Italy reports 6 dead, 229 infected as Europe braces for COVID-19

…. Italian health officials reported Monday that there are 229 people infected nationwide, with six deaths.

There are 101 people in the hospital, and 27 are in intensive care.

The hard-hit northern region of Lombardy reported 172 cases. Five of the deaths are in the Lombardy region……

At least 10 towns in northern Italy, with a population of around 50,000, were locked down Sunday to help stop the spread of the virus.

Iran Denies Cover-Up After Lawmaker Contradicts Official Coronavirus Figures, Says 50 Dead

Take you pick of the numbers from the another country whose rulers are known for lying through their teeth

A member of Iran’s parliament announced on Monday that 50 people had died from the new coronavirus in the city of Qom and accused Iran’s Health Ministry of covering up the true extent of the outbreak in the country. The Health Ministry claims just 12 people have died in Iran from COVID-19, with 66 people sick from the disease. The official numbers in Iran were up from a total of 8 deaths and 43 illnesses reported on Sunday.

Ahmad Amirabadi Farhani, who represents Qom, a city roughly 120 kilometres south of Tehran, told Iran’s semiofficial news outlet ILNA that he believes the death count in his city was far higher than what the Iranian government was saying.

“Up until last night, around 50 people died from coronavirus. The health minister is to blame,” Amirabadi Farhani said on Monday, according to an English translation by Middle East news network Al Arabiya, adding that he believes 10 people are dying per day.

S.Korea reports 161 new cases of coronavirus, brings total to 763

SEOUL, Feb 24 (Reuters) – South Korea reported 161 new cases of the coronavirus, bringing the total number of infected patients in the country to 763, health authorities said on Monday, a day after the government raised its infectious disease alert to its highest level.
Of the new cases, 115 were linked to a church in the southeastern city of Daegu after a 61-year-old woman known as “Patient 31” who attended services there tested positive, according to the Centres for Disease Control and Prevention (KCDC).

KCDC also reported the seventh death from the virus, a 62-year-old man from a hospital in Cheongdo, a county that saw surges in confirmed cases along with nearby Daegu in recent weeks.

Authorities are still investigating the exact cause of the new outbreak, with Patient 31 having no recent record of overseas travel.

Dr. Peter Hotez: As coronavirus spreads, the US is not fully prepared, but here is how we can be

Coronavirus disease 2019 (COVID-19)
Situation Report – 34

• No new countries reported cases of COVID-19 in the past 24 hours.

SITUATION IN NUMBERS
total and new cases in last 24 hours
Globally
78 811 confirmed (1017 new)
China
77 042 confirmed (650 new)
2445 deaths (97 new)
Outside of China
1769 confirmed (367 new)
28 countries
17 deaths (6 new)

Pandemic Seems Likely as Coronavirus Outbreaks Worsen in Several Countries.

On Friday, the head of the World Health Organization offered a stark warning about the chances of containing the global spread of the novel coronavirus amid ominous new outbreaks of the disease outside of China. “The window of opportunity is still there, but our window of opportunity is narrowing,” explained WHO director-general Tedros Adhanom Ghebreyesus. By Sunday, it seemed clear that window may have already closed.

Authorities are now struggling to contain — and understand — escalating outbreaks in three countries, South Korea, Iran, and Italy, while additional countries, like Lebanon and Israel, have recently reported their first cases as well.

Two Dead, 79 Infected as Italy’s Government Fights Coronavirus Outbreak

Cases of the new coronavirus in Italy, the most affected country in Europe, rose on Saturday to nearly 80, killing two people and prompting the government to close off the worst hit areas in the northern regions of Lombardy and Veneto.

Authorities in the two regions, where the outbreak is concentrated, have cancelled sports events and closed schools and universities, while companies from Ray-Ban owner Luxottica to the country’s top bank UniCredit have told workers living in the affected areas to stay home.

Iran Now Says 6th Person Dead of New Virus

TEHRAN, Iran — Iranian officials Saturday reported a sixth death from the new virus that emerged in China.

The governor of Markazi province told the official IRNA news agency that tests of a patient who recently died in the central city of Arak were positive for the virus.

Ali Aghazadeh said the person was also suffering from a heart problem.

Earlier on Saturday, health authorities reported a fifth death from the coronavirus and said the fatality was among 10 new confirmed cases in Iran. It was not immediately clear whether the sixth fatality was among those 10.

Coronavirus Cases Triple in South Korea; Who Keeps Eye on Africa, Iran

The number of new coronavirus cases nearly tripled in South Korea on Saturday, the fourth consecutive day that tally has seen a major spike. Korea Centers for Disease Control and Prevention reported that the total number of confirmed cases in the country rose to 433 — less than 24 hours after the sum stood at 156.

As of Tuesday, the number of confirmed cases was just 31.

Many of the new patients Saturday were located in or near Daegu, South Korea’s fourth-largest city, where dozens of people linked with a Christian sect known as the Shincheonji Church of Jesus have shown symptoms of respiratory illness. The church, which has about 150,000 adherents, says it has shared with authorities the names of members who may have been exposed to the virus, and it is encouraging them to enter quarantine.

Judge temporarily halts transfer of coronavirus patients to quarantine facility in California city.

A city in California won a battle against the state Friday, at least temporarily, when a judge halted the transfer of people diagnosed with the coronavirus to its community for a quarantine site.

Costa Mesa, California, filed a legal action after it learned federal officials planned to use its Fairview Development Center to house and quarantine several patients who tested positive for the COVID-19 virus.

The city said it was given little notice, and without input, about the plan.

“We have received no information regarding how the facility will be prepared, what precautions will be taken to protect those in the facility as well as those who live nearby, and other important planning measures,” Costa Mesa Mayor Katrina Foley said in a statement.

Judge Josephine Staton, according to the city, issued the temporary restraining order late Friday night. An expedited hearing is expected to be held Monday afternoon.

One key indicator will tell us when the coronavirus outbreak is winding down — but we’re not seeing it yet.

It has been more than seven weeks since the coronavirus outbreak started in Wuhan, China. Since then, at least 2,250 people have died and more than 76,000 have gotten sick.

The virus’ continued spread prompts an obvious question: When will this end?

A recent study from the Chinese Center for Disease Control found that illnesses in China may have peaked on February 1, when the largest number of patients started showing symptoms. That could be a sign that the outbreak is already tapering off, but the researchers also warned that it could rebound once Chinese residents return to school and work.

“The data from China continue to show a decline in new confirmed cases,” Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, said at a press conference on Thursday. “We’re encouraged by this trend, but this is no time for complacency.”

Lauren Ancel Meyers, an epidemiologist at the University of Texas at Austin, told Business Insider that one important figure can tell us when the outbreak has run its course. It’s the average number of people that a single patient is expected to infect. Epidemiologists call it the “basic reproduction number,” and it indicates how contagious a virus is.

When the outbreak is winding down, Meyers said, the basic reproduction will be below one.

“That means, on average, every person is infecting fewer than one other person and then the outbreak should burn out,” she said.

That’s not the case yet. A recent study of nearly 140 hospitalized patients in Wuhan estimated that the basic reproduction number for the coronavirus is 2.2, meaning that patients have been spreading the virus to more than two other people, on average. A study in the Journal of Travel Medicine estimated that the reproduction number was slightly higher: around 3.3.

Coronavirus disease 2019 (COVID-19)
Situation Report – 31

SITUATION IN NUMBERS
total and new cases in last 24 hours
Globally
75 748 confirmed (548 new)
China †
74 675 confirmed (399 new)
2121 deaths (115 new)
Outside of China
1073 confirmed (149 new)
26 countries (1 new)
8 deaths (5 new)

No real change in the U.S. There are still only 15 cases under care.

44 Americans on the Diamond Princess Cruise Ship Diagnosed With Coronavirus

Nice laboratory experiment they’ve got going there.

Another 70 cases of the coronavirus infection have been confirmed aboard the Diamond Princess cruise ship, currently quarantined in Japan, according to Japanese health officials.

This brings the total number of cases aboard the vessel as of Sunday to 355, the largest confirmed cluster outside mainland China. People with confirmed infections have been taken to hospitals in Japan.

After the ship’s two weeks of quarantine at sea, officials from various countries, including Canada, Italy, Hong Kong and South Korea, are in the process of extracting their citizens from the vessel. The Diamond Princess is reported to have around 3,700 passengers and crew members.About half the passengers are from Japan, according to Reuters.

Approximately 400 U.S. citizens are aboard the Diamond Princess. According to Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, 44 Americans on the cruise ship have been infected, though not all are sick.

Taiwan Confirms First Coronavirus Death

Taiwan on Sunday confirmed its first coronavirus death — marking the fifth fatality outside of mainland China.

The man, a 61-year-old taxi driver, was living with diabetes and hepatitis B when he died of the virus, according to Health Minister Chen Shih-Chung.

There’s an investigation underway to determine how the man, who had not recently traveled outside of Taiwan, contracted the illness, Chen said.

Coronavirus disease 2019 (COVID-19)
Situation Report – 26

SITUATION IN NUMBERS total and new cases in last 24 hours
Globally
50 580 laboratory-confirmed
(1527 new)
China
50 054 laboratory-confirmed
(1506 new)
1524 deaths (121 new) †
Outside of China
526 laboratory-confirmed
(21 new)
25 countries (1 new)
2 deaths

Chinese doctors say Wuhan coronavirus reinfection even deadlier
Instead of creating immunity the virus can reportedly reinfect an individual and hasten fatal heart attack

TAIPEI (Taiwan News) — It’s possible to get infected by the novel coronavirus (COVID-19) a second time, according to doctors on the frontline in China’s city of Wuhan, leading to death from heart failure in some cases.

The claim is made by doctors working in the Hubei Province capital that is at the center of the epidemic, which has to date infected 64,201 people and killed 1,487. One of the doctors reached out to a relative living in the United Kingdom, who then informed Taiwan News.

Both the relative and doctors asked to remain anonymous, out of consideration they might face retribution from the Chinese authorities. The doctor, Li Wenliang (李文亮), who first raised warnings about the Wuhan virus, was rebuked by the authorities before succumbing to the devastating disease himself earlier this month.

According to the message forwarded to Taiwan News, “It’s highly possible to get infected a second time. A few people recovered from the first time by their own immune system, but the meds they use are damaging their heart tissue, and when they get it the second time, the antibody doesn’t help but makes it worse, and they die a sudden death from heart failure.”

The source also said the virus has “outsmarted all of us,” as it can hide symptoms for up to 24 days. This assertion has been made independently elsewhere, with Chinese pulmonologist Zhong Nanshan (鍾南山) saying the average incubation period is three days, but it can take as little as one day and up to 24 days to develop symptoms.

Also, the source said that false negative tests for the virus are fairly common. “It can fool the test kit – there were cases that they found, the CT scan shows both lungs are fully infected but the test came back negative four times. The fifth test came back positive.”

According to the BBC and other media outlets, some laboratory tests are incorrectly telling people they are virus-free. There is also anecdotal evidence of people having up to six negative results before being diagnosed correctly.

Cholesterol drugs may help fight ‘high-risk’ prostate cancers.

Definitely something for further research.

Drugs that many men with prostate cancer might already be taking — cholesterol-lowering statins — may help extend their survival if they have a “high-risk” form of the disease, new research suggests.

High-risk patients include men with high blood levels of prostate specific antigen (PSA) and a “Gleason score” of 8 or more. Gleason scores are a calculation used to gauge prognosis in prostate cancer. Men with a high Gleason score may develop difficult-to-treat cancers.

Prior research had suggested that statins and the diabetes drug metformin (often prescribed together) have anticancer properties. However, it hasn’t been clear which of the two drugs is the bigger cancer-fighter, or whether either might help against high-risk prostate cancer.

To help answer those questions, a team led by Grace Lu-Yao of the Sidney Kimmel Cancer Center–Jefferson Health, in Philadelphia, tracked data on nearly 13,000 high-risk prostate cancer patients. All were diagnosed between 2007 and 2011.

The study couldn’t prove cause and effect, but it found that statins, taken alone or with metformin, did seem associated with an increase in survival.

Men who took both statins and metformin had higher median survival (3.9 years) than those who took statins alone (3.6 years), metformin alone (3.1 years), or those who did not take either drug (3.1 years).

No peak in sight as China reports 5,000 new coronavirus cases

BEIJING/SIHANOUKVILLE, Cambodia (Reuters) – China’s coronavirus outbreak showed no sign of peaking with health authorities on Friday reporting more than 5,000 new cases, while passengers on a cruise ship blocked from five countries due to virus fears finally disembarked in Cambodia.

Policymakers pledged to do more to stimulate Asian economies hit hard by the virus, helping Asia stock markets edge higher, with Chinese shares headed for their first weekly gain in four.

In its latest update, China’s National Health Commission said it had recorded 121 new deaths and 5,090 new coronavirus cases on the mainland on Feb. 13, taking the accumulated total infected to 63,851 people.

Some 55,748 people are currently undergoing treatment, while 1,380 people have died of the flu-like virus that emerged in Hubei province’s capital, Wuhan, in December. The latest toll takes account of some deaths that had been double counted in Hubei, the health commission said.

The new figures give no indication the outbreak is nearing a peak, said Adam Kamradt-Scott, an infectious diseases expert at the Centre for International Security Studies at the University of Sydney.

“Based on the current trend in confirmed cases, this appears to be a clear indication that while the Chinese authorities are doing their best to prevent the spread of the coronavirus, the fairly drastic measures they have implemented to date would appear to have been too little, too late,” he said.

Chinese scientists are testing two antiviral drugs and preliminary results are weeks away.

The head of a hospital in Wuhan, a city under virtual lockdown to prevent the spread of the virus, told reporters on Thursday that plasma infusions from recovered patients had shown some encouraging preliminary results.

Japan confirmed its first coronavirus death on Thursday – a woman in her 80s living in Kanagawa prefecture near Tokyo. The death was the third outside mainland China, after two others in Hong Kong and the Philippines…………

Evacuee at Lackland Air Force Base is 15th virus case in US

NEW YORK — U.S. officials on Thursday announced the country’s 15th confirmed case of the new coronavirus — an evacuee from China who had been under quarantine in Texas.

The patient, who had been flown to Lackland Air Force Base in San Antonio last week, is now in isolation at a hospital and was reported in stable condition. The infection was confirmed through a Wednesday night lab test, making the person the first coronavirus patient in Texas.

“There may be additional cases we identify. I do want to prepare you for that,” said Dr. Jennifer McQuiston, deputy director of the Centers for Disease Control’s division of high consequence pathogens and pathology.

Two earlier U.S. cases were found among evacuees flown to Marine Corps Air Station Miramar in Southern California.

Hundreds of people, including U.S. State Department employees and their families, were brought to military bases in Texas, California and Nebraska aboard chartered flights from Wuhan, a city of 11 million that is at the center of the outbreak.

There are 57 evacuees being held in quarantine at the Nebraska National Guard’s Camp Ashland southwest of Omaha, Nebraska, none of whom have shown any signs of the virus, Nebraska Medicine spokesman Taylor Wilson said. He said the Omaha hospital prepared to treat any of the evacuees if needed.

Why scientists are encouraging people to drink more coffee

Coffee, just what can’t it do?

The promise of strong bones meant something very different to us as children. We thought obtaining the physique of our favorite superhero was as simple as drinking as much milk as possible. Turns out, we were wrong about the prize and the best way to achieve it.

According to a new study published in The Journal of Clinical Endocrinology & Metabolism, there is a robust association between habitual coffee consumption and the prevention of bone fracturing later in life and the development of metabolic illnesses. In other words, more coffee for everyone!

Coffee, coffee, coffee

“Inconsistent associations between coffee consumption and bone mineral density (BMD) have been observed in epidemiological studies. Moreover, the relationship of bioactive components in coffee with BMD has not been studied. The aim of the current study is to identify coffee-associated metabolites and evaluate their association with BMD,” the authors wrote in the report.

In actuality, bone strength refers to mineral density. The amount of minerals present in bone tissue is a strong correlate of several metabolic bone diseases, including osteoporosis, rickets, osteomalacia, osteogenesis imperfecta, and fibrous dysplasia.

For many years research has been suppressed by a long-standing (and anecdotal) assumption that caffeine poses a negative effect on calcium absorption. Scholarly inspection concluded this impact to be a fractional one.

“There is no evidence that caffeine has any harmful effect on bone status or on the calcium economy in individuals who ingest the currently recommended daily allowances of calcium.” celebrated osteology expert,  Dr. Robert Heaney wrote back in 2002.

Coffee Consumption and its Association with Bone Mineral Density

The Hong Kong University researchers began their analysis with 564  healthy community-dwelling adults previously involved in an osteoporosis study from a few years back. The participants were tasked with documenting the frequency of their coffee consumption in the followup examination logged in November of last year.

Twelve serum metabolites important to bone mineral density were significantly more concentrated among regular coffee drinkers—three molecules (quinate, 3-hydroxypyridine sulfate, and trigonelline) evidenced particular relevance to the study’s premise.

“Among these metabolites, 11 known metabolites were previously identified to be associated with coffee intake and 6 of them were related to caffeine metabolism. Habitual coffee intake was positively and significantly associated with BMD at the lumbar spine and femoral neck,” the authors continued.

The health benefits linked to coffee consumption are almost all preventive in nature. The abundance of anti-oxidants contained in a single serving effectively disarms free-radicals which in turn delays many of the physical markers of the ageing process. These very same agents have been confirmed to be instrumental measures against cavities, diabetes, cirrhosis of the liver and various forms of cancer.

A study conducted back in 2018 that used mouse models determined that drinking four shots of espresso a day boosts heart health by reinvigorating important proteins and cardiovascular cells.

“For all those folks who drink lots of coffee and are concerned about the health effects of coffee, this is good news,” Cleveland Clinic’s Dr. Chad Deal, who was not directly involved in the study, said in a press release. “It appears to show that coffee is, in general, probably good for bone health.” 

Health experts warn Congress coronavirus may hit US hard in next two to four weeks.

Leading health officials expect to see a significant uptick in coronavirus cases nationwide.

“We’re going to start to see those outbreaks emerge sometime in the next two to four weeks,” said Scott Gottlieb, former Food and Drug Administration commissioner. “We should be leaning in very aggressively to try to broaden diagnostic screening right now, particularly in communities where there is a lot of immigration where these efforts could emerge to identify them early enough that they’ll be small enough that we can intervene to prevent — prevent more epidemic spread in this country.”

Gottlieb, one of five panelists who briefed the Senate Homeland Security and Governmental Affairs Committee on Wednesday, said although U.S. customs officials blocked some travel and are screening travelers returning from the Chinese city of Wuhan, where the virus is believed to have originated, they could not have stopped every person with coronavirus from getting into the United States.

“I don’t think we should be planning for the onesie-twosie cases that we’ve been seeing thus far in the United States,” said Asha George, executive director of the Bipartisan Commission on Biodefense. “We have to plan for the possibility that we have thousands of cases, you know.”

Hundreds of thousands of coronavirus cases could break out globally, George said, adding federal, state, and local governments should start planning for an outbreak on a massive scale.

“We’re going to see a lot more cases here, and I really worry about the helpers in the parasite patients,” said Luciana Borio, former director of medical and biodefense preparedness at the National Security Council.

Julie Gerberding, a former director of the Centers for Disease Control and Prevention, said the U.S. would begin to see more cases among people who did not visit China but were exposed to the virus by people who returned from China either before the travel ban or who were not flagged in health screenings upon their return.

“We shouldn’t assume that the 13 cases that we’ve identified — I think 10 of them were travel-related people who came directly from China and imported the virus into the United States — that we just managed to find all 10 people coming in from China who happened to have coronavirus,” said Gottlieb, who added many passengers returning from China or elsewhere could have been asymptomatic or only showed mild symptoms. “Some of the modeling out of the U.K. suggests that we’re capturing about 25% of cases at best. So for every case we identify, there’s three or four that we didn’t identify.”

He added, “One or a few breakouts may happen on a local level, but until there is a trend or deadly case, local governments may not realize or be able to sound off and at least some of those cases, probably are propagating at a local level, but not enough cases have accumulated yet to be identifiable.”

Gottlieb said he believes China first saw the epidemic spread internally in November and doubts the Chinese government’s data are sound. The coronavirus was confirmed to be in the U.S. in January, unbeknownst to the public. Chinese officials announced the first known human-to-human transmission on Jan. 20.

The panel members said they are watching the world to see how the virus progresses because it will show how cases exported from China become a global pandemic. Singapore has reported 50 cases, which Gottlieb said is “concerning” because it is the middle of summer there.

“We’re going to know much much more in the next two weeks as we examine what’s happening in Singapore. And what’s happening on a very unfortunate cruise ship because we get a better estimate of how many people with disease actually progressed to severe disease,” Gottlieb said. “What we should be worried about isn’t the cases that we know about — it’s the cases we don’t know about. There’s certainly cases we don’t know about.”

Coronavirus disease 2019 (COVID-19)
Situation Report – 23

SITUATION IN NUMBERS total and new cases in last 24 hours
Globally
45 171 confirmed (2068 new)
China
44 730 confirmed (2022 new)
8204 severe (871 new)
1114 deaths (97 new)
Outside of China
441 confirmed (46 new)
24 countries
1 death

People Under Investigation (PUI) in the United States*†

People under Investigation (PUI) in the United States

Positive	13
Negative	347
Pending§	60
Total	420

^*Cumulative since January 21, 2020.

Evacuee Confirmed to Have Coronavirus in California as US Total Reaches 13

One of the evacuees who was transported from China to California last week due to coronavirus fears was diagnosed on Monday with the new virus, becoming the 13th known case on U.S. soil, reports said.

The patient left Wuhan — the epicenter of the virus — on a State Department chartered flight carrying 167 evacuees that arrived at Marine Corps Air Station Miramar in San Diego on Wednesday.

The patient is under observation and isolation at UC San Diego Medical Center and is “doing well,” according to the hospital.

“CDC is conducting a thorough contact investigation of the person who has tested positive to determine contacts and to assess if those contacts had high-risk exposures,” the Centers for Disease Control and Prevention said in a statement, according to Reuters.

The evacuee was among four people — three adults and one child — who were taken to UC San Diego Medical Center with a fever or a cough, according to the CDC.

The CDC said all four patients had tested negative for the coronavirus on Sunday and were returned to MCAS Miramar, according to Reuters. However, on Monday, the CDC said that additional testing showed the patient had tested positive while in the 14-day mandatory quarantine.

Another patient was also transported to the hospital on Monday for evaluation and will remain there for further tests. It’s not clear if they were part of the four people originally tested.

“Both patients are doing well and have minimal symptoms,” the medical center said per the news organization.

195 Americans released from coronavirus quarantine at air base

The 195 Americans who were evacuated from Wuhan, China, last month have now been released from the first mandatory quarantine the Centers for Disease Control and Prevention has ordered in more than 50 years.

The group, which faced numerous health screenings both in China and during their trip and quarantine, has now been “medically cleared,” health officials said Tuesday, clearing the way for them to leave the March Air Reserve Base in Southern California.

“Our guests at March Air Reserve Base are happy to see an official end today to their 14-day quarantine and are looking forward to returning home. We wish them well!” Riverside University Health System – Public Health said via Facebook Tuesday, posting an image of the evacuees gathered together outside, tossing blue face masks into the air.

While the evacuees are glad to see the end of an ordeal that began at the epicenter of a global health emergency, there are also some mixed feelings about disbanding a group that has grown close.

“They’re very excited to go home, and at the same time, we’re kind of sad saying our goodbyes to each other,” evacuee Matthew McCoy, who worked in Wuhan as a theme park designer, told NPR’s Patti Neighmond.

“We’ve all created a family environment here,” McCoy said, adding that many of the evacuees plan to stay in touch through special groups on Skype and other platforms.

McCoy says the group coped with the quarantine as a team, trying to maintain a positive attitude.

“We chose to work together,” he said. “We chose to create classes and things like that. That made it more of a positive outlook. And we all helped each other. It’s better than sitting around sulking and not doing anything.”

There are no confirmed cases of the 2019 novel coronavirus among the 195 evacuees, the health system said in a statement disseminated by the Department of Health and Human Services.

“They have completed their final health check this morning, which included their symptom check and their temperature check,” said Rear Admiral Dr. Nancy Knight of the Centers for Disease Control and Prevention. Saying that it’s now safe for the group to rejoin their communities and families, Knight added, “This is a huge celebration for all of us here at March Air Reserve Base.”

Knight also stressed that the completion of the quarantine means that the evacuees have been determined to be entirely free of the virus that has now killed more than 1,000 people in China.

‘Diamond Princess’ Reports 66 New Coronavirus Infections, Bringing the Total to 136

The Diamond Princess, the cruise ship that has been quarantined off the coast of Yokohama, Japan for roughly a week now, saw the total number of confirmed nCoV infections climb to 136 on Monday, cementing its position as the host of the largest outbreak outside China.

Japanese health authorities have been extremely careful in dealing with the ship, which has become a massive albatross for the government of PM Shinzo Abe. While Hong Kong let a cruise ship sail yesterday following a 4-day quarantine (the ship was reportedly found to be free of viral infections), the ‘Diamond Princess’, and the 2,500+ remaining passengers and crew, will be stuck in place until mid-February. The NYT chronicled the growing sense of unease and paranoia aboard the ship, which we cited yesterday.

The ship’s captain Stefano Ravera announced Monday that 66 new cases of the virus had been confirmed, bringing the infection total of passengers and crew to 136, roughly equal to all the other cases in Asia outside China. Media reports have claimed more than 2,500 passengers and crew remain aboard the ship.

Novel Coronavirus(2019-nCoV)
Situation Report – 20

SITUATION IN NUMBERS
total and new cases in last 24 hours
Globally
37 558 confirmed (2676 new)
China
37 251 confirmed (2657 new)
6188 severe (87 new)
812 deaths (89 new)
Outside of China
307 confirmed (19 new)
24 countries
1 death

Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

Key Points

Question  What are the clinical characteristics of hospitalized patients with 2019 novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) in Wuhan, China?

Findings  In this single-center case series involving 138 patients with NCIP, 26% of patients required admission to the intensive care unit and 4.3% died. Presumed human-to-human hospital-associated transmission of 2019-nCoV was suspected in 41% of patients.

Meaning  In this case series in Wuhan, China, NCIP was frequently associated with presumed hospital-related transmission, 26% of patients required intensive care unit treatment, and mortality was 4.3%.

Abstract

Importance  In December 2019, novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.

Objective  To describe the epidemiological and clinical characteristics of NCIP.

Design, Setting, and Participants  Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up was February 3, 2020.

Exposures  Documented NCIP.

Main Outcomes and Measures  Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked.

Results  Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men. Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 [29%]) and hospitalized patients (17 [12.3%]). Common symptoms included fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]). Lymphopenia (lymphocyte count, 0.8 × 10⁹/L [interquartile range {IQR}, 0.6-1.1]) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients (39.9%). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Most patients received antiviral therapy (oseltamivir, 124 [89.9%]), and many received antibacterial therapy (moxifloxacin, 89 [64.4%]; ceftriaxone, 34 [24.6%]; azithromycin, 25 [18.1%]) and glucocorticoid therapy (62 [44.9%]). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 [61.1%]), arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%] vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]). Of the 36 cases in the ICU, 4 (11.1%) received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17 (47.2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). As of February 3, 47 patients (34.1%) were discharged and 6 died (overall mortality, 4.3%), but the remaining patients are still hospitalized. Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7.0-14.0).

Conclusions and Relevance  In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%.