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Yale ESF-8 Special Report COVID-19 3-26-2020

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Yale ESF-8 Special Report COVID-19 3-26-2020

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As of 26 March 2020, the United States has the most active cases of COVID-19 in world and has surpassed China.

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  1. 1. YALE ESF-8 SPECIAL REPORT CORONAVIRUS (COVID-19) US RESPONSE AS OF 26 MARCH 2020 2300 HRS EST US FEDERAL GOVERMENT • CORONAVIRUS.GOV • USA.GOV HHS COVID-19 CDC • CDC – COVID-19 NIH • COVID-19 NIOSH • NIOSH CORONAVISUS FEMA • FEMA DOD Coronavirus Response USAF _ COVID-19 NEWS SOURCES • New York Times COVID-19 Coverage • WASHINGTON POST • Reuters • CNN • Xinhua ASSOCIATION • AMERICAN HOSPITAL ASSOCIATION • NRHA SITUATION - GLOBAL PORTALS, BLOGS, AND RESOURCES • YALE NEWHAVEN HEALTH – COVID-19 • YALE MEDICINE • YALE NEWS _COVID 19 • JOHN HOPKINS UNIVERSITY COVID-19 GLOBAL CASES (CSSE) • COVID-19 SURVEILLANCE DASHBOARD • CIDRAP • H5N1 • VIROLOGY DOWN UNDER BLOG • CONTAGION LIVE • WORLDOMETER • 1POINT3ACRES UNITED STATES 85,428 1,290 GLOBAL 531,860 24,057 GLOBAL GLOBAL 122,203 Currently, COVID-19 is rapidly spreading worldwide. The speed with which COVID-19 can cause nationally incapacitating epidemics once transmission within the community is established, indicates that in a few weeks or even days. BACKGROUND WHO • WHO –COVID-19 • ECHO • PAHO AFRO • EMRO • Western Pacific OCHA • ReliefWeb ECDC • European Centre for Disease Prevention and Control CCDC • China Center for Disease Control and Prevention INTERNATIONAL CONFIRMED CASES DEATHS UNITED STATES RECOVERED UNITED STATES JOUNALS AND ONLINE LIBRARIES • BMJ • Cambridge University Press • Cochrane • Elsevier • JAMA Network • The Lancet 2019-nCoV Resource Centre • New England Journal of Medicine • Oxford University Press • Wiley CASES IN US 713 SITUATION - US As of 26 March 2020, the United States has the most active cases of COVID-19 in world and has surpassed China.
  2. 2. WHAT IS COVID-19 Coronavirus disease (COVID-19) is a new strain that was discovered in 2019 and has not been previously identified in humans. Coronaviruses are zoonotic, meaning they are transmitted between animals and people. HOW IS IT SPREAD? People can catch COVID-19 from others who have the virus. The disease spreads from person to person through small droplets from the nose or mouth when a person with COVID-19 coughs or exhales. Droplets can land surfaces around the infected person and other can catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in droplets from the infected person. This is why it is important to stay more than 3 feet away from a person who is sick. (WHO) Time from exposure to onset of symptoms is generally between 2 and 14 days. (CDC) WHAT ARE THE SYMPTONS? Common symptoms include fever, cough, and shortness of breath (CDC). Complications may include pneumonia and acute respiratory distress syndrome. PREVENTIVE MEASURES Recommended preventive measures: hand washing, covering the mouth when coughing, maintaining distance from other people, and monitoring and self-isolation for people who suspect they are infected. NOTE: Anecdotal evidence is rapidly accumulating from sites around the world that anosmia (lack of smell) and dysgeusia (lack of taste) are significant symptoms associated with the COVID-19 pandemic. Anosmia, in particular, has been seen in patients ultimately testing positive for the coronavirus with no other symptoms. BACKGROUND WHERE: WORLDWIDE WHEN: DECEMBER 2019 - CURRENT SITUATION PANDEMIC OUTBREAK – COVID-19 BACKGROUND: At the end of December 2019, Chinese public health authorities reported several cases of acute respiratory syndrome in Wuhan City, Hubei province, China. Chinese scientists soon identified a novel coronavirus as the main causative agent. The disease is now referred to as coronavirus disease 2019 (COVID-19), and the causative virus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is a new strain of coronavirus that has not been previously identified in humans. The initial outbreak in Wuhan spread rapidly, affecting other parts of China. Cases were soon detected in several other countries. Outbreaks and clusters of the disease have since been observed in Asia, Europe, Australia, Africa and the Americas. (ECDC)
  3. 3. SITUATION - GLOBAL GLOBALLY EUROPE • WHO has declared COVID-19 a global pandemic • 196 countries, areas or territories have confirmed cases • Europe is now the epi-center of the virus • The ECDC, in its seventh COVID-19 assessment, said that, since Mar 12, all European countries have now reported cases and that 63% of the global cases have been in Europe. With current testing capacity and if nations do not enact mitigation strategies, Europe could see by the middle of April a scenario similar to what China experienced in Hubei province at the beginning of the outbreak. • In EU/EEA countries with available data, 30% of diagnosed COVID- 19 cases were hospitalized and 4% had severe illness. • Hospitalization rates were higher for those aged 60 years and above. Estimates of crude case-fatality for Germany, Italy and Spain showed that both the risk and absolute numbers of deaths rapidly increased with age for those aged 60 years and above in each country. • Among hospitalized cases, severe illness was reported in 15% of cases, and death occurred in 12% of these cases, with higher case– fatality rates in older adults. (ECDC) ITALY • On 26 March Italy reported 6,153 new cases, its second highest daily total, lifting its overall number to 80,539. Italy also reported 662 more deaths, raising its fatality count to 8,165. SPAIN • On 26 March, Spain's daily total was 6,673 cases today, along with 442 more deaths, raising its respective totals to 56,188 and 4,089. • The Spanish government extended its lockdown until at least Apr 12. • The United Kingdom reported 2,128 new cases, along with 113 more deaths, putting the country over the 10,000-case mark with 11,658. So far, 578 patients in the UK have died from their infections. GERMANY - now has 36,508 cases, 44 of them fatal. RISK ASSESSMENT • The risk of severe disease associated with COVID-19 for people in the EU/EEA and the UK is currently considered moderate for the general population and very high for older adults and individuals with chronic underlying conditions. • The risk of occurrence of widespread national community transmission of COVID-19 in the EU/EEA and the UK in the coming weeks is moderate if effective mitigation measures are in place and very high if insufficient mitigation measures are in place. • The risk of healthcare system capacity being exceeded in the EU/EEA and the UK in the coming weeks is considered high.
  4. 4. SITUATION - GLOBAL • The African continent is rapidly being engulfed by the global coronavirus disease (COVID-19) pandemic, with 43 countries reporting confirmed cases and a few countries beginning to exhibit community transmission. • This recent trend is concerning as most of the low-income African countries have several vulnerabilities, including fragile health systems to cope up with high caseloads, high prevalence of HIV, malnutrition and a rising incidence of non-communicable and other chronic illnesses. (AFRO) RUSSIA - Announced that the country would seal all its borders and cancel all international flights, except for ones bringing Russians home. ASIA CHINA - Announced that foreigners will be barred from entering the country, except for diplomats and crew of international airlines and ships. It also reduced the number of international flights going in and out of China. Nearly all the country's new COVID-19 cases over the past few weeks have been imported cases. AFRICA SOURCE: NYT
  5. 5. DISTRIBUTION OF COVID-19 CASES WORLDWIDE SOURCE: WHO SITREP #66
  6. 6. EPIDEMIC CURVE OF CONFIRMED COVID-19, (AS OF 26 MARCH 2020) SOURCE: WHO SITREP #63 ECDC
  7. 7. CASE DISTRTIBUTION COVID-19 (AS OF 26 MARCH 2020) SOURCE: WHO SITREP #63 ECDC
  8. 8. SITUATION - US On 26 March, Governor Bel Edwards in a press conference said that he expects his state to be out of ventilators by the first week of April and that the state needed an additional 600 machines Louisiana Department of Health reports 676 patients are in hospitals, and 239 are on ventilators • Confirmed cases of the novel coronavirus, COVID-19, reached 82,404 today in the United States, giving it the most cases in the world. • 26 March was the most active day so far in the country, with 14,042 new cases reported, and the national death toll reaching 1,069 fatalities. • Certain hot spots are appearing to produce a hospitalization rate that was doubling every 2 to 3 days, namely in New York City and in parts of California. • Detroit, New Orleans, and Atlanta all reported quickly filling intensive care units (ICUs) NEW YORK As of 26 March New York state reported 39,125 cases, the most of any state in the country During his daily briefing, Governor Cuomo said 5,327 people are currently hospitalized in the state for COVID-19, including 1,290 patients in ICUs. NY Health officials project that 140,000 people will be hospitalized with the coronavirus over the next 14 to 21 days. NEW JERSEY New Jersey are ported a surge on 26 March, of 2,492 newly confirmed infections in a 24 hour period, brings the state’s total to 6,876. LOUISIANA SOURCE: CIDRAP SEATTLE TIMES GOV CUOMO DAILY BRIEF The state Department of Health announced 627 newly confirmed cases on 26 MARCH, bringing the state total to 3,207 cases, including 147 deaths. The bulk of Washington’s cases remain in King County, which has seen 1,577 people fall ill and 109 die. WASHINGTON
  9. 9. SITUATION - US STATE CASES DEATHS New York 39,125 454 New Jersey 6,876 81 California 4,019 82 Washington 3,207 150 Michigan 2,844 61 Illinois 2,541 26 Florida 2,484 29 Massachusetts 2,417 25 Louisiana 2,304 83 Pennsylvania 1,795 18 Texas 1,639 22 Georgia 1,505 56 Colorado 1,430 19 Tennessee 1,097 3 Connecticut 1,012 21 Ohio 868 15 North Carolina 744 3 Wisconsin 728 10 Indiana 645 17 Maryland 583 4 Missouri 520 9 Alabama 517 1 Arizona 508 8 Mississippi 485 6 Virginia 468 10 South Carolina 456 9 Nevada 420 10 Utah 396 1 STATE CASES DEATHS Minnesota 344 2 Arkansas 335 2 Oregon 316 11 District of Columbia 267 3 Oklahoma 248 7 Kentucky 247 5 Iowa 179 1 Kansas 172 3 Rhode Island 165 0 Vermont 158 9 Maine 155 0 Idaho 146 3 New Hampshire 137 1 New Mexico 136 1 Delaware 130 1 Hawaii 106 0 Montana 90 0 Nebraska 74 0 Puerto Rico 64 2 North Dakota 57 0 Alaska 56 1 Wyoming 53 0 West Virginia 52 0 South Dakota 46 1 Guam 45 1 Virgin Islands 17 0 Note: The Grand Princess Cruise Ship had 28 US confirmed cases and the Dimond Princess 49. SOURCE AS OF 2300 hrs 26 MARH 2020: JOHN HOPKINS UNIVERSITY COVID-19 GLOBAL CASES (CSSE)
  10. 10. CASES IN THE US SOURCE:JOHN HOPKINS UNIVERSITY COVID-19 GLOBAL CASES (CSSE) SOURCE: NYT • The number of known cases of the coronavirus in the United States continues to surge. • US has more known cases of coronavirus than any other country SOURCE: NYT
  11. 11. US RESPONSE FEMA • All 50 states, the District of Columbia, 5 territories, and 5 tribal nations are working directly with FEMA under the nationwide emergency declaration for COVID-19 • Using new acquisitions, the Strategic National Stockpile, and Department of Defense allocations, FEMA is leading the coordinated Federal agency efforts increasing hospital capacity, community-based testing sites (CBTS), and significant deployment of personal protective equipment and medical equipment. • NRCC: Level I in unified effort with HHS SOC • All RRCCs activated • President Donald J. Trump Approves Major Disaster Declaration for Maryland (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for Illinois (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for New Jersey (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for North Carolina (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for Florida (English) (Spanish) • President Donald J. Trump Approve Major Disaster Declaration for Texas (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for Louisiana (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for Iowa (English) (Spanish) • President Donald J. Trump Directs FEMA Support Under Emergency Declaration for COVID-19 (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for New York (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for Washington (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for California (English) (Spanish) DECLARATIONS
  12. 12. US RESPONSE HHS • Department of Health and Human Services designated certain health and medical resources needed to respond to the spread of COVID-19 subject to hoarding restrictions under the Defense Production Act and a March 23 executive order. The designation includes N95 and certain other respirators, ventilators, personal protective equipment, drug products, medical device sterilization services and disinfecting devices. • HHS Secretary Alex Azar yesterday asked the nation’s governors to immediately allow health professionals licensed or certified in other states to practice in their state in person or through telemedicine. In addition, he asked states to: o Waive certain statutory and regulatory standards “not necessary for the applicable standards of care to establish a patient-provider relationship, diagnose, and deliver treatment recommendations” using telehealth technologies o Relax scope of practice requirements for health professionals, including allowing them to practice in all care settings; o Allow physicians to supervise a greater number of other health care professionals and to do so using remote or telephonic means; o Allow for rapid certification/licensure and recertification/relicensure of certain health care professionals o Develop a list of their state liability protections for in-state and out-of-state health professionals during this national emergency and modify, rescind or waive any medical malpractice policies that may prevent coverage of health professionals responding to the COVID-19 emergency in another state; o Modify laws or regulations as appropriate to allow medical students to triage, diagnose and treat patients under the supervision of licensed medical staff; and o Allow pharmaceutical deliveries without signature to prevent delivery person contact with recipients. SOURCE: CDC
  13. 13. US RESPONSE ARNORTH • At the direction of U.S Northern Command, U.S. Army North requested the deployment of units to provide defense support of civil authorities in response to the COVID-19 national emergency. • Active Duty units supporting this mission include: o Joint Task Force-Civil Support Headquarters, Joint Base Langley-Eustis, Va. o 3rd Expeditionary Sustainment Command, Ft. Bragg, NC o 4th Sustainment Brigade, 4th Infantry Division, Fort Carson, CO o 63rd Expeditionary Signal Battalion, Fort Stewart, GA SOURCE: DOD The following US Army Hospital Centers a deploying: • 531st Hospital Center - Fort Campbell, Kentucky to support New York • 9th Hospital Center - Fort Hood, Texas to New York • 627th Hospital Center - Fort Carson, Colorado to Washington State The advance party is on the ground .The main body will arrive at Joint Base McGuire Dix Lakehurst, 27 MARCH. They will set up at the Javits Center in New York this weekend, and they will be operational for non-COVID-19 patients beginning March 30. (DOD) 1st MED Brigade headquarters has been assigned to support the Joint Task Force – Civil Support’s COVID-19 response efforts, and will be leading medical planning operations from Fort Hood. SOURCE: WHITE HOUSE DAILEY BRIEF – 26 MARCH 2020 USNS MERCY • The USNS Mercy, a 1000 bed ship, will deploy to the port of Los Angeles this week and will serve as a referral hospital for non-COVID-19 patients currently admitted to shore-based hospitals, and will provide a full spectrum of medical care to include critical and urgent care for adults. • The ship sailed from Naval Station San Diego on March 23 for Los Angeles . Over 800 Navy medical personnel and support staff, and more than 70 civil service mariners are on board. The ship will arrive is Los Angeles on Friday, 27 March.. USNS COMFORT • U.S.N.S. Comfort will disembark on Saturday, 28 MARCH, from Norfolk, Va., and arrive at Manhattan’s Pier 90 on Monday, 30 March and will serve as a referral hospital for non-COVID-19 patients currently admitted to shore- based hospitals, and will provide a full spectrum of medical care to include critical and urgent care for adults.
  14. 14. US RESPONSE • The US Army Corps of Engineers (USACE) and the US Department of Health and Human Services (HHS) developed Guidance materials to support States and municipalities in assessing and prioritizing potential facilities, and to rapidly engage contractors to convert and prepare the sites for medical use. • USACE is working with 18 state governments to provide planning and concept development and increase bed space by converting dorms, hotels, and other buildings into temporary medical facilities in 3 to 4 weeks • Javits Center in New York city will be the first alternate care facility to be created. Work began on 23 March to create the 1,000 bed facility and should be completed in 10 days. • Three other location in in NY will also be converted: o SUNY Stony Brook o SUNY Old Westbury o Westchester Convention Center ARMY CORPS OF ENGINEERS (USACE) SOURCE:USACE NY District Birdseye view of the Alternate Care Facility at Jacob Javits Convention Center. USACE SOURCE: USACE SOURCE: USACE
  15. 15. US RESPONSE NATIONAL GUARD • Over 11,400 National Guard are currently mobilized to assist states in their efforts to combat the virus. • The President has approved mobilizing troops under title 32 for Washington, California and New York. The troops will remain of under the command and control of the governors in these perspective states. • Current National Guard COVID-19 response missions include, but are not limited to: o Delivering food in hard-hit communities o Manning call centers to be a knowledgeable and calming voice o Providing critical Personal Protective Equipment training and sample collection to first responders and hospital personnel o Supporting local emergency management agencies with response planning and execution o Providing support to testing facilities o Serving as response liaisons and support to state Emergency Operations Centers o Proving transportation and assessment support to healthcare providers o Assisting with disinfecting/cleaning of common public spaces DUAL STATUS COMMANDERS Dual-status commanders have been appointed in eight states, with 10 more awaiting approval, as the National Guard continues to support COVID-19 response efforts throughout the country. The states where dual-status commanders have been appointed are California, Colorado, Massachusetts, Maryland, New York, Oklahoma, South Carolina and Washington. NOTE: A dual-status commander is typically appointed in large, complex stateside missions or response efforts involving both Guard members in state, or Title 32, status and other service members in federal, or Title 10 status. Army Spc. Reagan Long, left, a horizontal construction engineer with the New York Army National Guard’s 827th Engineer Company, and Army Pfc. Naomi Velez, a horizontal construction engineer with the New York Army Guard’s 152nd Engineer Support Company, register people at a COVID-19 mobile screening center in New Rochelle, New York(U.S. Army photo by Sgt. Amouris Coss) Governors across all 50 states, Puerto Rico, Guam, the U.S. Virgin Islands and Washington D.C. have each mobilized components of their Army and Air National Guard to assist in their state’s response to the COVID-19 pandemic.

Description

As of 26 March 2020, the United States has the most active cases of COVID-19 in world and has surpassed China.

Transcript

  1. 1. YALE ESF-8 SPECIAL REPORT CORONAVIRUS (COVID-19) US RESPONSE AS OF 26 MARCH 2020 2300 HRS EST US FEDERAL GOVERMENT • CORONAVIRUS.GOV • USA.GOV HHS COVID-19 CDC • CDC – COVID-19 NIH • COVID-19 NIOSH • NIOSH CORONAVISUS FEMA • FEMA DOD Coronavirus Response USAF _ COVID-19 NEWS SOURCES • New York Times COVID-19 Coverage • WASHINGTON POST • Reuters • CNN • Xinhua ASSOCIATION • AMERICAN HOSPITAL ASSOCIATION • NRHA SITUATION - GLOBAL PORTALS, BLOGS, AND RESOURCES • YALE NEWHAVEN HEALTH – COVID-19 • YALE MEDICINE • YALE NEWS _COVID 19 • JOHN HOPKINS UNIVERSITY COVID-19 GLOBAL CASES (CSSE) • COVID-19 SURVEILLANCE DASHBOARD • CIDRAP • H5N1 • VIROLOGY DOWN UNDER BLOG • CONTAGION LIVE • WORLDOMETER • 1POINT3ACRES UNITED STATES 85,428 1,290 GLOBAL 531,860 24,057 GLOBAL GLOBAL 122,203 Currently, COVID-19 is rapidly spreading worldwide. The speed with which COVID-19 can cause nationally incapacitating epidemics once transmission within the community is established, indicates that in a few weeks or even days. BACKGROUND WHO • WHO –COVID-19 • ECHO • PAHO AFRO • EMRO • Western Pacific OCHA • ReliefWeb ECDC • European Centre for Disease Prevention and Control CCDC • China Center for Disease Control and Prevention INTERNATIONAL CONFIRMED CASES DEATHS UNITED STATES RECOVERED UNITED STATES JOUNALS AND ONLINE LIBRARIES • BMJ • Cambridge University Press • Cochrane • Elsevier • JAMA Network • The Lancet 2019-nCoV Resource Centre • New England Journal of Medicine • Oxford University Press • Wiley CASES IN US 713 SITUATION - US As of 26 March 2020, the United States has the most active cases of COVID-19 in world and has surpassed China.
  2. 2. WHAT IS COVID-19 Coronavirus disease (COVID-19) is a new strain that was discovered in 2019 and has not been previously identified in humans. Coronaviruses are zoonotic, meaning they are transmitted between animals and people. HOW IS IT SPREAD? People can catch COVID-19 from others who have the virus. The disease spreads from person to person through small droplets from the nose or mouth when a person with COVID-19 coughs or exhales. Droplets can land surfaces around the infected person and other can catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in droplets from the infected person. This is why it is important to stay more than 3 feet away from a person who is sick. (WHO) Time from exposure to onset of symptoms is generally between 2 and 14 days. (CDC) WHAT ARE THE SYMPTONS? Common symptoms include fever, cough, and shortness of breath (CDC). Complications may include pneumonia and acute respiratory distress syndrome. PREVENTIVE MEASURES Recommended preventive measures: hand washing, covering the mouth when coughing, maintaining distance from other people, and monitoring and self-isolation for people who suspect they are infected. NOTE: Anecdotal evidence is rapidly accumulating from sites around the world that anosmia (lack of smell) and dysgeusia (lack of taste) are significant symptoms associated with the COVID-19 pandemic. Anosmia, in particular, has been seen in patients ultimately testing positive for the coronavirus with no other symptoms. BACKGROUND WHERE: WORLDWIDE WHEN: DECEMBER 2019 - CURRENT SITUATION PANDEMIC OUTBREAK – COVID-19 BACKGROUND: At the end of December 2019, Chinese public health authorities reported several cases of acute respiratory syndrome in Wuhan City, Hubei province, China. Chinese scientists soon identified a novel coronavirus as the main causative agent. The disease is now referred to as coronavirus disease 2019 (COVID-19), and the causative virus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is a new strain of coronavirus that has not been previously identified in humans. The initial outbreak in Wuhan spread rapidly, affecting other parts of China. Cases were soon detected in several other countries. Outbreaks and clusters of the disease have since been observed in Asia, Europe, Australia, Africa and the Americas. (ECDC)
  3. 3. SITUATION - GLOBAL GLOBALLY EUROPE • WHO has declared COVID-19 a global pandemic • 196 countries, areas or territories have confirmed cases • Europe is now the epi-center of the virus • The ECDC, in its seventh COVID-19 assessment, said that, since Mar 12, all European countries have now reported cases and that 63% of the global cases have been in Europe. With current testing capacity and if nations do not enact mitigation strategies, Europe could see by the middle of April a scenario similar to what China experienced in Hubei province at the beginning of the outbreak. • In EU/EEA countries with available data, 30% of diagnosed COVID- 19 cases were hospitalized and 4% had severe illness. • Hospitalization rates were higher for those aged 60 years and above. Estimates of crude case-fatality for Germany, Italy and Spain showed that both the risk and absolute numbers of deaths rapidly increased with age for those aged 60 years and above in each country. • Among hospitalized cases, severe illness was reported in 15% of cases, and death occurred in 12% of these cases, with higher case– fatality rates in older adults. (ECDC) ITALY • On 26 March Italy reported 6,153 new cases, its second highest daily total, lifting its overall number to 80,539. Italy also reported 662 more deaths, raising its fatality count to 8,165. SPAIN • On 26 March, Spain's daily total was 6,673 cases today, along with 442 more deaths, raising its respective totals to 56,188 and 4,089. • The Spanish government extended its lockdown until at least Apr 12. • The United Kingdom reported 2,128 new cases, along with 113 more deaths, putting the country over the 10,000-case mark with 11,658. So far, 578 patients in the UK have died from their infections. GERMANY - now has 36,508 cases, 44 of them fatal. RISK ASSESSMENT • The risk of severe disease associated with COVID-19 for people in the EU/EEA and the UK is currently considered moderate for the general population and very high for older adults and individuals with chronic underlying conditions. • The risk of occurrence of widespread national community transmission of COVID-19 in the EU/EEA and the UK in the coming weeks is moderate if effective mitigation measures are in place and very high if insufficient mitigation measures are in place. • The risk of healthcare system capacity being exceeded in the EU/EEA and the UK in the coming weeks is considered high.
  4. 4. SITUATION - GLOBAL • The African continent is rapidly being engulfed by the global coronavirus disease (COVID-19) pandemic, with 43 countries reporting confirmed cases and a few countries beginning to exhibit community transmission. • This recent trend is concerning as most of the low-income African countries have several vulnerabilities, including fragile health systems to cope up with high caseloads, high prevalence of HIV, malnutrition and a rising incidence of non-communicable and other chronic illnesses. (AFRO) RUSSIA - Announced that the country would seal all its borders and cancel all international flights, except for ones bringing Russians home. ASIA CHINA - Announced that foreigners will be barred from entering the country, except for diplomats and crew of international airlines and ships. It also reduced the number of international flights going in and out of China. Nearly all the country's new COVID-19 cases over the past few weeks have been imported cases. AFRICA SOURCE: NYT
  5. 5. DISTRIBUTION OF COVID-19 CASES WORLDWIDE SOURCE: WHO SITREP #66
  6. 6. EPIDEMIC CURVE OF CONFIRMED COVID-19, (AS OF 26 MARCH 2020) SOURCE: WHO SITREP #63 ECDC
  7. 7. CASE DISTRTIBUTION COVID-19 (AS OF 26 MARCH 2020) SOURCE: WHO SITREP #63 ECDC
  8. 8. SITUATION - US On 26 March, Governor Bel Edwards in a press conference said that he expects his state to be out of ventilators by the first week of April and that the state needed an additional 600 machines Louisiana Department of Health reports 676 patients are in hospitals, and 239 are on ventilators • Confirmed cases of the novel coronavirus, COVID-19, reached 82,404 today in the United States, giving it the most cases in the world. • 26 March was the most active day so far in the country, with 14,042 new cases reported, and the national death toll reaching 1,069 fatalities. • Certain hot spots are appearing to produce a hospitalization rate that was doubling every 2 to 3 days, namely in New York City and in parts of California. • Detroit, New Orleans, and Atlanta all reported quickly filling intensive care units (ICUs) NEW YORK As of 26 March New York state reported 39,125 cases, the most of any state in the country During his daily briefing, Governor Cuomo said 5,327 people are currently hospitalized in the state for COVID-19, including 1,290 patients in ICUs. NY Health officials project that 140,000 people will be hospitalized with the coronavirus over the next 14 to 21 days. NEW JERSEY New Jersey are ported a surge on 26 March, of 2,492 newly confirmed infections in a 24 hour period, brings the state’s total to 6,876. LOUISIANA SOURCE: CIDRAP SEATTLE TIMES GOV CUOMO DAILY BRIEF The state Department of Health announced 627 newly confirmed cases on 26 MARCH, bringing the state total to 3,207 cases, including 147 deaths. The bulk of Washington’s cases remain in King County, which has seen 1,577 people fall ill and 109 die. WASHINGTON
  9. 9. SITUATION - US STATE CASES DEATHS New York 39,125 454 New Jersey 6,876 81 California 4,019 82 Washington 3,207 150 Michigan 2,844 61 Illinois 2,541 26 Florida 2,484 29 Massachusetts 2,417 25 Louisiana 2,304 83 Pennsylvania 1,795 18 Texas 1,639 22 Georgia 1,505 56 Colorado 1,430 19 Tennessee 1,097 3 Connecticut 1,012 21 Ohio 868 15 North Carolina 744 3 Wisconsin 728 10 Indiana 645 17 Maryland 583 4 Missouri 520 9 Alabama 517 1 Arizona 508 8 Mississippi 485 6 Virginia 468 10 South Carolina 456 9 Nevada 420 10 Utah 396 1 STATE CASES DEATHS Minnesota 344 2 Arkansas 335 2 Oregon 316 11 District of Columbia 267 3 Oklahoma 248 7 Kentucky 247 5 Iowa 179 1 Kansas 172 3 Rhode Island 165 0 Vermont 158 9 Maine 155 0 Idaho 146 3 New Hampshire 137 1 New Mexico 136 1 Delaware 130 1 Hawaii 106 0 Montana 90 0 Nebraska 74 0 Puerto Rico 64 2 North Dakota 57 0 Alaska 56 1 Wyoming 53 0 West Virginia 52 0 South Dakota 46 1 Guam 45 1 Virgin Islands 17 0 Note: The Grand Princess Cruise Ship had 28 US confirmed cases and the Dimond Princess 49. SOURCE AS OF 2300 hrs 26 MARH 2020: JOHN HOPKINS UNIVERSITY COVID-19 GLOBAL CASES (CSSE)
  10. 10. CASES IN THE US SOURCE:JOHN HOPKINS UNIVERSITY COVID-19 GLOBAL CASES (CSSE) SOURCE: NYT • The number of known cases of the coronavirus in the United States continues to surge. • US has more known cases of coronavirus than any other country SOURCE: NYT
  11. 11. US RESPONSE FEMA • All 50 states, the District of Columbia, 5 territories, and 5 tribal nations are working directly with FEMA under the nationwide emergency declaration for COVID-19 • Using new acquisitions, the Strategic National Stockpile, and Department of Defense allocations, FEMA is leading the coordinated Federal agency efforts increasing hospital capacity, community-based testing sites (CBTS), and significant deployment of personal protective equipment and medical equipment. • NRCC: Level I in unified effort with HHS SOC • All RRCCs activated • President Donald J. Trump Approves Major Disaster Declaration for Maryland (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for Illinois (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for New Jersey (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for North Carolina (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for Florida (English) (Spanish) • President Donald J. Trump Approve Major Disaster Declaration for Texas (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for Louisiana (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for Iowa (English) (Spanish) • President Donald J. Trump Directs FEMA Support Under Emergency Declaration for COVID-19 (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for New York (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for Washington (English) (Spanish) • President Donald J. Trump Approves Major Disaster Declaration for California (English) (Spanish) DECLARATIONS
  12. 12. US RESPONSE HHS • Department of Health and Human Services designated certain health and medical resources needed to respond to the spread of COVID-19 subject to hoarding restrictions under the Defense Production Act and a March 23 executive order. The designation includes N95 and certain other respirators, ventilators, personal protective equipment, drug products, medical device sterilization services and disinfecting devices. • HHS Secretary Alex Azar yesterday asked the nation’s governors to immediately allow health professionals licensed or certified in other states to practice in their state in person or through telemedicine. In addition, he asked states to: o Waive certain statutory and regulatory standards “not necessary for the applicable standards of care to establish a patient-provider relationship, diagnose, and deliver treatment recommendations” using telehealth technologies o Relax scope of practice requirements for health professionals, including allowing them to practice in all care settings; o Allow physicians to supervise a greater number of other health care professionals and to do so using remote or telephonic means; o Allow for rapid certification/licensure and recertification/relicensure of certain health care professionals o Develop a list of their state liability protections for in-state and out-of-state health professionals during this national emergency and modify, rescind or waive any medical malpractice policies that may prevent coverage of health professionals responding to the COVID-19 emergency in another state; o Modify laws or regulations as appropriate to allow medical students to triage, diagnose and treat patients under the supervision of licensed medical staff; and o Allow pharmaceutical deliveries without signature to prevent delivery person contact with recipients. SOURCE: CDC
  13. 13. US RESPONSE ARNORTH • At the direction of U.S Northern Command, U.S. Army North requested the deployment of units to provide defense support of civil authorities in response to the COVID-19 national emergency. • Active Duty units supporting this mission include: o Joint Task Force-Civil Support Headquarters, Joint Base Langley-Eustis, Va. o 3rd Expeditionary Sustainment Command, Ft. Bragg, NC o 4th Sustainment Brigade, 4th Infantry Division, Fort Carson, CO o 63rd Expeditionary Signal Battalion, Fort Stewart, GA SOURCE: DOD The following US Army Hospital Centers a deploying: • 531st Hospital Center - Fort Campbell, Kentucky to support New York • 9th Hospital Center - Fort Hood, Texas to New York • 627th Hospital Center - Fort Carson, Colorado to Washington State The advance party is on the ground .The main body will arrive at Joint Base McGuire Dix Lakehurst, 27 MARCH. They will set up at the Javits Center in New York this weekend, and they will be operational for non-COVID-19 patients beginning March 30. (DOD) 1st MED Brigade headquarters has been assigned to support the Joint Task Force – Civil Support’s COVID-19 response efforts, and will be leading medical planning operations from Fort Hood. SOURCE: WHITE HOUSE DAILEY BRIEF – 26 MARCH 2020 USNS MERCY • The USNS Mercy, a 1000 bed ship, will deploy to the port of Los Angeles this week and will serve as a referral hospital for non-COVID-19 patients currently admitted to shore-based hospitals, and will provide a full spectrum of medical care to include critical and urgent care for adults. • The ship sailed from Naval Station San Diego on March 23 for Los Angeles . Over 800 Navy medical personnel and support staff, and more than 70 civil service mariners are on board. The ship will arrive is Los Angeles on Friday, 27 March.. USNS COMFORT • U.S.N.S. Comfort will disembark on Saturday, 28 MARCH, from Norfolk, Va., and arrive at Manhattan’s Pier 90 on Monday, 30 March and will serve as a referral hospital for non-COVID-19 patients currently admitted to shore- based hospitals, and will provide a full spectrum of medical care to include critical and urgent care for adults.
  14. 14. US RESPONSE • The US Army Corps of Engineers (USACE) and the US Department of Health and Human Services (HHS) developed Guidance materials to support States and municipalities in assessing and prioritizing potential facilities, and to rapidly engage contractors to convert and prepare the sites for medical use. • USACE is working with 18 state governments to provide planning and concept development and increase bed space by converting dorms, hotels, and other buildings into temporary medical facilities in 3 to 4 weeks • Javits Center in New York city will be the first alternate care facility to be created. Work began on 23 March to create the 1,000 bed facility and should be completed in 10 days. • Three other location in in NY will also be converted: o SUNY Stony Brook o SUNY Old Westbury o Westchester Convention Center ARMY CORPS OF ENGINEERS (USACE) SOURCE:USACE NY District Birdseye view of the Alternate Care Facility at Jacob Javits Convention Center. USACE SOURCE: USACE SOURCE: USACE
  15. 15. US RESPONSE NATIONAL GUARD • Over 11,400 National Guard are currently mobilized to assist states in their efforts to combat the virus. • The President has approved mobilizing troops under title 32 for Washington, California and New York. The troops will remain of under the command and control of the governors in these perspective states. • Current National Guard COVID-19 response missions include, but are not limited to: o Delivering food in hard-hit communities o Manning call centers to be a knowledgeable and calming voice o Providing critical Personal Protective Equipment training and sample collection to first responders and hospital personnel o Supporting local emergency management agencies with response planning and execution o Providing support to testing facilities o Serving as response liaisons and support to state Emergency Operations Centers o Proving transportation and assessment support to healthcare providers o Assisting with disinfecting/cleaning of common public spaces DUAL STATUS COMMANDERS Dual-status commanders have been appointed in eight states, with 10 more awaiting approval, as the National Guard continues to support COVID-19 response efforts throughout the country. The states where dual-status commanders have been appointed are California, Colorado, Massachusetts, Maryland, New York, Oklahoma, South Carolina and Washington. NOTE: A dual-status commander is typically appointed in large, complex stateside missions or response efforts involving both Guard members in state, or Title 32, status and other service members in federal, or Title 10 status. Army Spc. Reagan Long, left, a horizontal construction engineer with the New York Army National Guard’s 827th Engineer Company, and Army Pfc. Naomi Velez, a horizontal construction engineer with the New York Army Guard’s 152nd Engineer Support Company, register people at a COVID-19 mobile screening center in New Rochelle, New York(U.S. Army photo by Sgt. Amouris Coss) Governors across all 50 states, Puerto Rico, Guam, the U.S. Virgin Islands and Washington D.C. have each mobilized components of their Army and Air National Guard to assist in their state’s response to the COVID-19 pandemic.

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