Coronavirus disease 2019 (COVID-19): situation report, 79

Data as received by WHO from national authorities by 10:00 CET, 8 April 2020 Coronavirus disease 2019 (COVID-19) Situation Report – 79 HIGHLIGHTS • One new country/territory/area reported cases of COVID-19 in the past 24 hours: Saint Pierre and Miquelon. • WHO has published a guidance document on the rational use of personal protective equipment (PPE) in healthcare and home care settings, as well as during the handling of cargo. The document assesses the current disruption in the global supply chain and outlines considerations for decision-making during severe shortages of PPE. For more details, please see here. • WHO has listed the first two diagnostic tests for emergency use during the COVID-19 pandemic. The move should help increase access to quality-assured, accurate tests for the disease. It also means that the tests can now be supplied by the United Nations and other procurement agencies supporting the COVID- 19 response. For more information, please see here. • WHO has published a guideline on food safety, ‘COVID-19 and Food Safety: Guidance for Food Businesses’. For more details, please see here. • The Global Health Cluster, which WHO leads, has been supporting 29 countries to implement the Global Humanitarian Response Plan for COVID-19. This includes addressing newly-emerging needs and preserving the existing humanitarian health actions and commitments of the Humanitarian Response Plans for 2020. For more information on partner coordination, please see ‘Subject in Focus’. Figure 1. Countries, territories or areas with reported confirmed cases of COVID-19, 8 April 2020 SITUATION IN NUMBERS total (new) cases in last 24 hours Globally 1 353 361 confirmed (73 639) 79 235 deaths (6695) European Region 720 219 confirmed (33 881) 57 639 deaths (4904) Region of the Americas 417 416 confirmed (33 174) 12 597 deaths (1500) Western Pacific Region 114 667 confirmed (1026) 3922 deaths (30) Eastern Mediterranean Region 81 993 confirmed (3428) 4314 deaths (165) South-East Asia Region 10 707 confirmed (1575) 426 deaths (64) African Region 7647 confirmed (555) 326 deaths (32) WHO RISK ASSESSMENT Global Level Very High SUBJECT IN FOCUS: Partner Coordination Global Health Cluster • The Global Health Cluster, which WHO leads, has been supporting 29 countries to implement the Global Humanitarian Response Plan for COVID-19. This includes addressing newly-emerging needs and preserving the existing humanitarian health actions and commitments of the Humanitarian Response Plans for 2020. • In collaboration with the Gender-Based Violence Area of Responsibility (GBV AoR), a webinar was held on “Ensuring continuity of essential health services for survivors of GBV during COVID-19”. The GBV AoR is the global level forum for coordination and collaboration on GBV prevention and response in humanitarian settings. Emergency Medical Teams (EMT) Initiative • Over 100 Emergency Medical Teams (EMT) and focal points worldwide are working closely with the EMT Secretariat, and are continuously engaging in monitoring, guiding, and facilitating national and international COVID-19 response operations. • As of 5 April, five international EMTs have been deployed to eight countries. Twenty-nine EMTs are supporting and reinforcing local national health systems across all regions. EMTs are also involved in discussions to strengthen capacity and support to countries in Africa. In addition, WHO is working with EMTs worldwide to identify technical experts and coordinators who can support integrated public health and clinical teams. • WHO has finalised technical guidance on COVID-19 community facilities and treatment centers, pre-hospital emergency medical services recommendations, and recommendations for medical surge capacity and deployments of EMTs. A modular training package on COVID-19 is currently being developed for the EMT workforce. Global Outbreak Alert and Response Network (GOARN) deployments and partnership activities • WHO has deployed 59 experts from 27 partner institutions and technical networks to support countries. Twenty- two partners of the GOARN Capacity Development Network are meeting this week to strengthen coordination of training and capacity building activities. • The International Federation of Red Cross and Red Crescent Societies (IFRC), UNICEF, and WHO are supporting Risk Communications and Community Engagement (RCCE) with a special focus on highly vulnerable populations, and integration of humanitarian partners to support social distancing solutions amongst migrants and in camp settings. This week’s focus is mask guidance among the general population, and in the event of easing of movement restrictions. The partnership is also looking at social science and community insights, including perception surveys and community engagement during lockdowns, to explore guidance, operational challenges and lessons learnt from ongoing experience. Global Outbreak Alert and Response Network (GOARN) research activities GOARN research activities include: • Creating a repository of RCCE data collection tools to aid researchers and public health organizations to roll out rapid assessments in their communities of interest. If you would like to contribute, please contact Dr. Jeni Stolow at jstolow@tulane.edu. • Coordination with Field Epidemiology Training Programmes, regional and global networks, and alumni networks, on exchange of protocols and tools for investigations and response. • Coordination of global partners to support the WHO COVID-19 Research Innovation and Research Roadmap Social Science Working Group. Ongoing research includes psychosocial impact of community-based interventions, psychosocial assessment of healthcare workers (HCWs), HCW readiness for COVID-19 infection prevention and control, home-based care delivery, and decision-making for palliative care. • Knowledge management of COVID-19-related information, including identification of research findings and channeling of findings to appropriate audiences; and development of a process for rapid literature searches/reviews. For information on the above activities, please contact Dr. Lina Moses at lmoses2@tulane.edu. Critical Supply Chains and Goods • UNICEF is leading joint UN efforts to access substantial quantities of critical items such as PPE and supplies for intensive care, through a joint tender where the overall allocation principles of supplies will be guided by WHO and the Supply Chain Inter-Agency Coordination Cell. The detailed process is under development. SURVEILLANCE Table 1. Countries, territories or areas with reported laboratory-confirmed COVID-19 cases and deaths. Data as of 8 April 2020* Reporting Country/ Territory/Area† Total confirmed ‡ cases Total confirmed new cases Total deaths Total new deaths Transmission classification§ Days since last reported case Western Pacific Region China 83157 86 3342 2 Local transmission 0 Republic of Korea 10384 53 200 8 Local transmission 0 Australia 5956 112 45 3 Local transmission 0 Japan 4257 351 81 1 Local transmission 0 Malaysia 3963 170 63 1 Local transmission 0 Philippines 3764 104 177 14 Local transmission 0 Singapore 1481 106 6 0 Local transmission 0 New Zealand 969 26 1 0 Local transmission 0 Viet Nam 249 4 0 0 Local transmission 0 Brunei Darussalam 135 0 1 0 Local transmission 3 Cambodia 115 0 0 0 Local transmission 1 Fiji 15 1 0 0 Local transmission 0 Mongolia 15 0 0 0 Imported cases only 1 Lao People's Democratic Republic 12 0 0 0 Local transmission 1 Papua New Guinea 1 0 0 0 Imported cases only 18 Territories** Guam 121 8 4 0 Local transmission 0 French Polynesia 47 5 0 0 Local transmission 0 New Caledonia 18 0 0 0 Local transmission 5 Northern Mariana Islands (Commonwealth of the) 8 0 2 1 Local transmission 5 European Region Spain 140510 5478 13798 743 Local transmission 0 Italy 135586 3039 17129 604 Local transmission 0 Germany 103228 4003 1861 254 Local transmission 0 France 77226 3738 10313 1417 Local transmission 0 The United Kingdom 55246 3634 6159 786 Local transmission 0 Turkey 34109 3892 725 76 Local transmission 0 Belgium 22194 1380 2035 403 Local transmission 0 Switzerland 22164 590 641 0 Local transmission 0 Netherlands 19580 777 2101 234 Local transmission 0 Austria 12640 343 243 23 Local transmission 0 Portugal 12442 712 345 34 Local transmission 0 Israel 9404 793 71 19 Local transmission 0 Sweden 7693 487 591 114 Local transmission 0 Russian Federation 7497 1154 58 11 Local transmission 0 Norway 5863 108 69 10 Local transmission 0 Ireland 5709 345 210 36 Local transmission 0 Denmark 5071 390 203 16 Local transmission 0 Czechia 5017 195 88 10 Local transmission 0 Poland 4848 435 129 22 Local transmission 0 Romania 4417 360 182 25 Local transmission 0 Luxembourg 2970 127 44 3 Local transmission 0 Serbia 2447 247 61 3 Local transmission 0 Finland 2308 132 34 6 Local transmission 0 Greece 1832 77 81 2 Local transmission 0 Ukraine 1668 206 52 7 Local transmission 0 Iceland 1586 24 6 0 Local transmission 0 Croatia 1282 60 18 2 Local transmission 0 Estonia 1149 41 21 2 Local transmission 0 Republic of Moldova 1056 91 22 3 Local transmission 0 Slovenia 1055 34 36 6 Local transmission 0 Hungary 895 78 58 11 Local transmission 0 Lithuania 880 37 15 1 Local transmission 0 Armenia 877 44 8 0 Local transmission 0 Belarus 861 161 13 0 Local transmission 0 Bosnia and Herzegovina 781 86 32 4 Local transmission 0 Azerbaijan 717 76 8 1 Local transmission 0 Kazakhstan 709 39 6 0 Local transmission 0 North Macedonia 599 29 27 6 Local transmission 0 Slovakia 598 64 2 0 Local transmission 0 Bulgaria 577 28 23 1 Local transmission 0 Andorra 551 11 22 1 Local transmission 0 Latvia 548 6 2 1 Local transmission 0 Uzbekistan 534 62 3 1 Local transmission 0 Cyprus 494 29 14 0 Local transmission 0 Albania 400 23 22 0 Local transmission 0 Malta 293 52 0 0 Local transmission 0 San Marino 279 2 34 2 Local transmission 0 Kyrgyzstan 270 42 4 0 Local transmission 0 Montenegro 248 25 2 0 Local transmission 0 Georgia 208 13 3 1 Local transmission 0 Liechtenstein 78 0 1 0 Under investigation 2 Monaco 40 0 0 0 Local transmission 1 Holy See 7 0 0 0 Under investigation 5 Territories** Faroe Islands 184 3 0 0 Local transmission 0 Kosovo[1] 184 19 5 2 Local transmission 0 Jersey 170 15 3 0 Local transmission 0 Guernsey 166 12 4 1 Local transmission 0 Isle of Man 150 23 1 0 Local transmission 0 Gibraltar 113 10 1 0 Local transmission 0 Greenland 11 0 0 0 Under investigation 2 South-East Asia Region India 5194 1127 149 40 Local transmission 0 Indonesia 2738 247 221 12 Local transmission 0 Thailand 2369 149 30 4 Local transmission 0 Sri Lanka 186 10 6 1 Local transmission 0 Bangladesh 164 41 17 5 Local transmission 0 Myanmar 22 1 3 2 Local transmission 0 Maldives 19 0 0 0 Local transmission 5 Nepal 9 0 0 0 Local transmission 3 Bhutan 5 0 0 0 Imported cases only 5 Timor-Leste 1 0 0 0 Imported cases only 18 Eastern Mediterranean Region Iran (Islamic Republic of) 62589 2089 3872 133 Local transmission 0 Pakistan 4072 208 58 4 Local transmission 0 Saudi Arabia 2795 43 41 3 Local transmission 0 United Arab Emirates 2359 283 12 1 Local transmission 0 Qatar 2057 225 6 2 Local transmission 0 Egypt 1450 128 94 9 Local transmission 0 Morocco 1184 43 90 7 Local transmission 0 Iraq 1122 91 65 1 Local transmission 0 Bahrain 811 55 5 1 Local transmission 0 Kuwait 743 78 1 0 Local transmission 0 Tunisia 623 27 23 1 Local transmission 0 Lebanon 548 7 19 0 Local transmission 0 Afghanistan 423 56 14 3 Local transmission 0 Oman 419 48 2 0 Local transmission 0 Jordan 353 4 6 0 Local transmission 0 Djibouti 121 31 0 0 Local transmission 0 Libya 20 2 1 0 Local transmission 0 Syrian Arab Republic 19 0 2 0 Local transmission 2 Sudan 14 0 2 0 Local transmission 1 Somalia 8 1 0 0 Local transmission 0 Territories** occupied Palestinian territory 263 9 1 0 Local transmission 0 Region of the Americas United States of America 363321 29510 10845 1286 Local transmission 0 Canada 17049 1243 345 52 Local transmission 0 Brazil 12056 926 553 67 Local transmission 0 Chile 5116 301 43 6 Local transmission 0 Ecuador 3747 0 191 0 Local transmission 1 Peru 2561 280 92 9 Local transmission 0 Mexico 2439 296 125 31 Local transmission 0 Panama 2100 112 55 1 Local transmission 0 Dominican Republic 1956 128 98 12 Local transmission 0 Argentina 1628 74 53 7 Local transmission 0 Colombia 1579 94 46 11 Local transmission 0 Costa Rica 467 13 2 0 Local transmission 0 Uruguay 415 9 6 0 Local transmission 0 Cuba 396 46 11 2 Local transmission 0 Honduras 305 7 22 0 Local transmission 0 Bolivia (Plurinational State of) 194 11 14 3 Local transmission 0 Venezuela (Bolivarian Republic of) 165 6 7 4 Local transmission 0 Paraguay 115 2 5 0 Local transmission 0 Trinidad and Tobago 106 1 8 0 Local transmission 0 El Salvador 78 9 4 1 Local transmission 0 Guatemala 77 7 3 0 Local transmission 0 Barbados 60 4 2 1 Local transmission 0 Jamaica 59 1 3 0 Local transmission 0 Bahamas 33 4 5 0 Local transmission 0 Guyana 31 2 5 1 Local transmission 0 Haiti 25 1 1 0 Imported cases only 0 Antigua and Barbuda 15 0 0 0 Local transmission 1 Dominica 15 1 0 0 Local transmission 0 Saint Lucia 14 0 0 0 Local transmission 2 Grenada 12 0 0 0 Local transmission 3 Saint Kitts and Nevis 10 0 0 0 Imported cases only 1 Suriname 10 0 1 0 Local transmission 4 Belize 7 0 1 0 Local transmission 1 Saint Vincent and the Grenadines 7 0 0 0 Imported cases only 1 Nicaragua 6 0 1 0 Imported cases only 1 Territories** Puerto Rico 573 60 23 2 Local transmission 0 Martinique 151 2 4 0 Local transmission 0 Guadeloupe 139 4 7 0 Local transmission 0 French Guiana 72 4 0 0 Local transmission 0 Aruba 71 7 0 0 Local transmission 0 United States Virgin Islands 43 0 1 0 Local transmission 1 Sint Maarten 40 3 8 2 Imported cases only 0 Bermuda 39 2 2 2 Local transmission 0 Cayman Islands 39 0 1 0 Local transmission 1 Saint Martin 31 0 2 0 Under investigation 1 Curaçao 13 0 1 0 Imported cases only 1 Turks and Caicos Islands 8 3 1 0 Local transmission 0 Montserrat 6 0 0 0 Imported cases only 3 Saint Barthélemy 6 0 0 0 Under investigation 8 Anguilla 3 0 0 0 Local transmission 4 British Virgin Islands 3 0 0 0 Imported cases only 7 Bonaire, Sint Eustatius and Saba 2 0 0 0 Imported cases only 4 Falkland Islands (Malvinas) 2 0 0 0 Under investigation 2 Saint Pierre and Miquelon 1 1 0 0 Imported cases only 0 African Region South Africa 1749 63 13 1 Local transmission 0 Algeria 1468 45 194 21 Local transmission 0 Cameroon 555 0 9 0 Local transmission 3 Burkina Faso 364 19 18 1 Local transmission 0 Côte d’Ivoire 349 26 3 0 Local transmission 0 Ghana 287 73 5 0 Local transmission 0 Niger 278 94 11 1 Local transmission 0 Mauritius 268 24 7 0 Local transmission 0 Nigeria 254 22 6 1 Local transmission 0 Senegal 237 11 2 0 Local transmission 0 Democratic Republic of the Congo 183 22 20 2 Local transmission 0 Kenya 172 30 6 2 Local transmission 0 Guinea 144 33 0 0 Local transmission 0 Rwanda 105 1 0 0 Local transmission 0 Madagascar 92 15 0 0 Local transmission 0 Togo 58 14 3 0 Local transmission 0 Ethiopia 52 9 1 0 Local transmission 0 Uganda 52 0 0 0 Local transmission 1 Mali 47 8 5 1 Local transmission 0 Congo 45 0 5 0 Local transmission 3 Zambia 39 0 1 0 Local transmission 5 Guinea-Bissau 33 0 0 0 Imported cases only 1 Eritrea 31 2 0 0 Local transmission 0 Benin 26 3 1 0 Local transmission 0 Gabon 24 3 1 0 Imported cases only 0 United Republic of Tanzania 24 0 1 0 Local transmission 1 Angola 17 1 2 0 Imported cases only 0 Equatorial Guinea 16 0 0 0 Local transmission 3 Namibia 16 0 0 0 Local transmission 2 Liberia 14 0 3 0 Local transmission 1 Seychelles 11 0 0 0 Imported cases only 1 Zimbabwe 11 2 2 1 Local transmission 0 Chad 10 1 0 0 Local transmission 0 Eswatini 10 1 0 0 Imported cases only 0 Mozambique 10 0 0 0 Local transmission 6 Central African Republic 9 0 0 0 Local transmission 3 Malawi 8 4 1 1 Local transmission 0 Cabo Verde 7 0 1 0 Local transmission 1 Botswana 6 0 1 0 Imported cases only 1 Mauritania 6 0 1 0 Imported cases only 4 Sierra Leone 6 0 0 0 Imported cases only 2 Gambia 4 0 1 0 Imported cases only 5 São Tomé and Príncipe 4 0 0 0 Under investigation 1 Burundi 3 0 0 0 Local transmission 4 South Sudan 1 0 0 0 Under investigation 2 Territories** Réunion 358 9 0 0 Local transmission 0 Mayotte 184 20 2 0 Local transmission 0 Subtotal for all Regions 1352649 73639 79224 6695 International conveyance (Diamond Princess) 712 0 11 0 Local transmission 23 Grand total 1353361 73639 79235 6695 *Numbers include both domestic and repatriated cases †The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. ‡Case classifications are based on WHO case definitions for COVID-19. §Transmission classification is based on WHO analysis of available official data and may be subject to reclassification as additional data become available. Countries/territories/areas experiencing multiple types of transmission are classified in the highest category for which there is evidence; they may be removed from a given category if interruption of transmission can be demonstrated. It should be noted that even within categories, different countries/territories/areas may have differing degrees of transmission as indicated by the differing numbers of cases and other factors. Not all locations within a given country/territory/area are equally affected. Terms: - Community transmission is evidenced by the inability to relate confirmed cases through chains of transmission for a large number of cases, or by increasing positive tests through sentinel samples (routine systematic testing of respiratory samples from established laboratories). - Local transmission indicates locations where the source of infection is within the reporting location. - Imported cases only indicates locations where all cases have been acquired outside the location of reporting. - Under investigation indicates locations where type of transmission has not been determined for any cases. - Interrupted transmission indicates locations where interruption of transmission has been demonstrated (details to be determined) ** “Territories” include territories, areas, overseas dependencies and other jurisdictions of similar status [1] All references to Kosovo should be understood to be in the context of the United Nations Security Council resolution 1244 (1999). Due to differences in reporting methods, retrospective data consolidation, and reporting delays, the number of new cases may not always reflect the exact difference between yesterday’s and today’s totals. WHO COVID-19 Situation Reports present official counts of confirmed COVID-19 cases, thus differences between WHO reports and other sources of COVID-19 data using different inclusion criteria and different data cutoff times are to be expected. New countries/territories/areas are shown in red. Figure 1. Epidemic curve of confirmed COVID-19, by date of report and WHO region through 8 April 2020 STRATEGIC OBJECTIVES WHO’s strategic objectives for this response are to: • Interrupt human-to-human transmission including reducing secondary infections among close contacts and health care workers, preventing transmission amplification events, and preventing further international spread*; • Identify, isolate and care for patients early, including providing optimized care for infected patients; • Identify and reduce transmission from the animal source; • Address crucial unknowns regarding clinical severity, extent of transmission and infection, treatment options, and accelerate the development of diagnostics, therapeutics and vaccines; • Communicate critical risk and event information to all communities and counter misinformation; • Minimize social and economic impact through multisectoral partnerships. *This can be achieved through a combination of public health measures, such as rapid identification, diagnosis and management of the cases, identification and follow up of the contacts, infection prevention and control in health care settings, implementation of health measures for travelers, awareness-raising in the population and risk communication. PREPAREDNESS AND RESPONSE • To view all technical guidance documents regarding COVID-19, please go to this webpage. • WHO has developed interim guidance for laboratory diagnosis, advice on the use of masks during home care and in health care settings in the context of the novel coronavirus (2019-nCoV) outbreak, clinical management, infection prevention and control in health care settings, home care for patients with suspected novel coronavirus, risk communication and community engagement and Global Surveillance for human infection with novel coronavirus (2019-nCoV). • WHO is working closely with International Air Transport Association (IATA) and have jointly developed a guidance document to provide advice to cabin crew and airport workers, based on country queries. The guidance can be found on the IATA webpage. • WHO has been in regular and direct contact with Member States where cases have been reported. WHO is also informing other countries about the situation and providing support as requested. • WHO is working with its networks of researchers and other experts to coordinate global work on surveillance, epidemiology, mathematical modelling, diagnostics and virology, clinical care and treatment, infection prevention and control, and risk communication. WHO has issued interim guidance for countries, which are updated regularly. • WHO has prepared a disease commodity package that includes an essential list of biomedical equipment, medicines and supplies necessary to care for patients with 2019-nCoV. • WHO has provided recommendations to reduce risk of transmission from animals to humans. • WHO has published an updated advice for international traffic in relation to the outbreak of the novel coronavirus 2019-nCoV. • WHO has activated the R&D blueprint to accelerate diagnostics, vaccines, and therapeutics. • OpenWHO is an interactive, web-based, knowledge-transfer platform offering online courses to improve the response to health emergencies. COVID-19 courses can be found here and courses in additional national languages here. Specifically, WHO has developed online courses on the following topics: o A general introduction to emerging respiratory viruses, including novel coronaviruses (available in Arabic, Chinese, English, French, Russian, Spanish, Hindi, Indian Sign Language, Persian, Portuguese, Serbian and Turkish); o Clinical care for Severe Acute Respiratory Infections (available in English, French, Russian, Indonesian and Vietnamese); o Health and safety briefing for respiratory diseases - ePROTECT (available in Chinese, English, French, Russian, Spanish, Indonesian and Portuguese); o Infection Prevention and Control for Novel Coronavirus (COVID-19) (available in Chinese, English, French, Russian, Spanish, Indonesian, Italian, Japanese, Portuguese and Serbian); and o COVID-19 Operational Planning Guidelines and COVID-19 Partners Platform to support country preparedness and response (available in English and coming soon in additional languages). • WHO is providing guidance on early investigations, which are critical in an outbreak of a new virus. The data collected from the protocols can be used to refine recommendations for surveillance and case definitions, to characterize the key epidemiological transmission features of COVID-19, help understand spread, severity, spectrum of disease, impact on the community and to inform operational models for implementation of countermeasures such as case isolation, contact tracing and isolation. Several protocols are available here. One such protocol is for the investigation of early COVID-19 cases and contacts (the “First Few X (FFX) Cases and contact investigation protocol for 2019-novel coronavirus (2019-nCoV) infection”). The protocol is designed to gain an early understanding of the key clinical, epidemiological and virological characteristics of the first cases of COVID-19 infection detected in any individual country, to inform the development and updating of public health guidance to manage cases and reduce the potential spread and impact of infection. RECOMMENDATIONS AND ADVICE FOR THE PUBLIC If you are not in an area where COVID-19 is spreading or have not travelled from an area where COVID-19 is spreading or have not been in contact with an infected patient, your risk of infection is low. It is understandable that you may feel anxious about the outbreak. Get the facts from reliable sources to help you accurately determine your risks so that you can take reasonable precautions (see Frequently Asked Questions). Seek guidance from WHO, your healthcare provider, your national public health authority or your employer for accurate information on COVID-19 and whether COVID-19 is circulating where you live. It is important to be informed of the situation and take appropriate measures to protect yourself and your family (see Protection measures for everyone). If you are in an area where there are cases of COVID-19 you need to take the risk of infection seriously. Follow the advice of WHO and guidance issued by national and local health authorities. For most people, COVID-19 infection will cause mild illness however, it can make some people very ill and, in some people, it can be fatal. Older people, and those with pre-existing medical conditions (such as cardiovascular disease, chronic respiratory disease or diabetes) are at risk for severe disease (See Protection measures for persons who are in or have recently visited (past 14 days) areas where COVID-19 is spreading). CASE DEFINITIONS WHO periodically updates the Global Surveillance for human infection with coronavirus disease (COVID-19) document which includes case definitions. For easy reference, case definitions are included below. Suspect case A. A patient with acute respiratory illness (fever and at least one sign/symptom of respiratory disease, e.g., cough, shortness of breath), AND a history of travel to or residence in a location reporting community transmission of COVID-19 disease during the 14 days prior to symptom onset. OR B. A patient with any acute respiratory illness AND having been in contact with a confirmed or probable COVID-19 case (see definition of contact) in the last 14 days prior to symptom onset; OR C. A patient with severe acute respiratory illness (fever and at least one sign/symptom of respiratory disease, e.g., cough, shortness of breath; AND requiring hospitalization) AND in the absence of an alternative diagnosis that fully explains the clinical presentation. Probable case A. A suspect case for whom testing for the COVID-19 virus is inconclusive. a. Inconclusive being the result of the test reported by the laboratory. OR B. A suspect case for whom testing could not be performed for any reason. Confirmed case A person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms. • Technical guidance for laboratory testing can be found here. Definition of contact A contact is a person who experienced any one of the following exposures during the 2 days before and the 14 days after the onset of symptoms of a probable or confirmed case: 1. Face-to-face contact with a probable or confirmed case within 1 meter and for more than 15 minutes; 2. Direct physical contact with a probable or confirmed case; 3. Direct care for a patient with probable or confirmed COVID-19 disease without using proper personal protective equipment1; OR 4. Other situations as indicated by local risk assessments. Note: for confirmed asymptomatic cases, the period of contact is measured as the 2 days before through the 14 days after the date on which the sample was taken which led to confirmation. 1 World Health Organization. Infection prevention and control during health care when COVID-19 is suspected https://www.who.int/publications-detail/infection-prevention-and-control-during-health-care-when-novel-coronavirus-(ncov)- infection-is-suspected-20200125