EMERGENCIES

Editor’s Note:
While we have concentrated key reports below, COVID-19 announcements, analysis and commentary will be found throughout this issue, in all sections.

Coronavirus [COVID-19]
Public Health Emergency of International Concern (PHEIC)

Situation report – 25
Novel Coronavirus (COVID-19)
14 February 2020
[Excerpt]
SITUATION IN NUMBERS
Globally :: 49,053 laboratory-confirmed [2056 new]
China :: 48,548 laboratory-confirmed [1998 new]
:: 1,381 deaths [121 new]
Outside of China
:: 505 laboratory-confirmed [58 new]
:: 24 countries
:: 2 deaths [1 new]

WHO RISK ASSESSMENT
China – Very High
Regional Level – High
Global Level – High

HIGHLIGHTS
:: No new countries reported cases of 2019-nCoV in the past 24 hours.
:: The second death has been reported outside of China, in Japan. This individual did not have known travel history to China.
:: In China, health care workers account for 1716 confirmed cases of COVID-19 including six deaths.

STRATEGIC OBJECTIVES
WHO’s strategic objectives for this response are to:
:: Limit human-to-human transmission including reducing secondary infections among close contacts and health care workers, preventing transmission amplification events, and preventing further international spread from China*;
:: Identify, isolate and care for patients early, including providing optimized care for infected patients;
:: Identify and reduce transmission from the animal source;
:: Address crucial unknowns regarding clinical severity, extent of transmission and infection, treatment options, and accelerate the development of diagnostics, therapeutics and vaccines;
:: Communicate critical risk and event information to all communities and counter misinformation;
:: Minimize social and economic impact through multisectoral partnerships.

*This can be achieved through a combination of public health measures, such as rapid identification, diagnosis and management of the cases, identification and follow up of the contacts, infection prevention and control in health care settings, implementation of health measures for travelers, awareness-raising in the population and risk communication.

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National Health Commission of the People’s Republic of China
http://en.nhc.gov.cn/
News
:: Daily briefing on novel coronavirus cases in China
Updated: 2020-02-15
…As of 24:00 on Feb 14, the National Health Commission had received 66,492 reports of confirmed cases and 1,523 deaths in 31 provincial-level regions on the Chinese mainland and the Xinjiang Production and Construction Corps, and in all 8,096 patients had been cured and discharged from hospital. There still remained 56,873 confirmed cases (including 11,053 in serious condition) and 8,969 suspected cases. So far, 513,183 people have been identified as having had close contact with infected patients. 169,039 are now under medical observation…

China pushes for differentiated measures to battle coronavirus
Updated: 2020-02-14 Xinhua
Epidemic prevention and control in Hubei Province, particularly in the capital city of Wuhan, remain the top priority, said Premier Li Keqiang.
BEIJING, Feb. 13 (Xinhua) — Chinese authorities on Feb 13 stressed differentiated measures for different regions to fight the novel coronavirus outbreak at a high-level meeting chaired by Premier Li Keqiang.
The leading group of the Communist Party of China (CPC) Central Committee on the prevention and control of the novel coronavirus outbreak also demanded efforts to improve patient treatment and expedite research on drugs.
Epidemic prevention and control in Hubei Province, particularly in the capital city of Wuhan, remain the top priority, said the leading group headed by Li, who is also a member of the Standing Committee of the Political Bureau of the CPC Central Committee.
While ordering Wuhan to speed up hospital admission and suspected case quarantine, the leading group instructed hard-hit cities in Hubei such as Xiaogan and Huanggang to carry out equally strict measures as in Wuhan in surveillance, quarantine and treatment.
The demand for more medics in Hubei and Wuhan should be fulfilled, and the departure channels of the city and the province need further control, according to the meeting.
Multiple steps such as spacing out return trips have prevented large-scale flows of people after the Spring Festival, said the meeting.
Each province is responsible for formulating differentiated epidemic prevention and control strategies based on their own conditions, according to the meeting.
No one-size-fits-all approach should be taken and unfair and extreme practices must be corrected without delay, said the meeting…

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New York Times
http://www.nytimes.com/
Accessed 15 Feb 2020
China’s Leader, Under Fire, Says He Led Coronavirus Fight Early On
In pushing a new account of the country’s response, officials said President Xi Jinping was aware of the outbreak nearly two weeks before he first spoke publicly about it. It could draw him directly into questions about whether Chinese officials did too little, too late.
By Amy Qin
Feb. 15, 2020
Under fire for its response to the coronavirus epidemic, China’s authoritarian government appears to be pushing a new account of events that presents President Xi Jinping as taking early action to fight the outbreak that has convulsed the country.

But in doing so, the authorities have acknowledged for the first time that Mr. Xi was aware of the epidemic and involved in the response nearly two weeks before he first spoke publicly about it — and while officials at its epicenter in the city of Wuhan were still playing down its dangers.
That confirmation risks drawing the president, China’s most powerful leader in decades, directly into questions about whether top officials did too little, too late.

In an internal speech published on Saturday, Mr. Xi said he had “issued demands about the efforts to prevent and control” the coronavirus on Jan. 7, during a meeting of the Politburo Standing Committee, the highest council of the Communist Party, whose sessions are typically cloaked in secrecy.

In the speech, he also said he had authorized the unprecedented lockdown of Wuhan and other cities beginning on Jan. 23.

“I have at every moment monitored the spread of the epidemic and progress in efforts to curtail it, constantly issuing oral orders and also instructions,” Mr. Xi said of his more recent involvement…

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WHO News release 12 February 2020
World experts and funders set priorities for COVID-19 research
Leading health experts from around the world have been meeting at the World Health Organization’s Geneva headquarters to assess the current level of knowledge about the new COVID-19 disease, identify gaps and work together to accelerate and fund priority research needed to help stop this outbreak and prepare for any future outbreaks.

The 2-day forum was convened in line with the WHO R&D Blueprint – a strategy for developing drugs and vaccines before epidemics, and accelerating research and development while they are occurring.

“This outbreak is a test of solidarity — political, financial and scientific. We need to come together to fight a common enemy that does not respect borders, ensure that we have the resources necessary to bring this outbreak to an end and bring our best science to the forefront to find shared answers to shared problems. Research is an integral part of the outbreak response,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “I appreciate the positive response of the research community to join us at short notice and come up with concrete plans and commitment to work together.”

The meeting, hosted in collaboration with GloPID-R (the Global Research Collaboration for Infectious Disease Preparedness) brought together major research funders and over 300 scientists and researchers from a large variety of disciplines. They discussed all aspects of the outbreak and ways to control it including:
:: the natural history of the virus, its transmission and diagnosis;
:: animal and environmental research on the origin of the virus, including management measures at the human-animal interface;
:: epidemiological studies;
:: clinical characterization and management of disease caused by the virus;
:: infection prevention and control, including best ways to protect health care workers;
:: research and development for candidate therapeutics and vaccines;
:: ethical considerations for research;
:: and integration of social sciences into the outbreak response.

“This meeting allowed us to identify the urgent priorities for research. As a group of funders we will continue to mobilize, coordinate and align our funding to enable the research needed to tackle this crisis and stop the outbreak, in partnership with WHO,” said Professor Yazdan Yazdanpanah, chair of GloPID-R. “Equitable access – making sure we share data and reach those most in need, in particular those in lower and middle-income countries, is fundamental to this work which must be guided by ethical considerations at all times.”

During the meeting, the more than 300 scientists and researchers participating both in person and virtually agreed on a set of global research priorities. They also outlined mechanisms for continuing scientific interactions and collaborations beyond the meeting which will be coordinated and facilitated by WHO. They worked with research funders to determine how necessary resources can be mobilized so that critical research can start immediately.

The deliberations will form the basis of a research and innovation roadmap charting all the research needed and this will be used by researchers and funders to accelerate the research response.

WHO News release 13 February 2020
Remarks by Dr Michael Ryan, Executive Director, WHO Health Emergencies Programme at media briefing on COVID-19 on 13 February 2020

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Transcript for CDC Media Telebriefing: Update on COVID-19
Friday, February 14, 2020

FDA’s Actions in Response to 2019 Novel Coronavirus at Home and Abroad
Feb 14, 2020

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