Five more countries in the Middle East today reported their first COVID-19 cases, all linked to Iran travel, signaling an escalating situation in the region in the wake of Iran's outbreak, as World Health Organization (WHO) officials today announced that, although the global situation isn't yet a pandemic, the world should prepare for one.
Elsewhere, the pace of newly reported cases of the novel coronavirus continued to surge in South Korea and Italy, though cases are declining in China, where a WHO-led international joint mission wrapped up its visit and shared its initial findings today.
WHO calls China decline real
At a media telebriefing in Geneva today, WHO Director-Feneral Tedros Adhanom Ghebreyesus, PhD, said the team learned more about the transmissibility of the virus, its severity, and the measures China took. He said the decline in China's cases is real, and that the epidemic peaked and plateaued between Jan 23 and Feb 2 and has been steadily declining since then.
He said the agency found that the fatality rate ranges from 2% to 4% in Wuhan, but is lower at 0.7% outside of the city. For people with mild disease, recovery takes about 2 weeks, but patients who experience severe or critical disease it may take 3 to 6 weeks to recover.
The WHO concluded that China's strict measures averted a significant number of cases, Tedros said, adding that the team highlights remaining unanswered questions and makes 22 recommendations. He said joint mission leader Bruce Aylward, MD, MPH, will brief reporters on more details.
Addressing speculation on whether the recent escalating events constitute a pandemic, Tedros said health officials are still gauging the geographic spread, disease severity, and COVID-19's impact on societies. "For the moment, we are not witnessing the uncontained global spread of this virus, and we are not witnessing large-scale disease or death," he said.
Though the sudden surges in in some parts of the world are concerning, the word "pandemic" doesn't fit the facts and may raise fears, he said. Rather, he said as the WHO continuously monitors the epidemic, countries must make their own risk assessments, with an eye toward prioritizing three things: protecting healthcare workers, protecting people most at risk (older people and those with chronic health conditions), and protecting countries with weaker health systems.
Mike Ryan, MD, who directs the WHO's health emergencies program, said making a pandemic decision for an influenza virus would be an easier call, since health officials know what to expect with the spread. However, he added that experts still don't understand all the dynamics related to COVID-19. He also said the world is in a phase of preparing for a potential pandemic.
Five Mideast nations report first cases
The five Middle Eastern countries reporting their first cases today include Afghanistan, Bahrain, Kuwait, Iraq, and Oman, the WHO's Eastern Mediterranean regional office confirmed on Twitter.
Afghanistan's health ministry said its first confirmed case is one of three suspected cases, which were flagged in Herat province in the western part of the country on the border with Iran, Channel News Asia reported today, citing Afghanistan's health minister. One of the three people had recently returned from city of Qom, which is Iran's outbreak epicenter.
Bahrain's health ministry said its first confirmed case is a Bahraini citizen who had symptoms upon returning from Iran, Kuwait News Agency (KUNA) reported today. Meanwhile, Kuwait reported three cases, all traveling from Iran, one in a Kuwaiti citizen, one in a Saudi citizen, and the other with an unspecified nationality, according to a separate KUNA report.
Meanwhile, Iran's health ministry today reported 18 new cases and 4 more deaths, raising its totals to 61 cases, 12 of them fatal. Eight of the cases are from Qom, with the others from Tehran (3), Markazi province (2), Isfahan province (2), Guilan province (2), Hamedan province (1). All are in the northwestern part of the country.
At today's WHO media briefing, officials said a WHO expert team is slated to arrive in Iran tomorrow to assistant and support the country's health officials.
Korea total tops 800; relative of US service member infected
The South Korea Centers for Disease Control (KCDC) in three updates (161 cases, 207 cases, and 70 cases), reported 438 new infections today, raising its total to 833. The country also reported 8 more deaths, raising the fatality count to 11.
In a summary of the first 763 cases, it said most of the cases are still linked to the Shincheonji Church of Jesus cluster, with 186 cases are linked to an ongoing hospital cluster in Daegu.
In other South Korea developments, the family member of a US service member has tested positive for the virus, US Forces Korea (USFK) said in a statement today. The patient is a 61-year-old woman living in Daegu who visited Camp Walker's Post Exchange on Feb 12 and Feb 15. KCDC and USFK health officials are tracing contacts and the USFK has raised its risk level to high.
Italy cases rise; ECDC notes hospital spread
Since yesterday, Italy has reported 97 more cases, boosting its total to 229, including 6 deaths, according to an update from the health ministry.
The outbreak is still concentrated in four northern regions, including Lombardy (172), Veneto (33), and Emilia Romagna (18), and Piedmont (3). There are also three cases in Lazio region near Rome (including two Chinese tourists). Of the 222 people who are still under observation or treatment, 94 are in home isolation, and of 101 hospitalized patients, 27 are receiving intensive care unit (ICU) treatment.
In a related development, the European Centre for Disease Prevention and Control (ECDC) has issued a risk assessment, based on Italy's outbreak. It said local transmission is occurring with, cases linked to hospitals in both healthcare workers and patients. It said the situation in Italy is dynamic, with more cases expected on the days ahead, and so far, no close contacts or other related cases have been reported in other European countries.
It said the risk to people in the European Union and the United Kingdom is low to moderate, due to strong efforts in Italy to identify, isolate, and test contacts. It added that the possibility of new introductions from countries outside of China is increasing and that the risk of clusters similar to the ones in Italy is moderate to high. It said the impact would be moderate to high, especially if hospitals are affected and large numbers of healthcare workers are isolated. It said the threat to health systems during the peak of flu season, which is past peak in some countries, is low to moderate.
The WHO today announced a joint mission with the ECDC, which arrived in Italy today to support Italian authorities. It said though limited local spread outside China is expected, the rapid increase in Italy over the past 2 days is concerning.
China confirms 409 new infections
China today reported 409 new cases, down from 648 reported yesterday, raising the overall outbreak total to 77,150 cases, the country's National Health Commission said today in its daily update. Also, it reported 150 more deaths and 1,053 fewer serious cases, putting those respective totals at 2,592 and 9,915.
In other developments, China's government today announced an immediate and comprehensive ban on the trade and consumption of wild animals, which is suspected as the cause of the COVID-19 outbreak, Agence France-Presse reported today, citing a state TV report.
More cases in Japan, Singapore, Canada
Japan's health ministry today reported 12 more cases, raising its total to 139, though it notes an overall total of 156 that includes 16 asymptomatic carriers and 1 positive confirmed case. The newest cases were reported from Ishikawa prefecture, Sapporo, North Kaido, Kanagawa, Tokyo, and Sagamihara.
In separate reports, the health ministry also reported two Diamond Princess cruise ship related cases in outbreak responders, one of them a quarantine officer and the other a health ministry employee.
Singapore's health ministry today reported one more case, raising the country's total to 90. The latest case is linked to a church cluster. So far, only 9 local cases don't have known links.
Elsewhere, Canada reported one more presumed positive case, which would raise its total to 10. Ontario health officials said the woman arrived from China on Feb 21 and was seen at North York General Hospital for an intermittent cough that was improving. Given that her illness was mild, she was discharged for self-isolation at home.
The WHO said in its daily situation update today that over the past 24 hours it has received reports of 300 new cases outside of China, 6 of them fatal, raising the total to 2,069 cases and 23 deaths from 29 countries. Of those cases, 695 are linked to the Diamond Princess cruise ship in Japan.
Cases in US Diamond Princess evacuees, 2 more travel notices
The US Centers for Disease Control and Prevention (CDC) today reported 18 more cases in repatriated Americans, all apparently from the Diamond Princess cruise ship. So far, 53 cases have been reported, which includes 12 previously reported travel-linked cases and 2 in their contacts.
Also, the CDC yesterday posted two new travel notices, one for Iran and the other for Italy, both due to the spread of COVID-19 to the countries. Both are classified as "watch" level, the lowest of the CDC's three levels, which urges travelers to practice usual precautions.
In its latest risk assessment today, the CDC said the spread of the COVID-19 virus is a rapidly evolving situation and that as community spread is detected in more and more countries, the world is moving closer to meeting pandemic criteria.
"The potential public health threat posed by COVID-19 is high, both globally and to the United States," the CDC said, adding that the immediate risk to the American general public is low, but is higher for healthcare workers and close contacts of confirmed patients. It warned that current trends suggests the virus will likely cause a pandemic, which would change its risk assessment.