China's COVID-19 death toll tops 2,000; Iran reports first cases

China's death toll in its COVID-19 outbreak passed 2,000 today, as Iran reported its first two cases—both fatal—and the number of local cases grew in Japan, Singapore, and South Korea.

Also, 79 more people from the Diamond Princess cruise ship in Japan tested positive for the virus, with quarantine ending for many of those were not infected, and the US Centers for Disease Control and Prevention (CDC) issued a travel watch for Hong Kong.

China deaths reach 2,004 as case definition changes

China's National Health Commission today reported 1,739 new cases, down from the 1,886 new infections reported yesterday. The country's overall outbreak total stands at 74,185. It reported 136 more deaths lifting the outbreak's fatality count to 2,004. And health officials added 236 new serious cases, raising that total to 11,977.

An international joint mission led by the World Health Organization (WHO) in its fourth day of meetings in the country, where the experts are meeting with Chinese officials to learn more about the outbreak and to offer their assistance.

In other outbreak developments, China changed its COVID-19 case definition again, and instead of counting clinically diagnosed cases as confirmed infections, it will classify them as suspected cases, according to a government statement.

Iran cases both fatal

Earlier today, Iran's health ministry today reported the country's first two COVID-19 cases, which it said were preliminary positives that were undergoing further testing. It said the cases were detected in Qom, a holy city with a population of about 1.3 million located about 78 miles south of Tehran.

Then later today, media reports, citing Iran's health ministry, said the two patients died from the disease. Few details were available about the patients, other than that they were both elderly and had acute lung infections, Al Jazeera reported.

Iran is the third country in the Middle East to report COVID-19 cases and the first in the region to report fatal cases. The United Arab Emirates and Egypt are other countries that have reported cases.

Japan, Singapore, South Korea cases rise

Japan's health ministry today reported seven new cases, one of them asymptomatic, raising the country's total to 73. Three cases, including the asymptomatic one, are from Wakayama prefecture, three are from Tokyo, and one is from Aichi prefecture.

One of the patients from Wakayama prefecture is the son of a doctor who worked at Saiseikai Arida Hospital, whose illness was confirmed on Feb 14, Jiji Press reported yesterday. The other two are a nurse who worked on the Diamond Princess medical assistance team and a patient who shared a room with a previously identified  COVID-19 patient.

In Singapore, the health ministry today reported three more cases, one linked to a known church cluster, one linked to a different church cluster, and one with a still-undetermined exposure source. The country now has 84 cases. Contact links have been found for all but eight locally transmitted cases.

Elsewhere, South Korea today reported 20 new cases, 14 of them linked to church services in the city of Daegu, Reuters reported yesterday. The confirmations bring the country's overall total to 51. Citing a statement from the Korea Centers for Disease Control, it said the country's 31st patient, a 61-year-old woman, is linked to infections in at least 15 people who attended church services with her, plus a contact at the facility where she was hospitalized. Health officials have said the cluster of cases marks a super spreading event.

Diamond Princess total reaches 621

Also today, Japan's health ministry today reported that 79 more people on the Diamond Princess have tested positive for the virus that causes COVID-19, of whom 68 are asymptomatic. The new cases raise the total to 621.

The quarantined cruise ship has been in Yokohama port since Feb 3.

In related developments, hundreds of passengers who tested negative have started leaving the ship, now that their 14-day quarantine period is over, according to a BBC reported today, which also cited a Japanese expert who visited the ship and found inadequate infection control.

Yesterday, the US Centers for Disease Control and Prevention (CDC) said Diamond Princess passengers and crew are restricted from entering the United States for at least 14 days after they leave the ship, due to ongoing risk. It added though Japan took extraordinary efforts to quarantine the ship, they may not have been enough to prevent transmission among people on the ship.

The cruise ship company said today that Canada, Australia, and Hong Kong are coordinating charter flights for their citizens, which are expected to arrive today. All will be subject to 14-day quarantines and COVID-19 testing when they arrive home. For those not taking evacuation flights, Japan's health ministry is requiring a negative test before individuals exit the ship.

In a related development, the World Health Organization (WHO) today shared more details about the Westerdam cruise ship that was recently allowed to disembark in Cambodia, efforts that were halted after an American passenger tested positive for the virus after traveling on the Malaysia. It said 18 of 2,257 people were sick during the voyage, but samples were taken from 20 who had flulike symptoms, and all were negative for the virus before the passengers were allowed to disembark.

Temperature screening before the passengers left the ship found no people with fever.

In response to the positive test in the American woman, health screening and testing for COVID-19 are under way for all people still on the ship or are still in Cambodia. It said the WHO, CDC, Pasteur Institute, and related embassies are on the ground in Sihanoukville where the ship is located and in Phnom Penh.

The WHO said today in its daily update that over the past 24 hours it has received 120 new reports of COVID-19 cases outside China from 25 countries, 3 of them fatal. However, 542 of those are from the Diamond Princess cruise ship. Excluding the ship cluster, Singapore has the highest number of cases outside of China, followed by Japan.

CDC Hong Kong travel watch

The CDC today posted a travel watch, the lowest level that urges people to practice usual precautions, for Hong Kong, the second location to have an advisory for COVID-19.

It said the ongoing outbreak has spread to Hong Kong, where multiple instances of community spread have been reported. In an update today, Hong Kong's Centre for Health Protection said 62 cases have been confirmed so far, including 2 new ones today.

The administrative region has imposed a quarantine for China mainland travelers and has urged people to take social distancing steps. Today the CHP announced enhanced surveillance and testing for people who have fever and respiratory symptoms at outpatient clinics and hospital emergency departments to help detect mild cases and provide a better understanding of the epidemiological situation.

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