COVID-19 Updated Data & Developments - March 18, 2020

Nomenclature

The novel (new) coronavirus, formally named “SARS-CoV-2,” and the disease it causes has been named “coronavirus disease 2019” (abbreviated as COVID-19) by the World Health Organization.

What is coronavirus?

Coronavirus is a family of viruses that have been known to infect humans. Viruses in the family are known to cause the common cold, SARS, and MERS. The virus that causes COVID-19 infects people and is easily spread person-to-person but is far less virulent than SARS. Cases have been detected in most countries worldwide, including the United States, and has officially been declared a pandemic, or a global disease outbreak. COVID-19 causes a respiratory disease that may be identifiable by dry coughing, breathing difficulties, and fever. Those that suspect they are infected with coronavirus should call their health provider first and should not go to a health care facility unless directed to do so.

Why did the CDC recommend an 8-week moratorium on in-person gatherings?

On Monday the US government officially recommended that people should avoid in-person gatherings of 10 or more people.¹ This recommendation is supported by evidence from South Korea and China, both of which appear to slowly be returning to life as normal after 8 weeks of anti-coronavirus measures. ² On March 10, China closed the last of its temporary emergency hospitals ³ after seeing a dramatic decrease in new cases over the past couple of weeks. ⁴ Likewise, South Korea has experienced a substantial decrease in new cases over the past week.⁵

As the United States contends with this new and evolving situation, it appears likely that many businesses, offices, and schools will remain closed for longer than two weeks.

Information highlights from CDC website⁶

• Symptoms
  • Symptoms may appear 2-14 days after exposure.
    • Fever
    • Cough
    • Shortness of breath
• Testing⁷
  • As of March 15, all 50 states, the District of Columbia, and Guam have successfully verified COVID-19 diagnostic tests in state and local public health laboratories.
  • A number of states have opened “drive-through” coronavirus testing stations with more to come.⁸

How is coronavirus spread?⁹

• Person-to-person

Guidelines from the CDC to Minimize Chances of Infection¹¹

• Clean your hands often
• Avoid close contact
  • Avoid close contact with people who are sick
  • Put distance between yourself and other people if COVID-19 is spreading in your community. This is especially important for people who are at higher risk of getting very sick.
• Take steps to protect others
  • Stay home if you’re sick
    • Stay home if you are sick, except to get medical care. If you think you may have contracted the virus call your doctor first.
  • Cover coughs and sneezes
    • Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
    • Throw used tissues in the trash.
    • Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
  • Wear a facemask if you are sick
    • If you are sick: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a facemask if they enter your room. Learn what to do if you are sick.
    • If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers.
  • Clean and disinfect
    • Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
    • If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection.

International case numbers

• Wednesday, 03/18/20 2:30 pm: 214,010 COVID-19 cases worldwide; 8,727 deaths; 82,207 recovered.¹²
• Besides China, Italy has the second highest number of cases with over 31,000 cases and nearly 2,500 deaths.
  • The number of diagnosed cases outside of China exceeds those within China alone-- more than 60% of all coronavirus cases were diagnosed in other countries throughout the world.
  • The death risk estimate from Wuhan, China is likely higher than the rate that will likely be seen in the US and is associated with a breakdown of the healthcare system. ¹³ This finding indicates that proactive public health interventions to reduce burden on hospitals and healthcare workers, including social distancing, increased personal hygiene, and voluntary movement restrictions, are essential to reducing transmission and fatality rates. Incidence and mortality rates will likely vary from country to country depending on the health system and public health responses.

Epidemic curve of confirmed cumulative coronavirus cases worldwide (from WHO COVID-19 Dashboard, as of 3/18/2020).

Coronavirus cases by date of report worldwide (from WHO COVID-19 Dashboard, as of 3/18/2020).¹⁴

US National case numbers as of March 18, 2020, 2:30 pm¹⁵

• 7,327 cases of coronavirus confirmed by lab tests and 115 deaths.¹⁶
• Risk in population:¹⁷
  • General: Current estimates show that about 9 people per 1000 (1% case fatality rate) US COVID-19 cases will die of the disease.¹⁸ By contrast, the fatality rate from data already available is 1.3% in people 50-59, 0.4% in people 40-49, and 0.18% in people 30 to 39. Those that are 29 and under face mortality rates 0.09% and under, and children ages 0-9 are estimated to experience mortality at rates below 0.01%.¹⁹
  • Elderly: The death rate in elderly age 80 or older is very high and believed to be over 15% and possibly as high as 22%.²⁰ Older adults (those over 60 and particularly those over 80) and those with serious chronic health conditions (including heart disease, diabetes, and lung disease) are at a higher risk of getting very ill due to COVID-19. ²¹
  • Children: Initial evidence suggests that children seem to be getting infected at the same rate as adults but have milder symptoms.²² In China only 2.4% of all cases are in young children.²³ However, a new study of more than 2,000 children in China suggests that children may be more susceptible to coronavirus than previously thought. One third of the children included in the study were confirmed cases while the other two-thirds were suspected cases.²⁴
• Health care workers, home health aides, first responders, and teachers are among those at greatest risk of contracting coronavirus as a result of their job.²⁵
• Those that work in lower-income jobs may also face increased risk as the ability to work from home may not be feasible-- only 9.2% of those in the the bottom income quartile (lowest 25% income earners) are able to work from home while 20.1% of those in the third income quartile (second-lowest, 25-50% incomes earners) are able to work from home.²⁶

New US developments

• Phase 1 clinical trial for a vaccine to protect against COVID-19 is underway in Seattle.²⁷
• The US-Canadian border will be closed to all non-essential travel.²⁸
• The US Treasury and IRS delay the tax payment deadline by 90 days.²⁹
• As of March 18, the US government recommends all gatherings of more than 10 people be canceled or postponed.³⁰
• Drive-through testing has commenced in NYC, New Haven, and Hartford. People need to call first and be given permission to go from their doctor for testing.
• New York, New Jersey, Connecticut have banned gatherings of more than 50 people.³¹
• March 14, State Department recommends reconsidering travel abroad.³²
  • Travel to the United States for foreign nationals who have recently been in many countries is restricted; the United Kingdom and Ireland were most recently added to this list. This does not apply to returning US citizens or legal permanent residents.³³
  • US citizens returning from China are subject to a 14-day quarantine.
  • Travelers with underlying health conditions, should not travel by cruise ship.

Known cases in Connecticut (call 211 or text "CTCOVID" to 898211)

• As of 03/17/2020, there are 68 cases³⁴

Connecticut developments³⁵

• New Haven
• Access Health CT is announcing a special enrollment period for residents without health insurance the opportunity to purchase it.³⁰
• Connecticut bans gatherings of more than 50 people³⁹
  • Restaurants/bars will be takeout/delivery ONLY
  • Gyms closed
  • Movie theaters closed
  • Casinos closed
• All public schools will be closed until at least March 31.⁴⁰
• The CT Public Utilities Regulatory Authority (PURA) ordered a moratorium on all utility shut-offs. Gas, electric, and water public services shall refrain from terminating utility service to residential customers, except to maintain public safety, for 30 days to ensure that all residents can safely stay at home.⁴¹
• The CT State Department of Education received a waiver from the federal government to ensure that students can continue to receive meals during school closures and consume them at home. Many school districts have already begun to provide free meals for students.^{42 43}

Known cases in Rhode Island (call 401-222-8022)

• 23 confirmed and presumptive cases.⁴⁴

Rhode Island developments⁴⁵

• Starting March 23, all public schools in Rhode Island will implement distance learning for at least two weeks.⁴⁶
• The Rhode Island Public Utilities Commission mandated that all regulated utilities in the state cannot terminate service, except to maintain public safety, during the coronavirus emergency.⁴⁷
• Governor Raimondo signed an executive order on March 18 requiring that all health insurers doing business in the state pay for medically appropriate tele-health visits at the same rate as in-person office visits.⁴⁸
• Rhode Island bans gatherings of more than 25 people.⁴⁹
• Schools throughout Rhode Island are providing free “grab and go” meals to all children 18 and under while schools are closed. ⁵⁰ All public schools and childcare centers in the state are currently closed through March 20.⁵¹
• Governor Raimondo ordered that all dine-in food and beverage service in restaurants, bars, coffee shops, and other businesses must shut down until March 30. Take-out, delivery, and drive-thru service can continue.⁵²

Key international developments

• The EU bans all non-essential travel to Europe for at least 30 days. External borders will be closed but movement within member nations will still be allowed.⁵³
• The EU has linked Russian media outlets to disinformation about the coronavirus. The EU-produced report states that the disinformation seeks to undermine public trust in health care systems abroad.⁵⁴
• Japan is reporting its first case of a person becoming reinfected with the coronavirus after showing signs they had fully recovered. There have also been a number of cases of reinfection in China.⁵⁵

[1] https://www.whitehouse.gov/wp-content/uploads/2020/03/03.16.20_coronavirus-guidance_8.5x11_315PM.pdf

[2] https://www.nytimes.com/2020/03/17/opinion/coronavirus-social-distancing-effect.html

[3] http://www.xinhuanet.com/english/2020-03/10/c_138863160.htm

[4] https://www.worldometers.info/coronavirus/country/china/

[5] https://www.worldometers.info/coronavirus/country/south-korea/

[6] https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/index.html

[7]https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/testing-in-us.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Ftesting-in-us.html

[8] https://www.businessinsider.com/drive-through-coronavirus-tests-states-2020-3

[9] https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmission.html

[10]https://www.wsj.com/articles/what-we-know-about-the-wuhan-virus-11579716128?mod=theme_coronavirus-ribbon

[11] https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html

[12] https://coronavirus.jhu.edu/map.html

[13] https://wwwnc.cdc.gov/eid/article/26/6/20-0233_article

[14] https://experience.arcgis.com/experience/685d0ace521648f8a5beeeee1b9125cd

[15] https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

[16] https://coronavirus.jhu.edu/map.html

[17] http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51

[18] (Possibly outdated) https://www.bbc.com/news/health-51674743

[19]https://nymag.com/intelligencer/2020/03/coronavirus-and-its-high-mortality-rate-among-older-patients.html

[20] https://www.nytimes.com/2020/03/14/health/coronavirus-elderly-protection.html

[21]https://www.businessinsider.com/coronavirus-death-rate-by-age-countries-2020-3#still-older-patients-in-south-korea-also-had-a-much-higher-death-rate-than-younger-ones-patients-older-than-80-had-a-72-death-rate-as-of-wednesday-6

[22] https://www.nature.com/articles/s41591-020-0817-4

[23]https://www.washingtonpost.com/health/2020/03/10/coronavirus-is-mysteriously-sparing-kids-killing-elderly-understanding-why-may-help-defeat-virus/

[24] https://www.nytimes.com/2020/03/17/health/coronavirus-childen.html

[25] https://www.nytimes.com/interactive/2020/03/15/business/economy/coronavirus-worker-risk.html

[26] https://www.bls.gov/news.release/flex2.t01.htm

[27]https://www.nih.gov/news-events/news-releases/nih-clinical-trial-investigational-vaccine-covid-19-begins

[28] https://twitter.com/realDonaldTrump/status/1240271178692005889

[29] https://www.cnbc.com/2020/03/17/treasury-and-irs-to-delay-tax-deadline-by-90-days.html

[30]https://www.cdc.gov/coronavirus/2019-ncov/community/large-events/mass-gatherings-ready-for-covid-19.html

[31] https://twitter.com/NYGovCuomo/status/1239558725528178689

[32] https://travel.state.gov/content/travel/en/traveladvisories/ea/covid-19-information.html

[33]https://travel.state.gov/content/travel/en/traveladvisories/presidential-proclamation--travel-from-europe.html

[34] https://portal.ct.gov/coronavirus

[35]https://www.nhregister.com/news/coronavirus/article/Coronavirus-in-Connecticut-Live-updates-hour-by-15132401.php

[36]https://documentcloud.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3Af83d7741-3855-414e-92b0-3d6f0440238b

[37] https://www.foxnews.com/us/stop-shop-special-hours-coronavirus

[38] https://learn.accesshealthct.com/

[39] https://twitter.com/NYGovCuomo/status/1239558725528178689

[40] https://patch.com/connecticut/guilford/coronavirus-ct-gov-closes-all-schools-state-has-now-26-cases

[41] https://portal.ct.gov/Coronavirus

[42]https://www.nhregister.com/news/coronavirus/article/CT-school-districts-to-offer-meals-during-15132705.php

[43] https://patch.com/connecticut/naugatuck/school-meals-during-coronavirus-closure-announced

[44] https://health.ri.gov/data/covid-19/

[45] https://www.wpri.com/coronavirus/

[46] https://www.necn.com/news/local/ri-gov-to-provide-update-on-coronavirus-response/2247461/

[47] https://www.wpri.com/health/coronavirus/march-18-rhode-island-coronavirus-update/

[48] https://www.wpri.com/health/coronavirus/march-18-rhode-island-coronavirus-update/

[49] https://twitter.com/cnnbrk/status/1239590086519463937

[50]https://www.wpri.com/health/coronavirus/providence-schools-offering-free-grab-and-go-lunches-to-students/

[51]https://thehill.com/homenews/state-watch/487466-ri-gov-gina-raimondo-announces-closure-of-all-public-schools-next-week

[52] https://www.wpri.com/health/coronavirus/raimondo-briefing-on-coronavirus-expected-to-start-at-10-a-m/

[53] https://www.cnbc.com/2020/03/17/coronavirus-european-union-leaders-agree-to-close-borders.html

[54] https://www.theguardian.com/world/2020/mar/18/russian-media-spreading-covid-19-disinformation

[55]https://thehill.com/changing-america/well-being/prevention-cures/484942-japan-confirms-first-case-of-person-reinfected