Corona Virus in China (EN)

Current Developments

Number of cases in Italy has risen sharply (23.02.2020)

After the number of infected people in Italy rose to over 100, 11 municipalities near Milan and Padua were sealed off. The carnival in Venice has been cancelled. The number of infected people in Iran and South Korea has also risen sharply.

Current case numbers (21.02.2020)

In China, a total of over 74,187 confirmed cases of the disease have been registered totally since the outbreak, with 2,006 deaths. Worldwide, more than 75,316 cases with 2,012 deaths have been registered. 58,232 people are currently infected, with 79% of patients showing mild signs of the disease, while 21% are in a serious or critical state of health.

The following countries have already registered infections with the novel coronavirus (number of cases/deaths) Singapore (84), Japan (84/1), South Korea (156), Thailand (35), USA (29), Taiwan (23/1), Malaysia (22), Vietnam (16), Germany (16), Australia (15), France (12/1), United Kingdom (9), UAE (9), Canada (8), Philippines (3/1), Italy (3), India (3), Russia (2), Spain (2), Egypt (1), Nepal (1), Sri Lanka (1), Cambodia (1), Finland (1), Sweden (1), Belgium (1). Cruise ship: Diamond Princess (621).

Quarantine measures for travel to China become stricter (19.02.2020)

China is currently regularly tightening quarantine regulations, including a 14-day quarantine period for Beijing. Travelers arriving in Beijing from Germany on an international flight and who have not been in China for the past 14 days are not subject to the 14-day quarantine and can stay in Beijing without any physical restrictions. If the entry into Beijing is from another area of China, the 14-day quarantine period must be observed. This can be done at home or in a hotel.

Travel restrictions after stays in China (18.02.2020)

Irrespective of the exact place of stay in China, many countries have massively tightened their entry regulations for arrivals from China or even from its neighbouring countries. This can lead to long compulsory quarantine or a complete ban on entry. Please enquire in advance at your Foreign Office, your embassy in the destination country or the embassy of the destination country.

Case numbers in South Korea have risen sharply (21.02.2020)

With an increase from 52 to 156 infected persons, South Korea is now the country outside China most affected by the epidemic. 41 of these new infections alone have been registered in the 2.5 million city of Daegu and its surroundings. The city also saw the first death from the lung disease (Covid 19) caused by the virus. Seoul has now declared the city a "special management zone".

Case numbers in China have risen sharply (13.02.2020)

From 12 to 13 February 2020, the number of infected people in China has risen massively by almost 15,000 to a total of around 50,000 in the Wuhan metropolitan region and around 60,000 overall in mainland China. On the one hand, this corresponds to the expected peak of the epidemic, and on the other hand, it is the result of a more precise diagnostic procedure by the Chinese authorities and doctors.

Mortality risk for infection with Covid-19 (21.02.2020)

According to data from the Chinese authorities, the general mortality risk from contracting the lung disease Covid-19 is 2.3 percent. Age plays a significant role: the risk of dying from the infection increases significantly from the age of 50. People over 80 are most at risk, with a mortality rate of 14.8%. Gender also seems to play a role: While the mortality rate for men is 2.8%, it is only 1.7% for women.

Major events can be cancelled worldwide

Since the beginning of the epidemic, all major events such as festivals, sporting events and trade fairs in China have been cancelled or postponed indefinitely. Events may also be cancelled worldwide. For example, it was announced that the GSMA Mobile World Congress 2020 in Barcelona, the largest of its kind in the world, will be cancelled as a precautionary measure. It was to take place at the end of February.

New name for the virus and the disease caused

On February 11, 2020, the WHO announced that the official name for the pathogen previously named "2019-CoV" would in future be "SARS-CoV-2". The clinical picture triggered by the pathogen will in future be referred to as "COVID-19" (coronavirus disease 19).

Note on the quick test and reporting system

In China, there is a growing number reports about quick coronavirus tests (nCoV-PCR tests) which do not detect the pathogen in symptomatically infected persons, or only after a time delay. Random samples showed presumably false negative results in 50-70% of the infected persons examined. The testing of throat swabs is particularly susceptible to false negative results. (ProMED 09.02.20)

Increased entry controls

In general, increased entry controls to identify sick travellers, especially from China, and imported individual cases of illness, must currently be expected in all countries.

Risk of infection

The novel coronavirus is significantly less contagious than the measles virus, but seems to be as easily transmissible as influenza viruses. It is assumed that 2019-CoV is even more contagious than the SARS pathogen.

According to current estimates by researchers from the Universities of Greifswald and Bochum, corona viruses can survive for up to nine days on surfaces at room temperature. However, the pathogens react sensitively to numerous disinfectants. Ethanol (62-71 Vol%), hydrogen peroxide (0.5%) and sodium hypochlorite are particularly suitable for surface disinfection. Thus a sufficient effect can be achieved with an exposure time of only one minute. (Journal of Hospital Infection 2020)

What precautionary measures are possible?

The most important thing is personal hygiene, especially regular and proper hand washing. It is also recommended to avoid contact with people suffering from respiratory diseases. Very casual contacts are considered to be low risk, generally "face-to-face" contacts of at least 15 minutes are required for direct infection. 

Therapy and vaccine development

An established treatment or vaccine is not yet available, but intensive work on a vaccine is underway. Mild disease progressions probably do not require targeted therapy, while severe disease progressions may require intensive medical treatment with the aim of keeping the patient's vital functions stable until his immune system has successfully contained the pathogen. Antiviral substances are used for severe clinical courses of the disease. In Thailand, initial successes have been achieved in healing trials with a combination of anti-HIV and anti-influenza agents. The active ingredients used were lopinavir, ritonavir and oseltamivir. However, the effectiveness of drugs can hardly be assessed in the context of healing trials, especially in the case of infections with a high spontaneous healing rate.

The next step on the way to an internationally recognized therapy is therefore the implementation of randomized, placebo-controlled studies. Active ingredients that appear to be particularly good candidates for controlled clinical trials due to their pronounced efficacy under laboratory conditions (in vitro activity) include the antiviral Remdesivir and Chloroquine, which is known primarily as a classic anti-malarial agent. However, the clinical effectiveness of these therapeutic approaches cannot yet be assessed at this stage.

Current statistics suggest a mortality rate of around two percent. However, the mortality rate in Wuhan is about twice as high as in the rest of China.

However, due to the expected number of undetected cases of mild undiscovered diseases, the actual mortality rate could also be significantly lower. The rate of patients with severe symptoms of infection could be around 25 percent of those infected.

Fact sheets (German Federal Foreign Office, WHO and RKI)

Please note the information in the nCoV leaflet and on the pages of the World Health Organisation WHO and the Robert Koch Institute RKI.

Quick test and reporting system

By 5 January 2020, a quick test for infection with the novel corona virus is available. After the sample has arrived at a suitable laboratory, results can be obtained in less than two hours. However, not every patient with respiratory symptoms will be tested; in general, certain additional criteria must be met, in particular

  • a stay within a high risk area (Wuhan) at the time in question, or
  • contact with people who are confirmed to be infected, regardless of the severity of the symptoms.

In these cases, the laboratory and also the treating physicians should inform the public health department within 24 hours. In parallel, the attending physicians should isolate the patient in such a way that the risk of infection of third parties is reduced to a minimum.

An established treatment or vaccine is not yet available, but intensive work is currently underway on a vaccine.

General Information

The Corona Virus belongs to the order Nidovirales, whose representatives can cause very different diseases in various vertebrates such as mammals, birds and fish.
Corona viruses are genetically highly variable and can also cause serious infections in humans through so-called species transfers. Examples include the SARS pandemic of 2002/2003 and the MERS epidemic of 2012.

The Corona virus epidemic which has been spreading from the Chinese city of Wuhan since the turn of the year 2019/2020 is attributed to the previously unknown Corona virus 2019-nCoV. In humans it may lead to mild respiratory tract infections up to severe acute respiratory syndromes.

Symptoms of a possible infection can be:
 

  • Cough
  • Fever
  • Chills
  • Headache
  • Aching limbs
  • Weakness / fatigue
  • Frequently accompanied by diarrhoea

Risk of Infection

Where many people live together in a confined space, as is the case with the current outbreak, the transmission path from person to person becomes more relevant and may quickly become the main transmission mode in the course of the epidemic.

Nevertheless, infection when encountering infected persons is at most the exception rather than the rule. Infection is most likely to occur in very close and prolonged contact.

Depending on the degree of exposure, face masks of the classes FFP2 to FFP3 can reduce the risk of infection in personal contact. In addition, when symptoms of infection occur, the wearing of even the simplest face masks by the infected person can significantly reduce the risk of infection of others.

Selfcare Measures - What to Do to Prevent Infection?

In order to keep the risk of infection as low as possible, people who are currently in China should observe the following rules of conduct:

  • Avoid large crowds and markets
  • Avoid using public transportation
  • Wear a face mask of at least protection class FFP 2 outside your apartment / hotel
  • Pay close attention to your hand hygiene and use a suitable hand disinfectant regularly
  • Avoid contact with sick people and colleagues and especially with free-range animals
  • Expatriates living and working in the area should, if possible, work as much as possible from their home offices.

Due to the surge in demand, suitable face masks and disinfectants have become scarce in China and in some regions are no longer available to normal consumers or are only available at horrific prices.

On request, MD Medicus Assistance Service GmbH supplies the employees of their client businesses living in China with face masks, gloves and disinfectants from Germany. Should you require further information, please send an e-mail to assistance@md-medicus.net.

Dashboard of Current Illnesses

What to Do If You Are Suspected of Being Infected

The Chinese authorities have implemented a strictly followed schedule for all suspected Corona cases. Patients with the above symptoms must present themselves in a fever clinic that is designated for the respective location.

The fever clinics are responsible for the correct recording of all suspected cases, carry out all necessary examinations and ultimately decide whether a corona infection is confirmed or not.

The private, internationally oriented hospitals in China, which are preferred by tourists and expatriates, are usually not part of this emergency plan and are currently not allowed to treat patients with fever!

Here is a list of the fever clinics:

Fever Clinic in Wuhan

Fever Clinic in Shanghai (Main)

Fever Clinic in Beijing (Main)

Fever Clinic in Suzhou

Fever Clinic in Guang Dong

Fever Clinic in HangZhou

The incubation period, i.e. the time between exposure to the virus and the possible onset of the disease, is between one and 12 days for Corona. Patients who are already back home but who have been in Asia within the last two weeks should seek medical treatment immediately if the above symptoms occur and should also draw attention to their previous stay in Asia!

Evacuation / Repatriation of Patients from China (general - independent of Corona)

Flights, including ambulance flights to the quarantined areas such as the city of Wuhan or even into the entire Hubei region, are currently not officially possible and, if at all, in individual cases only feasible with a special permit that has to be to be applied for. For this reason, short-term evacuation flights from these regions are currently not feasible.

All non-quarantined regions can be flown to by the ambulance planes organized and provided by MD Medicus without any problems, as long as the patient to be transported does not suffer from unclear fever or even a confirmed Corona infection.

Evacuation / Repatriation of Patients from China with Confirmed Corona Infection or Reasonable Suspicion of Infection

In the event of undiagnosed fever or even of confirmed Corona infection, evacuation or repatriation is only possible under certain conditions, after consultation with the responsible epidemic control authorities in the recipient country and, in particular, only with aircraft specially equipped for transporting highly infectious patients.

MD Medicus Assistance Service GmbH is in a position to arrange everything for a speedy evacuation of patients with suspected or confirmed Corona infection around the clock. The special aircraft required for this purpose have been part of MD Medicus' worldwide network for years.

Flights, including ambulance flights to the quarantined areas such as the city of Wuhan or even into the entire Hubei region, are currently not officially possible and, if at all, in individual cases only feasible with a special permit that has to be to be applied for. For this reason, short-term evacuation flights from these regions are currently not feasible.

Risk Assessment

On 28/01/2020, the Federal Foreign Office issued a partial travel warning for China and especially for the Hubei region. According to the MD Medicus travel medicine experts, travel to the Hubei region including business trips should be completely avoided for the time being. You should also consider to refrain from postponable trips / business trips to the rest of China. Tour operators and airlines already offer free cancellations of already booked China trips. 

As it must be assumed that the current evacuation radius will be extended by the Chinese authorities at short notice in case of continuously increasing case numbers, sufficient distance to the current evacuation zone should be maintained on all unpostponable trips to China. This also serves to avoid being detained overnight and not being allowed to leave the country until further notice.

 

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