China: Beijing's New COVID-19 Cluster

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Although the numbers we get out of China are highly suspect, it does appear that for the past 3 months COVID-19 activity on the Mainland has been largely suppressed, with most cases attributed to infected travelers arriving from other countries.

There have been a few exceptions, including two small clusters reported in early May:

Jilin City, China On Lockdown After Small Uptick In COVID-19 Cases

Wuhan Ordered To Test All Residents Following New COVID Spike

Yesterday, however, reports began to filter out of China (see FluTrackers' Thread) of a fresh outbreak linked to a market in Beijing. Some local schools have been closed, and sporting events canceled, as the city has reportedly gone to a `war footing'. 

Last night the World Health Organization published the following news item:

A cluster of COVID-19 in Beijing, People’s Republic of China

13 June 2020
News release

WHO is following up with Chinese authorities about a cluster of COVID-19 cases in Beijing, People’s Republic of China.

Today, officials from the National Health Commission and Beijing Health Commission briefed WHO’s China country office, to share details of preliminary investigations ongoing in Beijing.

As of 13 June, 41 symptomatic laboratory confirmed cases and 46 laboratory confirmed cases without symptoms of COVID-19 have been identified in Beijing.

The first identified case had symptom onset on 9 June, and was confirmed on 11 June. Several of the initial cases were identified through six fever clinics in Beijing.

Preliminary investigations revealed that some of the initial symptomatic cases had a link to the Xinfadi Market in Beijing. Preliminary laboratory investigations of throat swabs from humans and environmental samples from Xinfadi Market identified 45 positive human samples (all without symptoms at the time of reporting) and 40 positive environmental samples. One additional case without symptoms was identified as a close contact of a confirmed case.

All cases are in isolation and under care as needed, and contact tracing is underway. Genetic sequencing of samples is also underway and rapid sharing of these results is important to understand the origin of the cluster and links between cases.

WHO has offered support and technical assistance, as well as requested further information about the cluster and the investigations underway and planned.

Beijing's Centers For Disease Control has released a detailed listing of 36 new cases (see below), with the following summary:

From 0:00 to 24:00 on June 13th, 36 new cases of newly diagnosed coronary pneumonia and 1 positive tester were added in our city. Among the confirmed cases, 15 were male and 21 were female; 8 were from Beijing and 28 from other provinces; 30 are currently living in Fengtai District, 4 are in Daxing District, 1 is in Fangshan District, and 1 is in Xicheng District; working in Xinfadi Market Of the 27 cases, 9 cases were directly or indirectly exposed to the new market; 11 cases were found through active medical treatment, and 25 cases were actively found through traceability screening. The main situation is now reported as follows:

          (Continue . . . )

Interestingly, the oldest case was 61 (M), and of the 36 cases, 27 are under the age of 50. 

We've this report from the Beijing Municipal Health Commission, providing instructions to local officials on the required response.

Further strengthen the management of fever clinics and hospital infection prevention and control during the epidemic

Release Date: 2020-06-14
Source: Beijing Municipal Health Commission

After new confirmed cases of coronary artery pneumonia were added in our city on June 11, the medical security team took the following measures to strengthen the management of fever clinics and hospital infection prevention and control:

First, strict management of fever clinics. Require all medical institutions in the city, especially the 79 medical institutions (including 6 military units) that have issued hot clinics, to perform new coronavirus nucleic acid and antibody tests and CT and blood routine tests (referred to as 1+3 tests) for all fever personnel who have visited the clinic. Strengthen inquiries about relevant epidemiological history, especially whether you have visited places such as Xinfadi and other farmers' markets in the past 14 days.

While waiting for the results of the inspection, the patient must strictly regulate the management on the spot. Require all medical institutions to make outpatient consultations without refusal; without the approval of the health and health administrative department, they must not stop, monitor the number of medical staff at any time, and report to the health and health administrative department of the jurisdiction when an abnormal increase in medical staff is found, and take emergency measures Disposal measures, give full play to the role of fever diagnosis probe and outpost.

The second is to strengthen the prevention and control of hospital sense. Strengthen the implementation of 16 measures for the prevention and control of Beijing courts. In particular, medical institutions are required to further strengthen the training of all medical personnel, strictly implement the national and Beijing medical personnel protection guidelines, strengthen the protection of personnel in key places such as pre-examination triage points, hot clinics, and observation areas to minimize the risk of medical staff infection.  

It is required that hospitals that have received confirmed cases of new coronary pneumonia quickly carry out investigation and disinfection, comprehensively investigate medical personnel and other relevant personnel who are in contact with the confirmed cases, and do a good job in disinfecting the wards.

For example, a total of 79 medical personnel and other staff who had contact with confirmed cases such as Xuanwu Hospital and Boai Hospital were tested for nucleic acids, and the results were all negative. On June 13, eight city-level hospital experts were dispatched to conduct further on-site guidance and inspections on the prevention and control of hospitals in relevant hospitals.

In the next step, we will continue to strengthen the supervision and inspection of medical institutions with the district health committees, and do our best to check the patients with new coronary pneumonia, while improving the level of hospital prevention and control to ensure the safety of doctors and patients in the city. In addition, some hospitals are carrying out the transformation and promotion of fever clinics in accordance with the requirements of the "Three-year Action Plan for Strengthening the Construction of the Capital Public Health Emergency Management System (2020-2022)".

While there are obvious similarities to the Wuhan outbreak (both were initially linked to a fresh food market) - and the Chinese media seems to be playing up reports that the virus was detected on cutting boards used to prepare `imported salmon' - it is far from clear where this new outbreak stems from.

Salmon are an unlikely host for this mammalian adapted virus, and it seems far more likely that these environmental surfaces were contaminated by infected humans, rather than fish. 

Nevertheless, local media reports indicate that all salmon, sushi, and many other types of seafood have been removed from the market. 

Unlike in Wuhan, there won't be any delays or half measures taken by Beijing to stop this outbreak. Local officials are well aware how precarious their positions would be if they failed to contain an outbreak in the capital city. 

That said, the reappearance of COVID-19 in Beijing isn't that much of a surprise, and it should remind us that this virus won't go away without a prolonged, and difficult, fight.