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Coronavirus Bulletin Significant Disease Outbreak Update

World Health Organization (WHO) Definesthe Current Outbreak as a Pandemic
WHO’s characterization of COVID-19 as a pandemic was accompanied by a very careful message from the
Director-General: the characterization does not change either the WHO assessment of the threat or the
responses required. It was stressed that all countries can still change the course of the outbreak, and the
priorities remain to detect, test, isolate and treat cases, and trace contacts. It does not represent a shift from
containment to mitigation, and WHO urges that containment is still the priority, pointing out that 81 countries
have no cases, 57 have 10 or fewer cases, and that 90% of the global cases are in 4 countries.
WHO also underlined the significantly declining epidemics in China and South Korea.
U.S. Suspends Entry of Foreign Nationals from European Countries
President Trump signed a Presidential Proclamation that suspends the entry of most foreign nationals who have
been in certain European countries at any point during the 14 days prior to their scheduled arrival to the United
States. These countries, known as the Schengen Area, include Austria, Belgium, Czech Republic, Denmark,
Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg,
Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, and Switzerland. This does not
apply to legal permanent residents, (generally) immediate family members of U.S. citizens, and other individuals
who are identified in the proclamation.
Italy Closes All Shops, Except Food Stores and Chemists
Prime Minister Giuseppe Conte of Italy ordered bars, restaurants, hairdressers, and non-essential
company departments would also close. At present, visitors to the country are able to travel home,
however several airlines have suspended flights for up to a month.
U.K. COBRA Emergency Committee Move Towards a ‘Delay’ Strategy
The U.K. government’s COBRA Emergency Committee met March 12, 2020. They announced that the current
phase of the pandemic in the U.K. is causing the government to move to a “delay” strategy. Although the
policy of contact tracing and isolation will continue, interventions designed to delay the community spread
of the virus will be put into place. The aim is to slow the spread, reduce the immediate burden on the health
service, and allow time for intensive care capacity to be increased.

2. Social controls are expected to predominate in this phase and may include curtailment of public gatherings,
school and college closures, and asking companies to enable home working. In a press briefing today, both the
Prime Minister and the Chief Medical Advisor stressed the importance of the timing of the response for
maximum impact. Allergy and Infectious Diseases Director Anthony S. Fauci Warns Against Complacency

On March 11, 2020, U.S. National Institute of Allergy and Infectious Diseases Director, Anthony S. Fauci,
warned against complacency at a hearing on Capitol Hill saying, “If we are complacent and don’t do really
aggressive containment and mitigation, the number could go way up and be involved in many, many millions.”

Case Numbers – as of 03/17/2020 (https://coronavirus.jhu.edu/):
Total Confirmed – 196,106
Total Deaths – 7,869
Total Recovered – 80,840
With total cases at approximately 196,000, active cases at approximately 115,000 and recovered cases near
81,000. 70% of active cases are outside China and are in Italy, Iran, Spain, Germany, South Korea and
France. Deaths now total over 7,800 globally, primarily in China, Italy, Iran and Spain.
Note: The deaths in Korea are 81 representing a much lower proportion of the identified cases, presumably
because of the very successful drive to identify community cases.

Author
Dr. Geoff Tothill, MB, BS, FRCP Edin. FFTM RCPS Glas. Cert AvMed
Chief Medical Officer
International Medical Group
Akeso Care

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