Dec, 2019 to Present
Wuhan, ChinaCorona-viruses are a group of viruses that cause diseases in mammals and birds. In humans, the viruses cause respiratory infections – including the common cold – which are typically mild. Rarer forms such as SARS, MERS and the novel corona-virus causing the 2019–20 Covid-19 Virus outbreak can be lethal. In cows and pigs corona-viruses cause diarrhea. In chickens they cause an upper respiratory disease. There are no vaccines or antiviral drugs that are approved for prevention or treatment.
Of the first 41 confirmed cases of 2019-nCoV infection, two-thirds were found to have a link with the Huanan Seafood Wholesale Market, which also sold live animals. The earliest reported symptoms occurred on 1 December 2019, in a person who did not have any exposure to the market or to the remaining 40 affected people. As the number of cases has increased, the significance of the market lessened.
Since 31 December 2019, some regions and countries near China tightened their screening of selected travelers. The Centers for Disease Control and Prevention (CDC) of the United States later issued a Level 1 travel watch. Guidances and risk assessments were shortly posted by others including the European Centre for Disease Prevention and Control and Public Health England. In China, airports, railway stations and coach stations installed infrared thermometers. Travelers with a measured fever are taken to medical institutions after being registered and given masks. A real-time reverse transcription-polymerase Chain Reaction (RRT-PCR) test was used to confirm new cases of coronavirus infection.
On 17 January, a research group from the Imperial College London in the United Kingdom published a report that there had been 1,723 cases (95% confidence interval, 427–4,471) with the onset of symptoms by 12 January. This was based on the pattern of the initial spread to Thailand and Japan. They also concluded that "self-sustaining human-to-human transmission should not be ruled out", which has since been confirmed. As further cases came to light, they later recalculated that there may be 4,000 symptomatic cases of 2019-nCoV in Wuhan City by 18 January (uncertainty range of 1,000 to 9,700). A Hong Kong University group has reached a similar conclusion as the earlier study, with additional detail on transport within China.
The virus spread to other Chinese provinces in early and mid-January 2020, helped by the Chinese new year migration. On 20 January, China reported a sharp rise in cases with nearly 140 new patients, including two people in Beijing and one in Shenzhen.
In Asia, Hong Kong, Mongolia, Nepal, North Korea, Russia, and Vietnam have also responded with border tightening/closures with mainland China. On 22 January 2020, North Korea closed its borders to international tourists to prevent the spread of the virus into the country. Chinese visitors make up the bulk of foreign tourists to North Korea.
On 23 January 2020, a quarantine on travel in and out of Wuhan was imposed in an effort to stop the spread of the virus out of Wuhan. Flights, trains, public buses, the metro system, and long-distance coaches were suspended indefinitely. Large-scale gatherings and group tours were also suspended.
On 23 January 2020, the number of reported confirmed cases of 2019-nCoV has increased by 267 cases since the last situation report published on 22 January 2020. As of 23 January, China reported cases in 25 provinces (autonomous regions and municipalities). Twenty-five percent of confirmed cases reported by China have been classified by Chinese health authorities as seriously ill (from Wubei Province: (16% severely ill, 5% critically ill, and 4% having died).
A specialty hospital named Huoshenshan Hospital has been constructed as a countermeasure against the outbreak and to better quarantine the patients. Wuhan City government had demanded that a state-owned enterprise construct such a hospital "at the fastest speed" comparable to that of the SARS outbreak in 2003. On 24 January, Wuhan authorities specified its planning, saying they planned to have Huoshenshan Hospital built within six days of the announcement and it will be ready to use on 3 February. Upon opening, the specialty hospital has 1,000 beds and takes up 30,000 square meters. The hospital is modeled after the Xiaotangshan Hospital, which was fabricated for the SARS outbreak of 2003, itself built in only seven days. State media reported that there were 7,000 workers and nearly 300 units of construction machinery on the site at peak.
Additional provinces and cities outside of Hubei imposed travel restrictions. Beijing suspended all Intercity bus services on 25 January, with several others following suit. Shanghai, Tianjin, Shandong, Xi'an, and Sanya all announced suspension of intercity or inter-province bus services on 26 January.
On 26 January, the city of Shantou in Guangdong declared a partial lockdown, though this was reversed two hours later. This created chaos, as residents rushed to supermarkets to stock food as soon as the lockdown was declared until the authorities reversed their decision. Caixin said, that the wording of Shantou's initial declaration was "unprecedentedly strict" and will severely affect residents' lives if implemented as-is. Shantou's Department for Outbreak Control later clarified, that they will not restrict traveling, and all they would do, is to sterilize vehicles used for transportation. A total of 2,014 confirmed 2019-nCoV cases have been reported globally reported by the WHO
On 27 and 28 January 2020, Xiangyang respectively closed its railway stations and suspended all ferry operations, after shutting down its airport and intercity bus services earlier. Thus, the entire Hubei province entered a city-by-city quarantine, save for the Shennongjia Forestry District. WHO reported on that day that the confirmed casa has increased by 784 cases since the last report and the death count has increased by 24 cases
On 27 January 2020, the United States CDC issued updated travel guidance for China, recommending that travelers avoid all nonessential travel to all of the country. The CDC has directed U.S. Customs and Border Protection to check individuals for symptoms of the coronavirus.
On 30 January 2020, following confirmation of human-to-human transmission outside of China and the increase in number of cases in other countries, the WHO declared the outbreak a Public Health Emergency of International Concern (PHEIC), the sixth PHEIC since the measure was first invoked during the 2009 Swine flu pandemic. Tedros clarified that the PHEIC, in this case, was "not a vote of no confidence in China", but because of the risk of global spread, especially to low- and middle-income countries without robust health systems.
Outside Mainland China, some cruise ships were quarantined after passengers developed symptoms or tested positive for 2019-nCoV. The Costa Smeralda was quarantined on 30 January off Civitavecchia in Italy, after passengers developed flu-like symptoms – the quarantine was lifted when tests for the virus came back negative. Two further ships were quarantined on 5 February: Diamond Princess in the Port of Yokohama, Japan and World Dream, which returned to Hong Kong after being refused entry to Kaohsiung, Taiwan. In both cases, passengers and crew tested positive and the ships remained quarantined as of 6 February.
On 31 January 2020, Italy closed all passenger air traffic between Italy and China and Taiwan. The Italian Civil Aviation Authority NOTAM says that effective 31 January, all passenger flights from China, including the special administrative regions of Hong Kong and Macau, and Taiwan are suspended until further notice, on request of the Italian health authorities. Aircraft that were flying to Italy when the NOTAM was published, was cleared to land. On the same day, the WHO declared that the number of infected cases is 9826 and 213 confirmed death case
On 1 February Huanggang, Hubei implemented a measure whereby only one person from each household is permitted to go outside for provisions once every two days, except for medical reasons or to work at shops or pharmacies. Many cities, districts, and counties across mainland China implemented similar measures in the days following, including Wenzhou, Hangzhou, Fuzhou, Harbin, and the whole of Jiangxi Province.
On 2 February, the WHO declared there was a "massive infodemic" accompanying the outbreak and response, citing an over-abundance of reported information, accurate and false, about the virus that "makes it hard for people to find trustworthy sources and reliable guidance when they need it." The WHO stated that the high demand for timely and trustworthy information has incentivized the creation of a direct WHO 24/7 myth-busting hotline where its communication and social media teams have been monitoring and responding to misinformation through its website and social media pages.
On 4 February 2020, two more cities in Zhejiang province restricted the movement of residents. The city of Taizhou, three Hangzhou districts, and some in Ningbo began to only allow one person per household to go outside every two days to buy necessities, city officials said. More than 12 million people are affected by the new restrictions.
On 8 February 2020, it was announced that a Japanese and an American died due to the virus in Wuhan. They are the first foreigners killed by the virus. By that day the WHO announced the confirmed cases is now 34 886 cases and the number of deaths is 724.
On 12 February, the Hubei government adopted a broader definition of confirmed cases, which now includes clinically diagnosed patients diagnosed by their symptoms and CT scans but without a nucleic acid test, which can take days to process and delay treatment. "Using CT scans that reveal lung infection would help patients receive treatment as soon as possible and improve their chances of recovery," the provincial health commission said. This new methodology accounts for the sharp increase in Hubei's daily confirmed cases: 13,332 of the 14,840 newly confirmed cases in the province on 12 February were diagnosed clinically under the new definition.
The Lombardy outbreak came to light when a 38-year-old Italian tested positive in Codogno, a comune in the province of Lodi. According to his wife, he had met an Italian friend who had returned from China on 21 January, who subsequently tested negative. On 14 February, he felt unwell and went to a doctor in Castiglione d'Adda. He was prescribed treatments for influenza.
Egypt reported its first confirmed case of COVID-19 on the 15th of February. This is the second country in the WHO EMRO region to confirm a case and the first reported case from the African continent. WHO was informed by the Egyptian Ministry of Health and Population.
On 16 February, as the 38-year-old man's condition worsened, he went to Codogno Hospital, reporting respiratory problems. Initially, there was no suspicion of COVID-19, so no additional precautionary measures were taken, and the virus was able to infect other patients and health workers. Later, the patient, his pregnant wife, and a friend tested positive. Three more cases were confirmed on the same day after the patients reported symptoms of pneumonia. Thereafter, extensive screenings and checks were performed on everyone that had possibly been in contact or near the infected subjects.
On 25 February, the WHO declared that "the world should do more to prepare for a possible coronavirus pandemic," stating that while it was still too early to call it a pandemic, countries should nonetheless be "in a phase of preparedness." In response to a developing case of the outbreak of the coronavirus in Iran, the WHO has sent a Joint Mission Team there on the same day to assess the situation in the country.
The Ministry of Health announced new guidelines for reporting cases on 27 February in response to the previous blanket testing that caused case numbers to surge and inflamed public panic. It would no longer report asymptomatic cases (swabs taken from patients which tested positive but were not showing symptoms) which counted as 40 to 50% of all reported cases at the time. These people would undergo isolation at home and would be followed up with new tests until they were negative.
On 28 February, WHO officials said that the coronavirus threat assessment at the global level will be raised from "high" to "very high," its highest level of alert and risk assessment. Mike Ryan, executive director of WHO’s health emergency program, warned in a statement that "This is a reality check for every government on the planet: Wake up. Get ready. This virus may be on its way and you need to be ready. You have a duty to your citizens, you have a duty to the world to be ready," urging that the right response measures could help the world avoid “the worst of it." Ryan further stated that the current data does not warrant public health officials to declare a global pandemic, saying that the declaration would mean "we’re essentially accepting that every human on the planet will be exposed to that virus."
On 11 March, President Donald Trump announced the suspension of most travel from Europe (excluding the United Kingdom) for 30 days, beginning on 13 March. He also said that health insurance companies agreed to waive all co-payments for coronavirus treatments and extend insurance coverage to cover coronavirus treatments. The Department of Homeland Security clarified that the travel suspension only applied to the Schengen Area; it does not apply to European countries that are not members of the Schengen Agreement, such as the United Kingdom, the Republic of Ireland, Croatia, Albania, or Belarus. Furthermore, the travel ban does not apply to US citizens or permanent residents, or their family members or those traveling on certain types of visas.
On 13 March, U.S. President Trump declared a national emergency due to the virus outbreak. The action made federal funds available to respond to the crisis. Per media reports on 15 March, many businesses closed or reduced hours throughout the U.S. as a method to try to combat the virus.
On 14 March, President Trump expanded the travel ban on Europe to include the United Kingdom and Ireland. In addition, a representative of the insurance industry clarified that, contrary to the president's statement, major health insurers had only agreed to waive co-payments for coronavirus testing, and not for coronavirus treatment, which is far more costly.
As of March 18, Wuhan, along with the rest of China has not had any new cases, raising questions of the potential consequences when social distancing requirements start to be lifted. Estimates are that less than 1% in China have had the disease, leaving more than 99% vulnerable to future waves of infection. With SARS in 2003, there was no transmission to others during incubation and the early symptoms. With COVID-19, there is evidence of early transmission. Ben Cowling, professor of epidemiology at Hong Kong University, said, “This coronavirus is more comparable to influenza.” It is not known how and if Covid-19 may resurface, though some fear it could follow a similar path to the 1918-1919 flu pandemic in which the second and third waves were more deadly than the first.
On 20 March, the government announced that all leisure establishments (pubs, gyms, etc.) were to close as soon as possible, and promised to pay up to 80% of workers' wages, to a limit of £2,500 per month, to prevent unemployment in the crisis.
The South Korean society was initially polarized with President Moon Jae-in's response to the crisis. Many Koreans signed petitions either calling for the impeachment of Moon over what they claimed is the government's mishandling of the outbreak or praising his response. On 23 March, it was reported that South Korea had the lowest one-day case total in four weeks. South Korea's approach to the outbreak includes having 20,000 people tested every day for coronavirus.
On 23 March, the Prime Minister announced tougher social distancing measures, banning gatherings of more than two people and restricting travel and outdoor activity to that deemed strictly necessary. Unlike previous measures, these restrictions were enforceable by police through the issuing of fines and the dispersal of gatherings. Most businesses were ordered to close, with "essential" exceptions including supermarkets, pharmacies, banks, hardware shops, petrol stations, and garages.
On 24 March 2020, Chinese Premier Li Keqiang reported that the spread of domestically transmitted cases has been basically blocked and the outbreak has been controlled in China. The same day travel restrictions were eased in Hubei, apart from Wuhan, two months after the lockdown was imposed.
On 3 April, the Chinese government declared 4 April, the Qingming Festival of 2020, a national day of mourning for those who lost their lives in the coronavirus pandemic. At 10 a.m., people were asked to observe three minutes of silence while sirens and vehicle horns blasted out. Chinese flags were flown at half-mast across the country and at embassies overseas. All public entertainment was halted for the day.
As of 4 April, there were 119,827 confirmed cases, 14,681 deaths, and 19,758 recoveries in Italy, with the majority of those cases occurring in the Lombardy region. A CNN report indicated that the combination of Italy's large elderly population and the inability to test all who have the virus to date may be contributing to the high fatality rate.
Canada reported 60,616 cases and 3,842 deaths on 4 May, while Mexico reported 23,471 cases and 2,154 deaths. The Dominican Republic and Cuba are the only Caribbean countries reporting more than 1,000 cases (7,954 and 1,649, respectively), while Panama and Honduras lead Central America with 7,197 and 1,055 cases, respectively.
As of 8 May 2020, there have been 222,857 confirmed cases and 26,299 deaths while there have been 131,148 recoveries. The actual number of cases, however, is likely to be much higher, as many people with only mild or no symptoms are unlikely to have been tested. The number of deaths is also believed to be an underestimate due to lack of testing and reporting, perhaps by as much as 10,000 according to excess mortality analysis.