Fidel Castro, who defied 10 US presidents in his 50 year rule, dies aged 90

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.

Mar 13: Canadian Prime Minister Justin Trudeau and his wife announced they were self-isolating Thursday as she undergoes tests for the new coronavirus after returning from a speaking engagement with "mild flu-like symptoms."

Sophie Gregoire-Trudeau's symptoms have subsided since she recently got back from Britain, but as a precaution the prime minister "will spend the day in briefings, phone calls and virtual meetings from home," according to a statement.

Trudeau also cancelled a meeting Thursday and Friday with Canada's provincial and territorial leaders in Ottawa, but still planned to speak with them and world leaders by phone about measures being taken to curb the spread of the virus in Canada.

Gregoire-Trudeau's symptoms had included "a low fever late last night." She immediately sought medical advice and testing.

Trudeau has exhibited no symptoms, and was advised by doctors "to continue daily activities while self-monitoring."

"However, out of an abundance of caution, the prime minister is opting to self-isolate and work from home until receiving Sophie's results," said his office.

Since the novel coronavirus first emerged in late December 2019, 127,070 cases have been recorded in 115 countries and territories, killing 4,687 people, according to an AFP tally compiled at 1200 GMT on Thursday based on official sources.

Canada has so far reported more than 100 cases in six provinces, and one death.

Also Thursday, the Canada's Juno music awards cancelled its upcoming gala show, planned for Sunday evening in Saskatoon, Saskatchewan.

"We are devastated to cancel this national celebration of music, but at this time of global uncertainty, the health, safety and well-being of all Canadians must stand at the forefront of any decisions that impact our communities," organisers said in a statement.

And in Quebec province, Premier Francois Legault unveiled a series of measures to prevent the spread of the coronavirus, including placing all travellers returning from overseas under quarantine for two weeks.

Quebec also banned indoor gatherings of more than 250 people.

Feb 17: Chinese authorities on Monday reported a slight upturn in new virus cases and 105 more deaths for a total of 1,770 since the outbreak began two months ago.

The 2,048 new cases followed three days of declines but was up by just 39 cases from the previous day’s figure. Another 10,844 people have recovered from COVID-19, a disease caused by the new coronavirus, and have been discharged from hospitals, according to Monday’s figures.

The update followed the publication late Saturday in China’s official media of a recent speech by President Xi Jinping in which he indicated for the first time that he had led the response to the outbreak from early in the crisis. While the reports were an apparent attempt to demonstrate the Communist Party leadership acted decisively from the start, it also opened Xi up to criticism over why the public was not alerted sooner.

In his speech, Xi said he gave instructions on fighting the virus on Jan. 7 and ordered the shutdown of the most-affected cities that began on Jan. 23.

The disclosure of his speech indicates top leaders knew about the outbreak’s potential severity at least two weeks before such dangers were made known to the public. It was not until late January that officials said the virus can spread between humans and public alarm began to rise.

New cases in other countries are raising growing concerns about containment of the virus.

Taiwan on Sunday reported its first death from COVID-19, the fifth fatality outside of mainland China. Taiwan’s Central News Agency, citing health minister Chen Shih-chung, said the man who died was in his 60s and had not traveled overseas recently and had no known contact with virus patients.

Japanese Prime Minister Shinzo Abe convened an experts meeting to discuss containment measures in his country, where more than a dozen cases have emerged in the past few days without any obvious link to China.

“The situation surrounding this virus is changing by the minute,” Abe said.

Japanese Health Minister Katsunobu Kato said the country is “entering into a phase that is different from before,” requiring new steps to stop the spread of the virus.

Japan now has 413 confirmed cases, including 355 from a quarantined cruise ship, and one death from the virus. Its total is the highest number of cases among about two dozen countries outside of China where the illness has spread.

Hundreds of Americans from the cruise ship took charter flights home, as Japan announced another 70 infections had been confirmed on the Diamond Princess. Canada, Hong Kong and Italy were planning similar flights.

The 300 or so Americans flying on U.S.-government chartered aircraft back to the U.S. will face another 14-day quarantine at Travis Air Force Base in California and Lackland Air Force Base in Texas. The U.S. Embassy said the departure was offered because people on the ship were at a high risk of exposure to the virus. People with symptoms were banned from the flights.

About 255 Canadians and 330 Hong Kong residents are on board the ship or undergoing treatment in Japanese hospitals. There are also 35 Italians, of which 25 are crew members, including the captain.

In China’s Hubei province, where the outbreak began in December, all vehicle traffic will be banned in another containment measure. It expands a vehicle ban in the provincial capital, Wuhan, where public transportation, trains and planes have been halted for weeks.

Exceptions were being made for vehicles involved in epidemic prevention and transporting daily necessities.

Hubei has built new hospitals with thousands of patient beds and China has sent thousands of military medical personnel to staff the new facilities and help the overburdened health care system.

Last Thursday, Hubei changed how it recognized COVID-19 cases, accepting a doctor’s diagnosis rather than waiting for confirmed laboratory test results, in order to treat patients faster. The tally spiked by more than 15,000 cases under the new method.