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Discussions to resume tomorrow

China's Wuhan blocks all travel as virus deaths hit 17 Ground zero city closes airports and suspends public transit SHUNSUKE TABETA and ALEX FANG, Nikkei staff writersJANUARY 23, 2020 03:41 JST UPDATED ON JANUARY 23, 2020 04:15 JST Passengers crowd a railway station in Wuhan, in central China's Hubei Province. All of the city's public transportation will be suspended starting Thursday. © Reuters BEIJING/NEW YORK -- The Chinese city of Wuhan is shutting down transit out of and within its borders, as the death toll from a new respiratory virus originating there climbed to 17 people as of Wednesday, up from the nine fatalities previously reported. The travel restriction, announced hours before it goes into effect at 10 a.m. Thursday, involves an indefinite suspension of Wuhan's airports, train stations and intercity buses, as well as public transit within the city of 11 million people. Residents should remain in Wuhan "except under extraordinary circumstances," the announcement said. The coronavirus has infected 543 patients in China, an increase from earlier reports of 440. China's National Health Commission confirmed cases in 13 provinces and provincial-level cities. Cases have been reported in Thailand, Japan, South Korea and the U.S. as well. The sharp rise in reported infections in China is credited partly to improved diagnostic techniques. Authorities reject accusations that the government is hiding the real numbers. "We're singularly focused on disclosing information," said a senior National Health Commission official. Travelers wear face masks as they line up at turnstiles at a Nantong train station in Jiangsu Province on Jan. 22. © AP Wednesday marked the first time the commission held a news conference attended by a high-ranking official. Deputy Director Li Bin raised the concern that the virus could evolve into a more serious threat. "The virus might mutate, and there is risk for further spreading," he said. Li and the experts in attendance cited the likelihood of the coronavirus originating from wild animals sold at a seafood market in Wuhan. Many of the patients visited that particular market. Wuhan will strictly monitor and control markets in the city, as well as impose tougher restrictions on trade in wild animals, Li said. Health officials have classified the new coronavirus as a Class B infectious disease, a grade below Class A infections such as cholera. Authorities have avoided comparing the virulence with that of severe acute respiratory syndrome and Middle East respiratory syndrome, two illnesses also caused by coronaviruses. China observes the one-week Lunar New Year holiday starting Friday. Travelers are expected to make roughly 3 billion trips over the 40 days surrounding the period. Sichuan Province officials sent a notice to bus companies saying that trips to Wuhan should generally be suspended, according to local media. An Olympic boxing qualifier for Asia and Oceania, scheduled to be held in Wuhan in February, also was canceled. https://asia.nikkei.com/Spotlight/Virus-outbreak/China-s-Wuhan-blocks-all-travel-as-virus-deaths-hit-17 Stay ahead with

China Halts Travel From Chinese City at Center of Virus Outbreak The Chinese city at the center of a widening respiratory-virus outbreak suspended outbound flights and rail service, as China ramps up efforts to contain an illness that’s killed at least 17 people and infected more than 500. The travel halt by the city of Wuhan was reported by state broadcaster CCTV. The city also suspended travel by bus, subway and ferry. Citizens shouldn’t leave the city without special reasons, the report said. CCTV reported earlier that the death toll has nearly doubled from a previous total of nine. There were two “preliminary positive” reports of the pneumonia-causing virus in Hong Kong, with one diagnosis in the U.S. and patients under examination in Mexico and Russia. Health officials around the world are racing to control the SARS-like virus that first appeared last month. The World Health Organization will decide Wednesday whether to declare the outbreak a public health emergency of international concern, a designation used for complex epidemics that can cross borders. After volatility Tuesday, Asian markets calmed Wednesday as China’s National Health Commission detailed actions to contain the disease. The number of cases has climbed to at least 550, according to the People’s Daily. One 39-year-old Hong Kong patient was found by temperature screening after traveling from Wuhan to Shenzhen, and then to Hong Kong via rail, according to Sophia Chan, Hong Kong’s secretary for food and health. While final test results are still forthcoming, the man’s case is “highly suspicious,” according to Constance Chan, head of Hong Kong’s Department of Health. Four family members who didn’t have symptoms stayed overnight at a hotel in a popular tourist area and then departed for Manila. In a briefing in Beijing Wednesday, health officials said China has stepped up monitoring of transportation links and ordered a near-complete shutdown of Wuhan, where the virus originated. Officials acknowledged that they’re still grappling to understand the pathogen, which has infected multiple medical workers. “We are still on a learning curve,” said Gao Fu, head of Chinese Center for Disease Control and Prevention. “The disease will continue to develop.” It has already changed from the early stages of detection, he said in the briefing. China said it had seen no evidence yet of “super spreaders,” infected people who pass on the disease rapidly to many other people, but could not rule out that some would emerge. Super spreaders played a key role in the SARS pandemic 17 years ago, which killed almost 800 people and hurt economies across the region. The 17 deaths from the new virus have been in Hubei province, whose capital is Wuhan, a city of 11 million people, CCTV said. About 4,000 people in Wuhan may be currently infected, based on the number of known cases and the estimated mean time between infection and detection, according to a study by Neil Ferguson, a researcher at Imperial College London. While Ferguson’s group released an estimate of 1,700 infections over the weekend, the new total doesn’t mean that the outbreak has doubled in size, according to the study. Factors such as delays in reporting and confirming cases make it difficult to estimate the epidemic’s growth rate, the researchers said. Symptoms include fever, cough or chest tightness, and difficulty breathing. Both the Wuhan virus, known as 2019-nCoV, and SARS belong to the family of coronaviruses, so called because of their crown-like shape. Many such viruses cross the barrier between animals and humans. Gao said in the Beijing briefing that the source of 2019-nCoV was wild animals sold in so-called wet markets. Some of the first group of patients in Wuhan worked or shopped at a seafood market where live animals and wildlife parts were reportedly sold. A WHO declaration of a public health emergency can help mobilize an international response and focus government attention. The body most recently declared such an emergency last year, as an Ebola outbreak worsened in Congo. An emergency declaration for the Wuhan virus case could include recommendations to restrict travel or trade. Such a move would come as concern grows that the virus could spread rapidly during China’s Lunar New Year break, which starts at the end of this week. Hundreds of millions of people are poised to travel for the holidays in the biggest annual migration of humans on the planet. The WHO has formed teams at its Geneva headquarters to study the virus, its spread and its symptoms and is sending experts to China to help gather information, according to David Heymann, an infectious disease researcher in the U.K. who advises the agency. As they did during the SARS and Ebola outbreaks, health officials and scientists globally are tracking patients and testing samples of saliva and other fluids to determine the exact cause and severity of their ailments. They’re identifying and monitoring people with whom the patients were in contact to see if the virus is spreading easily from person to person. And they are placing restrictions on travel to try to limit the exposure to scores of new people. The U.S. Centers for Disease Control and Prevention, or CDC, expanded its inspection of airline passengers who had spent time in China to airports in Atlanta and Chicago on Tuesday, building on the 1,200 people who had been screened in California and New York over the weekend. No new cases were uncovered. The U.S. case is a man in his 30s who was traveling in Wuhan and arrived back in the U.S. on Jan. 15, Washington state health officials said on a call with the CDC Tuesday. The resident of Snohomish, Washington, said he hadn’t spent any time at the live-animal market where the virus is believed to have originated and didn’t have contact with anyone who was sick. The man sought care quickly after monitoring news about the virus and is in good condition, though he has been hospitalized out of an abundance of caution, the officials said. President Donald Trump told reporters at the World Economic Forum in Davos that the U.S. has a plan to deal with the virus. “The CDC has been terrific,” he said. “We’re in very good shape and I think China is in very good shape also.” U.K. health officials raised the risk level of the virus to low from very low and issued guidance to airports. The focus of concern is about three flights a week that arrive from Wuhan at London Heathrow, according to a statement from the Department of Health and Social Care. A message will be broadcast during those flights to encourage reporting of illness, and the planes will be received in an isolated area of the airport. Passengers will be met by health officials who will check for symptoms. The European Centre for Disease Control and Prevention said there’s a “moderate likelihood of imported cases being detected” in Europe. The U.S., South Korea, Taiwan, Japan, Thailand and the Chinese territory of Macau have already reported cases. “This is an evolving situation,” said Nancy Messonnier, director of the U.S. CDC’s National Center for Immunization and Respiratory Diseases. “We do expect additional cases in the United States and globally.” https://www.newsmax.com/newsfront/wuhan-china-travel-halt/2020/01/22/id/950855/

JUST IN: Officials in Wuhan, China have suspended outbound flights and rail services, according to CCTV, as cases of the viral respiratory illness rise sharply throughout the country QuickTake by Bloomberg @QuickTake · 25m JUST IN: Officials in Wuhan, China have suspended outbound flights and rail services, according to CCTV, as cases of the viral respiratory illness rise sharply throughout the country

Wuhan Municipal Health Commission: 1 new case of death, 15 medical staff infected Release time: 2020-01-21 10:11 Source: CCTV News Client [Font: Tai Zhong small ] Wuhan Municipal Health and Health Commission issued a notice that at 12:00 on January 19th and at 24:00 on January 19th, one patient died without any discharged patients and new cases. The deceased, Chen, male, 89 years old, developed symptoms on January 13, 2020, was admitted to the hospital for severe breathing difficulties on January 18, and died on January 19 at 23:39. Patients have basic diseases such as hypertension, diabetes, coronary heart disease, and frequent ventricular premature beats. As of 24:00 on January 19, Wuhan had reported 198 cases of pneumonia caused by new coronavirus infection, 25 patients had been discharged from hospital, and 4 died. Currently, 169 patients are still being treated in the hospital, of which 35 are critically ill and 9 are critically ill. They are all under isolation treatment at designated medical institutions in Wuhan. (Wang Han, Li Wei)

early morning of the 21st, there are currently 15 medical staff in Wuhan who have been diagnosed with pneumonia cases of the new coronavirus infection http://www.hubei.gov.cn/zxjy/rdhy/202001/t20200121_2013415.shtml

Release time: 2020-01-22 09:30 Source: Hubei Daily [Font: Tai Zhong small ] Provincial Health and Health Committee notified the province of pneumonitis infected by new coronavirus Wuhan Huanggang adds 72 confirmed cases At 21 o'clock on January 21, the Provincial Health and Health Commission's official website announced the pneumonia situation of the new type of coronavirus infection in the province: from 00:00 to 24:00 on January 20, 2020, 72 cases of pneumonia of new type coronavirus infection were added in Hubei Among them, there were 60 new cases in Wuhan, 2 deaths, and no discharges; 12 new cases in Huanggang (including 1 doctor and 4 nurses). As of 24:00 on January 20, Hubei Province had reported a total of 270 cases of pneumonia caused by new coronavirus infection, 25 patients have been discharged from the hospital, and 6 have died. 239 patients are still being treated in the hospital, including 51 critically ill and 12 critically ill, all of whom are receiving isolation treatment at designated medical institutions. A total of 1,070 close contacts have been tracked, 739 people have been released from medical observation, and 331 people are still receiving medical observation. (Longhua) Chief Editor: Zhang Yawei

12 new coronavirus cases in Huanggang (including 1 doctor and 4 nurses). http://www.hubei.gov.cn/zxjy/rdhy/202001/t20200122_2013950.shtml

Transcript of Update on 2019 Novel Coronavirus (2019-nCoV) Press Briefing Transcript Tuesday, January 21, 2020 Audio recording media icon[MP3 – 43 MB] Please Note: This transcript is not edited and may contain errors. Operator: Standby for today’s conference, we will begin in just a few moments. Know if you are standing by, all lines will be listen only. You can press start and 1 to ask a question on the phone line. This call is being recorded if you have objections, you can continue next disconnect at this time. You may begin. Ben Haynes: Thank you, Sarah, and thank you for joining us for today regarding the CDC 2019 novel coronavirus response. We are joined today by Dr. Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Disease and health officials from the state of Washington. Dr. Messonnier will provide opening remarks before taking your questions. I will now turn the call over to Dr. Messonnier. Nancy Messonnier: Good afternoon and thank you all for joining us. During our briefing last Friday, I foreshadowed that we could see a novel coronavirus infection in the United States, most likely in a traveler from Wuhan. Today I am joined by representatives from the state of Washington to announce that we have now confirmed the first case of novel coronavirus in the United States. CDC has been proactively preparing for an introduction of the virus here. We know that today’s news is concerning. I’m grateful with the work being done at all levels within the federal government and at the state and local level to prepare and respond. Based on international reports, there are now close to 300 people who have been confirmed with this novel coronavirus in China, and there have been travel associated introductions in Thailand, Japan, Taiwan, and South Korea. Additional deaths have also been reported. Human to human spread has been confirmed. How easily or sustainably this virus is spreading remains unknown. These new developments further emphasize CDC’s proactive approach in responding to this evolving outbreak. In terms of our response: Over the weekend CDC finalized development of a real time Reverse Transcription-Polymerase Chain Reaction – abbreviated as rRT-PCR – test that can diagnose this new virus. We used this test to quickly confirm our first U.S. case. Right now, testing for this virus must take place at CDC, but in the coming weeks, we anticipate sharing these tests with domestic and international partners through the agency’s International Reagent Resource. Yesterday, we activated our Emergency Operations Center in response to the newest developments. I know a lot of you are likely wondering about the entry screening that we started on Friday at San Francisco airport, New York JFK, and LAX airport. So far, CDC staff have screened over 1,200 passengers. However, no individuals have been referred to a hospital or discovered yet through entry screening. This is an evolving situation and again, we do expect additional cases in the United States and globally. This week CDC will add entry health screening at two more airports – Atlanta Hartsfield-Jackson and Chicago O’Hare. Today, we will also be raising our travel health notice from a level 1 to a level 2. Preliminary information suggests that older adults with underlying health conditions may be at increased risk for severe disease. I’m now going to hand the briefing over to my colleague, Washington State Secretary of Health, John Wiesman, who will introduce key players in Washington state and outline what the public health system is doing in response to the case. Dr. Wiesman. John Wiesman: Great, thank you Dr. Messonnier. I appreciate that. Hello, I am John Wiesman, Secretary of Health for the state of Washington. I first want to begin by recognizing the quick, collaborative work being done with our local and federal public health and healthcare partners. Over the holiday weekend, this group of people quickly identified a possible risk, coordinated the patient care, sent samples to CDC, and CDC tested them immediately. Together we are implementing actions to ensure the public’s health is protected. I am also thankful that the man who tested positive for this virus acted so quickly to seek treatment. Because of that we were able to isolate him from the public. His actions gave us a head start. All of this work means we believe the risk to the public is low. It’s true that we are learning more about the new coronavirus. We have a strong public health team here in Snohomish county and Washington state. And together with our partners at CDC, we will share any additional information as we learn it. To give you information about the situation, I’ll hand it over to our state infectious disease epidemiologist, Dr. Scott Lindquist and Dr. Chris Bidders, the health officer from Snohomish Health District, who will tell you more about the current situation. Dr. Lindquist. Scott Lindquist: Thanks, this is Scott Lindquist, the state epidemiologist for Washington state. And just want to remind everyone how we had anticipated screening, so our system was ready despite a holiday weekend. I’m thrilled to say we were able to detect this gentleman early. This is a man in his 30s in a county north of Seattle, Snohomish county, and we have been in close contact, thanks to the CDC’s Emergency Operations Center helping direct the appropriate specimen collection, isolation, and investigation procedures with the local health jurisdiction. So, I’ll turn it over to our local health officer, Dr. Chris Bidders, who can give us some details of where they’re working on this patient right now. Chris. Chris Bidders: Thank you Scott. Last night, the Snohomish Health District coordinated with the Snohomish county emergency medical system to safely transport the patient to Providence Regional Medical Center in Everett. That facility is following our jointly developed infectious disease protocols to ensure prevention of transmission in the facility. As stated earlier, the risk to the general public is low. We are working with the medical center to ensure that the small number of healthcare workers and patients that may have been exposed are notified for symptom watch and monitored. No one wants to be the first in the nation in these types of situations, but these are the types of situations that public health and its partners train and prepare for. Because of this, everything has been going along quite smoothly and on behalf of the Snohomish Health District, I’d like to thank the Centers for Disease Control, the Washington State Department of Health, and Providence Regional Medical Center, as well as all of our local partners in Snohomish county for their support and collaboration in this effort. Nancy Messonnier: Thank you all. I just wanted to add briefly that a CDC team has been deployed to support the ongoing investigation in the state of Washington, including tracing close contacts to determine if anyone else has become ill. As always, we stand by to help out state, local, and global partners in any way we can. As I mentioned on Friday, we have faced similar challenges before – with SARS and MERS. Those outbreaks were complex and required a comprehensive public health response. Because of that experience, we know it’s crucial to be proactive and prepared. The confirmation that human to human spread with this virus is occurring in Asia certainly raises our level of concern about this virus, but we continue to believe the risk of this novel coronavirus to the American public at large remains low at this time. Activation of the EOC and the enhanced airport entry screening reflect the continuation of CDC’s very aggressive public health response strategy. Enhanced airport screening is just one part of a layered approach to increasing the public health and healthcare delivery system to raising its awareness to properly detect the cases early. This individual had a level of concern that enabled him to seek medical care promptly and his clinicians appropriately evaluated and reported the patient. I want to remind everyone that we are still in the early days of this investigation – both domestically and abroad. We are monitoring the situation closely and working to keep you informed every step of the way. I want to take a moment to thank our colleagues in Washington at both the state and local level, as well as the healthcare staff that have been fully engaged and collaborating with us since yesterday when this case was discovered and tested as novel coronavirus. Our ability to coordinate and react this quickly is entirely dependent on these collaborations. We are aware that this situation could change quickly. Therefore, we at CDC are taking a cautious approach to this outbreak and are prepared to respond to any new developments. Ben Haynes: Thank you doctor, we are now ready for questions. Operator: The first question is from Helen Branswell with STAT, your line is open. Helen Branswell: Could we get something clear off the top. This was supposed to be an embargoed press conference, but this news is out. We can assume the embargo has lifted, yes? Nancy Messonnier: I understand the answer to that is yes. Helen Branswell: Thank you very much. In this case with this individual, can you give us information about his condition? Is he ill? Do you know if he had contact with people who were contagious? Nancy Messonnier: Washington state we will let you answer that. Chris Bidders: So, regarding the patient’s condition, they are in good condition and again, they’re currently hospitalized out of an abundance of precaution and for short term monitoring. Not because there was severe illness. At this point, the individual has reported that he did not visit any of those implicated markets and did not know anyone who was ill. He was just traveling from that area. Ben Haynes: Next question please. Operator: Thank you, our next question from Evan Brown with Fox News, your line is open. Evan Brown: Thank you very much. Just thinking back a number of years to the Ebola incident in Dallas. We saw a real push to not only have that individual placed in isolation as well as the other folks who became ill with very strict isolated standards. Is this a scenario where this same contingency is needed? Or no? What type of care is given to the patient for this? Are they isolating him and what type of medications can he get? Or, is it a matter of supportive care? Nancy Messonnier: This is CDC, maybe we’ll give a general answer and then we’ll turn it over to Washington for you all to talk specifically about this patient. Thank you for that question. It’s actually important to clarify that the precautions for this patient are standard isolation precautions. This is something many hospitals know how to do and we’re grateful that in this region in Washington state they were quite prepared for this contingency. So this is not a situation like the Dallas one. This is something where most hospitals in the region should have a hospital that can utilize these kinds of precautions. Washington? This is CDC, maybe I’ll also say this is a hugely important issue and the health of our healthcare workers is very important to all of us. And we are practicing very, we are being proactive at all levels to make sure that as much as possible the people taking care of this patient are careful and cautious. And CDC will be working closely with the state health department on the particulars of this patient’s care. Scott Lindquist: Just regarding the Dallas or the Texas incident, this is again, not the same situation and plus this is an area of the state that has drilled recently on transporting a person in the ambulance and what types of isolation they should require. And there’s no question that there is isolation equipment available to the hospital. Again, we are very comfortable that this patient is isolated, poses a very little risk to the staff or the general public in this current situation. And again, because of an abundance of caution, we have used pretty strict isolation requirements and hospitalization because it is the first person in the United States. We will likely learn from this and future cases and we will adjust our recommendations accordingly. Ben Haynes: The next question please. Operator: Our next question comes from Lena Sun with the Washington Post. Lena Sun: Hi, can someone go over the basics with us. When did this person arrive? Did they arrive through one of the airport screening locations? Were they on a direct flight from Wuhan? What was the timeframe? Is this person a resident of the United States he went to China for business or pleasure and is now back in the United States? Scott Lindquist: We can give you the detail we know and that’s our priority today is really all the details of flight numbers, seat numbers, and people that would have been exposed. What we know currently is he proceeded the institution of the screening at the airports. He came in before that screening was done and was actually not with symptoms when he came to the United States. But this was a very astute gentleman that is looking at internet activity and had actually researched this and shared this information with his provider. We know it was not a direct flight from Wuhan to Sea-Tac, which is our local airport. And that’s really our challenge coming forward. We had talked about this on Friday that while we weren’t screening at Sea-Tac, we potentially could have a traveler that came through many routes. So we decided to activate and be ready before all the screening airports were set into motion. So, this gentleman kind of preceded and slipped around that type of screening, but because the public health system was aware and because this is a really agreeable gentleman who was looking out for his health care, we were able to detect it early and really minimize ongoing exposure to anybody. Lena Sun: So I have a follow-up question that I want to understand. So, this gentleman came to Seattle and you’re not sure how. It was not a direct flight and because he was monitoring the internet and did not have symptoms, when he started to get symptoms, he proactively reached out to providers or health officials? Scott Lindquist: Correct, that’s exactly how he did it. Chris, is there anything you would like to add? Chris Bidders: Just to add on that he has been fully cooperative. Lena Sun: Okay, is he a resident of the United States? Chris Bidders: Yes, a resident of the U.S. Nancy Messonnier: Before we move on, I just want to say that as this situation and as the information has been accumulating over the weekend, CDC has been thinking and rethinking our stance and we made some decisions on Sunday even in advance of this case. And Dr. Marty Cetron, who many of you know, is just going to tell us where we are on that screening. Marty Cetron: First I want to highlight the fact that, leave not doubt, entry screening is just one part of a multilayered system. The point is to alert the system. Individuals are often very empowered to make good decisions if they are informed. Healthcare systems and public health departments, as you just heard, are being alerted. The entry screening is one part of that with notices going out. The screening system started after the Seattle case, this gentleman was indirect, not through a direct flight. Over the weekend with the increasing cases, we decided to move into this full on 100% coverage strategy which means adding additional airports and instructing on Sunday the Department of Homeland Security and the Department of Transportation to begin our funneling approach and redirect all the traffic to the airports that have screening so the benefit of the alert can be more completely covered. So that plan is in place, the new airports will be rolling online this week and the operationalizing of the funneling, which is a very complex process involves reissuing tickets and rerouting passengers from all over the globe through connecting and direct flights. All of that is part of the strategy that was acutally initiated before we even heard about this case to compete that coverage. Lena Sun: I have another follow-up question. The reporter would like to know the date of when this gentleman came to Seattle? Marty Cetron: Our best understanding is on the 15th of January. The screening initiated on the 17th. Lena Sun: When did he reach out to providers? Scott Lindquist: Yeah, he actually reached out on the 16th. This is Scott Lindquist. He actually reached out to his medical provider on the 19th. We were in communication with the CDC Emergency Operations Center coordinating specimens that were shipped overnight and had the results the following day, incredibly fast. Ben Haynes: Next question, please. Operator: The next question comes from USA Today. Your line is open. Grace Hauch: Hi there. I wonder if this gentleman came through Sea-Tac why there is an screening there and at Chicago, has screening begun or is it about to begin? Are there other airports considering? Marty Cetron: Yeah, no, the kind of active screen isn’t in place at Sea-Tac and as I indicated last Friday, when we spoke, you have to go down to a lot of airports to do this across the country, for every single possible flight. So, we concentrate that by volume and when we get to the top five as we are looking at here in this regard, that we begin to redistribute the flights so they can be concentrated in the airports. However, all 14 airports that had passengers had notices and had been put on alert, had been working from the airport quarantine stations with their public health partners. So, again, it’s a multistep process. It rolls out and, in fact, this idea of funneling means redirecting and reissuing tickets so all the arriving passengers from Wuhan would come in to the airports where we can surge this capacity at. All the airports are doing other steps, particularly passenger education, as which you can see if very important in this regard. And that education is in both English and Mandarin. Ben Haynes: Next question, please. Operator: The next question from Ryan with the Seattle Times, your line is open. Ryan Blethen: Hi, I wasn’t let onto the phone call until the question- and-answer period and I may be asking about things already covered. Where in Washington state is this man? You can start with that. I am curious as to where he is in Washington in which hospital he is at? And what are hospitals doing in Washington now to look for this? Also, on the screening question, is Sea-Tac going to be one of the airports that will be screening for this now? Chris Bidders: So the gentleman is a Snohomish county resident and he is currently at Providence Medical Center. This is Chris, I am the health officer for the Snohomish Health District. Marty Cetron: I think it’s important to point out that all the quarantine stations do enhanced education and respond to any illness report. I indicated that active screening, which is where every passenger is questioned and has a temperature check is going on at the top three airports right now – JFK, San Francisco which has direct flights and LAX which has most of the indirect flights. Additional screening will be added to Chicago and Atlanta this week and rolled out as soon as the capacity. And the rest of the airports, all of the people who originate in Wuhan and travel into the United States, all of those tickets, passengers will be rerouted into these five. Scott Lindquist: And this is Scott Lindquist, the state epidemiologist for Washington state. This is part of our larger plan of preparing the hospitals and the healthcare system for all hazard preparedness which means Ebola, SARS, MERS, or in this case, the novel coronavirus. Most of these hospitals have been prepared with infection control with how to sample, how to isolate. And we were well prepared as this hospital is one of the hospitals that recently did a drill as well as our ambulance system for transporting this patients. John Wiesman: And just sort of reinforcing the layered approach here, hospitals need to be prepared with patient education. In this case we don’t believe even if we had active screening at the airport that this patient would have been picked because at the time, we don’t believe the patient had symptoms or a fever. So, this is the important piece about having a strong public health system all across this country that is prepared for this kind of biosecurity approach. Ben Haynes: Two more questions. Our next question comes from Roni Rabin with the New York Times. Roni Rabin: I also came in very late and right now what is being done to secure or what steps is the CDC doing about that? You have people in China who are working with the Chinese authority. Nancy Messonnier: This is CDC. As you say, there is new information hour by hour, day by day that we are tracking and following closely. We do have staff in China and Thailand and they have long term placements there working closely with the ministries of health. We also have staff at WHO and certainly have collaborated with global health leaders worldwide. We and the global health community are really working together to understand the situation. Information is rapidly evolving and we hope that over the next coming days, the situation will become clearer and certainly as you point out, the key issue that we all need to understand is how easily or sustainably the virus is spread form human to human and that is information we don’t completely have nailed down yet. But we’re continuing to work globally with all our partners to better understand it. Roni Rabin: Thank you. Can you still hear me? In the case of the Washington patient –? Just a reminder of the timeline. Scott Lindquist: Just a reminder of the timeline. This gentleman presented on Sunday, specimens were obtained, and the results were learned on Monday. And today, Tuesday, our priority is doing contact investigation and tracing. So, we have had three people assigned to us from CDC that are here and that is our priority to determine what it means to be at risk, who those people are, doing the contact investigations all the way from China to his home here in Snohomish county. That’s exactly what our priority is right now early in this investigation. Nancy Messonnier: Just to add that we are grateful that the patient is doing well and that is clinically not ill and he has been so cooperative. Things have been moving quickly and the health department has appropriately been prioritizing their activities. But there will be a whole set of activities to come in the coming days. But their first priority was clearly making sure this patient was healthy and being appropriately treated as we move on to the next phase. Ben Haynes: Last question. Operator: The last question comes from Julie Steenhuysen with Reuters, your line is open. Julie Steenhuysen: Are you coordinating with the world health organization in terms of how to treat this patient? What are you using at this point? Nancy Messonnier: There is a global effort to share information about potential treatments. That’s globally among the community of people that have dealt with similar issues with MERS and SARS, as well as inter-governmentally within the United States. So all those conversations are ongoing and very active. That being said, as our collaborators in Washington state said, the gentleman is right now very healthy. I think that it would be characterized that he is getting supportive care and monitoring. Chris Bidders: That’s absolutely correct, I have nothing to add. Julie Steenhuysen: One more follow-up, is CDC working with NIH to develop a vaccine and where is that effort? Nancy Messonnier: NIH has always been very active in this area and there is early work early and early conversations. As you know, the development of a vaccine is a complex process. It’s not something that’s going to be available tomorrow. But there are active conversations about vaccines as well as diagnostics [editor’s note: therapeutics should replace diagnostics]. Ben Haynes: Thank you Dr. Messonnier, Dr. Cetron and colleagues from the state of Washington. I’d also like to thank you all for joining us for today’s briefing. Please visit the 2019 novel coronavirus webpage for continued updates. If you have further questions, please call the CDC media line at 404-639-3286 or email [email protected]. Operator: That does conclude today’s call. Thank you for participating. You may disconnect your lines at this time. https://www.cdc.gov/media/releases/2020/t0121-Telebriefing-Coronavirus.html

A number of patients have been treated at hospitals and released within a few days. For others, the complications have been much more severe. As of Wednesday, 17 people with the infection in China had died. https://www.statnews.com/2020/01/22/the-basics-what-we-know-and-dont-know-about-the-virus-spreading-in-china/

Newly added 69 cases of new coronavirus pneumonia in Hubei, with 17 deaths The Beijing News (Reporter Xu Wen) Hubei Province held a press conference on January 22 to inform the province of the prevention and control of pneumonia caused by new coronavirus infection. As of 20:00 on January 22, Hubei Province had reported a total of 444 cases of pneumonia and 17 deaths. Between January 22 and 0200 on January 22, 69 cases of pneumonia of new coronavirus infection were added in Hubei Province. Beijing News reporter Xu Wen Edited by Liu Mengjie http://www.bjnews.com.cn/news/2020/01/22/678165.html

Latest figures show number of coronavirus deaths has doubled chinadaily.com.cn | Updated: 2020-01-22 22:43 People wearing face mask walk across a street in Wuhan, Hubei province, Jan 21, 2020. [Photo/China Daily] As of 8pm on Wednesday, local government data in Hubei reported a total of 444 confirmed cases of infection with the new coronavirus, including 17 deaths.

As of 8pm on Wednesday, local government data in Hubei reported a total of 444 confirmed cases of infection with the new coronavirus, including 17 deaths. https://www.chinadaily.com.cn/a/202001/22/WS5e285faea310128217272d87.html

Hong Kong reported its second case of coronavirus infection on Wednesday hours after its first report, a source has told the Post. The second case involved a 56-year-old man who has been to Wuhan. An initial test came back positive, and the result of a confirmation test is still pending. The man, who was initially isolated and treated at Prince of Wales Hospital, was transferred to Princess Margaret Hospital, where the Hospital Authority Infectious Disease Centre is located. Earlier, a mainland Chinese tourist on Wednesday became the city’s first confirmed case of the new coronavirus infection, as authorities scrambled to trace four other members of his family who had travelled with him to the city before flying to Manila.

The second case involved a 56-year-old man who has been to Wuhan. An initial test came back positive, and the result of a confirmation test is still pending. https://www.scmp.com/news/hong-kong/health-environment/article/3047193/china-coronavirus-first-case-confirmed-hong-kong

Epidemic situation of new coronavirus infection on January 22, 2020 Published: 2020-01-22Source : Health Emergency Office 　　At 04:00 on January 21, 2020, our committee received 149 newly diagnosed pneumonia cases with new type of coronavirus infection (5 in Beijing, 2 in Tianjin, and 7 in Shanghai). Cases, 5 cases in Zhejiang Province, 2 cases in Jiangxi Province, 1 case in Shandong Province, 1 case in Henan Province, 105 cases in Hubei Province, 1 case in Hunan Province, 12 cases in Guangdong Province, 5 cases in Chongqing City, 2 cases in Sichuan Province and 1 case in Yunnan Province Cases), 3 new deaths (all from Hubei Province); in addition to Hubei Province, 6 provinces (districts, cities) reported 26 new suspected cases (10 in Shanghai, 10 in Zhejiang Province, 2 in Anhui Province, 1 in Guangxi Zhuang Autonomous Region, 1 in Guangdong Province and 2 in Sichuan Province). 　　As of 24:00 on January 21, our committee had received 440 confirmed cases of pneumonia of new coronavirus infection in 13 provinces (autonomous regions, municipalities) in China (10 in Beijing, 2 in Tianjin, 9 in Shanghai, and Zhejiang Province). 5 cases, 2 cases in Jiangxi, 1 case in Shandong Province, 1 case in Henan Province, 375 cases in Hubei Province, 1 case in Hunan Province, 26 cases in Guangdong Province, 5 cases in Chongqing City, 2 cases in Sichuan Province and 1 case in Yunnan Province), of which severe cases 102 cases, 9 deaths (all from Hubei Province); except Hubei Province, a total of 37 suspected cases were reported in 12 provinces (districts, municipalities) (1 in Shanxi Province, 1 in Jilin Province, 1 in Heilongjiang Province, and 10 in Shanghai Cases, 10 cases in Zhejiang Province, 3 cases in Anhui Province, 1 case in Guangdong Province, 2 cases in Guangxi Zhuang Autonomous Region, 1 case in Hainan Province, 5 cases in Sichuan Province, 1 case in Guizhou Province and 1 case in Ningxia Hui Autonomous Region). 　　One confirmed case was reported from Japan, three confirmed from Thailand, and one confirmed from South Korea.

105 new coronavirus confirmations raising total to 375, with another 37 suspect (PCR confirmed by local lab). http://www.nhc.gov.cn/yjb/s3578/202001/a3c8b5144067417889d8760254b1a7ca.shtml

Epidemic situation of new coronavirus infection on January 22, 2020 Published: 2020-01-22Source : Health Emergency Office 　　At 04:00 on January 21, 2020, our committee received 149 newly diagnosed pneumonia cases with new type of coronavirus infection (5 in Beijing, 2 in Tianjin, and 7 in Shanghai). Cases, 5 cases in Zhejiang Province, 2 cases in Jiangxi Province, 1 case in Shandong Province, 1 case in Henan Province, 105 cases in Hubei Province, 1 case in Hunan Province, 12 cases in Guangdong Province, 5 cases in Chongqing City, 2 cases in Sichuan Province and 1 case in Yunnan Province Cases), 3 new deaths (all from Hubei Province); in addition to Hubei Province, 6 provinces (districts, cities) reported 26 new suspected cases (10 in Shanghai, 10 in Zhejiang Province, 2 in Anhui Province, 1 in Guangxi Zhuang Autonomous Region, 1 in Guangdong Province and 2 in Sichuan Province). 　　As of 24:00 on January 21, our committee had received 440 confirmed cases of pneumonia of new coronavirus infection in 13 provinces (autonomous regions, municipalities) in China (10 in Beijing, 2 in Tianjin, 9 in Shanghai, and Zhejiang Province). 5 cases, 2 cases in Jiangxi, 1 case in Shandong Province, 1 case in Henan Province, 375 cases in Hubei Province, 1 case in Hunan Province, 26 cases in Guangdong Province, 5 cases in Chongqing City, 2 cases in Sichuan Province and 1 case in Yunnan Province), of which severe cases 102 cases, 9 deaths (all from Hubei Province); except Hubei Province, a total of 37 suspected cases were reported in 12 provinces (districts, municipalities) (1 in Shanxi Province, 1 in Jilin Province, 1 in Heilongjiang Province, and 10 in Shanghai Cases, 10 cases in Zhejiang Province, 3 cases in Anhui Province, 1 case in Guangdong Province, 2 cases in Guangxi Zhuang Autonomous Region, 1 case in Hainan Province, 5 cases in Sichuan Province, 1 case in Guizhou Province and 1 case in Ningxia Hui Autonomous Region). 　　One confirmed case was reported from Japan, three confirmed from Thailand, and one confirmed from South Korea. 　　At present, 2,197 close contacts have been traced, 765 people have been released from medical observation, and 1394 people are still receiving medical observation.

Shanghai coronavirus cases jump to 19 (9 confirmed and 10 suspect) http://www.nhc.gov.cn/yjb/s3578/202001/a3c8b5144067417889d8760254b1a7ca.shtml

Tourist tests positive for Wuhan virus in Hong Kong 2020-01-22 HKT 19:52 The tourist from Wuhan has tested positive for the new coronavirus, and is being treated in isolation at Princess Margaret Hospital. Photo: RTHK Secretary for Health Sophia Chan on Wednesday said a tourist from Wuhan has tested positive for the new coronavirus that has infected hundreds in the mainland, and killed at least nine. She said officials are waiting for results from confirmatory tests, but said he is "highly suspected" to have contracted the virus. Results are expected on Thursday. The man, 39, had arrived in Hong Kong with his family on Tuesday night, after taking train G1015 from Wuhan to Shenzhen North, then train G1015 to West Kowloon, arriving at 7.54pm. He had sat on seat 10D in carriage three on the journey to Shenzhen North; and on seat 2D on carriage two for his trip to Hong Kong. A new hotline, 2125 2122, has been set up for people who may have been on the same train, or think they may have come into close contact with the patient. People who sat in within two rows of the patient will be sent to quarantine camps for medical observation. Chan said when the man arrived, health inspectors noticed that he was running a fever, and took him to Queen Elizabeth hospital for further tests, before he was transferred to Princess Margaret Hospital, where he remains in a stable condition. Four of his family members, however, stayed the night at the Empire Hotel Kowloon on Kimberly Road in Tsim Sha Tsui before flying to Manila on Cebu Pacific flight 5J 111 on Wednesday morning. All are asymptomatic. However, the hotel has been informed of the situation so they can disinfect the floor in which the tourists had stayed, and officials say the Philippines government will be notified so they can take the appropriate disease control measures. Asked why the family were not quarantined, the Director of Health, Constance Chan, said they had already left by the time preliminary test results for the man became available. Meanwhile, Sophia Chan said the patient also reported that he had not been to the wet market in Wuhan thought to be the epicentre of the outbreak; nor had he been to a hospital, come across wild animals or birds, or anyone with respiratory symptoms. The MTR Corporation has said the train he'd been on, along with part of the West Kowloon terminus that the patient had walked through, have been thoroughly disinfected. Current temperature checks at border crossings will be maintained, Chan said, and additional preventative measures may be taken in future as needed. She said the government will hold an emergency cross-departmental meeting to discuss how to deal with the situation, and give daily press briefings to keep the public apprised of what's happening. Chan said the latest incident demonstrates that Hong Kong's 'stringent' health checks at border checkpoints are effective in identifying suspected cases. However, she said cases elsewhere show that infected people may only develop fevers after they arrive, and urged people who are ill to go see a doctor immediately. She also urged people not to travel to Wuhan unless absolutely necessary, and to keep wearing masks for 14 days after their return. Macau also reported its first case on Wednesday, with the patient a businesswoman from Wuhan who had travelled to the SAR via a high-speed train to Zhuhai at the weekend. ______________________________ Last updated: 2020-01-22 HKT 20:34 https://news.rthk.hk/rthk/en/component/k2/1504257-20200122.htm?spTabChangeable=0

in addition to Hubei Province, 6 provinces (districts, cities) reported 26 new suspected cases (10 in Shanghai, 10 in Zhejiang Province, 2 in Anhui Province, 1 in Guangxi Zhuang Autonomous Region, 1 in Guangdong Province and 2 in Sichuan Province).

Television footage showed the man, wearing a mask, was taken from Queen Elizabeth to Princess Margaret Hospital, where the Hospital Authority Infectious Disease Centre is located. He was on a stretcher pushed by several healthcare workers in full protective gear. The man had arrived in Hong Kong’s West Kowloon high-speed rail terminus on Tuesday. Photo: AP A hospital source said the man also had a runny nose, but did not have symptoms of pneumonia. The MTR Corp said it was notified by the Department of Health’s port health officers that a male passenger took high-speed rail train G5607, from Shenzhen North station to West Kowloon Station. The MTR said the train in question had already taken a new batch of passengers and left West Kowloon station before it was notified by Hong Kong’s port health officers. The MTR Corp had immediately notified relevant units on the mainland to clean and disinfect the seat in carriage No 2 carriage where the man sat, as well as spaces nearby. Explainer | What do you need to know about the new coronavirus in China? 22 Jan 2020 Health minister Professor Sophia Chan Siu-chee will announce further details tonight at 7.30pm.

Hong Kong confirms first case of China coronavirus after man who arrived in city with a fever found positive in two tests Mainland Chinese passenger travelled to city on high-speed rail, having earlier been to Wuhan Tests conducted at Queen Elizabeth Hospital before patient was moved to Hospital Authority Infectious Disease Centre in Princess Margaret Hospital. Elizabeth Cheung andAlvin Lum Published: 5:38pm, 22 Jan, 2020 A mainland Chinese tourist has been confirmed infected by the Wuhan coronavirus. Photo: Handout A mainland Chinese tourist has become Hong Kong’s first infected case of the new coronavirus, sources told the Post on Wednesday. The man arrived in Hong Kong on a high-speed train on Tuesday night and is a citizen of the city at the epicentre of the outbreak, Wuhan. He was found to have a fever on his arrival at the rail terminus in West Kowloon. He tested positive to the virus in two tests at Queen Elizabeth Hospital in Jordan, while a third was still ongoing.

A mainland Chinese tourist has become Hong Kong’s first infected case of the new coronavirus, sources told the Post on Wednesday. The man arrived in Hong Kong on a high-speed train on Tuesday night and is a citizen of the city at the epicentre of the outbreak, Wuhan. He was found to have a fever on his arrival at the rail terminus in West Kowloon. He tested positive to the virus in two tests at Queen Elizabeth Hospital in Jordan, while a third was still ongoing.

Mainland Chinese passenger travelled to city on high-speed rail, having earlier been to Wuhan https://www.scmp.com/news/hong-kong/health-environment/article/3047193/china-coronavirus-first-case-confirmed-hong-kong