ECDC (Updated) Rapid Risk Assessment On Novel Coronavirus - Jan 26th

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With every passing day there is a growing realization that the window of opportunity for containing the novel coronavirus outbreak in China may be closing - and that we may soon be dealing with a global public health crisis - not just a regional one.

How severe, and how widespread its impact might be remains unknowable, due to the limited data we have.  But as Dr. Nancy Messonnier, Director, National Center for Immunization and Respiratory Diseases said at the end of yesterday's CDC news conference:

"We need to be preparing as if this is a pandemic, but I continue to hope it is not."

This isn't hyperbole, or pessimism. This is simply the only practical approach available to us.  Pandemics can move rapidly in our hyper mobile 21st century, and time will not be our friend should  this coronavirus embark on a world tour (see Sept 2018's WHO/World Bank GPMB Pandemic Report : `A World At Risk').

Yesterday the ECDC issued an updated Rapid Risk Assessment following the detection of the first cases (ex China) imported into Europe, which warns of the potential for more to come.

Risk assessment: outbreak of acute respiratory syndrome associated with a novel coronavirus, China; First cases imported in the EU/EEA; second update

Risk assessment
26 Jan 2020

A novel coronavirus (2019-nCoV) has been isolated and considered the causative agent of the cluster of 2026 pneumonia cases in the area of Wuhan, Hubei province in China, as well as 38 imported cases monitored from other countries around the world. Fifty six deaths have been reported among the cases.

Executive summary

On 31 December 2019, a cluster of pneumonia cases of unknown aetiology was reported in Wuhan, Hubei Province China. On 9 January 2020, China CDC reported a novel coronavirus (2019-nCoV) as the causative agent of this outbreak, which is phylogenetically in the SARS-CoV clade.

As of 26 January 2020, a total of 2 026 laboratory-confirmed 2019-nCoV cases have been reported, 1 988 in China and 38 imported cases from other countries around the world. Fifty six deaths have been reported among the cases. Chinese health authorities have confirmed human-to-human transmission outside Hubei province and 16 healthcare workers are reported to have been infected.

Imported cases in Europe

On 24 January 2020, the first imported cases (3) of 2019-nCoV were identified in France.

The rapid increase in the number of reported cases can be partly attributed to the ongoing improved testing protocols and epidemiological investigations of the Chinese authorities; however, since the original source remains unknown and human-to-human transmission has been documented, further cases and deaths are expected.

Further cases are also expected among travellers from Hubei Province. Therefore, health authorities in Member States should remain vigilant and strengthen their capacity to respond to such an event.

There are considerable uncertainties in assessing the risk of this event, due to lack of detailed epidemiological analyses.

On the basis of the information currently available, ECDC considers that:

• the potential impact of 2019-nCoV outbreaks is high;

• further global spread is likely;

• there is currently a moderate likelihood of infection for EU/EEA citizens residing in or visiting Wuhan, Hubei province, China;

• there is a high likelihood of further case importation into countries with the greatest volume of people who have travelled from Wuhan, Hubei Province (i.e. countries in Asia);

• there is a moderate likelihood of further case importation into EU/EEA countries;

• adherence to appropriate infection prevention and control practices, particularly in healthcare settings in EU/EEA countries with direct links to Hubei, means that the likelihood of a case detected in the EU resulting in secondary cases within the EU/EEA is low;

• the impact of the late detection of an imported case in an EU/EEA country without the application of appropriate infection prevention and control measures would be high, therefore in such a scenario the risk of secondary transmission in the community setting is estimated to be very high.

Risk assessment pneumonia Wuhan China 26 Jan 2020
Open file in new window - EN - [PDF-980.96 KB]

The bulk of the world's preparedness for this coronavirus remains in our government's hands, but two days ago, in Not Too Soon To Be Thinking About Preparedness, I wrote about some of the things you ought to consider doing to prepare in the event this epidemic expands.

Some steps, like buying N95 respirators, are becoming increasingly difficult (see Caught With Our Masks Down (Revisited), although I still see some on the shelves of local retailers. 

On Amazon, many retailers are out of stock, and earlier today I heard from a friend who ordered a box nearly a week ago who received an email from the supplier saying - due to the epidemic in China - they could not deliver and were canceling her order.

  But there are some items - like hand sanitizer, tissues, surgical masks, fever-reducing meds, etc. - that are still readily available, and should be part of your home emergency stash.

Ready.gov recommends:

Before a Pandemic

• Store a two week supply of water and food.
• Periodically check your regular prescription drugs to ensure a continuous supply in your home.
• Have any nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.
• Get copies and maintain electronic versions of health records from doctors, hospitals, pharmacies and other sources and store them, for personal reference. Get help accessing electronic help records.
• Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.

Granted, we've been at the brink of pandemics, wars, and other global crises before, and often the threat has receded.  The 2009 H1N1 pandemic, despite early predictions, turned out to be far milder than expected.

And with luck, that could happen again. 

But by the time we know the ultimate trajectory and impact of this coronavirus, the time to prepare will have pretty much vanished.  The following quote is more than a dozen years old, but it is just as true today as it was in 2006:

“Everything you say in advance of a pandemic seems alarmist. Anything you’ve done after it starts is inadequate." - Michael Leavitt, Former Secretary of HHS