Wednesday 26 February 2020

Coronavirus update - 25 February, 2020


San Francisco Declares State 

Of Emergency Over Covid-19 

As CDC Warns Pandemic 

"Inevitable": Live Updates

25 February, 2020

Summary:
  • WHO warns the rest of the world "is not ready for the virus to spread..."
  • CDC warns Americans "should prepare for possible community spread" of virus.
  • San Francisco Mayor declares state of emergency
  • Later, CDC says pandemic not a question of it, but when
  • Germany confirms first case; traveler from Milan
  • Italy cases spike to 322; deaths hit 10
  • Kudlow tries to jawbone markets higher
  • HHS Sec. Azar warns US lacks stockpiles of masks
  • Italy Hotel in Lockdown After First Coronavirus Case in Liguria
  • Algeria confirms 1st case
  • First case in Switzerland
  • Kuwait halts all flights to Singapore and Japan
  • Iran confirms 95 cases, 15 deaths
  • First case in Austria
  • First case in Spain
  • Iran Deputy Health Minister infected with Covid-19
* * *
Update (1700ET): SFChronicle reports that Mayor London Breed declared a state of emergency for San Francisco Tuesday, which will ramp up the city’s efforts to prepare for and confront potential cases.
There have been no confirmed coronavirus cases in San Francisco to date, but “the global picture is changing rapidly, and we need to step-up preparedness,” Breed said in a statement.
Three people have been treated at San Francisco hospitals for coronavirus, two of which have been discharged, but to date no cases have originated inside the city.
“We see the virus spreading in new parts of the world every day, and we are taking the necessary steps to protect San Franciscans from harm.”
This decision follows Santa Clara County, which declared a state of emergency a few weeks ago for similar reasons.
*  *  *
Update (1545ET): In keeping with the spate of ominous comments from American government officials, there have been reports about FDA Director Stephen Hahn warning about a shortage of medical supplies like facemasks as the CDC warns that outbreaks in the US are inevitable.
He made a similar comment yesterday...
“We are now many weeks into the response with still no diagnostic or surveillance test available outside of CDC for the vast majority of our member laboratories,” the Association of Public Health Laboratories wrote in a letter to FDA Commissioner Stephen Hahn on Monday.
See The_Real_Fly's other Tweets
* * *
Update (1520ET): Following an intro from HHS's Alex Azar where he assured the public that the US is expanding its flu-monitoring surveillance system and taking other measures to mitigate the outbreak, a CDC representative attested that its response to the virus started in December following the initial reports.
The US has pursued a policy of containment, travel restrictions and travel warnings. "We believe those precautions are working."
She largely repeated the warnings from earlier, hinting at the possibility of "community-based measures" for infection response that could include quarantines, while the US shifts to a policy of treating mild cases in isolation at home.
She also reiterated that it's no longer a question of if a pandemic will happen - it's a question of when.
"Our public health system has detected 14 people among the travelers entering the US. The fact that we have been cases at this level is an accomplishment. Based on what we know right now we believe the immediate risk in the US remains 'low'. But we must use this time to prepare for the event of human transmission in the US. Part of that is educating the public about what transition from emergency measures to community-based measures would look like.
"Patients with the virus with mild or no symptoms have been placed in medical environments in quarantined. That level of care is mostly not needed. In most cases, the proper care would be management at home, with use of healthcare facilities only permitted for those with other underlying conditions, the elderly and other vulnerable people."
"Circumstances suggest the virus will cause a pandemic, if that happens, new strategies will need to be implemented. These interventions at the community level will vary depending on local conditions."
"It's not so much a question of if this will happen, but when, and how many people will become infected, and how many of those will develop a more complicated disease. "
Well, there you have it...
After that, Dr. Fauci spoke about the issue of a vaccine.
Vaccine development began as soon as the virus genome was uploaded to the international database, and that human trials would likely begin within two months. He then explained the painstaking process of drug trials to illustrate why it will take "an additional 6-8 months" just to get the vaccine in circulation within "a year-year-and-a-half".
But that's okay, Dr. Fauci said, because this virus isn't going away any time soon, and will likely return with next year's flu season.
* * *
Update (1500ET): Germany has confirmed its first case of the virus, a traveler who reportedly came from Milan.
Maybe they should give the whole 'keep the borders open' idea a rethink?
Meanwhile, HHS is delivering its press conference:
* * *
Update (1445ET): Algeria has confirmed its first case of the virus as the focus on the Middle East intensifies.
Back in the US, the Dems are on the offensive against President Trump, with Chuck Schumer likening the administration's purportedly 'lackluster' virus response to Chernobyl (we also enjoyed the HBO series, Mr. Senator). Conn. Sen. and wax-faced robot Dick Blumenthal also criticized Trump's request for Congressional funds as "too little, too late."
* * *
Update (1420ET): Kuwait has halted all flights to Singapore and Japan, according to Al Arabiya, as the paranoia over the outbreak in Iran intensifies, particularly among the GCC member states who barely need an excuse to shit on Iran.
* * *
Update (1400ET): Here's an update on the situation in Iran via the Washington Post.
Iran has confirmed 95 cases across the country, with at least 15 deaths, as more cases have popped up in Bahrain, the region of Kirkuk in neighboring Iraq, and elsewhere.
* * *
Update (1335ET): Like a champion boxer who is just past his prime, Trump economic advisor Larry Kudlow took to CNBC early Tuesday afternoon to try and jawbone the markets higher as US stocks headed for their fourth day in a row.
Kudlow stressed that the US has been "ahead of the curve" when it comes to "protecting citizens" (by canceling flights, barring foreigners etc.) - even as the CDC warns that the US is dangerously unprepared for "community outbreaks" that it believes will inevitably arrive. People need to stay "calm", Kudlow said, adding that we won't really know how bad this will be for the US until a few weeks have passed.
Kudlow stressed the human toll of the outbreak, calling it "an incredible human tragedy." But as far as the economy is concerned, "I don't think we're looking at an economic disaster at all," he added.
To support his claim, Kudlow cited the recent spate of Fed data, claiming there has been "no evidence" of supply disruptions.
Granted, there have been bright spots, but we can't help but wonder: Is Kudlow looking at the same data we are?
And how does one explain gold and the 30-year?
As far as rate cuts are concerned, Kudlow says "I'm not hearing that."
"I'm not hearing the Fed is going to make any panic moves."
Notably, Kudlow echoed Fisher's comments from earlier.
FISHER on @CNBC: "I'm not clear what a Fed cut of the Fed Funds rate would do to sort of 'goose' those supply chains. You really can't solve this problem in that way. So I would not be advocating for a cut here."@SquawkStreet
50 people are talking about this
We can almost hear the bulls shouting 'Aw, C'mon Larry!' at their TV screens.
* * *
Update (1245ET): More updates out of Europe. Earlier, we reported the first coronavirus cases had been confirmed in Austria and Croatia, showing that the virus has now spread to both central and southeastern Europe.
Austria placed a hotel in the Alpine city of Innsbruck under lockdown after an Italian receptionist working there contracted the coronavirus, becoming one of the country's first cases http://u.afp.com/3UCZ  pic.twitter.com/S76E4uVYAL
149 people are talking about this
Over in Italy, the number of confirmed cases has surpassed 300 to 322, while the number of dead climbed to 10, according to Italian emergency chief Angelo Borrelli, who said the newly deceased were over the age of 80. That's up from just 20 confirmed cases on Friday.
Newly deceased were over 80 years old, says at press conference in Rome Tuesday. The new infections include three cases in southern Sicily region, Italian Civil Protection official Borrelli said.
Earlier, we noted the WHO saying that while the pace of new infections has slackened in China thanks in part to the administration's heavy handed crackdown to fight the virus, if officials and the public aren't careful, we could see a resurgence. The WHO also warned that the world is wildly unprepared for the coronavirus, a fact that the CDC and HHS Secretary have now echoed about America's ability to respond to the crisis.
German officials gave the first hint at what is coming earlier today when they said that closing borders with Italy wouldn't solve the problem (note: this is the same logic they used during the migrant crisis and we all remember how that turned out). Now, European health officials have collectively decided that closing borders would be "ineffective," concluding days of mounting speculation about whether Italy, or its neighbors, would suspend Schengen rules governing the free movement of people across the EU.
According to Bloomberg, health ministers from Austria, Croatia, France, Germany, Italy, Slovenia, Switzerland and a representative from San Marino agreed on Tuesday to keep European borders open, arguing that closing them would be a "disproportionate and ineffective measure" at this time.
* * *
Before we go, the story of the four-star hotel at Tenerife, a Spanish island where an Italian doctor and his wife who both tested positive for COVID-19, appears to have captured the imagination of the international press.
According to the BBC, the couple were staying at the H10 Costa Adeje Palace hotel on the island, which is the largest of Spain’s Canary Islands. The doctor tested positive Monday, and his wife the following day. They've been placed in isolation at the University Hospital Nuestra Senora de Candelaria.
But in their wake, an entire hotel with more than 100 guests has been put under quarantine.
Here's a still from a video of the residents gazing forlornly at the outside world that was initially shared by the NY Post.
Residents have been told to wait in their rooms as health officials test everyone in the building.
*  *  *
Update (1145ET): US CDC says COVID-19 epidemic is rapidly evolving and expanding, warning that a vaccine could be ready in a year, and Americans should prepare for possible spreads in communities.
"Now is the time for businesses, hospitals, communities, and schools to begin preparing to respond to coronavirus."
Nancy Messonnier, the director of the CDC's National Center for Immunization and Respiratory Diseases, said: "As more and more countries experience community spread, successful containment at our borders becomes harder and harder."
Additionally, HHS Secretary Alex Azar says at Senate panel hearing that the U.S. doesn’t have enough stockpiles of masks and ventilators to fight the coronavirus and that’s one reason the Trump administration is seeking $2.5b in funding.
About 30m so-called N95 respirator masks are stockpiled but as many as 300m are needed for healthcare workers, Azar says, adding that his department doesn't yet know how much they would cost.
Democratic Sen. Patty Murray, who questioned the administration’s readiness to battle the spread of the virus:
"I’m deeply concerned we’re way behind the eight ball on this," Murray said while questioning Azar at the Appropriations subcmte hearing.
Azar also says the money would be used to help develop vaccines and treatments for the virus and that a vaccine could be ready in a year.
*  *  *
Update (1100ET): WHO's Bruce Aylward told journalists that China's actions "prevented hundreds of thousands of cases" and warned that the rest of the world "is not ready for the virus to spread," adding that "countries should instruct citizens now on hygeine."
*  *  *
Update (1001ET)A case of the novel corona virus has been confirmed for the first time in Switzerland. The federal government announced on Tuesday. One person was tested positive for the virus, said those responsible.
Italian officials stated that the first patient was "obviously infected in Italy," and will consider further measures if they think "uncontrolled transmission" of the virus is occurring.
*  *  *
Update (0950ET): Spanish authorities have confirmed the fourth case of coronavirus in Catalonia, according to La Vanguardia.
Jordan has banned flights arriving from Italy, becoming the first country in the region to guard against travelers from Europe's third-largest economy.
* * *
Update (0900ET): Iran's MP Mahmoud Sadeghi said he had tested positive for the coronavirius, telling supporters: "I don't have a lot of hope of continuing life in this world".
CBS has confirmed that it was an Italian doctor visiting the Spanish isle of Tenerife who prompted all guests at his hotel to be confined to their rooms on Tuesday. The country has now confirmed nearly 60 cases on Tuesday.
In the UAE, home to long-haul carriers Emirates and Etihad, airlines have suspended flights to and from Iran for at least a week, cutting the country's 80 million people off from thousands of flights.
Unsurprisingly, the Dems were quick to slam the White House's $2.5 billion spending plan that was sent lawmakers on Monday to address the deadly coronavirus outbreak. Democrats said the request fell far short of what's needed.
House Speaker Nancy Pelosi called the president's request "long overdue and completely inadequate to the scale of this emergency" in a statement released Monday. She added that the House would propose a "strong, strategic" funding package of its own to address the public health crisis.
Because nothing solves a public health crisis like a political stalemate.
"We have a crisis of coronavirus and President Trump has no plan, no urgency, no understanding of the facts or how to coordinate a response," said Senate Minority Leader Chuck Schumer.
Trump joked in public remarks Tuesday that if he had authorized more, Chuck Schumer and the rest would be criticizing him, saying "it should be less."
For those who have been watching, CNBC has been talking up a storm about the drugmaker Moderna, which delivered its first experimental coronavirus vaccine for testing, with the clinical trial slated to start in April. The WSJ is supposedly one reason why market's are clinging to optimism on Tuesday.
The CDC's Dr. Fauci praised the development, said "nothing has ever gone that fast."
"Going into a Phase One trial within three months of getting the sequence is unquestionably the world indoor record. Nothing has ever gone that fast," Dr. Fauci said.
As Jim Cramer won't stop repeating Tuesday morning, the advances are "really remarkable."
Finally, Austrian health officials have confirmed that at least one of the likely coronavirus patients isolated Tuesday was an Italian living in the country.
This comes after Italian authorities reported the first coronavirus case in the country’s south: a tourist visiting Sicily who had traveled from Bergamo, an Italian city in the Lombardy region.
* * *
Update (0825ET): Bahrain has banned its citizens from traveling to Iran as it reports 9 new cases of coronavirus, raising the total cases in the tiny island kingdom to 17 in the span of 24 hours.
* * *
Update (0800ET): With his reputation under fire and his popularity slipping, PM Giuseppe Conte said Tuesday that he's confident that the measures his government has put in place will contain the contagion in the coming days.
This comes after the PM admitted that a hospital in Lombardy inadvertently helped spread the virus by not adhering to certain health-care protocols. The PM has blamed the hospital for the outbreak in the north, raising questions about whether "the European nation is capable of containing the outbreak," according to CNN. To put things in perspective, Italy now has 3x the number of cases in Hong Kong.
"That certainly contributed to the spread," Conte said, without naming the institution concerned. The infection has been centered around the town of Codogno, around 35 miles south of Milan.
"Obviously we cannot predict the progress of the virus. It is clear that there has been an outbreak and it has spread from there," Conte told reporters, referring to the hospital.
A team of health experts from the World Health Organization and the European Center for Disease Prevention and Control arrived in Italy on Monday to assist local authorities while some 100,000 remain under an effective quarantine.

Over in India, Trump added to his earlier comments by saying a vaccine is "very close", even though the most generous estimates claim we need another year.
Market experts cited a WSJ report on a possible vaccine as helping market sentiment, though even that report made clear that human tests of the drug are not due until the end of April and results not until July or August.
* * *
Update (0650ET): It's not even 7 am in the US, and it looks like a new outbreak is beginning in Central Europe.
Local news agencies report that Croatia has confirmed its first case, while the Austrian Province of Tyrol has confirmed two cases.
In South Korea, meanwhile, officials have just confirmed the 11th coronavirus-linked death, a Mongolian man in his mid-30s who had a preexisting liver condition.
Over in India, where President Trump is in the middle of an important state visit with the newly reelected Prime Minister Narendra Modi, the president struck an optimistic tone once again claiming that the virus will be a "short-term" problem that won't have a lasting impact on the global economy.
"I think it's a problem that's going to go away," he said.
Trump also reportedly told a group of executives gathered in India that the US has "essentially closed the borders" (well, not really) and that "we're fortunate so far and we think it's going to remain that way," according to CNN.
Meanwhile, SK officials announced they're aiming to test more than 200,000 members of the Shincheonji Church of Jesus, the "cult-like" church at the center of the outbreak in SK.
* * *
Last night, a post written by Paul Joseph Watson highlighted commentary from a Harvard epidemiology professor (we realize we've heard from pretty much the whole department at this point in the crisis, but bear with us for a moment) who believes that, at some point, 'we will all get the coronavirus'.
Well, up to 70% of us, but you get the idea: The notion that this outbreak is far from over is finally starting to sink in. Stocks are struggling to erase yesterday's losses, with US futures pointing to an open in the green after the biggest drop in two years. More corporations trashing their guidance, and more research offering a glimpse of the faltering Chinese economy (offering a hint that all the crematoriums are keeping air pollution levels elevated even as coal consumption and travel plunge) have seemingly trampled all over the market's Fed-ensured optimism.
And across Europe, the Middle East and the Far East, headlines tied to the outbreak hit at a similarly non-stop pace on Tuesday.
With so much news, where to start?
In China, data out of the Transport Ministry revealed that barely one-third of China's workforce has returned to work, despite state-inspired threats. CNN reported Tuesday that only 30% of small businesses in China have returned to work. The problem? Travel disruption has left millions of migrant workers stranded. There's also the question of schools: Some cities, including Shanghai, are offering students the option of completing their studies online after March 2.
China's rapidly advancing tech sector has responded to the crisis by unleashing a wide range of technologies outfitted for specific tasks, including ferrying supplies to medical workers, fitting drones with thermal cameras and leveraging computer-processing power to aid the search for a vaccine. 
In a televised interview, one health official said it might take 28 days to safely say an area is free of coronavirus, while another official insisted that "low risk" areas should "resume normal activity" on Tuesday. The government is dividing the country outside Hubei and Beijing into three 'risk' tranches, and will mandate that those in the lowest tranche get back to work, school or whatever they were doing before the virus hit.
Investors are clearly concerned that, instead of the 'v'-shaped recovery promised by the IMF, the economic bounce-back from the coronavirus might be closer to a "u"-shape. On top of that, as cases proliferate in South Korea, Italy and the US, pundits are beginning to worry that the rest of the world is where China was two months ago - in other words
Throughout the day, South Korea confirmed 144 more cases, bringing the country-wide total to 977, the highest number outside China.
As the Korean government warns that foreigners shouldn't travel there, Korean Air Lines and Asiana Airlines, to South Korean airlines, said they would halt flights to Daegu until next month, leaving the door open to a longer shutdown.
On Tuesday afternoon, South Korean President Moon Jae-in traveled to Daegu, the city where more than half of the country's cases have been detected, and advised its residents to stay indoors but pledged to avoid the draconian restrictions Chinese authorities implemented in Wuhan.
Outbreak-related news in Seoul took on a more morbid tone Tuesday following reports in the local press that a civil servant from the Ministry of Justice's Emergency Safety Planning Office jumped off a bridge in Seoul at around 5 am local time Tuesday.
The official was one of several individuals charged with overseeing the government's response to the virus. As cases soar and hysteria mounts, we suspect this news won't exactly help quiet the public's nerves.
A Singaporean government minister warned that the city-state could impose sweeping travel restrictions targeting South Korea if the outbreak gets worse.
Minutes ago, Italian authorities confirmed another 8 coronavirus cases, 54 of which have been confirmed on Tuesday, bringing the total to 283. 
More than 100,000 Italians in 10 villages are under lockdown in the 'red zone' in northern Italy, where the military has been deployed and people have been told to stay inside. Fears about the virus spreading throughout the region were validated yesterday when Spain reported a third case, an Italian traveler. On Tuesday, Reuters reports that Spanish authorities have closed the Tenerife Hotel on the Canary Islands and are testing all of its occupants.
Most of the cases have been recorded in Lombardy (200+), while Veneto, Emilia-Romagna, Piedmont, Bolzano, Trentino and Rome have all confirmed at least one case. The UK government warned that any British travelers in northern Italy should self-isolate, according to the Washington Post.
In Japan, the "J League", Japan's professional soccer league, has announced that it will postpone all games until at least March 15, saying in a statement that it's "fully committed" to stopping the spread of the coronavirus. The decision followed a government recommendation to cancel all public events and gatherings.
Embracing a markedly different approach from Beijing, Japan has announced a new policy on Tuesday designed to focus medical care on the most serious cases, while urging people with mild symptoms to treat themselves at home.
According to the FT, the new strategy of containment announced by a panel overseeing the virus response acknowledged that simply testing everyone potentially exposed to the more than 100 cases outside the 'Diamond Princess' would overwhelm its health-care system.
It is radically different approach from that adopted by China,
Though it hasn't announced new cases in a day or so, Japan has confirmed 840 cases of novel coronavirus so far, with nearly 700 of them linked to the 'Diamond Princess' cruise ship.
Iran's 'official' death toll climbed to 14 on Tuesday, with 61 cases confirmed so far. Despite a wave of border closures that left Iran virtually isolated by its neighbors, more cases have started to bleed across the border: Iraqi health ministry officials have confirmed four coronavirus cases in Kirkuk, all of whom are members of a family. He previously looked unwell during a press conference.
We suspect we'll be hearing more bad news from the Middle East as the full scope of the Iranian outbreak becomes more clear.

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