Global & Disaster Medicine

Coronavirus: A pandemic or not?

https://www.vox.com/future-perfect/2020/3/9/21163412/who-coronavirus-covid19-pandemic-world-health-organization

“………….The WHO says that since there’s still uncertainty about the disease’s impact, most countries still have only a few cases, and containment is not yet hopeless, the word “pandemic” isn’t appropriate yet. But many observers have disagreed with the WHO’s decision……… The World Health Organization defines an epidemic as “the occurrence in a community or region of cases of an illness … clearly in excess of normal expectancy.” The CDC defines it as “an increase, often sudden, in the number of cases of a disease above what is normally expected” in a region.……

According to A Dictionary of Epidemiology, the standard reference for epidemiologists, a pandemic is “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people.”

A “pandemic” disease sounds much scarier than a mere “outbreak.” But it’s important to remember that “pandemic” refers to how many parts of the world are dealing with an elevated rate of the disease — and, in theory, says nothing about how serious the disease is………”


COVID-19 Resources

MAPS AND STATISTICS
US DHHS CDC Global COVID-19 Map
US DHHS CDC US Outbreak Statistics
COVID-19 Outbreak Tracker.  Johns Hopkins
COVID-19 Outbreak Tracker.  Kaiser Family Foundation
US Dpt of State Travel Advisories
DEFINITIONS, BACKGROUND, PLANS
US DHHS Public Health Emergency Declaration
Flu Types, definitions, and naming conventions.   US DHHS CDC
Definitions and Risk Assessments,  US DHHS CDC  (Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposure in Travel-associated or Community Settings)
National Pandemic Strategy Page,   US DHHS CDC
Pandemic Intervals Framework,  US DHHS CDC
Pandemic Phases,  World Health Organization (2009 H1N1)
INTERNATIONAL SITES
World Health Organization  (WHO)
EU European Centre for Disease Prevention and Control.  COVID-19 site
UK Government COVID-19 Publications
Canada Government COVID-19 Info Page
Mexico Government Dpt of Health COVID-19 Page
Australian Government.  Dpt of Health COVID-19 Resource page
US GOVERNMENT SITES
US DHHS Office of the Assistant Secretary for Preparedness and Response (ASPR) COVID-19 page (PHE.GOV)
US DHHS ASPR TRACIE.
US DHHS National Institutes of Health (NIH)
US DHHS NIH National Library of Medicine (NLM)
US DHHS CDC
   US DHHS CDC Travel Health Notices
   US DHHS CDC Weekly COVID-19 newsletter updates
US DHHS CDC NIOSH
   Respirator Information
US DHHS Centers for Medicare and Medicaid Services (CMS)
US DHHS Food and Drug Administration.
     COVID-19 Emergency Use Authorizations  (FDA)
US Dpt of Labor OSHA
US Dpt of State.  Overseas Security Advisory Council.
US Dpt of Transportation FAA.  Interim Aircrew Guidance for COVID-19
USA GOV International Traveler Issues for Americans
US National Governors Association.  COVID-19 Site
PROFESSIONAL, ORGANIZATIONAL, PRIVATE AND ACADEMIC SITES
American College of Emergency Physicians.  COVID-19 Resource page
American College Health Association
Health Industry Distributors Association
International Air Transport Association.  Air Transport and Communicable Diseases Page
National Ebola Training and Education Center.  (Search under COVID-19 Resources)
Network for Public Health Law.  Coronavirus Primer.  Authorities, etc…
University of Minnesota.  Center for Infectious Disease Research and Policy.  COVID-19 page.
Massachusetts General Hospital.  2019 Novel Coronavirus Toolkit
Region I (New England) Government Information Sites:
Boston Public Health Commission
Connecticut DPH
Massachusetts DPH
Maine CDC
New Hampshire DHHS
Rhode Island DOH
Vermont DOH

Coronavirus has been swift and ferocious in Italy. In less than 20 days, the number of confirmed cases has skyrocketed to more than 9,000 while the number of deaths has surpassed 450

https://www.cnbc.com/2020/03/09/italy-extends-its-quarantine-to-the-entire-country-pm-asks-residents-to-stay-at-home.html

“…….People throughout the country of 60 million should not travel other than for work or emergencies, Conte said. He added that all public gatherings will be banned and sporting events suspended. The decision was made to protect the most vulnerable people in the country, he said, and the measures will take effect Tuesday and last until April 3….”


China recorded just 19 new cases of COVID-19 on Tuesday

https://www.usatoday.com/story/news/world/2020/03/10/coronavirus-italy-china-global/5008438002/

“………While more than 3,000 people in China have died from the disease since it emerged in Wuhan in December, almost three-fourths of China’s more than 80,000 patients have recovered. Meanwhile, 14 makeshift hospitals constructed in Wuhan to care for the sick have been closed and public places closed for weeks amid the outbreak will reopen once they have been disinfected. …..”


A preliminary 5.8 magnitude earthquake struck off the coast of northern California Sunday night

DYFI intensity map


COVID-19: Environmental Cleaning and Disinfection Recommendations

https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/cleaning-disinfection.html

Interim Recommendations for US Community Facilities with Suspected/Confirmed Coronavirus Disease 2019

 

Background

There is much to learn about the novel coronavirus that causes coronavirus disease 2019 (COVID-19). Based on what is currently known about the virus, spread from person-to-person happens most frequently among close contacts (within about 6 feet). This type of transmission occurs via respiratory droplets. Transmission of novel coronavirus to persons from surfaces contaminated with the virus has not been documented. Transmission of coronavirus in general occurs much more commonly through respiratory droplets than through fomites. Current evidence suggests that novel coronavirus may remain viable for hours to days on surfaces made from a variety of materials. Cleaning of visibly dirty surfaces followed by disinfection is a best practice measure for prevention of COVID-19 and other viral respiratory illnesses in community settings.

Purpose

This guidance provides recommendations on the cleaning and disinfection of rooms or areas of those with suspected or with confirmed COVID-19 have visited. It is aimed at limiting the survival of novel coronavirus in key environments. These recommendations will be updated if additional information becomes available.

These guidelines are focused on community, non-healthcare facilities (e.g., schools, institutions of higher education, offices, daycare centers, businesses, community centers) that do and do not house persons overnight. These guidelines are not meant  for cleaning staff in healthcare facilities or repatriation sites, households, or for others for whom specific guidance already exists.

Definitions
  • Community facilities (e.g., schools, daycares centers, businesses) comprise most non-healthcare settings that are visited by the general public outside of a household.
  • Cleaning refers to the removal of dirt and impurities, including germs, from surfaces. Cleaning alone does not kill germs. But by removing the germs, it decreases their number and therefore any risk of spreading infection.
  • Disinfecting works by using chemicals to kill germs on surfaces. This process does not necessarily clean dirty surfaces or remove germs. But killing germs remaining on a surface after cleaning further reduces any risk of spreading infection.

Cleaning and Disinfection After Persons Suspected/Confirmed to Have COVID-19 Have Been in the Facility

Timing and location of cleaning and disinfection of surfaces

  • At a school, daycare center, office, or other facility that does not house people overnight:
    • It is recommended to close off areas used by the ill persons and wait as long as practical before beginning cleaning and disinfection to minimize potential for exposure to respiratory droplets. Open outside doors and windows to increase air circulation in the area. If possible, wait up to 24 hours before beginning cleaning and disinfection.
    • Cleaning staff should clean and disinfect all areas (e.g., offices, bathrooms, and common areas) used by the ill persons, focusing especially on frequently touched surfaces.
  • At a facility that does house people overnight:
    • Follow Interim Guidance for US Institutions of Higher Education on working with state and local health officials to isolate ill persons and provide temporary housing as needed.
    • It is recommended to close off areas used by the ill persons and wait as long as practical before beginning cleaning and disinfection to minimize potential for exposure to respiratory droplets. Open outside doors and windows to increase air circulation in the area. If possible, wait up to 24 hours before beginning cleaning and disinfection.
    • In areas where ill persons are being housed in isolation, follow Interim Guidance for Environmental Cleaning and Disinfection for U.S. Households with Suspected or Confirmed Coronavirus Disease 2019. This includes focusing on cleaning and disinfecting common areas where staff/others providing services may come into contact with ill persons, but reducing cleaning and disinfection of bedrooms/bathrooms used by ill persons to as needed.
    • In areas where ill persons have visited or used, continue routine cleaning and disinfection as in this guidance.

How to Clean and Disinfect

Surfaces

  • If surfaces are dirty, they should be cleaned using a detergent or soap and water prior to disinfection.
  • For disinfection, diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants should be effective.
    • Diluted household bleach solutions can be used if appropriate for the surface. Follow manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against coronaviruses when properly diluted.
  • Prepare a bleach solution by mixing:
    • 5 tablespoons (1/3rd cup) bleach per gallon of water or
    • 4 teaspoons bleach per quart of water
    • Products with EPA-approved emerging viral pathogens claimspdf iconexternal icon are expected to be effective against COVID-19 based on data for harder to kill viruses. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.).
    • For soft (porous) surfaces such as carpeted floor, rugs, and drapes, remove visible contamination if present and clean with appropriate cleaners indicated for use on these surfaces. After cleaning:
    • If the items can be laundered, launder items in accordance with the manufacturer’s instructions using the warmest appropriate water setting for the items and then dry items completely.
    • Otherwise, use products with the EPA-approved emerging viral pathogens claims (examples at this linkpdf iconexternal icon) that are suitable for porous surfaces 

Linens, Clothing, and Other Items That Go in the Laundry

  • Do not shake dirty laundry; this minimize the possibility of dispersing virus through the air.
  • Wash items as appropriate in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely. Dirty laundry that has been in contact with an ill person can be washed with other people’s items.
  • Clean and disinfect hampers or other carts for transporting laundry according to guidance above for hard or soft surfaces.

Personal Protective Equipment (PPE) and Hand Hygiene:
  • Cleaning staff should wear disposable gloves and gowns for all tasks in the cleaning process, including handling trash.
    • Gloves and gowns should be compatible with the disinfectant products being used.
    • Additional PPE might be required based on the cleaning/disinfectant products being used and whether there is a risk of splash.
    • Gloves and gowns should be removed carefully to avoid contamination of the wearer and the surrounding area. Be sure to clean hands after removing gloves.
  • Gloves should be removed after cleaning a room or area occupied by ill persons. Clean hands immediately after gloves are removed.
  • Cleaning staff should immediately report breaches in PPE (e.g., tear in gloves) or any potential exposures to their supervisor.
  • Cleaning staff and others should clean hands often, including immediately after removing gloves and after contact with an ill person, by washing hands with soap and water for 20 seconds. If soap and water are not available and hands are not visibly dirty, an alcohol-based hand sanitizer that contains 60%-95% alcohol may be used. However, if hands are visibly dirty, always wash hands with soap and water.
  • Follow normal preventive actions while at work and home, including cleaning hands and avoiding touching eyes, nose, or mouth with unwashed hands.
    • Additional key times to clean hands include:
      • After blowing one’s nose, coughing, or sneezing
      • After using the restroom
      • Before eating or preparing food
      • After contact with animals or pets
      • Before and after providing routine care for another person who needs assistance (e.g., a child)

Additional Considerations for Employers:
  • Employers should work with their local and state health departments to ensure appropriate local protocols and guidelines, such as updated/additional guidance for cleaning and disinfection, are followed, including for identification of new potential cases of COVID-19.
  • Employers should educate staff and workers performing cleaning, laundry, and trash pick-up activities to recognize the symptoms of COVID-19 and provide instructions on what to do if they develop symptoms within 14 days after their last possible exposure to the virus. At a minimum, any staff should immediately notify their supervisor and the local health department if they develop symptoms of COVID-19. The health department will provide guidance on what actions need to be taken.
  • Employers should develop policies for worker protection and provide training to all cleaning staff on site prior to providing cleaning tasks. Training should include when to use PPE, what PPE is necessary, how to properly don (put on), use, and doff (take off) PPE, and how to properly dispose of PPE.
  • Employers must ensure workers are trained on the hazards of the cleaning chemicals used in the workplace in accordance with OSHA’s Hazard Communication standard (29 CFR 1910.1200external icon).
  • Employers must comply with OSHA’s standards on Bloodborne Pathogens (29 CFR 1910.1030external icon), including proper disposal of regulated waste, and PPE (29 CFR 1910.132external icon).
  • 3D illustration of the novel coronavirus

COVID-19: Guidance for Student Foreign Travel for Institutions of Higher Education

https://www.cdc.gov/coronavirus/2019-ncov/community/student-foreign-travel.html

Jet airplane flying above the clouds

This guidance is for Institutes of Higher Education with students participating in foreign exchange or study abroad programs.

Consider postponing or canceling student foreign exchange programs

Given the global outbreak of novel coronavirus (COVID-19) institutes of higher education (IHE) should consider postponing or canceling upcoming student foreign exchange programs. IHE should consider asking current program participants to return to their home country. Those overseeing student foreign exchange programs should be aware that students may face unpredictable circumstances, travel restrictions, challenges in returning home or accessing health care while abroad.

IHEs should consider asking students participating in study abroad programs to return to the United States. IHEs should work with state and local public health officials to determine the best approach for when and how (e.g., chartered transportation for countries or areas assessed as high-risk for exposure) their study abroad students might return. All plans for returning study abroad students should be designed to protect participants from stigma and discrimination.

The COVID-19 situation is dynamic. Given the speed of spread and the number of countries experiencing human-to-human transmission, IHEs should evaluate the risks associated with choosing to maintain programs abroad and take the appropriate proactive measures. IHEs that continue to maintain programs abroad should monitor cdc.gov/COVID-19 for additional information.


COVID-19: Resources for Institutes of Higher Education

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-schools.html

Interim Guidance for Administrators of US Childcare Programs and K-12 Schools

Plan, Prepare and Respond to Coronavirus Disease 2019

This interim guidance is based on what is currently known about the transmission and severity of coronavirus disease 2019 (COVID-19).

The US Centers for Disease Control and Prevention (CDC) will update this guidance as needed and as additional information becomes available. Please check the following CDC website periodically for updated interim guidance: https://www.cdc.gov/coronavirus/2019-ncov/index.html.

Health officials are currently taking steps to prevent the introduction and spread of COVID-19 into US communities. Schools can play an important role in this effort. Through collaboration and coordination with local health departments, schools can take steps to disseminate information about the disease and its potential transmission within their school community. Schools can prepare to take steps to prevent the spread of COVID-19 among their students and staff should local health officials identify such a need.

Schools should continue to collaborate, share information, and review plans with local health officials to help protect the whole school community, including those with special health needs. School plans should be designed to minimize disruption to teaching and learning and protect students and staff from social stigma and discrimination. Plans can build on everyday practices (e.g., encouraging hand hygiene, monitoring absenteeism, communicating routinely) that include strategies for before, during, and after a possible outbreak.

Who is this guidance for?

This interim guidance is intended to help administrators of public and private childcare programs and K-12 schools prevent the spread of COVID-19 among students and staff. Administrators are individuals who oversee the daily operations of childcare programs and K-12 schools, and may include positions like childcare program directors, school district superintendents, principals, and assistant principals. This guidance is intended for administrators at both the school/facility and district level.

Why is this guidance being issued?

Information provided should help childcare programs, schools, and their partners understand how to help prevent the transmission of COVID-19 within childcare and school communities and facilities. It also aims to help childcare programs, schools, and partners to react quickly should a case be identified. The guidance includes considerations to help administrators plan for the continuity of teaching and learning if there is community spread of COVID-19.

What is the role of schools in responding to COVID-19?

COVID-19 is a respiratory illness caused by a novel (new) virus, and we are learning more about it every day. There is currently no vaccine to protect against COVID-19. At this point, the best way to prevent infection is to avoid being exposed to the virus that causes it. Stopping transmission (spread) of the virus through everyday practices is the best way to keep people healthy. More information on COVID-19 is available here.

Schools, working together with local health departments, have an important role in slowing the spread of diseases to help ensure students have safe and healthy learning environments. Schools serve students, staff, and visitors from throughout the community. All of these people may have close contact in the school setting, often sharing spaces, equipment, and supplies.

Guidance for schools which do not have COVID-19 identified in their community

To prepare for possible community transmission of COVID-19, the most important thing for schools to do now is plan and prepare. As the global outbreak evolves, schools should prepare for the possibility of community-level outbreaks. Schools want to be ready if COVID-19 does appear in their communities.

Childcare and K-12 school administrators nationwide can take steps to help stop or slow the spread of respiratory infectious diseases, including COVID-19:

  • Review, update, and implement emergency operations plans (EOPs). This should be done in collaboration with local health departments and other relevant partners. Focus on the components, or annexes, of the plans that address infectious disease outbreaks.
    • Ensure the plan includes strategies to reduce the spread of a wide variety of infectious diseases (e.g., seasonal influenza). Effective strategies build on everyday school policies and practices.
    • Ensure the plan emphasizes common-sense preventive actions for students and staff. For example, emphasize actions such as staying home when sick; appropriately covering coughs and sneezes; cleaning frequently touched surfaces; and washing hands often.
    • Ensure handwashing strategies include washing with soap and water for at least 20 seconds or using a hand sanitizer that contains at least 60% alcohol if soap and water are not available.
    • Reference key resources while reviewing, updating, and implementing the EOP:
    • Develop information-sharing systems with partners.
      • Information-sharing systems can be used for day-to-day reporting (on information such as changes in absenteeism) and disease surveillance efforts to detect and respond to an outbreak.
      • Local health officials should be a key partner in information sharing.
    • Monitor and plan for absenteeism.
      • Review the usual absenteeism patterns at your school among both students and staff.
      • Alert local health officials about large increases in student and staff absenteeism, particularly if absences appear due to respiratory illnesses (like the common cold or the “flu,” which have symptoms similar to symptoms of COVID-19).
      • Review attendance and sick leave policies. Encourage students and staff to stay home when sick. Use flexibility, when possible, to allow staff to stay home to care for sick family members.
      • Discourage the use of perfect attendance awards and incentives.
      • Identify critical job functions and positions, and plan for alternative coverage by cross-training staff.
      • Determine what level of absenteeism will disrupt continuity of teaching and learning.
    • Establish procedures for students and staff who are sick at school.
      • Establish procedures to ensure students and staff who become sick at school or arrive at school sick are sent home as soon as possible.
      • Keep sick students and staff separate from well students and staff until they can leave.
      • Remember that schools are not expected to screen students or staff to identify cases of COVID-19. The majority of respiratory illnesses are not COVID-19. If a community (or more specifically, a school) has cases of COVID-19, local health officials will help identify those individuals and will follow up on next steps.
      • Share resources with the school community to help families understand when to keep children home. This guidance, not specific to COVID-19, from the American Academy of Pediatrics can be helpful for familiesexternal icon.
    • Perform routine environmental cleaning.
      • Routinely clean frequently touched surfaces (e.g., doorknobs, light switches, countertops) with the cleaners typically used. Use all cleaning products according to the directions on the label.
      • Provide disposable wipes so that commonly used surfaces (e.g., keyboards, desks, remote controls) can be wiped down by students and staff before each use.
    • Create communications plans for use with the school community.
      • Include strategies for sharing information with staff, students, and their families.
      • Include information about steps being taken by the school or childcare facility to prepare, and how additional information will be shared.
    • Review CDC’s guidance for businesses and employers.
      • Review this CDC guidance to identify any additional strategies the school can use, given its role as an employer.

Childcare and K-12 administrators can also support their school community by sharing resources with students (if resources are age-appropriate), their families, and staff. Coordinate with local health officials to determine what type of information might be best to share with the school community. Consider sharing the following fact sheets and information sources:

For questions about students who plan to travel, or have recently traveled, to areas with community spread of COVID-19, refer to CDC’s FAQ for travelers. Schools can also consult with state and local health officials. Schools may need to postpone or cancel trips that could expose students and staff to potential community spread of COVID-19. Students returning from travel to areas with community spread of COVID-19 must follow guidance they have received from health officials. COVID-19 information for travel is updated regularly on the CDC website.

This is a picture of CDC’s laboratory test kit for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). CDC is shipping the test kits to laboratories CDC has designated as qualified, including U.S. state and local public health laboratories, Department of Defense (DOD) laboratories and select international laboratories. The test kits are bolstering global laboratory capacity for detecting SARS-CoV-2.

Guidance for schools with identified cases of COVID-19 in their community

If local health officials report that there are cases of COVID-19 in the community, schools may need to take additional steps in response to prevent spread in the school. The first step for schools in this situation is to talk with local health officials. The guidance provided here is based on current knowledge of COVID-19. As additional information becomes available about the virus, how it spreads, and how severe it is, this guidance may be updated. Administrators are encouraged to work closely with local health officials to determine a course of action for their childcare programs or schools.

Determine if, when, and for how long childcare programs or schools may need to be dismissed.

Temporarily dismissing childcare programs and K-12 schools is a strategy to stop or slow the further spread of COVID-19 in communities. During school dismissals, childcare programs and schools may stay open for staff members (unless ill) while students stay home. Keeping facilities open a) allows teachers to develop and deliver lessons and materials remotely, thus maintaining continuity of teaching and learning; and b) allows other staff members to continue to provide services and help with additional response efforts.

Childcare and school administrators should work in close collaboration and coordination with local health officials to make dismissal and large event cancellation decisions. Schools are not expected to make decisions about dismissal or canceling events on their own. Schools can seek specific guidance from local health officials to determine if, when, and for how long to take these steps. Large event cancellations or school dismissals may be recommended for 14 days, or possibly longer if advised by local health officials. The nature of these actions (e.g., geographic scope, duration) may change as the local outbreak situation evolves.

If an ill student or staff member attended school prior to being confirmed as a COVID-19 case:

  • Local health officials may recommend temporary school dismissals if a student or staff member attended school prior to being confirmed as a COVID-19 case. Local health officials’ recommendations for the scope (e.g., a single school, a full district) and duration of school dismissals will be made on a case-by-case basis based on the most up-to-date information about COVID-19 and the specific cases in the impacted community.
  • Schools should work with the local health department and other relevant leadership to communicate the possible COVID-19 exposure. This communication to the school community should align with the communication plan in the school’s emergency operations plan. In such a circumstance, it is critical to maintain confidentiality of the student or staff member as required by the Americans with Disabilities Act and the Family Education Rights and Privacy Act.
  • If a student or staff member has been identified with COVID-19, school and program administrators should seek guidance from local health officials to determine when students and staff should return to schools and what additional steps are needed for the school community. In addition, students and staff who are well but are taking care of or share a home with someone with a case of COVID-19 should follow instructions from local health officials to determine when to return to school.

If schools are dismissed, schools can consider the following steps:

  • Temporarily cancel extracurricular group activities and large events.
    • Cancel or postpone events such as after-school assemblies and pep rallies, field trips, and sporting events.
  • Discourage students and staff from gathering or socializing anywhere.
    • Discourage gatherings at places like a friend’s house, a favorite restaurant, or the local shopping mall.
  • Ensure continuity of education.
    • Review continuity plans, including plans for the continuity of teaching and learning. Implement e-learning plans, including digital and distance learning options as feasible and appropriate.
    • Determine, in consultation with school district officials or other relevant state or local partners:
      • If a waiver is needed for state requirements of a minimum number of in-person instructional hours or school days (seat time) as a condition for funding;
      • How to convert face-to-face lessons into online lessons and how to train teachers to do so;
      • How to triage technical issues if faced with limited IT support and staff;
      • How to encourage appropriate adult supervision while children are using distance learning approaches; and
      • How to deal with the potential lack of students’ access to computers and the Internet at home.
    • Ensure continuity of meal programs.
      • Consider ways to distribute food to students.
      • If there is community spread of COVID-19, design strategies to avoid distribution in settings where people might gather in a group or crowd. Consider options such as “grab-and-go” bagged lunches or meal delivery.
    • Consider alternatives for providing essential medical and social services for students.
      • Continue providing necessary services for children with special healthcare needs, or work with the state Title V Children and Youth with Special Health Care Needs (CYSHCN) Program.

Collapse of a quarantine ACS in China: Deaths and Injuries


COVID-19 reached a global milestone, topping 100,000 cases across more than 100 countries over this weekend

https://www.npr.org/2020/03/08/813396080/coronavirus-italy-orders-massive-shutdown-amid-spread

“….Italy is imposing an extraordinary lockdown on about a quarter of its population and restricting public activities throughout the entire country.

The quarantine includes the cities of Milan and Venice, as well as the entire northern region of Lombardy, Italy’s financial heart. It affects more than 16 million people in coronavirus hotbed areas and is scheduled to remain in effect until at least April 3.

Prime Minister Giuseppe Conte announced the move after confirmed cases in Italy spiked over the weekend. By Sunday more than 7,300 people had been sickened and 366 had died — an uptick of 133 dead from the day before….”

 


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