Preventive measures by countries - Coronavirus outbreak - Covid-19 pandemic (2020)

Coronavirus outbreak - Covid-19 pandemic (2020)

Preventive measures by countries

Scientists and health specialists around the globe are trying to stop the spread of a deadly virus that originated in December in the Chinese city of Wuhan. The new corona virus has already been contracted by thousands of people which cause respiratory disease. The death toll is 213, and increases regular. The outbreak was declared a "public-health emergency of international concern" by the World Health Organization (WHO) on 30 January— a warning it reserves for incidents that pose a risk to multiple countries and that involve a concerted international response.

How Many People will the Virus Infect?

The Chinese authorities have locked down cities at the center of the outbreak, and researchers have been swift to share virus data with the World Health Organization and with researchers. But the numbers of cases have increased, and past 9,000 have surged in the past day, mostly in China. This has resulted in one estimate that the virus could infect about 39,000 of the 30 million people living in the Wuhan region. It seems like the virus got out of hand in China, spreading too far, spreading too quickly to really be controlled.

In the best case, fewer people will get infected because the results of the control measures will start kicking in, says University of Hong Kong epidemiologist Ben Cowling. But it's too early to tell if efforts are working to quarantine men, and the common use of face masks. The virus incubation period-up to 14 days is longer than most prevention measures are in place, he notes.

In a worst-case scenario, according to another prediction model, some 190,000 people could get infected in Wuhan. Scientists are particularly concerned by the appearance of fresh outbreaks outside China. The virus has already spread in small, scattered clusters in Vietnam, Japan, Germany and the U.S., but officials were able to isolate the affected people. As of January 30 fewer than 100 cases were reported outside China.

Is the Virus Here To Stay?

It is said to be normal when a virus circulates continuously in a population. In many countries, the viruses that cause chicken pox and influenza are common but outbreaks can be managed through vaccination and holding people at home when they're sick.

One big question is if the corona virus is here to live, too. When attempts to eradicate it fail, then there is a high likelihood it will become widespread. This could mean, as with influenza, that deaths occur every year as the virus circulates, until a vaccine is created. When people who are infected but do not have symptoms will spread the virus, it will be harder to control its spread, making it more likely that the virus will become endemic to them.

Some cases of infected people with no symptoms have occurred, but it is still uncertain whether such asymptomatic or mild cases are normal and whether or how contagious they are. "Probably we are looking at a virus that will be with us for a long time, possibly forever," Mackay says.

Asymptomatic cases differentiate the new virus from related corona virus, which causes severe acute respiratory syndrome (SARS). This virus had a global epidemic in 2002-03 but usually only spread until people were sick enough to need hospital care. When outbreaks were brought under control in hospitals, SARS had been controlled. There's no proof the virus continues to spread in humans, says Mackay.

If control measures are successful, and transmission slows down so that no more than one person infects per infected person, the current outbreak may simply peter out, Cowling says.

Is the Virus Likely To Change?

Some researchers are worried that the pathogen will mutate as China's corona virus spreads so that it can spread more easily, or become more likely to cause disease in young people. The virus has currently caused severe illness and death, particularly in older people, especially those with pre-existing conditions such as diabetes and heart disease. The youngest victim identified so far, is a 36-year-old Wuhan man with no documented pre-existing health conditions.

Kristian Andersen, a Scripps Research infectious-disease expert in La Jolla, California, is not concerned about the virus becoming more virulent. He says viruses are continually mutating as part of their life cycle, but these mutations usually don't make the virus more virulent or cause more serious illness. "I can't think of any cases of this having happened with pathogenic outbreaks," he says.

In cases where a virus moves from one animal host to another species— which is possibly how the current corona virus began infecting humans— there may be a selection pressure in the new host to enhance survival, but that seldom, if ever, affects human disease or the transmissibility of the virus. Some mutations damage the virus, or have no consequence. A 2018 study of SARS in primate chambers showed that his virulence was possibly diminished by a mutation sustained by the virus during the 2003 epidemic.

Scientists have exchanged hundreds of genetic sequences from the latest corona virus strains, and a steady supply of those samples will show genetic changes as the epidemic progresses, MacKay said. "If they change sequence, viruses do not change behavior, and we need to see persistent or consistent virus change," he says.

How Many People Will It Kill?

The fatality rate for a virus— the proportion of infected people who die — is difficult to calculate in the midst of an outbreak as reports are continuously being updated on new cases and deaths. The fresh corona virus has a decease amount of 2-3 percent with 213 deceases so far out of nearly 10,000 infections. This is expressively lesser than SARS, which killed about 10 percent of its infected people. The reported mortality rate for the latest corona virus is likely to decline as mild and asymptomatic cases are detected, virologist Mark Harris at Leeds University, UK, told London's Science Media Centre.

There are no effective drugs against the virus at this time. Two HIV treatments that are thought to target a protein that helps replicate corona viruses are being studied as a cure. Many current medicines that target this role have also been identified by scientists, and numerous intercontinental investigative groups are operating on a serum.

The amount of deceased will also depend on how the large number of cases copes with China's health care system. Putting people on drips and ventilators will make sure they get enough fluids and oxygen while the immune system in their body battles the infection. China is constructing two new hospitals in Wuhan to treat sick people, but if the virus spreads to parts of the world with fewer resources, such as African income regions, their health systems could fail, says Sanjaya Senanayake, an infectious disease specialist at Canberra's Australian National University.

The director-general of the WHO, Tedros Adhanom Ghebreyesus, said his main concern in announcing a global health emergency was that the epidemic could spread to countries with weak health care systems.

If the virus is spreading all over the world, the number of deaths could be significant. For an infectious disease, the current death rate of 2-3 per cent— although not as high as for SARS — is still quite high. The epidemic of influenza in 1918, known as Spanish flu, affected about half a billion people at the time, one-third of the world's population, and killed more than 2.5 per cent of those infected; others reported that as many as 50 million people died. The China corona virus is unlikely to induce such an apocalyptic scenario, because it does not usually infect or kill healthy young people.

How Long Will It Take To Exploit A Serum?

A vaccination is still one year away — at least. A corona virus vaccine may prevent infection and stop the disease from spreading. But it does take time for the vaccines. While new technology, advances in genomics and improved global collaboration have enabled researchers to move at unprecedented pace, vaccine development remains a costly and risky operation. Scientists usually have to start from scratch with every new outbreak. After the 2003 SARS outbreak, it took about 20 months for researchers to get a vaccine ready for human trials. (The vaccine was never needed, because it ultimately contained the disease.) By the 2015 Zika outbreak, experts had brought down the timetable for vaccine development to six months.

Now, they are hoping research from previous outbreaks will help further cut the timeline. Scientists have already researched the current corona virus genome and identified the proteins that are essential to infection. National Institutes of Health scientists, in Australia and at least three companies are working on candidates for vaccines.

If they do not face any unexpected challenges, a Phase 1 trial can be completed within the next three months. The experts warned that it may also take months, and even years, to carry out extensive testing after initial trials that can confirm a vaccine is safe and effective. A vaccine will, in the best case, be made available to the public a year from now.

What if I’m traveling?

Traveling to China at that time is possibly ill-advised. It is not clear how the virus can be transmitted, and who is at the greatest risk of a poor result. Hubei has been given a Level 4 travel advisory by the U.S. State Department which means "do not fly" and is the highest level of alert. For the rest of China, a Level 3 alert is in place. The biggest risk of travel to China right now is that the Chinese government has imposed stringent quarantine and travel bans. That said, if you have to go to China where there are reports of the virus, experts recommend that you wear a mask, wash your hands regularly and avoid anyone who's sick.

Remember that over - the-counter masks do not protect against airborne diseases and masks will be ineffective if the virus mutates to become airborne. In the United States the CDC is closely monitoring the status. There are a total of 165 cases under investigation as of 29 January 2020. Four were upheld. Arizona, Washington, California and Illinois are the states with confirmed cases.

Should I Wear a Surgical Mask To Protect Myself?

If you have a respiratory infection, wearing a mask will help protect the people around you from getting sick by reducing the risk of spreading the infection. And if there is an epidemic, wearing a surgical mask may somehow protect you from infection in a crowd. However, in general, surgical masks are not sufficiently close-fitting to absorb all the air you breathe in, and the heavy-duty N95 respirators are extremely uncomfortable. Experts recommend you regularly wash your hands throughout the day. Stop touching your face, and keep a distance from anyone who coughs or sneezes.

Apparently, the risk of infection in the United States with the latest corona virus is far too small for the general public to start wearing a face mask. If you have signs of a respiratory disease, however, wearing a mask reduces the risk of infecting others. "I've arranged a trip to China; should I go?

I Have a Trip Planned to China; Should I Go?

Do not go. The department of state has warned Americans not to go to China unless it is absolutely necessary. If it is appropriate for visitors to go, the C.D.C. recommends improved precautions: avoid contact with anyone who is ill, as well as with the animals and markets in which they are sold; and avoid eating raw or undercooked meats.

Anyone who is older or has an underlying health problem that raises infection vulnerability should check with a health care provider before making a trip. Considering the outbreak, access to medical care in China may be difficult, and federal officials have warned that new travel restrictions, including quarantine, may be placed upon return. Several airlines have cancelled flights to China and many passengers have been left in limbo when looking for bookings to change or cancel.

What are Health Authorities Doing to Contain the Virus?

It is no surprise that 2020 began a new decade in China with the announcement of a novel threat to corona virus (Covid-19). Changes in human behavior and environmental factors have led over the past three decades to the emergence of more than 30 novel infectious diseases ranging from rotavirus, which causes infantile diarrhea, to Middle East respiratory corona virus syndrome, first identified in 2012. As the human populace remains to grow, demand for agricultural land is increasing, exposing livestock and humans to wildlife infections. Climate change is also changing the environment and animal vector abundance, and rapid expansion of air traffic, people's movement through different borders, political instability and conflicts means that these new diseases can easily spread around the world.

China took drastic measures to prevent people from leaving affected areas, but five million people left Wuhan alone before the restrictions came into effect. On 8 December 2019, the Chinese government confirmed the deaths of 1 patient and 41 others hospitalized with unknown etiology in Wuhan, a city in central China2 with an estimated population of approximately 10 million and a major transport hub3. The government shut down a seafood market known to sell live exotic small animals for food on 1 January 2020, less than a month after the first patients were identified, of which most of the 41 laboratory-confirmed cases were found to have ties.

People were also told to wear the masks in public to prevent the disease from spreading. Two new hospitals are being built for patients with corona virus; the first one opened Monday. Governments around the world have screened new Chinese travelers for signs of illness, and some have gone even further, barring people from China from entering. Most of its borders with China were closed by Russia and Mongolia. Australia has said it will evacuate Wuhan citizens and quarantine them on Christmas Island for 14 days.

A consortium led by Chinese scientists and foreign researchers was quickly coming together in a massive effort of national and international cooperation. These included the Shanghai Public Health Medical Center and Public Health School, Wuhan Central Hospital, China's Center for Disease Control and Prevention (CDC), Huazhong University of Science and Technology, the Wuhan Center for Disease Control and Prevention, the National Institute for Communicable Disease Control and Prevention, and the University of Sydney, Australia.

By 10 January 2020, the group had sequenced and publicly released partial sequences obtained from a Wuhan patient showing at least 70 percent genetic material similarities to severe acute respiratory syndrome (SARS) 5. This openness in sharing information about the sequence is crucial to the production of diagnostic tests and future treatments and vaccinations to help control the outbreak, should it spread widely. The sequences were deposited in GenBank (code MN908947 for accession). Recent findings appear to suggest that the Covid-19 fatality (2 deaths out of 48 laboratory-confirmed cases, or 4.1 percent) may be smaller than that of SARS. A better understanding of the Covid-19 animal reservoir, pathogenesis, epidemiology and clinical continuum also needs to be provided.

The response to this new outbreak by the Chinese Government has been swift and decisive. This indicates a marked departure from public health policies that led to the deaths of 774 people during the 2002 SARS epidemic, the spread of the disease to 37 countries and an economic loss of more than US$ 40 billion over a 6-month period6,7. It is clear that China has made significant progress in responding effectively to disease outbreaks in just less than two decades. First, a notable change in the political stance of public-health has prompted China to accept that a novel corona virus exists quite early on. The Chinese government did not report the irregular new infection to the World Health Organization until 4 months after the first case was identified, in reaction to the 2002 SARS outbreak.

Second, the government was proactive in closing the seafood market in Wuhan, taking lessons from the 2002 SARS outbreak which only came to an end when the palm civet eaten in China was later identified as the source and withdrawn from the markets.

Thirdly, the rapid development of a national and international consortium has helped to diagnose the virus quickly and make the sequences available to the public within a few days. By comparison, on 24 March 2003, 5 months after the first cases were reported in November 2002, the first laboratory sequences indicating a new corona virus was the cause of SARS. The 2002 SARS epidemic clearly demonstrated the vulnerabilities of their leading public health organization, the China CDC program. Nevertheless, once the epidemic ended, through the Field Epidemiology Training Program, the government prioritized improvement of CDC processes, improving public health monitoring and laboratory services, as well as the workforce-development program. No doubt this increase in key public-health systems and facilities will be crucial in the response to the current outbreak of Covid-19. Nevertheless, an assessment performed in 2012 revealed the impressive progress made by China CDC since 2002, resulting in quicker responses to emerging epidemics, with the overall comprehensiveness of public health services increasing dramatically from 47.4% to 76.6%.

China CDC has played a critical role in improving the country's tiered national public-health system. The agency has also acknowledged that global disease risks will impact China; therefore, it is now actively exporting its expertise to help other developing countries better prepare for and respond to emerging pathogen outbreaks, including active support for the 2013 epidemic of West Africa's Ebola virus. C.D.C. teams also support state health investigations of illnesses, including contact monitoring, which ensures that anyone who may have been in touch with an infected person is warned of exposure and monitored. The research will enhance knowledge of the virus and how it can be stopped from spreading. C.D.C. teams have also offered to send experts in public health to China to help with the testing and containment efforts. The strengthening of the Chinese Center for Disease Control and Prevention was a turning point in region outbreak responses. That reflects very important progress and development for the security and diplomacy of global health.

Building Hospitals for Corona virus Care and Treatment

China planned the opening of Dabie Mountain Regional Medical Center, a 1,000-bed hospital, by expediting its building and opening it to people with corona virus symptoms in quarantine on 29 January. It is also building a second quarantine hospital called Leishenshan with up to 1,500 beds in Wuhan.

A new 1,000-bed hospital, called Huoshenshan hospital, has been completed in just ten days to provide better care and treatment for patients with corona virus. The new temporary hospital was opened on 03 February to admit patients.

China has planned to turn 11 facilities across the city of Wuhan, including gymnasiums, exhibition centers and sports centers, into make-shift hospitals with over 10,000 beds to treat patients with mild symptoms. Eight additional sites to be converted into hospitals were announced. On 03 February, the first three hospitals were converted offering 3,400 beds for treating patients.

Furthermore, 20 mobile hospitals and 1,400 nurses from across the country were sent to Wuhan to treat patients with mild symptoms. There was also the construction of an infectious disease hospital in Zhengzhou, Henan Province.

In collaboration with a biopharmaceutical firm developed two diagnostic kits for the novel corona virus antibody by the Wuhan Institute of Virology of the Chinese Academy of Sciences. The infection is detected in just two hours or more using an improved test method developed by Wuhan University's Zhongnan Hospital, which has helped to start care sooner and improve recoveries.

The National Medical Products Administration also licensed on January 26 two diagnostic kits and a test system developed by biopharmaceutical companies based in Hubei. Meanwhile, vaccine development efforts are advancing, with two chemical compounds found to be successful in controlling the viral activity that will help the novel corona virus accelerate drug development. Wuhan Jinyintan Hospital was the earliest to use Kaletra (lopinavir / ritonavir), a treatment for HIV / AIDS, to treat patients with novel corona virus, and to note that it is safe. The Chinese Academy of Sciences has provided open and free access for Chinese researchers to resources and services from the China Science and Technology Cloud (CSTC) to assist in their Covid-19 work. To promote cooperation with co-researchers, researchers must gain access to high-performance computing and software, and other tools.

Baidu Research has allowed gene testing agencies, disease control centers and research institutions to use LinearFold, their RNA structure algorithm that will help understand the virus and screening compounds in less than half a minute compared to roughly an hour before.

Why Africa Should Be Prepared

As of January 20, 2020, the Chinese government announced 136 new cases of infection with this virus that spread to other cities across the country over the weekend, bringing the total confirmed cases to over 200 worldwide (ref. 10). Cases of Covid-19 infection have now been identified in several other countries in the region: a case of Covid-19 infection of a 61-year-old Chinese tourist from Wuhan in Bangkok was registered in Thailand on 8 January 202011. On 10 January 2010, a male patient was confirmed to be hospitalized by the Japanese Ministry of Health and tested positive for the virus. It also reported suspected cases in Hong Kong and Singapore.

The study of the models has suggested that more than 1,700 people could have been contaminated. The study, which had a broad confident interval of 95 percent ranging from 427 to 4,471, made assumptions based on the vast international air traffic from Wuhan, which is a travel hub, and the patients ' incubation periods in Thailand and Japan.

As a consequence of air traffic and vast population movements the rapid spread of Covid-19 in Asia will matter in Africa. Africa was largely spared the SARS epidemic in 2002, as only one case was recorded in South Africa— a businessman who had traveled to Hong Kong. But as a result of the rapid expansion of Chinese investment in Africa18, air traffic between China and Africa has risen by more than 600 per cent in the past decade. For example, Ethiopian Airlines, Africa's largest airline, today operates nearly half of Africa's 2,616 annual flights to China18.

Therefore, African countries need to be on the alert and improve their public-health surveillance and laboratory networks, coordinated by functional national public-health agencies, to better prepare to prevent, identify and monitor any potential spread of the novel virus on the continent, rapidly. Efforts between the Africa Centers for Disease Control and Prevention, based in Addis Abeba, Ethiopia, and China CDC for sharing information on potential people suspected of being sick traveling from China to Africa also need to be more organized.

China's political openness to timely coverage and the discovery of the novel Covid-19 virus, together with the rapid sequencing and public dissemination of the sequences, represents a new dawn for global health security and international health diplomacy. Additionally, there is hope that China CDC's much-strengthened networks will produce a huge return on public health investment in combating the outbreak, should it spread more widely in China. It will also improve health protection for the world, as the global health chain is only as strong as its weakest link, so a threat to disease will easily become a threat anywhere.

List of Countries That Have Restricted or Banned Chinese Tourists or Visitors

On 2 February 2020, the US released the highest level of travel advisory (level 4) and instructed its citizens not to fly to China. It also encouraged US people in China to leave as far as possible through commercial means or stay home while avoiding contact with others. On 1 February 2020, Australia announced strengthened border control measures to curb the spread of the virus. All incoming passengers are subject to enhanced screening measures and, as of 1 February 2020, passengers leaving China are denied entry. The trip excludes Australian nationals, permanent residents and members of their immediate family.

New Zealand imposed temporary travel restrictions for all foreign nationals coming from China into the country. The limits were set for up to 14 days and should be checked every 48 hours.

On 3 February 2020, Maldives announced new border security measures to limit the entry of all passengers from China, except Maldivian nationals or those who have transited through China. Maldivians were also warned against non-essential travel to China and other countries affected by the virus.

Indonesia, Israel, Iraq, Italy, Honduras, El Salvador Oman, Saudi Arabia, Russia, Japan, Vietnam, Singapore and Pakistan are some of the other countries that either have placed travel restrictions or cancelled direct flights to China, as stated by the BBC and Reuters.

Fiscal Measures to Minimize Economic Impact: Liquidity Infusion and Tariff Cuts

Cuts Corona virus outbreaks will have a greater negative impact on the global economy than the outbreak of SARS (Severe Acute Respiratory Syndrome) in 2003, as any recession in the Chinese economy would not send ripples but waves around the globe, IHS Markit said Friday.

The epidemic has brought to a standstill large part of the world's second-largest economy and its influence has been felt through industries. Corona virus will have a greater negative impact on the global economy than was the 2003 SARS outbreak. China was the sixth biggest economy at the time of SARS, accounting for only 4.2 per cent of world GDP. China is now the second-largest economy in the world, accounting for 16.3 per cent of global GDP. Therefore, any downturn in the Chinese economy does not send ripples but waves across the globe, "IHS said in a commentary on corona virus outbreak.

In this case, the corona virus and the subsequent measures will reduce global real GDP by 0.4% in 2020. On the other hand, if containment measures begin to rise on February 10, the impact on global GDP will be more minimal, leading to 0.1 per centimeter.

The effects of corona virus in household consumption are most pronounced and somewhat mitigated in the industrial sector because factories are seasonally idle during this time period. Nonetheless, China's economy today is more fragile in many ways than it was in 2003, with production and overall economic growth already slowing and the consequences of the trade dispute between the US and China, "it said.

Because SARS and its effect on the world economy are now much bigger, China's GDP has risen dramatically.

Chinese growth slowdown can be a significant drag on global growth. China contributed 23 per cent of global GDP growth in 2002, with China contributing an additional 38 per cent of world growth in 2019, "IHS said.

The People's Bank of China (PBOC) publicized strategies to carry out RMB1.2tn ($173bn) reverse repurchase operations to ensure an adequate supply of liquidity to the economy. The current liquidity in the banking system is RMB900bn ($129bn) more than the one registered in the previous year during the same time. China is also expected to announce tariff reductions on essential goods imported from major countries like the US, in order to ensure supplies despite the recent trade war between the two countries.

Non-Fiscal Measures

The Chinese Trade Ministry ensures that adequate stocks of beef, pork and other essential food items are maintained in order to avoid shortages. Amid preventive safety measures by some of the biggest and busiest international airports to prevent corona virus from spreading after its outbreak in Wuhan, China, many others took similar action. The corona virus spread to 25 more countries in a month, prompting border closures and a number of countries declared health emergencies.

CDC Response

To counter this public health issue, the federal government works closely with state, local, tribal, and territorial partners, as well as public health agencies. The approach to public health is multi-layered, with the goal of identifying and mitigating introductions of this virus in the United States to reduce the spread and effects of this virus. On 7 January 2020, CDC developed a Covid-19 Incident Management Program. CDC activated its Emergency Operations Center on January 21, 2020 to help provide continued support for the Covid-19 response.

CDC released revised health advice for China on January 27, 2020, recommending that travelers avoid all non-essential travel to all of the country (Level 3 Health Notice).

The U.S. government has taken unprecedented travel measures in response to the growing threat posed by this emerging corona virus to public health: effective February 2, 2020 at 5 pm, the U.S. government has prohibited the entry of foreign nationals who have been in China for the past 14 days.

U.S. citizens, visitors and their immediate family members who have been to Hubei Province and other areas of mainland China are permitted to enter the U.S., but are subject to health monitoring and potential quarantine for up to 14 days. On 1 February 2020, the CDC released an interim Health Alert Network (HAN) update to notify state and local health departments and health professionals about this outbreak.

On January 30th, 2020, CDC released guidelines on the clinical care of Covid-19 patients for health care professionals. CDC released guidelines on February 3, 2020 to determine the potential risk for different exposures to Covid-19 and to treat those people appropriately.

CDC has sent multidisciplinary teams to Oregon, Illinois, California, Arizona and Wisconsin to support hospital care, information finding, and outreach divisions of safety. CDC developed a real-time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR) test that can diagnose Covid-19 from clinical specimens in both respiratory and serum samples. CDC publicly posted the assay protocol for that study on January 24, 2020. The CDC sent to the United States an Emergency Use Authorization (EUA) kit, food and Drugs Administration for their check on 3 February 2020. On 4 February 2020 the FDA approved the EUA. On February 5, 2020, CDC test kits were available to order through the agency's International Reagent Service External symbol from domestic and international partners. When sequencing was done, CDC submitted the entire genome of the viruses from reported cases in the United States to GenBank. CDC has developed the Covid-19 virus in cell culture that is required for additional studies, including further genetic characterization. The cell-grown virus has been sent to the NIH BEI Tool symbol for the large scientific community to use.

Travelers from China Arriving in the United States

CDC is collaborating with public health agencies to implement new travel protocols reported in a Presidential Proclamation on Novel Corona virus to slow the spread of 2019 novel corona virus into the United States. Will summarize:

  1. Foreign nationals visiting China in the past 14 days are not allowed to enter the United States.
  2. American citizens, lawful permanent residents, and their families who have been in China for the last 14 days will be allowed to enter the United States, but will be diverted to one of 11 airports to undergo health screening. We will have some form of limits on their movements for 14 days, depending on their safety and travel background, from the time they leave China.

If you are in the second group above and are flying to the U.S.:

  • Your travel will be diverted to one of 11 U.S. airports where CDC has quarantine stations
  • We'll ask you about your health and your work.
  • Your well being is checked for fatigue, cough or breathing difficulties.

Based on your safety and travel history:

  • For a cycle of 14 days from the time you exited China you will have certain limits on your movement.
  • Such measures are being taken to protect your safety, other travelers ' health and the health of U.S. communities from the current corona virus that is spreading from person to person in parts of China.

Travelers who have been in Hubei Province for the past 14 days:

If you have fever, cough, or breathing problems, you will be checked for illness by CDC workers at the airport. They will drive you to a medical facility for further examination and care. Your travel itinerary won't be complete.

If you have no symptoms (fever, cough, breathing problems): you will be put under a federal, state, or local quarantine order for a maximum of 14 days from the time you left China. You might not have the chance to complete your travel itinerary until the time of 14 days is finished.

Travelers from other parts of China (outside the province of Hubei) in the last 14 days: if you have fever, cough, or breathing problems: CDC workers at the airport will test you for illness. They will drive you to a medical facility for further examination and care. Your travel itinerary may not be complete.

If you have no symptoms: you will reach your final destination. When you arrive at your final destination, you are asked to monitor your health for 14 days from the time you left China. You will receive a health information card telling you what symptoms to watch for and what to do if symptoms arise. You will stay home during that time and restrict as much contact with others as possible. You will be contacted by the State or local health department for further follow-up.

Interim Considerations for Disposition of Hospitalized Patients with Covid-19 Infection

There is currently limited information available to describe the scope of clinical illness, the efficiency of transmission and the length of the Covid-19 infection viral shedding. On the basis of available Covid-19 knowledge and what is known about associated corona viruses (MERS-CoV and SARS-CoV), interim guidance for the disposition of hospitalized patients with Covid-19 infection was established. When new information becomes available this advice is subject to change. The following attempts to act as a guide for the treatment of patients. All patients should be handled on a case-by-case basis and addressed with health care providers and public health agencies about their attitude.

For Hospitalized Patients with Confirmed Covid-19 infection:

  • Usually, in an Airborne Infection Isolation Room (AIIR), hospitalized patients with confirmed Covid-19 infection should be managed using Normal, Contact, and Airborne Precautions with eye protection.

  • If no immediate AIIR is available, consideration should be given to moving the patient to an AIIR facility. The patient should be cared for in a single-person room and the door should be kept closed if relocation is necessary or not medically acceptable. Ideally, the space should have no exhaust, which is re-circulated within the building without filtration of high-efficiency particulate matter (HEPA). Healthcare staff should still use boots, mask, breathing and eye protection and follow all other approved procedures in the prevention and control of infections when caring for these patients.

  • If there are inadequate AIIRs for patients with reported Covid-19 infection, prioritization should be provided to existing AIIRs for patients with symptoms of severe illness (e.g., people needing ventilator assistance).

  • The decision to discontinue Transmission-Based Precautions for Covid-19 hospitalized patients should be taken on a case-by-case basis in conjunction with physicians, infection prevention and control professionals and public health officials and should consider the seriousness of disease, the signs and symptoms of disease and the findings of the Covid-19 laboratory test in respiratory specimens. Considerations to discontinue Transmission-Based Precautions include meeting all the following: o Relief of fever, without use of antipyretic medication or Improvement of disease signs and symptoms o Negative results of Covid-19 rRT-PCR examination from at least two consecutive respiratory tracts (nasopharyngeal swab and throat swab) specimens obtained within 24 hours*. For 2019 Novel Corona virus (Covid-19), see Interim Guidelines for the Selection, Treatment, and Testing of Clinical Specimens from Persons under Investigation (PUIs). As more information becomes available, initial guidance is based on limited knowledge and is subject to change. In persons with chronic active cough, sputum specimens may detect Covid-19 RNA for longer periods than the upper respiratory tract specimens (nasopharyngeal swab and throat swab).

For Non-Hospitalized Patients with Confirmed Covid-19 infection:

  • Wherever clinically indicated, patients may be discharged from the health care facility.

  • Isolation at home should be maintained when the patient returns home before the decision to discontinue Transmission-Based Precautions is made. The decision to send the patient home should be taken in consultation with the patient's clinical care team and local or state departments of public health and should include considerations of: the suitability of the home for and the ability of the patient to meet the guidelines for home isolation, and the potential risk of secondary transmission to household members with immune compromising conditions. See CDC Interim Home Care Guidelines for patients with reported nCoV infection and those under review for nCoV infection and Interim Guidelines for Preventing Covid-19 from Spreading to Others at Homes and Communities.

Hospital Preparedness Checklist for Suspected or Confirmed Covid-19 Patients

All U.S. hospitals must be prepared for the 2019 (Covid-19) patients with suspected or confirmed novel corona virus. All hospitals should be prepared and ready to:

  • Prevent the spread of Covid-19
  • Classify and isolate patients with Covid-19 and notify key facilities personnel and public health authorities
  • Care for a small number of patients with Covid-19 identified or suspected as part of routine operations
  • Care for a larger number of patients with escalating transmission
  • Outline plans for Covid-19
  • Track and handle healthcare workers potentially exposed to nCoV in 2019

  • Handle effects on patients, facilities and healthcare staff

The format of the checklist is not intended to prescribe mandatory requirements or set national standards.

  • Ensuring that the infection prevention and control policies of the facility are in line with the Covid-19 guidance from the Centers for Disease Control and Prevention.
  • Review protocols for the rapid detection and isolation of suspected Covid-19 patients,
  • Ensure the ability to carry out triage activities based on public health guidelines, including at the hospital and using remote (i.e., cellular, internet-based) methods to reduce pressure on the health care system where applicable.
  • Ensure that airborne infection negative pressure isolation rooms are available and function properly, and are adequately monitored for airflow and exhaust handling.
  • Assess the availability of personal protective equipment (PPE) and other infection prevention and control devices (e.g. hand hygiene supplies) to be used for the safety of both healthcare personnel (HCP) and source control for infected patients (e.g., patient facemask).
  • Provide contingency plans if the supply exceeds the need for PPE or other supplies;
  • Review plans to implement surge efficiency practices and crisis care requirements.
  • Check protocols for the delivery of Covid-19 research specimens to laboratory.
  • Assess the effectiveness of environmental cleaning procedures; provide training / refresher training for staff working in environmental services.
  • Review policies and procedures for monitoring and managing HCP with potential for Covid-19 exposure, including ensuring that HCP has ready access to medical consultation, including by telephone;
  • Ensure that suitable HCP has been cleaned medically, tested and trained for respiratory use.
  • Include HCP awareness and refresher training on Covid-19 identification, how to obtain specimen testing, and correct PPE use, triage protocols including patient location, HCP sick leave policies, and how and to whom Covid-19 cases should be identified, procedures for taking unprotected exposures to suspected Covid-19 patients at the facility (i.e. not wearing the required PPE).
  • Review visitor access and movement plans within the facility
  • Ensure that the facility has designated specific persons responsible for communicating with public health officials and disseminating information to other HCP officers at the facility.
  • Confirm local or state health department contacts and confirm reporting requirements for Covid-19 incidents.
  • Monitor the situation on CDC's web page 2019 Novel Corona virus, Wuhan, China

How Airports and Airlines Are Guaranteeing a Secured Travel

Some of the world's largest and busiest international airports have started to announce preventive safety measures against corona virus spread in China following its outbreak and rapidly spread to 25 more countries. The corona virus has crossed borders, reporting cases in more than 24 countries including the United States, Canada, United Kingdom, Russia, Germany, France, Japan, India, South Korea, Hong Kong, Macau, Thailand.

Having completed the first case of a Wuhan corona virus on 21 January, followed by a second on 24 January, the Center for Disease Control (CDC) officially announced measures against corona virus by three international airports each in the US and Canada to prevent its spread, with European airports taking similar steps too. Due to the rising increase of the virus, the CDC extended the screening into 20 airports within a week.

United Airlines announced on 1 February the cancelation of several scheduled flights from US hubs to Beijing, Hong Kong and Shanghai expecting lower demand due to nCoV concerns. On 24 January to 29 February, the airline also declared travel waiver, initially to China and later to Hong Kong. American Airlines, the world's largest carrier, followed suit too, and reported similar cancellations to Beijing and Shanghai, but through March for an even longer period.

Different cancelations of select flights were announced by Air Canada to maximize its capacity based on reduced demand. British Airways suspended direct flights from and to China, following confirmed cases of infection with corona virus in France and Germany. In addition to isolating those with the symptoms of the disease, the Changi Airport in Singapore has initiated thermal screening for passengers arriving from China. Indigo Airlines and Air India cancelled majority flights to China, even before the nation reported the first case on 30 January.

Intensive measures being taken at Chinese airports

Aggressive action at Chinese airports has begun China to take aggressive action including shutting Wuhan outbound traffic as millions of people, including local and international visitors, are expected to travel on the occasion of the Chinese Lunar New Year on January 25. Covid-19 cases of people traveling to Wuhan were also reported in Beijing and Guangdong. Airports across China have begun screening travelers and accepting for special cares immediately those with even the simplest of symptoms. Three mostly affected of the ten provinces host China's busiest airports.

Rigorous passenger screening in Thailand

Thailand is conducting thermal screening at all of its 28 airports operated by the Department of Airports (DOA), which has guided thermal scanners and thermometers to be used. At U-Tapao Rayong-Pattaya International Airport, which is also operated by the Royal Thai Navy, thermal scanning is carried out. Across all airports and tourist destinations, sanitation initiatives are being enforced.

Measures at Hong Kong international airport

Hong Kong quarantined Wuhan traveler who was discovered with symptoms of corona virus to prevent the spread of the novel Corona virus disease (nCoV). Among tourists, the virus arrives at a busy holiday time. International airport in Hong Kong, which had already experienced a decrease in passenger traffic in 2019 as a result of anti-government demonstrations, is taking immediate action to prevent the future epidemic.

Aircraft flying from Wuhan to Hong Kong are parked in a specially designated field. Cleaning and disinfection are rapidly increasing for passengers coming from Wuhan at the arrival terminal, as stated by Time. Meanwhile, Hong Kong flag carrier Cathay Pacific and Hong Kong Airlines plan to cut flights to China and have begun to allow passengers who booked to / from Wuhan to reschedule their trips at no cost.

Turkey: Thermal screening at airports and flight cancellations

Turkey began screening using thermal cameras at all major airports including Istanbul airport. Turkish Airlines flagship carrier cancelled flights to China until February 09. Turkey has also taken safety measures against corona virus across its ports.

Corona virus care at South Korean airports

In addition to disinfecting aircraft more regularly, hazardous material suits are being provided to airline crews flying to and from South Korean airports after the first case of corona virus infection have been identified in South Korea.

Screening at Heathrow, Paris and other European airports

Three European airports provide direct flights from major cities like London, Rome and Paris to Wuhan. Airlines like China Southern and Air France provide year-round non-stop flights into Europe. A special area at Terminal 4 has been approved by London Heathrow Airport to screen passengers arriving from Wuhan and search for, as well as notify passengers of the symptoms. The European Union Aviation Safety Agency (EASA) has proposed that airlines have Universal Security Kits for crew flying to / from the countries affected.

Increasingly, United States and Canadian airports scan for corona virus infection; the US imposes a temporary travel ban on Chinese people. International airports John F. Kennedy, Los Angeles and San Francisco were the first to start screening for corona virus followed by international airports O'Hare and Hartsfield-Jackson. Within a week the screening expanded to a minimum of 20 airports across the US.

Canadian airports like Toronto International Airport, Montreal International Airport and Vancouver International Airport have confirmed that international passengers will be required to undergo additional screening such as temperature and other symptomatic tests, and to ask about their trips to Wuhan to check for the likelihood of contracting the infection. The US has also placed a ban on tourists traveling to China with a recent travel history.

Thermal screening at Indian airports

The Civil Aviation Ministry of India initially announced several preventive measures against Wuhan corona virus at 11 airports including Chennai, Vishakapatnam, Bengaluru, Bhubaneswar, Hyderabad, Cochin, Delhi, Mumbai, Amritsar, Kochi, and Kolkata. Thermal screening has been expanded to 20 airports, with rapid spread of the infection to other countries. Passengers arriving in Chinese cities such as Wuhan in the preceding 14 days and with signs of viral infection are asked to make a self-declaration, while international passengers from China and Hong Kong are being screened at the airport's pre-immigration areas. Thermal cameras were mounted, and airport signage was shown at all airports. Kerala is India's State with the highest number of perpetrators of corona virus.

Corona virus screening at New Zealand, UAE and Iranian airports

Screening stations were set up at New Zealand's Auckland and Christchurch airports, with further steps planned to be introduced in future. Big UAE airports like Abu Dhabi and Dubai have commenced passenger thermal screening on direct flights from China. Imam Khomeini International Airport in Iran has also undertaken patient health screening.

Measures at Australian airports

Similar to the US, Australia closed borders with visitors arriving from China and foreigners who have a recent history of traveling to China, while Australians returning from China are being checked before allowing entry into the country. Numerous flights from China to Australia have been diverted, although Australians staying in the affected Chinese cities including Wuhan are brought back in special evacuation planes. Major airlines like Qantas have announced that they would cancel services to Chinese cities like Beijing and Shanghai.

Travel restrictions in Trinidad and Tobago against corona virus

It has been declared by the Government of Trinidad and Tobago that travel restrictions on Chinese travelers, disallowing them for 14 days from the date of departure. Thermal cameras, both handheld and fixed, are mounted at all airports, including Piarco International Airport and guidelines for infectious diseases are being enforced through them, the Ministry of Health, Trinidad and Tobago reported. The health ministry also urged its citizens to postpone travel to countries affected by the corona virus.

How airports perform thermal screening of passengers

Airports perform passenger thermal screening to detect fevers caused by infections like CoV, swine flu and influenza (such as H1N1). Using thermal imaging and temperature measuring equipment such as the FevIR Scan, thermal screening is carried out using mass screening systems which measure the skin temperature at high speed. Such quick mass-screening ensures safety measures are taken without causing passengers delays and discomfort.