H5N1

Coronavirus: Germany announces sixth infection — live updates

Via Deutsche Welle, a flood of news: Coronavirus: Germany announces sixth infection — live updates. Excerpt:

16:37 Beijing is criticizing the US for warning its citizens not to travel to China and encouraging those already there to leave.   

The US state department earlier on Friday had issued an official travel advisory discouraging non-essential travel to China.  

"Certain US officials' words and actions are neither factual nor appropriate," spokesperson for China's foreign affairs ministry Hua Chunying said in a statement. "Just as the WHO recommended against travel restrictions, the US rushed to go in the opposite way. Certainly not a gesture of goodwill."  

16:14 Guatemala's president announces the country is imposing travel restrictions to prevent the infection from entering the country. Anyone who has been to China in the last 15 days will not be allowed to enter the country, President Alejandro Giammattei has said.   

15:59 Screening people arriving from Chinese cities is not an effective way to detect coronavirus. This is according to modelling conducted by the European Centre for Disease Prevention and Control (ECDC).   

"Approximately 75% of cases from affected Chinese cities would arrive at their destination in the incubation period and would remain undetected, even if the efficacy of the screening test to detect symptomatic individuals were 80 per cent for both exit and entry screening," said ECDC infectious disease expert Pasi Penttinen.  

The new coronavirus' incubation period is thought to be unusually long, at up to 14 days, during which time people may be contagious despite displaying no symptoms. 

15:44 Here is a recap of the numbers: 

• Over 9,800 cases of coronavirus have been confirmed globally. 

• 9,692 of those cases are found on mainland China. 

• All 213 reported deaths from the virus have also been in China, the majority of them in the Hubei province, where the outbreak originated.  

15:32 Iran suspends all flights to China.  

15:18 US airline Delta temporarily suspends all flights to China in response to the US elevating a travel advisory.  

15:11 Sweden confirms its first case of coronavirus. In a statement, the country's public health ministry said, "It is a woman who visited the Wuhan area in China and experienced cough symptoms after arriving in Sweden. She is not gravely ill."  

14:58 China's ambassador in Geneva Chen Xu says "excessive measures" like border closures are going too far and insists there is "no need for unnecessary panic."

Epidemiological and clinical characteristics of 99 cases of 2019-nCoV pneumonia in Wuhan, China

Published in The Lancet on January 30: Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The summary:

Background 

In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. 

Methods 

In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. 

Findings 

Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). 

According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. 

Interpretation 

The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection.

New paper raises fresh doubts over authorities’ withholding of coronavirus details

Via Caixinglobal.com (free registration required): New Paper Raises Fresh Doubts Over Authorities’ Withholding of Coronavirus Details. Excerpt:

China’s national center for disease control has responded to accusations that it withheld crucial information about the spread of the coronavirus in the early stages of the outbreak, amid growing anger on social media over revelations in an academic paper that the authorities were allegedly aware of human-to-human transmission far earlier than they publicly admitted.  

The Chinese Center for Disease Control and Prevention (CDC) put out a statement on Friday defending its handling of the outbreak and its information disclosure. Two of the agency’s senior scientists who were involved in writing the report also supported the center’s actions and the publication of the paper, “Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia.” More than 40 disease control officials and experts from the Chinese mainland, Hong Kong, and the World Health Organization (WHO) contributed to the paper which was published in the New England Journal of Medicine on Wednesday. 

“There is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019,” the paper said in its conclusion, indicating that the authorities knew the disease could be passed between people several weeks before the Chinese CDC publicly disclosed the threat on Jan. 20. 

The CDC issued its statement after the paper went viral on Chinese social media and prompted a wave of angry comments from internet users. 

“I'm beyond furious,” Wang Liming, a professor of neuroscience at Zhejiang University, said Wednesday in a post on Weibo, China's microblogging website, where he has about 500,000 followers. "This is the first time that I've found unmistakable evidence that human-to-human transmission of the new coronavirus has been intentionally hidden,” he wrote in the post which has since been deleted. 

Transmission concealed 

“My question is simple: Judging from the data in this paper, the National Centers for Disease Control and Prevention already had clear evidence of human-to-human transmission as early as the first few days of January. From then until Jan. 20, at what point was this information concealed,” Wang wrote on Weibo. 

The authors of the report based their conclusions on a study of 425 people who had been infected with the coronavirus since December. Of those, 15 were medical workers – seven were confirmed as having contracted the disease from Jan. 1 to Jan. 11, and eight during Jan. 12 to Jan. 22. 

In its statement, which was distributed to state media and is not on its website, the Chinese CDC said the study referred to in the paper was a “retrospective study” and all cases mentioned had been reported to the public by Zhong Nanshan and the Wuhan Municipal Health Commission on Jan. 20 and 21, respectively, according to the statement. Zhong is one of China’s best-known epidemiology experts who leads the National Health Commission team investigating the outbreak. He was thrust into the spotlight for his role in investigating the SARS outbreak in 2003.  

“The paper’s conclusion ­­–– that human-to-human transmission occurred among close contacts of infected patients from the middle of December 2019 –– was made retrospectively, based on survey data from the epidemiological investigation into the 425 cases,” the CDC said. It did not directly address the accusations that it had withheld information about the spread of the coronavirus.  

Feng Zijian, a deputy director at the Chinese CDC, and Gao Fu, a director, who were among the contributors to the paper have spoken to Caixin about the study and defended the center against accusations that it withheld data and disclosure of human-to-human transmission. 

Feng told Caixin the center only obtained the data related to the 425 cases on Jan. 23 and immediately began its research and analysis. Its contributions to the paper were submitted on Jan. 25 and 26. “Carrying out retrospective research is a part of the work of disease control,” he said.

Singapore to close its border to Chinese visitors

Via The New York Times: Coronavirus Live Updates: Singapore to Close Its Border to Chinese Visitors. Excerpt:

Singapore and Mongolia will bar entries from China. 

Singapore on Friday announced a sweeping ban on Chinese visitors and other foreigners who had been to China in the past 14 days, in an escalation of travel restrictions by the Southeast Asian transportation hub. 

The city-state will also stop issuing all forms of visas to people holding Chinese passports, Lawrence Wong, the minister for national development, said on Friday.  

Singapore currently has 13 confirmed cases of the coronavirus. The outbreak and the entry shutdown will be another blow to its economy, which was already hit by the fallout from the United States-China trade war.  

Regional neighbors and airlines from countries that have not had any confirmed cases are also taking extra precautions to cope with the rapidly spreading epidemic.

The government of Mongolia, a landlocked country between China and Russia, said on Friday that it would close its border with China until March 2 in an effort to prevent the virus from being imported. 

The authorities said they would work to bring home 30 Mongolian nationals from Wuhan, and its citizens in China would have until Feb. 6 to return. Non-Chinese foreigners visiting Mongolia will also not be able to enter through China.  

Hong Kong’s pro-Beijing government, rocked by months of antigovernment protests and public distrust, has come under fire for not sealing off its border with mainland China. 

Russia, which shares a 2,600-mile border with China, has been racing to prevent the spread of the disease. The country reported its first two coronavirus cases on Friday, both in Siberia and among Chinese nationals who had recently traveled to China.

Three drugs fairly effective on novel coronavirus at cellular level

Via Xinhua: Three drugs fairly effective on novel coronavirus at cellular level. Excerpt:

BEIJING, Jan. 30 (Xinhua) -- Chinese researchers have found three existing drugs with fairly good inhibitory effects on the novel coronavirus (2019-nCoV) at the cellular level, a local newspaper has reported.  

The three drugs are Remdesivir, Chloroquine and Ritonavir. They are now under relevant procedures to gain approval for clinical use, said Hubei Daily on Wednesday.  

The discovery was jointly made by researchers from the Academy of Military Medical Sciences and the Wuhan Institute of Virology (WIV) under the Chinese Academy of Sciences (CAS). 

Previously, researchers from the Shanghai Institute of Materia Medica under the CAS and ShanghaiTech University jointly selected 30 existing drug candidates, biologically active natural products and traditional Chinese medicines which may have therapeutic effects on the novel coronavirus.  

The candidates included 12 anti-HIV drugs like Indinavir, Saquinavir, Lopinavir and Carfilzomib, two anti-respiratory syncytial virus drugs, an anti-schizophrenia drug, an immunosuppressant, as well as traditional Chinese medicines including Polygonum cuspidatum. 

Since the outbreak of 2019-nCoV, several research teams led by the WIV have carried out research on five aspects, including rapid detection products, antiviral drugs and vaccines, animal traceability research, as well as etiology and epidemiology research. 

A team led by renowned virologist Shi Zhengli in the WIV said on Wednesday 2019-nCoV may originate in bats.  

The genome sequencing of the novel coronavirus is as high as 96 percent identical with a type of coronavirus from bats, the team said, adding that the new coronavirus enters the receptor using the same cells with SARS virus.

CHP investigates two additional cases of novel coronavirus infection

Via the Centre for Health Protection: CHP investigates two additional cases of novel coronavirus infection. Excerpt:

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (January 31) investigating two additional cases of novel coronavirus infection. The public is again urged to maintain strict personal, food and environmental hygiene both locally and during travel.        

The first case involves a 37-year-old woman residing in the Coronation in Yau Ma Tei who is the daughter of the patients of the 9th and 10th case. She developed cough on January 28 and was sent to Queen Elizabeth Hospital yesterday (January 30) where she was admitted for isolation and management. She is in stable condition. The patient's respiratory sample was tested positive for novel coronavirus.        

The CHP has immediately commenced epidemiological investigations and conducted relevant contact tracing. According to the information the patient provided, she stayed at W Hong Kong with her parents from January 22 to 28 and then visited The Ritz-Carlton Hong Kong and Four Seasons Hotel Hong Kong along with her parents. She returned home after accompanying her parents to Queen Mary Hospital on January 28. Preliminary investigations revealed that she neither visited any wet market or seafood market, nor had any exposure to wild animals or poultry during the incubation period.        

The second case involves a 75-year-old man residing in Hong Mei House, Cheung Hong Estate in Tsing Yi. He developed cough and shortness of breath on January 22. He sought treatment at Princess Margaret Hospital on January 24 and was admitted for management. His respiratory sample was tested positive for novel coronavirus yesterday under enhanced laboratory surveillance. He is now in a stable condition and being treated in isolation at Princess Margaret Hospital.        

According to the patient's information, he visited Shunde in Guangdong Province from December 30 last year to January 7 this year and sought treatment at a clinic there. He took day trips to Macao from January 10 to 14. His wife, daughter and son are asymptomatic and will be transferred to Lady MacLehose Holiday Village for quarantine. The CHP is following up on relevant contact tracing. Investigations are ongoing.        

The CHP will report the cases to the World Health Organization, National Health Commission, Health Commission of Guangdong Province and the health authority of Macao.        

So far, 12 confirmed cases are reported in Hong Kong. The CHP is continuing its epidemiological investigations and relevant contact tracing. The CHP is also closely monitoring a number of overseas cases and conducting related contact tracing.        

The CHP today received verification of a case confirmed on January 26 by the health authority of Taiwan and noted that the patient took the flight CZ3097 by China Southern Airlines from Guangzhou to Taipei on January 25. A Hong Kong resident on the same flight is regarded as a close contact of the confirmed case.        

Quarantine will be arranged for close contacts while medical surveillance will be arranged for other contacts. The Lady MacLehose Holiday Village under the Leisure and Cultural Services Department has been converted as quarantine centre and close contacts would be transferred to the village for quarantine. For the progress on the contact tracing of the cases, please see annex.

2019-nCoV: January 31 in China

Via the Global Times: Real-time update on coronavirus outbreak. Excerpt:

8:50 pm Jan 31 

First two cases of novel coronavirus confirmed in Russia: RT 

8:40 pm Jan 31  

Around 5 pm Friday, 20 patients infected with novel coronavirus were discharged from Jinyintan Hospital, a major hospital treating the deadly spreading virus in Wuhan, marking the largest number of simultaneous discharges since the outbreak.  

8:30 pm Jan 31 

Beijing's local authorities have asked companies to work from home until Feb 10 to prevent the spread of the coronavirus.  

7:00 pm Jan 31 

Visitors who recently traveled to China are not allowed to enter Singapore due to the spread of coronavirus.  

6:30 pm Jan 31 

Shanghai Stock Exchange donated 30 million yuan ($4.33 million) to Hubei Charity Federation on Friday, as an effort to prevent and fight the novel coronavirus. 

5:30 pm Jan 31 

The UK has just confirmed its first two cases of the novel coronavirus. 

3:30 pm Jan 31 

Shanghai had blocked or removed wild animal trade info from the city's 105 e-commerce platforms, closed 9,021 wild animal e-shops selling 14,462 related items by Jan 29: Shanghai Municipal Health Commission. 

12:00 pm Jan 31 

Shanghai has opened two 24-hour service hotlines through which 60 local medical experts can provide citizens with free #coronavirus-related guidance and consultations. 

11:10 am Jan 31 

The Chinese government will send chartered planes overseas to bring stranded Chinese citizens from Hubei Province, particularly those from Wuhan, back home. 

8:20 am Jan 31 

China reports 9,692 confirmed cases of new coronavirus pneumonia, 213 deaths. 8:03 am Jan 31 Italy confirmed its first two novel coronavirus cases, Italian Prime Minister Giuseppe Conte announced at a press briefing on Thursday night. Two Chinese tourists infected with the virus are in stable condition and being treated in isolation. 

8:00 am Jan 31 

16 new novel coronavirus cases were confirmed in Shanghai on Jan 30, taking the total infection number to 128 in the city, with 5 recovered, 5 in critical condition and 1 dead. 164 suspected cases are under monitor. 

 6:20 am Jan 31  

Hubei Province reported 1,220 new cases, 42 deaths and 26 recovered cases of novel coronavirus on Jan 30; total infection number in the province increased to 5,806, with 116 recovered and 204 deaths.

NHC: Update on pneumonia of new coronavirus infection as of 24:00 on January 30

Last night's report from the National Health Commission: Update on pneumonia of new coronavirus infection as of 24:00 on January 30. The Google translation:

At 04:00 on January 30, 31 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps reported 1982 new confirmed cases, 157 severe cases, and 43 new deaths (42 cases in Hubei Province, Heilongjiang Province). 1 case in the province), 47 new cases were cured and discharged, and 4812 new cases were suspected.

As of 2400 on January 30, the National Health and Health Commission has received a total of 9,692 confirmed cases (31 cases in Sichuan Province were subtracted from the cumulative confirmed cases) in 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps. A total of 213 deaths and 171 cases were cured and discharged, with a total of 15,238 suspected cases. 　　

At present, a total of 11,3579 close contacts have been tracked (21 cases of reductions in Beijing). On the day, 4,201 people were released from medical observation, and a total of 102,427 people were receiving medical observation. 　　

A total of 28 confirmed cases were reported from Hong Kong, Macao, and Taiwan: 12 from the Hong Kong Special Administrative Region, 7 from the Macao Special Administrative Region, and 9 from Taiwan.

Coronavirus: Chinese health experts warn patients can get reinfected

Via the South China Morning Post: Coronavirus: Chinese health experts warn patients can get reinfected. Excerpt:

The daily death toll from the rapidly spreading coronavirus hit a record high in China on Thursday, health authorities said, with 43 more fatalities – 42 of them in Hubei province, the outbreak’s epicentre. 

Of the newly reported deaths, 30 were in Hubei’s provincial capital Wuhan, where the virus was first reported, according to the Hubei health commission. The other death was in Heilongjiang province, in the country’s northeast, as Thursday’s toll took the total number of deaths nationwide to 213, with none so far reported outside mainland China. 

A total of 1,982 new cases were confirmed on the mainland on Thursday, bringing the country’s total to 9,692, far exceeding that of the 2002-03 Sars epidemic, which killed almost 800 people worldwide. 

No more square-dancing 

Medical experts on Friday warned that patients who had recovered from the virus were still at risk of being infected again, and said people should avoid any mass gathering, even dancing in public parks and squares – a popular activity for exercise in China. 

Zhan Qingyuan, head of infectious diseases at the China-Japan Friendship Hospital, said in a press briefing on Friday that people who had already had the virus would have developed antibodies but should remain on alert so they did not get ill again. 

“The antibodies may not remain for a long time, so there is still a risk that these recovered patients will be infected again,” Zhan said. “They should continue to keep themselves protected.” 

The National Health Commission said 47 patients had recovered from the virus on Thursday. 

Zhan said people could still go for a walk in the park, but they should avoid group dance activities. 

“Dancing itself increases the risk of cross-infections. It uses a lot of oxygen, so it will be hard to breathe with a mask on while you’re dancing,” he said. “Joining in square-dancing with a mask on is risky, especially for people with hypertension and heart disease.”

Singaporean evacuated from Wuhan among country's 3 new cases of coronavirus, total now 16

Via Channel NewsAsia: Singaporean evacuated from Wuhan among country's 3 new cases of coronavirus, total now 16: MOH. Excerpt:

SINGAPORE: The Ministry of Health (MOH) confirmed three new cases of the Wuhan coronavirus in Singapore on Friday (Jan 31), bringing the total to 16 cases. 

All three cases recently travelled to China's Wuhan, where the virus originated.  

THREE NEW CASES 

The 14th case is a 31-year-old Chinese national with a Singapore work pass. He arrived in Singapore from Wuhan on Jan 26, and reported to be asymptomatic on his flight but developed symptoms on Jan 28. 

He sought medical treatment at a clinic on Thursday and was taken to the National Centre for Infectious Diseases (NCID) in an ambulance.  

The man tested positive for the coronavirus at about 11pm on Thursday.   

He is currently warded in an isolation room at NCID. Prior to admission, the man stayed at home in Jurong East Street 13.  

The 15th case is a 47-year-old Singaporean, who had travelled to Wuhan with her family and was one of the 92 Singaporeans who were evacuated from the city on Thursday.   

She was asymptomatic when she boarded the flight, but was found to have a fever during the medical screening at Changi Airport and was taken to NCID.  

She tested positive for the coronavirus at about 2pm on Friday and is warded in an isolation room at NCID.   

The 16th case is a 38-year-old Chinese man who arrived in Singapore from Wuhan on Jan 22. He tested positive for the coronavirus at about 2pm on Friday and is currently warded in an isolation room at the Singapore General Hospital.  

All three cases are in stable condition, said MOH.