Brazil tops 1 million cases as coronavirus spreads inland

Feb 26: China’s massive travel restrictions, house-to-house checks, huge isolation wards and lockdowns of entire cities bought the world valuable time to prepare for the global spread of the new virus.

But with troubling outbreaks now emerging in Italy, South Korea and Iran, and U.S. health officials warning Tuesday it’s inevitable it will spread more widely in America, the question is: Did the world use that time wisely and is it ready for a potential pandemic?

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen — and how many people in this country will have severe illness,” said Dr. Nancy Messonnier of the U.S. Centers for Disease Control and Prevention.

Some countries are putting price caps on face masks to combat price gouging, while others are using loudspeakers on trucks to keep residents informed. In the United States and many other nations, public health officials are turning to guidelines written for pandemic flu and discussing the possibility of school closures, telecommuting and canceling events.

Countries could be doing even more: training hundreds of workers to trace the virus’ spread from person to person and planning to commandeer entire hospital wards or even entire hospitals, said Dr. Bruce Aylward, the World Health Organization’s envoy to China, briefing reporters Tuesday about lessons learned by the recently returned team of international scientists he led.

“Time is everything in this disease,” Aylward said. “Days make a difference with a disease like this.”

The U.S. National Institutes of Health’s infectious disease chief, Dr. Anthony Fauci, said the world is “teetering very, very close” to a pandemic. He credits China’s response for giving other nations some breathing room.

China locked down tens of millions of its citizens and other nations imposed travel restrictions, reducing the number of people who needed health checks or quarantines outside the Asian country.

It “gave us time to really brush off our pandemic preparedness plans and get ready for the kinds of things we have to do,” Fauci said. “And we’ve actually been quite successful because the travel-related cases, we’ve been able to identify, to isolate” and to track down those they came in contact with.

With no vaccine or medicine available yet, preparations are focused on what’s called “social distancing” — limiting opportunities for people to gather and spread the virus.

That played out in Italy this week. With cases climbing, authorities cut short the popular Venice Carnival and closed down Milan’s La Scala opera house. In Japan, Prime Minister Shinzo Abe called on companies to allow employees to work from home, while the Tokyo Marathon has been restricted to elite runners and other public events have been canceled.

Is the rest of the world ready?

In Africa, three-quarters of countries have a flu pandemic plan, but most are outdated, according to authors of a modeling study published last week in The Lancet medical journal. The slightly better news is that the African nations most connected to China by air travel — Egypt, Algeria and South Africa — also have the most prepared health systems on the continent.

Elsewhere, Thailand said it would establish special clinics to examine people with flu-like symptoms to detect infections early. Sri Lanka and Laos imposed price ceilings for face masks, while India restricted the export of personal protective equipment.

India’s health ministry has been framing step-by-step instructions to deal with sustained transmissions that will be circulated to the 250,000 village councils that are the most basic unit of the country’s sprawling administration.

Vietnam is using music videos on social media to reach the public. In Malaysia, loudspeakers on trucks blare information through the streets.

In Europe, portable pods set up at United Kingdom hospitals will be used to assess people suspected of infection while keeping them apart from others. France developed a quick test for the virus and has shared it with poorer nations. German authorities are stressing “sneezing etiquette” and Russia is screening people at airports, railway stations and those riding public transportation.

In the U.S., hospitals and emergency workers for years have practiced for a possible deadly, fast-spreading flu. Those drills helped the first hospitals to treat U.S. patients suffering from COVID-19, the disease caused by the virus.

Other hospitals are paying attention. The CDC has been talking to the American Hospital Association, which in turn communicates coronavirus news daily to its nearly 5,000 member hospitals. Hospitals are reviewing infection control measures, considering using telemedicine to keep potentially infectious patients from making unnecessary trips to the hospital and conserving dwindling supplies of masks and gloves.

What’s more, the CDC has held 17 different calls reaching more than 11,000 companies and organizations, including stadiums, universities, faith leaders, retailers and large corporations. U.S. health authorities are talking to city, county and state health departments about being ready to cancel mass gathering events, close schools and take other steps.

The CDC’s Messonnier said Tuesday she had contacted her children’s school district to ask about plans for using internet-based education should schools need to close temporarily, as some did in 2009 during an outbreak of H1N1 flu. She encouraged American parents to do the same, and to ask their employers whether they’ll be able to work from home.

“We want to make sure the American public is prepared,” Messonnier said.

How prepared are U.S. hospitals?

“It depends on caseload and location. I would suspect most hospitals are prepared to handle one to two cases, but if there is ongoing local transmission with many cases, most are likely not prepared just yet for a surge of patients and the ‘worried well,’” Dr. Jennifer Lighter, a pediatric infectious diseases specialist at NYU Langone in New York, said in an email.

In the U.S., a vaccine candidate is inching closer to first-step safety studies in people, as Moderna Inc. has delivered test doses to Fauci’s NIH institute. Some other companies say they have candidates that could begin testing in a few months. Still, even if those first safety studies show no red flags, specialists believe it would take at least a year to have something ready for widespread use. That’s longer than it took in 2009, during the H1N1 flu pandemic — because that time around, scientists only had to adjust regular flu vaccines, not start from scratch.

The head of the World Health Organization, Tedros Adhanom Ghebreyesus, said the U.N. health agency’s team in China found the fatality rate between 2% and 4% in the hard-hit city of Wuhan, the virus’ epicenter, and 0.7% elsewhere.

The world is “simply not ready,” said the WHO’s Aylward. “It can get ready very fast, but the big shift has to be in the mindset.”

Aylward advised other countries to do “really practical things” now to get ready.

Among them: Do you have hundreds of workers lined up and trained to trace the contacts of infected patients, or will you be training them after a cluster pops up?

Can you take over entire hospital wards, or even entire hospitals, to isolate patients?

Are hospitals buying ventilators and checking oxygen supplies?

Countries must improve testing capacity — and instructions so health workers know which travelers should be tested as the number of affected countries rises, said Johns Hopkins University emergency response specialist Lauren Sauer. She pointed to how Canada diagnosed the first traveler from Iran arriving there with COVID-19, before many other countries even considered adding Iran to the at-risk list.

If the disease does spread globally, everyone is likely to feel it, said Nancy Foster, a vice president of the American Hospital Association. Even those who aren’t ill may need to help friends and family in isolation or have their own health appointments delayed.

“There will be a lot of people affected even if they never become ill themselves,” she said.

Beijing, Jan 21: The Chinese official investigating a pneumonia outbreak stemming from a new coronavirus said the disease can spread from person to person but can be halted with increased vigilance, as authorities on Tuesday confirmed a fourth death.

Zhong Nanshan said there was no danger of a repeat of the Severe Acute Respiratory Syndrome (SARS) epidemic that killed nearly 800 people globally during a 2002-2003 outbreak, which started in China, as long as precautions were taken.

"It took only two weeks to identify the novel coronavirus," state news agency Xinhua quoted Zhong as saying late on Monday.

The outbreak was still in its early stages and China had good surveillance and quarantine systems to help control it, he added.

The outbreak has spread from the central city of Wuhan to cities including Beijing and Shanghai, with more than 200 cases reported so far. Four cases have been reported outside China - in South Korea, Thailand and Japan.

Australia on Tuesday said it would screen passengers on flights from Wuhan amid rising concerns that the virus will spread globally as Chinese travellers take flights abroad for the Lunar New Year holiday starting this week.

Authorities around the globe, including in the United States and many Asian countries, have stepped up screening of travellers from Wuhan.

Chinese authorities confirmed a total of 217 cases of the virus in China as of 6 p.m. (1000 GMT) on Monday, state television reported, 198 of which were in Wuhan.

A fourth person died on Jan. 19, the Wuhan Municipal Health Commission said. The 89-year-old man, who had underlying health diseases including coronary heart disease, developed symptoms on Jan. 13 and was admitted to hospital five days later, it added.

Zhong, who is renowned in China for his work fighting SARS in 2003, confirmed that the virus can pass from person-to-person.

Fifteen medical workers in Wuhan had been diagnosed with pneumonia, with one other suspected case, the Wuhan Municipal Health Commission said. Of the infected staff, one was in critical condition.

In Shanghai, officials on Tuesday confirmed a second case involving a 35-year-man who had visited Wuhan in early January, and said they were monitoring four other suspected cases.

The virus causes a type of pneumonia and belongs to the same family of coronaviruses as SARS. Symptoms include fever and difficulty in breathing, which are similar to many other respiratory diseases and pose complications for screening efforts.

The World Health Organisation (WHO) said on Monday an animal source appeared most likely to be the primary origin of the outbreak and that some "limited human-to-human transmission" occurred between close contacts.

The Geneva-based U.N. agency convened an emergency committee for Wednesday to assess whether the outbreak constitutes an international health emergency and what measures should be taken to manage it.

So far, the WHO has not recommended trade or travel restrictions, but a panel of independent experts could do so or make other recommendations to limit spread.

Wellington, Jun 8: New Zealand lifted all domestic coronavirus restrictions on Monday after its final COVID-19 patient was given the all clear, with Prime Minister Jacinda Ardern revealing she danced around her living room when told about the milestone.

While strict border controls will remain in place, Ardern said restrictions such as social distancing and limits on public gatherings were no longer needed.

"We are confident we have eliminated transmission of the virus in New Zealand for now," she said in a televised address, saying Kiwis had "united in unprecedented ways to crush the virus".

The South Pacific nation, with a population of five million, has had 1,154 confirmed COVID-19 cases and 22 deaths.

There have been no new infections for 17 days and, until Monday, just one active case for more than a week.

Details of the final patient were not released for privacy reasons but it is believed to be a woman aged in her 50s who was linked to a cluster at an Auckland nursing home.

Ardern said the sacrifices made by New Zealanders, including a drastic seven-week lockdown that helped curb infection rates, had been rewarded now that there were no active cases in the country.

Asked about her reaction upon hearing the news, she replied: "I did a little dance" with baby daughter Neve.

"She was caught a little by surprise but she joined in, having absolutely no idea why I was dancing around the lounge."

New Zealand's move down to Level 1, the lowest rating on its four-tier virus response system, means nightclubs can operate without dance floor restrictions and theatres will reopen.

It also means sporting events can proceed with crowds in the stands, a change New Zealand Rugby (NZR) said offered its Super Rugby Aotearoa competition the opportunity to achieve a world first when it kicks off this weekend.

"We're incredibly proud, and grateful, to be the first professional sports competition in the world to be in a position to have our teams play in front of their fans again," NZR chief executive Mark Robinson said.

While many other sporting competitions around the globe have announced plans to restart, the vast majority will be played either with no crowds or with numbers severely restricted.

On a broader level, Ardern said easing restrictions would help New Zealand's economy.

"We now have a head start on economic recovery because at level one we become one of the most open, if not the most open, economies in the world," she said.

The prime minister said modelling showed the economy would operate at just 3.8 percent below normal at Level 1, compared with a 37 percent impairment at Level 4 lockdown.