Subscribe
Chinese state-run media reported a decline in the number of new coronavirus (COVID-19) cases across the country on February 18, 2020, minus in the province of Hubei for the 14th consecutive day. Hubei’s Wuhan city has been the epicentre of the outbreak.
The global tally of COVID-19 cases jumped to 73,336 globally on February 18. Of these, 72,438 were reported from mainland China, of which, nearly 60,000 have been confirmed positive in Hubei.
As many as 29 countries have reported these cases, along with 454 on the Diamond Princess cruise ship in Japan. The death toll has risen up to 1,874.
However, the fact that cases were on decline in mainland China with the exception of a province should not lead the drawing of any trends, the World Health Organization (WHO) warned.
“It’s too early to tell if this reported decline will continue. Every scenario is still on the table,” WHO Director-General Tedros Adhanom Ghebreyesus, said.
Fate of healthworkers
The director of Wuhan Wuchang Hospital, Liu Zhiming, died due to the coronavirus infection on February 18, China Central Television quoted the Wuhan Municipal Health Commission as saying.
This was the second high-profile death after that of Li Wenliang two weeks ago. Wenliang had been hailed as a whistle-blower as he had warned about an impending epidemic in the first week of December 2019, after which he was detained.
Around 1,716 health care workers have been infected, and six have died due to COVID-19, according to statements by Chinese authorities. The WHO has been warning against the shortage of masks and personal protective equipment (PPE) for frontline healthcare workers in China.
However, at a press meet on February 17, the director of WHO's Epidemic and Pandemic diseases programme, Sylvie Briand said it was just not about shortage of PPE. “The availability of PPE is one element of protection but what is more important is how to use it. Due to lack of attention or if health workers commit any mistake because of being tired, one may not use it properly and still get infected,” she said.
“Medical staff are at higher risk of infection. Infection rates are associated with contact time and the amount of suction virus,” a paper written by a group of researchers working at various health institutions in Wuhan and published pre-print on February 17 in the Chinese Journal of Tuberculosis and Respiratory Diseases, read.
“Severe patients had Body Mass Index increased, heating time prolonged, white blood cell count, lymphocyte count, D-dimer and albumin level significantly changed and were prone to be complicated with liver damage and myocardial damage. Strict protection measures are important to prevent infection for medical workers,” it added.
So were frontline workers not trained properly? “The continual reports of healthcare workers becoming infected would suggest that staff are not always aware of or able to implement the standard precautions as required by the technical guidance provided by the National Health Commission and WHO,” Min Zhang, occupational health professor in the School of Public Health, Chinese Academy of Medical Sciences, wrote in a blog published in the BMJ.
She added that a lack of a standardised procedure for daily or even routinely carrying out the health surveillance and environmental monitoring of healthcare workers was adding to the problems.
Asked to put the number of 1,716 in context, Briand said, it was difficult, since the number might rise. But it was not odd to see healthcare workers being affected.
Africa’s turn?
Meanwhile, as two cases of COVID-19 have been confirmed in Africa — one each in Egypt and Cameroon — the WHO is gearing up to contain the spread on the continent if it were to spread.
The WHO has prioritised support for 13 countries on the basis of their close transport links with China: Algeria, Angola, Côte d’Ivoire, the Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Mauritius, Nigeria, South Africa, Tanzania, Uganda, and Zambia.
“The risk and likelihood of getting an outbreak is very, very high,” a Lancet report quoted Ambrose Talisuna, the WHO Africa team lead for emergency preparedness.
“We all know how fragile health systems [are] in the African continent. They are already overwhelmed by many outbreaks. For us, it is critical to detect coronavirus earlier [so] that we can prevent spreading within communities that can trigger a number of cases that can overwhelm the treatment capacity,” Michel Yao, WHO Africa programme manager for emergency operations, said.
Meanwhile, questions are looming large over the fate of the Olympics that are to be hosted by Japan this year.
“So far, the Japanese authorities have not sought any advice from us. Whether they would be cancelled or not is something that the Japan government has to decide,” Mike Ryan, executive director of WHO Health Emergencies programme, said, in response to a query as to whether the Olympics will be staged or not.
WHO officials also said it was difficult to implement containment measures on board the Diamond Princess. They were working closely with the Japanese authorities and the chief medical officer of the ship to contain the spread of the virus as much as possible.
The WHO will not suggest any advisory against travelling by ships, the officials said in response to a query.