government ordered 65 million people in Hubei Province to remain at home in an effort to contain Covid-19, allowing one family member out every three days for food and essentials and in cases of an emergencies. The use of private cars has been banned indefinitely.
Current CDC Travel Alerts for Covid-19:
Warning Level 3 – Avoid all nonessential travel
Watch Level 1 – Practice usual precautions
Other Destinations with Apparent Community Spread:
Community spread means people have been infected with the virus, including some who are not sure how or where they became infected. At this time, the extent of virus spread is not sustained or widespread enough to meet the criteria for a travel notice.
Singapore, South Korea, Taiwan, Thailand, Vietnam
Symptoms to Watch Out For:
Officials say the respiratory disease, is capable of spreading through human-to-human contact, droplets carried through sneezing and coughing, and germs left on inanimate objects. Chinese officials warn that the virus might spread during the incubation period – when a person has the virus but isn’t yet showing symptoms. Incubation period is currently believed to be anywhere from 1 to 14 days. Authorities have advised citizens to be on the lookout for the following symptoms:
Difficulty breathing or shortness of breath
Cough and/or sore throat
Muscle Aches in some cases also being reported
Pneumonia (secondary infection)
Mitigating Measures to Apply:
Monitor local authorities for updates
Avoid travel to or through China (including layovers) and specifically through Wuhan and Hubei province
Avoid contact with animals (alive or dead), animal markets, and products that come from animals (such as uncooked meat)
Wash hands frequently with soap and water; use an alcohol-based hand sanitizer if soap and water isn’t available
Older travelers and those with underlying health issues may be at higher risk and should speak to their healthcare provider before travel
Avoid exposure to those presenting the above symptoms
Allow extra time for temperature screening at airports worldwide
Enroll in a Safe Traveler Program to receive warnings from your preferred embassy
Seek medical care immediately if you experience symptoms and have recently traveled to the infected areas; notify your healthcare provider of your recent travel
DISCLAIMER and Hold Harmless
Disclaimer: LSDS™ gathers information from multiple sources and offers insight and perspective to travelers. Sources cannot be validated for accuracy in every instance. Travelers assume all risk associated with their travel and are responsible for the decisions associated with travel and for their own safety. Users of this reference document agree, to hold harmless LSDS™ (LLC) its employees and clients associated with any risk or injury incurred during travel.