Egypt confirmed its first COVID-19 case on Friday, the first on the African continent, Egyptian media said, a report also confirmed by the World Health Organization’s Egypt office in a tweet.  A  Health Ministry statement said that it had informed WHO of the infection in a foreign national, who had been tested and then placed in isolation at a hospital. The WHO message added that the case was asymptomatic. Although the English tweet by WHO was quickly removed, an Arabic version remained online Friday evening.

Meanwhile, an official Chinese announcement said that some 1,716 healthcare workers had been infected with the virus, mostly in the epidemic’s epicentre of Wuhan and Hubei province. The announcement came as another 5,107 new cases of the novel virus were reported in China over the last 24 hours, bringing the cumulative total worldwide to 63,950 cases and 1382 deaths.

Abroad, the number of reported infections appeared more stable, with 507 cases on Friday, an increase of just seven people over the day before.

Even so, expert modeling assessments suggested that trends in Wuhan imply that the eventual number of COVID-19 infections could range anywhere between 5-40% the city’s population of over 10 million people, depending on how contagious the virus proves to be. Some projections have held that the virus could reach as much as two-thirds of the world’s population, should attempts underway now to contain it internationally fail.

Quarantine, Containment & Travel Restrictions 

Countries across Asia, Africa, Europe and the Americas were still working frantically to mitigate that threat not only by beefing up public health preparedness, which has been the main WHO focus, but also through a combination of tough travel restrictions and quarantines of suspected cases, both voluntary and forced.

In Hong Kong, which has 56 confirmed cases, officials were hurriedly leasing and building quarantine facilities  as part of a plan to repatriate some 2,200 residents currently trapped on the China mainland, ten of which are said to have the virus.

At Friday’s WHO press update on the epidemic developments, WHO’s Emergencies Head Mike Ryan cautioned that such policies also carry weighty ethical implications.

“Decisions on mass evacuation and mass quarantines need to be made with the highest public health standards and consideration of human rights,” Ryan said. “In general we need to be very careful in doing those kinds of processes, we have to balance the public health benefit against the issues of quarantine.. how we manage it, from an ethical and human rights perspective.”

He added that so far, Hong Kong has not requested advice from WHO on protocols for safely undertaking such an evacuation and quarantine.

WHO has, however, repeatedly advised countries to restrain from travel restrictions as an epidemic response, although some 72 countries have applied such restrictions anyway. Under the provisions of the International Health Regulations, a binding treaty on emergency response, countries are not required to follow those WHO recommendations, Ryan clarified.

“We issue general guidance which allows countries to act in good faith.. countries may exceed that,” Ryan said.

What is binding is that countries shall provide a “public health rationale” to WHO for restrictive measures that are taken, he said, adding, “In the end, sovereign countries are responsible for the health and welfare of their societies. They are entitled to make decisions….within their own national and legal frameworks.”

In other developments, WHO’s Director General Dr Tedros Adhanom Ghebreyesus, said that a team of a dozen international experts was set to arrive in Beijing this weekend to support the Chinese government response.  But he declined once more to say what countries or institutions were represented. “The experts are from very different countries, and really good in the area of their expertise, which is needed. …. we will give you more information about the experts whenever it is necessary,” he said.

As for earlier comments by US officials that they had not been included in the delegation, Ryan hinted that experts from the US were somehow be represented, saying, “with regards to the team, I believe we will have US experts. We will have to wait and see.” He noted that scientists often had fewer problems collaborating than politicians, and that in fact there has been “deep scientific collaboration between the United States and China, increasingly over the last 20 years. Not incidentally, the major scientific coordination organization in China is called China CDC,” he said. “Scientists collaborate regardless – we need to let them get on with it. ”

Health Worker Infections in China

As of midnight February 11, a total of 1,716 confirmed cases of infection of medical personnel were reported nationwide, “accounting for 3.8% of the confirmed cases nationwide. Six of them died unfortunately, accounting for 0.4% of national deaths,” according to a Chinese government press release [translated].

“Health workers are the glue that holds the health system together,” said Dr Tedros, speaking to the Geneva press briefing via a video link from Kinshasa, Democratic Republic of Congo (DRC), where he was on a visit to review next steps for strengthening the DRC health system as the Ebola emergency there winds down. “But we need to know more about this figure [of health worker infections], including the time and circumstances in which [Chinese] health workers became sick.”

The news about the health worker infections was released by Zeng Yixin, Deputy Director of the National Health Commission, at a press conference on Friday.  He said that Hubei Province, had reported 1502 confirmed cases of the novel coronavirus among medical staff, accounting for 87.5% of the confirmed cases of health workers staff across the country.

The city of Wuhan alone has reported 1,102 confirmed cases of medical staff, accounting for 73.4% of the confirmed cases of medical staff in Hubei Province.

“This is the first official release of data on infections and deaths of medical staff in this outbreak. Let us remember these ….medical workers who have been infected and sacrificed at the front line of the epidemic,” stated a press release issued after the conference.  “They are worth protecting, …and caring for!”

Image Credits: Wikimedia Commons: Gangston Tech, Twitter: @WHOEgypt, WHO, China Government Network.