Countries Pursue Aggressive Containment Measures As New Cases Outside China Grow

Governments around the world are ramping up COVID-19 containment measures as new infections outside of China surged by 497 cases over the past 24 hours, outnumbering those inside the country for the first time ever during the epidemic.

The increase abroad was largely linked to an acceleration of COVID-19 outbreaks in Italy, Iran, and South Korea, which also were spilling over into other countries, in Europe and the Middle East.  Officials were aggressively restricting movement in areas with confirmed local transmission in an effort to curb person-to-person spread of the contagious virus.

On a more positive note, nine countries with COVID-19 cases had not reported any new cases in two weeks, including Belgium, Cambodia, Finland, India, Nepal, Philippines, the Russian Federation, Sri Lanka, and Sweden.

“The primary objective of all countries with cases must be to contain the virus,” said World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus in his opening remarks at a WHO briefing to UN Missions in Geneva on the emergency.  “I read the list of 9 countries who have not reported cases for two weeks. We should do the same: try to contain.”

Map shows growing case numbers in Italy, Iran, and South Korea. (Source: Johns Hopkins CSSE Global Map of COVID-19 Cases)

As of 4:30PM CET, China continued reporting a downwards trend in new cases, with 416 infections and 52 deaths by COVID-19 over the past 24 hours, for a cumulative total of 78195 cases and 2718 deaths since the epidemic began. Around the world, there have now been a total of 81,265 cases and 2770 deaths.

The highest overnight increase in cases was in South Korea, which reported 368 new infections and 4 new deaths in the past 24 hours. The country, now the largest center of an outbreak outside of China, has reported a total of 1261 cases and 12 deaths. Iran, meanwhile, reported 46 new infections, for a total of 139 cases and 19 deaths, making it the country with the highest number of deaths from the virus outside China. Italy saw an increase in 52 infections, to 374 total cases and 12 deaths.

Across all three countries, authorities have undertaken aggressive measures to lock down cities and communities with the highest concentration of cases.  Classes suspended in schools and universities; local public transportation was shut down, mass gatherings were canceled, and community members were strongly encouraged to stay home.

Despite the escalation of cases in multiple countries, the WHO director-general emphasized that, for the moment, the COVID-19 emergency had not reached “pandemic status” as there was no “sustained and intensive community transmission” of the virus, nor was there “large-scale severe disease or death.”

However, he underlined that all countries, whether they have cases or not, must prepare for a “potential pandemic”.  

Officials Pursue Containment of Outbreak in Italy and Iran

Officials across Europe were ramping up measures to stop the virus in its tracks, as cases linked to Italy were confirmed in Austria, Croatia, Germany, Spain, and Switzerland. An Italian adult who arrived in Algeria on 17 February became the second confirmed case of COVID-19 on the African continent on Tuesday, and a 61-year old patient in Brazil who had recently traveled to Italy was confirmed by the Brazilian Ministry of Health as the first case on the South American continent.

“In the European Union we are still in the containment phase, it is important to underline this,” Stella Kyriakides health commissioner of the European Center for Disease Control (ECDC) said at a press briefing in Rome at the conclusion of a joint WHO-ECDC mission to Italy.

However, “given how quickly the situation can change, even if we are currently in the containment phase, our public health care response across the EU must be ready to deal with increased numbers of COVID-19 infections,” she stressed. EU member states are currently reviewing pandemic plans, health care capabilities, and capacities for tracking contacts of infected individuals, diagnosing and testing cases, and treating acute respiratory illnesses.

Kyriakides praised countries for keeping borders with Italy open rather than “resorting to what at this point could be considered disproportionate and inefficient measures.” In Italy however, train service had been interrupted and there were barriers on roads around the 11 towns in Lombardy and Venetto at the center of Italy’s outbreak. Residents remained largely confined to their homes as authorities try to track down all suspected cases of COVID-19.

Health officials in Algeria discuss the country’s first COVID-19 case

Meanwhile, Algeria confirmed its first case of COVID-19 on Tuesday, just days after Dr Tedros met with African Ministers of Health at an emergency meeting on the coronavirus outbreak on 22 February. A WHO survey previously had determined that the African regional readiness level for COVID-19 was about 66% of what should be full preparedness capacity. Algeria was among 13 countries on the continent initially identified as “high priority” due to direct links and a high volume of travel to China, although the first confirmed case was in an Italian adult.

“The window of opportunity the continent has had to prepare for coronavirus disease is closing,” said Dr Matshidiso Moeti, WHO’s Regional Director for Africa in a press release. “All countries must ramp up their preparedness activities.”

WHO will be sending a team of experts to assist the response in Algeria in the coming days to assist in response efforts.

This upcoming weekend, the agency is also sending a team of experts to Iran, where numbers of cases and fatalities have climbed rapidly as officials tracked down suspected cases. Following in the footsteps of other countries with larger outbreaks, Iran has begun to limit large gatherings and public events, including suspending classes at 10 universities across the country by the end of the week, including schools in Qom where Iran’s first cluster of COVID-19 cases, rapidly followed by an out-sized number of deaths, was detected.

US CDC Warns Communities To Prepare For Community Spread

Across the Atlantic in the United States, US Centers for Disease Control officials warned journalists at a press briefing on Tuesday to “ultimately expect” to see community spread of the virus and prepare for “severe” disruption to everyday life.

The messaging represents a huge shift in tone for the US, which had up until then been largely focused on “largely successful” existing quarantine measures.”  There are currently 54 confirmed cases and no deaths in the country.

Nancy Messonier, director of the National Center for Immunization and Respiratory Diseases at the US CDC said that the country is now pursuing a “dual strategy” of continuing measures to contain the disease, while preparing “strategies to minimize the impact on communities.” She added that if communities experienced local transmission, the government may enact measures such as “school closures and dismissals,” encourage businesses to allow workers to telecommute, and postpone or cancel mass gatherings – similar to the strict measures China has taken to attempt to curb the outbreak.

CDC is concerned about the situation… And now is the time for businesses, hospitals, community schools, and everyday people to begin preparing as well,” said Messonier.

COVID-19 response planning at the US CDC’s Emergency Operations Center.

Image Credits: European Center for Disease Control, Johns Hopkins CSSE, WHO AFRO, US Centers for Disease Control and Prevention.

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