2019 Novel Coronavirus (2019‑nCoV): STRATEGIC PREPAREDNESS .
Draft as of 3 February 20202019 Novel Coronavirus (2019‑nCoV):STRATEGIC PREPAREDNESSAND RESPONSE PLAN
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CONTENTSABOUT THIS DOCUMENT 01SITUATION ASSESSMENT 03Epidemiological overview as of 1 February 2020 Risk assessment Recommendations of the Emergency Committee RESPONSE STRATEGY A) Rapidly establishing international coordinationand operational support Partner coordination Epidemiological analysis and forecasting Risk communication and managing the infodemic Laboratory and diagnostics Technical expertise and guidance Pandemic supply chain coordination Travel and trade B) Scaling up country readiness and response operations 03040405060607070708081011Country-level coordination 12Risk communication and community engagement 12Surveillance 12Points of entry 13Rapid response teams 13National laboratory system 13Infection prevention and control 13Case management and continuity of essential services 14Logistics, procurement, and supply management 16C) Accelerating priority research and innovation 17Enhancing global coordination of all relevant stakeholders 17 Support a clear and transparent global researchand innovation priority setting process 17 Build common platforms for standardized processes, protocolsand tools, as well as for sharing specimens, data, and information 17MONITORING FRAMEWORK 19RESOURCE REQUIREMENTS 21
ABOUT THIS DOCUMENTOn 31 December 2019, WHO was alerted to a cluster of pneumonia patients in WuhanCity, Hubei Province of China. One week later, on 7 January 2020, Chinese authoritiesconfirmed that they had identified a novel (new) coronavirus as the cause of the pneumonia(figure 1). The proposed interim name of the virus is 2019‑nCoV.Since the first cases were reported, WHO and its partners have been working with Chineseauthorities and global experts to learn more about the virus, including how it is transmitted,the populations most at risk, the spectrum of clinical disease, and the most effective waysto detect, interrupt, and contain human-to-human transmission.This strategic preparedness and response plan outlines the public health measures thatthe international community stands ready to provide to support all countries to preparefor and respond to 2019‑nCoV. The document takes what we have learned so far aboutthe virus and translates that knowledge into strategic action that can guide the effortsof all national and international partners when developing context-specific national andregional operational plans.Figure 1 Timeline of early stages of 2019‑nCoV outbreak30/12/2019Cluster of cases of pneumonia ofunknown origin reported in Wuhanto China National Health Commission07/01/2020Novel coronavirus isolated11/01/2020First fatal case reported01/01/2020Huanan Seafood Wholesale marketclosed1Draft as of 3 February 202013/01/2020First case reported from Thailand24/01/2020835 cases reported in China(549 from Hubei province).Further cases reported fromall but one province.19/01/2020First case reported in Republicof Korea; two cases in Beijingand one case in Guandong16/01/2020First case reported inJapan12/01/2020Whole genome sequence sharedwith WHO and public; virusdesignated 2019‑nCoV20/01/2020First reports of infection inhealthcare workers caring forpatients with 2019‑nCoV2019 Novel Coronavirus (2019-nCoV): Strategic Preparedness and Response Plan
iStock.com/Robert WeiDraft as of 3 February 20202019 Novel Coronavirus (2019-nCoV): Strategic Preparedness and Response Plan2
SITUATION ASSESSMENTEpidemiological overview as of 1 February 2020 A total of 11953 confirmed cases of 2019‑nCoV have been reported worldwide (figure 2);Of the total cases reported, 11821 cases have been reported from China;In China, 60.5% of all cases since the start of the outbreak have been reported from Hubei Province. The remaining39.5% of cases have been reported from 33 provinces, regions, and cities. After Hubei Province, the second largestnumber of cases has been reported from Zhejiang Province (599 cases);132 confirmed cases have been reported outside of China in 23 countries (figure 2);Of the cases reported outside China, 14 are due to secondary transmission;259 deaths have been reported to date.Epidemiological evidence shows that 2019‑nCoV can be transmitted from one individual to another. During previous outbreaksdue to other coronaviruses, including Middle-East respiratory syndrome coronavirus (MERS-CoV) and the Severe AcuteRespiratory Syndrome coronavirus (SARS-CoV), human-to-human transmission most commonly occurred through droplets,personal contact, and contaminated objects (fomites). The modes of transmission of 2019‑nCoV are likely to be similar.The precise zoonotic (animal) origin of the 2019‑nCoV is still uncertain. The virus has been identified in environmental samplesfrom a live animal market in Wuhan, and some human cases have been epidemiologically linked to this market. Othercoronavirus, such as SARS and MERS, are also zoonotic, and can be transmitted from animals (civet cats and dromedarycamels, respectively) to humans.Figure 2 Distribution of 2019‑nCoV cases as of 01 February 2020The boundaries and names shown ans the designationsused on this map do not imply the expression of anyopinion whatsoever on the part of the World HealthOrganization concerning the legal status of any country,territory, city or area or of its authorities, or concerningthe delimitation of its frontiers or boundaries. Dotted anddashed lines on maps represent approximate border linesfor which there may not yet be full agreement.3Data Source: World Health Organization, National HealthCommission of the People’s Republic of China World Health Organization 2020, All rights reserved.Map Production: WHO Health Emergencies ProgrammeDraft as of 3 February 20202019 Novel Coronavirus (2019-nCoV): Strategic Preparedness and Response Plan
Risk assessmentWHO assesses the risk to be very high for China,high at the regional level, and high at the global level.Factors taken into consideration include: Likelihood of further spread: Human-to-humantransmission, including transmission within families andhealthcare settings, has been confirmed within Wuhan,and in several cities outside China. The outbreak continuesto grow within China at a rapid rate, and now affectsall 31 provincial-level administrative regions. Ordinarilyhigh volumes of domestic and international travel havebeen increased further by travel linked to Lunar New Yearcelebrations. Imported cases continue to be reportedinternationally, with several reported cases of secondarytransmission now confirmed in countries outside ofChina. Limited testing capacity in many countries globally,non-specific symptoms of 2019‑nCoV acute respiratorydisease (the disease caused by 2019‑nCoV infection), andco-circulation of other respiratory pathogens are factorsthat can complicate efforts to detect the virus quickly.Potential impact on human health: The virus cancause severe illness and death, although most casesappear to be mild. However, many uncertainties remain,including the full extent of the current outbreak withinChina, and the full clinical spectrum of illness, includingthe prevalence of mildly symptomatic cases.Effectiveness of current preparedness and responsemeasures: China has dedicated substantial resourcesto public health control measures and clinicalmanagement, and has taken action that has includedthe quarantine of cities, and the widespread suspensionof transport links between population centres. It willbe important to continually assess the extent to whichmeasures are effective and the need to adapt measuresas the situation evolves. Up to now, countries that havereported an imported case have demonstrated efficientand effective disease surveillance and response measures.However, some countries are less prepared to detect andrespond to an imported case. Rumours, misconceptions,and misinformation disseminated online via social mediacan have a negative impact on response measures andhealth-seeking behaviors.Recommendations ofthe Emergency CommitteeOn 30 January 2020, the Director-General of WHOdeclared the 2019‑nCoV outbreak a public healthemergency of international concern under the InternationalHealth Regulations (IHR) (2005), following advice fromthe Emergency Committee. The Director-General andEmergency Committee issued temporary recommendations1to the People’s Republic of China and to other countries.The Emergency Committee also provided advice to WHO,and welcomed a forthcoming WHO-led multidisciplinaryand multi-partner technical mission to China. The missionwill review and support efforts to investigate the animalsource of the outbreak, the clinical spectrum of the diseaseand its severity, the extent of human-to-human transmissionin the community and in healthcare facilities, and effortsto control the outbreak. This mission will provide informationto the international community to aid in understandingthe situation, its impact, and effective public health measuresto respond to the virus. The Committee recommended thatWHO should continue to use its networks of technical expertsto assess how best this outbreak can be contained globally,and intensify support for preparation and response, especiallyin vulnerable countries and regions.iStock.com/izzetugutmen1 Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV), ncov) (accessed 04.02.2020)Draft as of 3 February 20202019 Novel Coronavirus (2019-nCoV): Strategic Preparedness and Response Plan4
RESPONSE STRATEGYThe overall goal of the strategic preparedness and response plan is to stop furthertransmission of 2019‑nCoV within China and to other countries, and to mitigatethe impact of the outbreak in all countries.Taking the above into account, the strategic objectivesof the plan are to: Limit human-to-human transmission, including reducingsecondary infections among close contacts and healthcareworkers, preventing transmission amplification events,and preventing further international spread from China;Identify, isolate, and care for patients early, includingproviding optimized care for infected patients;Identify and reduce transmission from the animal source;Address crucial unknowns regarding clinical severity,extent of transmission and infection, treatment options,and accelerate the development of diagnostics,therapeutics, and vaccines;Communicate critical risk and event informationto all communities, and counter misinformation;Minimize social and economic impact throughmultisectoral partnerships.These objectives can be achieved by:A) Rapidly establishing international coordination to deliverstrategic, technical, and operational support throughexisting mechanisms and partnerships;B) Scaling up country preparedness and responseoperations, including strengthening readiness to rapidlyidentify, diagnose and treat cases; identification andfollow-up of contacts when feasible (with priority givento high-risk settings such as healthcare facilities);infection prevention and control in healthcare settings;implementation of health measures for travelers;and awareness raising in the population thoughrisk communication and community engagement.C) Accelerating priority research and innovation to supporta clear and transparent global process to set researchand innovation priorities to fast track and scale-upresearch, development, and the equitable availabilityof
3 Draft as of 3 ebruary 2020 2019 Novel Coronavirus (2019-nCoV): Strategic Preparedness and Response Plan Epidemiological overview as of 1 February 2020 A total of 11953 confirmed cases of 2019‑nCoV have been reported worldwide (figure 2); Of the total cases reported, 11821 cases have been reported from China; In China, 60.5% of all cases since the start of the outbreak have been .
Annex). We designed candidate diagnostic RT-PCR assays before release of the first sequence of 2019-nCoV. Upon sequence release, the following assays were selected based on their matching to 2019-nCoV as per inspection of the sequence alignment and initial evaluation (Figures 1 and 2). All assays can use SARS-CoV genomic RNA as positive control.
1 Brief summary of evidence of lab-made 2019 nCoV From 2017-2019, a series academic papers about a novel zoonotic coronavirus isolated from bats in Zhoushan, Zhejiang (in short, ZS bat-CoV) were published in
Testing with the CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel is intended for use by trained . version 1.4 software. In the process, the probe anneals to a specific target sequence located between the forward and reverse primers. During the extension phase of the PCR cycle, the 5' nuclease activity of .
Jan 31, 2020 · Note for figure 2: Of the 106 cases reported outside China, seven were detected while asymptomatic. For the remaining 99 cases, information on date of onset is available only for the 62 cases presented in the epidemiologic curve. Figure 3: Epidemic curve of 2019-nCoV cases (n 106) identified o
An outbreak of a novel coronavirus disease-19 (nCoV-19) infection began in December 2019 in Wuhan, China (1). Since then, nCoV-19 spread in 68 different countries in the world (including one cruise ship with 705 documented cases classified as "others"), causing 87.470 cases with 2.990 deaths as of March 1st, 2020 (https://gisanddata.
A new flu-like coronavirus has been reported in several cities around the world in recent weeks. The 2019 Novel Coronavirus (2019-nCoV) is a virus identified as the cause of an out-break of respiratory illness first detected in Wuhan, China. Bein
Jan 11, 2021 · A new flu-like coronavirus has been reported in several cities around the world in recent weeks. The 2019 Novel Coronavirus (2019-nCoV) is a virus identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China
Korean also has a formality system built into the language. That is, the way one speaks to an older person who deserves high respect would be different than the way one speaks to a friend. There are many ways words in a sentence can change depending on the formality of the situation, but the two most common, basic and important things to be aware of are: 1) There are two ways to say “I” or .
