A coronavirus, at a "drive-through" virus test facility in Goyang, north of Seoul (Photo by JUNG YEON-JE/AFP via Getty Images)

A glance at the global spread of Covid-19, beyond China

Siouxsie Wiles looks at the places with the largest number of coronavirus cases outside mainland China, and the efforts to understand its spread. 

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We are now clearly dealing with a very serious global threat, as the number of confirmed cases of Covid-19 reaches over 93,000, with more than 3,000 deaths.

As I noted recently, China now seems to have the outbreak under control. So, let’s take a look at what’s happening in a few other countries.

Countries which currently have the largest number of cases outside of mainland China

Let’s start with Italy, as this is the country our second confirmed-positive Kiwi came from. According to the Johns Hopkins virus tracker dashboard, there have been over 2,500 confirmed cases to date. Interestingly, Italy was one of the first countries that not only closed contact with Wuhan but also all air contact with China.

In late January Italy confirmed their first few Covid-19 cases, all associated with travel to China. Then a few weeks later, on February 21, they announced they had a cluster of 16 cases in Lombardy. The next day another 60 people tested positive. The number of confirmed cases has been rising every day since. Yesterday they announced another 466 people had tested positive for the virus. Over 1,500 of the people with COVID-19 in Italy are in the northern Lombardy region, and several towns in the area have been quarantined. Italy has become a source of cases in various countries in Europe, as well as in Nigeria and the US.

According to this article in the Guardian, of those infected with the virus, 1,034 are in hospital. Of these 229 are in intensive care. The remaining people are recovering at home. So far, 79 people in Italy have died of Covid-19. They were all aged between 63 and 95 and had underlying health conditions. Italy has one of the highest life expectancies in Europe with nearly a quarter of its population over 65. This means Covid-19 could hit its population pretty hard.

The country with the highest number of confirmed cases outside of mainland China is the Republic of Korea. They currently have over 5,300 confirmed cases and 32 deaths. Their outbreak started in earnest around February 19 and it’s not clear if it has peaked yet.

One of the reasons they may have so many confirmed cases is because they have been doing the most extraordinary number of tests. They are trying to find anyone and everyone who tests positive so that they can try to halt the spread of the virus. They have even set up drive-through testing stations.

Next after the Republic of Korea in terms of number of cases is Iran, which has announced over 2,300 confirmed cases and 77 deaths just in the last few days. Several government ministers and aides have the virus, which is not surprising after the country’s deputy health minister sweated and coughed his way through press conferences and interviews. Turns out he had Covid-19.

Other countries to watch

The latest WHO situation report has an excellent table which lists all the countries with Covid-19 and whether the cases are imported or through local transmission like the ones described above. So far 30 countries show local transmission. It’s worth taking a look at, especially if you have any travel booked for the near future. Most of the clusters are small, but for countries with larger numbers it does suggest the virus may be spreading in the community.

I’ve already written about the US which clearly now has community transmission of Covid-19 and likely has had for several weeks. They are now up to more than 100 cases and six deaths. We should expect numbers to explode in the coming weeks as they get their testing set up and start doing contact tracing. Our close neighbour Australia has had its share of imported cases for more than a month now. But is now reporting local transmission too.

And Singapore

The island nation of Singapore has had 110 people test positive for coronavirus and no deaths. According to their Ministry of Health’s website they currently have 32 active cases. Twenty-five of these people are in a stable condition in hospital, while one is listed as critical.

I include Singapore here mainly because Alex Koh is producing the most incredible visualisations of their outbreak data. It shows how many of the early cases were imported, but that more recent cases don’t have any links back to imported cases suggesting transmission in the community. The visualisation show how Singapore has also experienced six clusters of cases, including two associated with churches, one with a Chinese health products shop, and one with a construction site.

This infographic on the Singapore Ministry of Health’s website shows how several of the clusters were linked.

It’s by studying clusters like this that we start to get a handle on how the virus spreads –our understanding is growing with every passing day.

For more on the latest in New Zealand, and a note on asymptomatic transmission, see here.


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