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COVID-19 Update

Updated on 24 February 2020

The Situation:

As of Monday, 24 February, there are over 79,700 confirmed COVID-19 cases worldwide and 2,629 deaths. Thirty-five deaths have been reported outside of mainland China and cases are spiking in several countries. The WHO, on Monday, declined to declare the outbreak a pandemic saying that it has “pandemic potential” but does not yet require that designation. However, the WHO director general said that officials are preparing for a potential pandemic.

Italy, Iran and South Korea all saw significant spikes in cases while Iran currently reports 12 deaths – the highest outside of mainland China. WHO teams of experts are currently headed to Italy and Iran.

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

  • Saturday (22 February) – 397

  • Sunday (23 February) – 648

  • Monday (24 February) - 409

Italy Case Spike

Italy saw a spike in cases in two northern regions over the weekend and now reports 6 deaths. The Italian government imposed quarantines on 11 communes in the regions in an effort to stem the spread.

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”.

  • More than half of South Korea’s cases are in Daegu and centered around members of the same church

Number of Confirmed Cases by Country: 79,737

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: 77,340 (varying number being reported as some include Hong Kong and Macau)

  • Afghanistan: 1

  • Australia: 22

  • Bahrain: 1

  • Belgium: 1

  • Cambodia: 1

  • Canada: 11

  • Egypt: 1

  • Finland: 1

  • France: 12

  • Germany: 16

  • Hong Kong: 81

  • India: 3

  • Iran: 47

  • Iraq: 1

  • Israel: 2

  • Italy: 229

  • Japan: 146

  • Kuwait: 3

  • Lebanon: 1

  • Macau: 10

  • Malaysia: 22

  • Nepal: 1

  • Oman: 2

  • Philippines: 3

  • Russia: 2

  • Singapore: 90

  • South Korea: 833

  • Spain: 2

  • Sri Lanka: 1

  • Sweden: 1

  • Taiwan: 30

  • Thailand: 35

  • Tibet: 1

  • U.A.E.: 13

  • U.S.: 53

  • U.K.: 13

  • Vietnam: 16

  • Diamond Princess Cruise Ship: 691

Recoveries: 25,271

Deaths: 2,628

  • China: 2,539

  • Diamond Princess cruise ship: 3

  • Hong Kong: 2

  • Iran: 12

  • Italy: 7

  • France: 1

  • Philippines: 1

  • Japan: 1

  • South Korea: 8

  • Taiwan: 1

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%

Travel Effects:

  • 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

Alert Level 2 – Practice Enhanced Precautions

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, 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:

  • High fever

  • 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

  • Ensure the validity of all visas prior to travel as this could be subject to restrictions and changes

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.


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