The focus is shifting away from the epicenter of the coronavirus outbreak with international cases outpacing new cases in China for the second day in a row and nations are preparing for outbreaks of the deadly virus at home.
In the past 24 hours, seven countries have reported cases for the first time, bringing the new viral illness, COVID-19, to every continent except Antarctica.
World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus has been urging nations for weeks not to squander a "window of opportunity," and today he once again warned that it is narrowing.
"My advice to these countries is to move swiftly," he said of the new cases.
The epidemic is sending stocks spinning and people into a panic as health officials, reporters, and private citizens try to determine personal risk and the chances the virus becomes a full-blown pandemic.
Dr. Tedros cautioned that the world is still not at that point yet, and maintained in a phone call with reporters on Thursday that there still does not appear to be "widespread community transmission." He described four different levels of escalation in a community: the first case, the first cluster, the first evidence of community transmission, and, ultimately, sustained community transmission. So far, Iran, Italy, and South Korea are confronting instances of community transmission but not yet sustained.
It is still unclear what the state of COVID-19 in the U.S. might be after a patient in California waited days before diagnoses after failing to meet the strict federal criteria required to be tested. The U.S. Centers for Disease Control and Prevention said it was possible the patient was exposed to an infected traveler. If confirmed, the case may prove to be that of the first person in the U.S. to be infected through community spread.
"This virus does not respect borders. It does not distinguish between races or ethnicities," Dr. Tedros forewarned. "The point is not only to prevent cases arriving on your shores. The point is what you do when you have cases." He said if any nation, developed or developing, does not have plans in place for detection, dealing with misinformation, testing centers, border preparations, and training health workers, "your country has a gap that this virus will exploit."
He said his concern is highest for a potential spread on the African continent and for vulnerable populations — like older people and those with underlying health problems — in every country.
But in China, the number of new cases appears to be slowing. Within its borders, there have been a reported 78,630 cases and 2,747 deaths. Outside of the country, there are 3,474 cases in 44 countries and 54 deaths.
More than 80 percent of cases in China were described as mild according to a study on the first 44,672 cases by Feb. 11, but experts are concerned that the mildness of the disease actually makes it harder to keep the virus contained as it presents much like the common cold. Cases defined as mild did not involve pneumonia, or only involved mild pneumonia.
Severe cases included low oxygen saturation in blood and lung problems, while critical cases include organ dysfunction, septic shock, and respiratory failure. The study documented that less than 14 percent of cases were severe and less than 5 percent critical. In China, the overall fatality rate is 2.3 percent.
Dr. Tedros said asymptomatic patients are not currently driving the epidemic, and individuals should take precautions they would for the general flu. "If I am asked to advise communities to prevent the virus I would give the same advice I would give for the flu," he said, like washing one's hands with soap, refraining from touching one’s face, coughing into a sleeve, and being careful about touching surfaces.