COVID-19: The Authoritative Chronology, December 2019-March 2020 - Background paper 2a The Independent Panel for Pandemic Preparedness and ...
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COVID-19: The Authoritative Chronology, December 2019–March 2020 Background paper 2a The Independent Panel for Pandemic Preparedness and Response May 2021
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 2 of 48 Glossary and abbreviations AFCOR—Africa Task Force for Novel Coronavirus GOARN—WHO Global Outbreak Alert and Response Rt and Re—R at time t, effective reproduction number, Network estimates how many other cases one infected individual AFR—WHO African Region is likely to cause at a specific time, considering immunity HCWs—health care workers and public health measures AMR—WHO Region of the Americas h-to-h—human-to-human RaTG13—a type of bat coronavirus AP—Associated Press HQ—headquarters RCCE—Risk Communication and Community Article 6—International Health Regulations section regarding Member State notifications to the World IASC—Inter-agency Standing Committee Engagement Health Organization about a potential international SARS—severe acute respiratory syndrome health threat IDVI—Infectious Disease Vulnerability Index IFRC—International Federation of Red Cross SARS-CoV-2—severe acute respiratory syndrome- Article 10—International Health Regulations section coronavirus-2, the virus that causes COVID-19 disease regarding Member State verification of emerging and Red Crescent Societies disease threat information IHR—International Health Regulations SCMP—South China Morning Post AU—African Union ILO—International Labour Organization SEAR—WHO South-East Asian Region CCDC—Chinese Center for Disease Control Mean serial interval—indicates the length of time STAG-IH—WHO Strategic and Technical Advisory Group between symptom onset of an initial case and any for Infectious Hazards COVID-19—the disease caused by SARS-CoV-2 subsequent cases UN—United Nations DG—WHO Director-General nCoV—novel coronavirus UNHCR—UN High Commissioner for Refugees Dispersion factor k—describes how a disease clusters PCR—polymerase chain reaction UK—United Kingdom EB—WHO Executive Board R&D—research and development US—United States ECDC—European Centre for Disease Prevention and Control PHEIC—Public Health Emergency of International US CDC—United States Centers for Disease Control Concern and Prevention ED—Executive Director PPE—personal protective equipment WASH—Water, Sanitation, and Hygiene EEA—European Economic Area ProMED—Program for Monitoring Emerging Diseases WHO—World Health Organization EMR— WHO Eastern Mediterranean Region PUO—pneumonia of unknown origin WPRO—WHO Western Pacific Regional Office EU—European Union R0—R naught, basic reproduction number, estimates 2019-nCoV—novel coronavirus 2019 EUR—WHO European Region how many other cases one infected individual is likely to cause prior to institution of public health measures or G7—Group of Seven development of immunity G20—Group of Twenty
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 3 of 48 CHRONOLOGY LEGEND SUB-CATEGORY Headline Author/Actor Published: Caption Source Links to other sources e.g. news release Time zones CST – China Standard Time CET – Central European Time International actions Country actions Real-time evidence Retrospective evidence Annotations Key events Private document Public document WHO action Strength of research 1 - low quality pre-print 2 - medium peer reviewed 3 - high quality top tier journal
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 4 of 48 INTERNATIONAL COUNTRY REAL-TIME EVIDENCE pre-Dec 2019 01 Dec 2019 08 Dec 2019 15 Dec 2019 mid-Dec 2019 SCIENCE CASES Patient with COVID-like SCIENCE Assumed spillover from animals RETROSPECTIVE EVIDENCE symptoms identified CASES SARS-CoV-2 could have infected to humans SCIENCE van Dorp L, Acman M, et al. Huang C, Wang Y, et al. First identified COVID-19 patient people in the US in mid-Dec Published: 5 May 2020 Published: 24 Jan 2020 becomes ill R0 increased during Dec. 2019 Basavaraju S, Patton M, et al. Analysis of genomic diversity over 62-year-old man developed Joint WHO-China mission Lai A, Bergna A, et al. Published: 30 Nov 2020 symptoms of a respiratory illness Published: 30 Mar 2021 Published: 25 Feb 2020 time found that all sequences Blood samples in the United States share a common ancestor towards on this date. He was identified “The case with the earliest onset The analysis of 52 viral genomes (US) were found to have cross- the end of 2019, suggesting this by some as the first patient with date reported to the Chinese from different countries reactive antibodies to SARS- as the period when SARS-CoV-2 eventual laboratory confirmed National Notifiable Disease determined that R0 increased CoV-2, suggesting that the virus spilled over to a human host. COVID-19. Subsequent evidence Reporting System became ill on from 0.8 to 2.4 during Dec. 2019, could have infected people there suggests he was infected later in December 8”. with a mean doubling time of as early as Dec. 2019. Infection, Genetics and Evolution, Nature, WHO-convened Global Study of the December. WHO-convened Global Study of the around 4 days. Clinical Infectious Diseases, Wall Street Origins of SARS-CoV-2 The Lancet, WHO, WHO-convened Global Origins of SARS CoV-2 Journal of Medical Virology Journal Study of the Origins of SARS-CoV-2
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 5 of 48 INTERNATIONAL COUNTRY REAL-TIME EVIDENCE 16 Dec 2019 18 Dec 2019 21 Dec 2019 24 Dec 2019 16 Dec 2019–02 Jan 2020 21 Dec–30 Dec 2019 NEWS REPORT CASES CASES RETROSPECTIVE EVIDENCE Wuhan doctors sent lung fluid Patients with PUO admitted to Three patients with PUO identified in Wuhan (later sample to commercial lab for Wuhan hospital (later confirmed SCIENCE confirmed as SARS-CoV-2) testing as SARS-CoV-2) Sewage samples in Italy possibly Zhu N, Zhang D, et al. Published: 05 May 2020 Huang C, Wang Y, et al. positive for SARS-CoV-2 Published: 24 Jan 2020 Wuhan doctors noticed Published: 24 Jan 2020 La Rosa G, Mancini P, et al. Three patients with PUO were identified in Wuhan pneumonia patients were not 41 patients with pneumonia of Published: 15 Aug 2020 from 21 Dec. onwards. Lung fluid samples collected responding to usual treatments unknown origin (PUO) were Sewage samples from 18 Dec. in 30 Dec. during hospital admission later confirmed and sent a test sample to Vision admitted to a Wuhan hospital Milan and Turin were found to be SARS-CoV-2. One patient was a retailer at the Huanan Medicals (commercial lab) for next between 16 Dec.-2 Jan. Confirmed positive for SARS-CoV-2, but may Seafood Market, another a frequent market visitor. generation sequencing/testing. as SARS-CoV-2 in Jan. 2020. be false positives. One died 9 Jan. 2020, the others were discharged. Chinese Medical Journal, PBS Frontline, The Lancet Science of the Total Environment New England Journal of Medicine Caixin
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 6 of 48 INTERNATIONAL First reported suspected cluster ACTION ACTION ACTION Wuhan CDC collects samples Suspicious cases admitted to Additional suspicious cases from PUO patients Wuhan hospital identified at Wuhan hospital, Wuhan CDC Dr. Zhang Jixian cluster reported COUNTRY Wuhan CDC visits Hubei Hospital Dr. Zhang Jixian One female with fever and dry of Integrated Chinese and Western cough symptoms is identified Staff at Hubei Hospital of Medicine to collect lung fluid and by Dr. Zhang Jixian in Hubei Integrated Chinese and Western blood samples from three PUO Hospital of Integrated Chinese Medicine realize that the two patients (husband, wife, son) for and Western Medicine. Her cases are a couple, and transfer more investigation. Dr. Zhang husband is admitted to a different the husband to the same Jixian reports to Wuhan CDC that department of the hospital on department as his wife. Their son, she is “concerned about human- the same day. The results of the who is asymptomatic, is also CT to-human (h-to-h) transmission.” diagnostic work-ups are different scanned, which reveals that he has Dr. Zhang Jixian notes “Wuhan than normal pneumonia cases. similar lung abnormalities as his CDC didn’t dismiss my thoughts The female reports close contact parents. Dr. Zhang Jixian reports nor did they confirm them, but REAL-TIME EVIDENCE with the Huanan Seafood Market, the three cases to the Jianghan said they needed to confirm while her husband reports no District Center for Disease Control through lab investigations.” contact with the market. and Prevention (CDC). Interview and correspondence with Interview and correspondence with Interview and correspondence with Dr. Zhang Jixian, Journal of Nuclear Dr. Zhang Jixian, Journal of Nuclear Dr. Zhang Jixian, Journal of Nuclear Medicine, IHR Review Committee Report Medicine, WHO-convened Global Medicine, IHR Review Committee Report Study of the Origins of SARS-CoV 25 Dec 2019 26 Dec 2019 27 Dec 2019 NEWS REPORT NEWS REPORT Chinese lab identified SARS-like Private lab in China pieced most NEWS REPORT virus in samples of genome RETROSPECTIVE EVIDENCE Senior director at Wuhan hospital SCIENCE Published: 01 Feb 2020 Published: 26 Feb 2020 heard of possible spread Respiratory sample from hospitalised patient in An account published in multiple Private lab shared next generation Published: 28 Jan 2020 Chinese news sites by an France positive for SARS-CoV-2 sequence data of potential new Dr. Lu Xiaohong, head of anonymous lab technician, said his Deslandes A, Berti V, et al. virus with homology to SARS-like gastroenterology at City Hospital company had received samples Published: 03 May 2020 coronavirus with Wuhan officials No. 5, told China Youth Daily that from Wuhan and determined on A hospital in the north of Paris retrospectively tested and the Chinese Academy of on 25 Dec. she heard unexplained 26 Dec. they contained a new respiratory samples from patients admitted to the Medical Sciences. First reported viral pneumonia was spreading coronavirus with 87% similarity intensive care unit with influenza-like illness in Dec. by Chinese finance publication among health care workers to Severe Acute Respiratory 2019. The sample from a patient admitted on 27 Dec. Caixin; independently confirmed (HCWs). Syndrome (SARS). was found to be positive for SARS-CoV-2. by the Associated Press (AP). China Youth Daily, NY Times Washington Post, Caixin International Journal of Antimicrobial Agents, Reuters Caixin, Associated Press
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 7 of 48 INTERNATIONAL 30 Dec 2019 – 15:10 CST/08:10 CET 18:50 CST/11:50 CET ALERT ALERT Wuhan issues a first “urgent Wuhan issues a second “urgent notice” to health institutions notice” to health institutions Wuhan Municipal Health Commission Wuhan Municipal Health Commission The Wuhan Municipal Health The Wuhan Municipal Health 12:16 CST/05:16 CET ACTION Commission issues an “urgent Commission issues a second REQUEST notice” to health institutions about notice to health institutions, Wuhan Institute of Virology cases of PUO linked to the Huanan with instructions not to disclose receives PUO samples Taipei CDC IHR Point of Contact Seafood Market. The notice is information to the public without Wuhan Institute of Virology emails WHO via IHR shared in online chat groups, authorisation. The “urgent Taipei CDC IHR Point of Contact COUNTRY Wuhan Institute of Virology including by ophthalmologist Dr. notice” includes the following receives samples from seven Taipei CDC IHR Point of Contact Li. three headings: Strengthening patients with PUO. The samples emails WHO via the International Wuhan Municipal Health Commission Responsibility and Guidance, are sent by staff at Wuhan Health Regulations (IHR) system archived document, WHO internal Regularizing Medical Care, and Jinyintan Hospital. and requests information about documents, Associated Press, PBS Frontline Strict Reporting Information cases, referring to recent news System. Interview and correspondence with Dr. Zhengli Shi , Nature 31 Dec 2019 – 10:16 CST/03:16 CET reports. WHO Headquarters (HQ) SCIENCE Wuhan Municipal Health Commission NEWS REPORT acknowledges the request. archived document, WHO internal Private laboratory sequences WHO internal documents, Taiwan Centers documents, The Guardian, Associated First report of cases in Chinese for Disease Control genome of novel coronavirus Press media Vision Medicals Published: 31 Dec 2019 REAL-TIME EVIDENCE Scientists at private lab report Finance Sina publishes the first genome sequencing results as report in Chinese media on cases “highly suspicious of SARS”. This is of PUO in Wuhan. Other media shared with the hospital that sent articles are published shortly after the samples. in Beijing News, Central News Pre-print Agency, Taiwan and South China Morning Post (SCMP). Finance Sina, WHO internal documents 30 Dec 2019 31 Dec 2019 CASES RETROSPECTIVE EVIDENCE 55% of cases linked to Huanan Seafood Market NEWS REPORT Li Q, Guan X, et al. Published: 29 Jan 2020 China CDC visited Huanan Seafood Market A study of the first laboratory confirmed patients in Wuhan Published: 2 Nov 2020 with COVID-19 found a link to the China CDC visited Huanan Huanan Seafood market in 55 % of Seafood Market and took samples cases with onset of disease before before the market was closed. 1 Jan. NY Times New England Journal of Medicine
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 8 of 48 12:17 CST/05:17 CET 13:55 CST/06:55 CET 16:57 CST/09:57 CET REQUEST ACTION REQUEST WHO China Country Office WHO China takes note of public WHO HQ requests information receives query from Beijing bulletin and notifies WPRO from WHO WPRO IHR Focal Point INTERNATIONAL bureau of New York Times WHO China Country Office WHO HQ WHO China Country Office WHO China Country Office sees Having detected ProMED signal, WHO China Country Office online public bulletin from Wuhan WHO HQ surveillance team receives a query from the Beijing Municipal Health Commission requests more information bureau of New York Times and immediately notifies the WHO from the WHO WPRO IHR Focal regarding cases in Wuhan. WPRO IHR Focal Point by email, Point, who provides a machine WHO internal documents and specifies no IHR notification translation of the Wuhan has been issued. Municipal Health Commission WHO staff interview, WHO internal public bulletin. On the same day, documents WHO receives requests for more information from the United BORDER MEASURES Kingdom (UK) and the European Taiwan (China) starts screening Centre for Disease Control airline passengers (ECDC). COUNTRY WHO internal documents Taiwan (China) Taiwan (China) starts screening BORDER MEASURES airline passengers from Wuhan for fever. Hong Kong SAR (China) makes public health announcement Taiwan Today, JAMA Hong Kong SAR (China) Hong Kong SAR (China) makes 12:59 CST/05:59 CET 13:38 CST/06:38 CET public health announcement ALERT CASES related to cluster of PUO cases in Wuhan, and underscores thermal ProMED reports cases in Wuhan Wuhan releases public bulletin REAL-TIME EVIDENCE imaging systems are in place at ProMED about PUO cases borders to screen for possible WHO HQ Epidemic Intelligence Wuhan Municipal Health Commission cases. from Open Sources detects 27 cases of PUO are confirmed Government of the Hong Kong Special signals of outbreak on Program by Wuhan Municipal Health Administrative Region for Monitoring Emerging Diseases Commission in public bulletin. (ProMED). State Council Information Office of the ProMED, WHO staff interview, WHO People’s Republic of China internal documents, IHR Review Committee Report 31 Dec 2019, cont. RETROSPECTIVE EVIDENCE
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 9 of 48 01 Jan 2020 – 10:35 CST/03:35 CET 16:54 CST/09:54 CET 01 Jan – 23:05 CET 10:45 CST/03:45 CET REQUEST REQUEST 02 Jan – 06:05 CST REQUEST REQUEST WHO WPRO IHR Focal Point WHO Representative to China WHO China Country Office requests information emails Chinese NHC WHO HQ requests WHO WPRO to contacts WPRO INTERNATIONAL WHO WPRO WHO Representative to China trigger Article 10 of IHR WHO China Country Office WHO HQ WHO WPRO IHR Focal Point WHO Representative to China Replying to the email from WHO requests information about emails the Chinese National In an email, WHO HQ requests HQ, WHO Country Office repeats the cluster of cases from the Health Commssion to offer WHO WPRO to activate Article request to WPRO to follow up with Chinese National Focal Point, who support and repeats the requests 10 of the IHR and issue a formal the Chinese National Focal Point. acknowledges request one hour for information. request for verification. The WHO internal documents later. WHO WPRO IHR Focal Point WHO internal documents Incident Management System sends a more detailed request for is activated and an Incident information shortly afterward. Management Support Team 13:05 CST/06:05 CET WHO Timeline, WHO internal documents, ACTION established. ACTION IHR Review Committee Report REQUEST Huanan Seafood Market closed WHO internal documents, WHO Timeline Wuhan Institute of Virology Singapore National Focal Point Wuhan local health authority sequences the virus contacts WHO WPRO Wuhan Institute of Virology Singapore National Focal Point The Huanan Seafood Market is Published: 29 Jan 2020 COUNTRY closed, cleaned, and disinfected. The Singapore National Focal People’s Daily, WHO Using next-generation Point contacts WHO WPRO, sequencing, Wuhan Institute of requesting information about Virology decodes the sequence the cases in Wuhan. WHO WPRO of the virus genome, except the replies four hours later. 5’ and 3’ terminus. The Institute NEWS REPORT WHO internal documents sequences the full genome by 7 Media reports WHO is in contact Jan. with Chinese authorities Interview and correspondence with Dr. Zhengli Shi, Wuhan Institute of Virology, Published: 01 Jan 2020 Associated Press South China Morning Post REAL-TIME EVIDENCE reports that “The World Health Organisation said it is in ongoing contact with authorities in China over an unidentified outbreak of viral pneumonia in the central city of Wuhan, amid concern it may have been transmitted from animals.” South China Morning Post 01 Jan 2020 02 Jan NEWS REPORT RETROSPECTIVE EVIDENCE Eight doctors questioned by Wuhan police Published: 01 Feb 2020 The doctors questioned include ophthalmologist Li Wenliang, who had sent a private chat message to colleagues about a new SARS-like virus. The incidents were reported on the Chinese newscast “Xinwen Lianbo”, watched by millions. The police followed up with a warning in the Xinhua News Agency and “call on all netizens to not fabricate rumors, not spread or believe rumors.” Washington Post, The Lancet
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 10 of 48 16:00 CST/09:00 CET 21:00 CST/13:00 CET REQUEST 03 Jan – 11:15 CST/04:15 CET 16:00 CST/09:00 CET MEETING MEETING REQUEST MEETING WHO Representative to China First three-level teleconference WHO and GOARN teleconference writes formal letter to China WHO WPRO contacts China, First technical briefing between triggering Article 10 of IHR China and WHO INTERNATIONAL WHO Incident Manager Support Team WHO and GOARN WHO Representative to China WHO WPRO WHO Country Office WHO Incident Manager Support WHO and WHO Global Outbreak WHO Representative to China Team holds its first three-level Alert and Response Network writes a letter to the National WHO WPRO requests information First of three technical briefings teleconference. In a context (GOARN) hold a teleconference Health Commission, offering from the Chinese National Focal between WHO China Country of increasing requests for about the outbreak. China CDC support and urging the Point under Article 10 of IHR. The Office and the Chinese National information from several Member does not join the call. Commission and the China Focal Point replies five hours Health Commission. China gives States, specifics of activating IHR WHO internal documents, WHO Timeline IHR National Focal Point to later and confirms information WHO information matching to obtain further information from respond urgently to requests for issued by Wuhan Municipal Health the public bulletin, issued one China are discussed. information. Commission. hour later. A WHO three-level WHO internal documents WHO internal documents, WHO Timeline WHO internal documents, IHR Review teleconference is held immediately Committee Interim Progress Report following the meeting. REQUEST BORDER MEASURES WHO internal documents, WHO Timeline BORDER MEASURES Countries ask WHO for Hong Kong SAR (China) to add information “mystery Wuhan pneumonia” to Thailand implements screening notifiable infectious diseases list of patients travelling from COUNTRY Countries Wuhan Hong Kong SAR (China) Several Member States, including Government of Thailand Malaysia and the Republic of Hong Kong SAR (China) announces Korea, request further information that they will add “mystery Wuhan Thailand implements measures about the outbreak from WHO. pneumonia” to a list of notifiable for screening patients travelling WHO internal documents infectious diseases, allowing the from Wuhan at four airports, and authorities to place patients in steps up surveillance at public and quarantine. private hospitals. South China Morning Post Euro Surveillance, WHO REAL-TIME EVIDENCE 02 Jan, cont. 03 Jan SCIENCE Sampling at Huanan Seafood Market showed the RETROSPECTIVE EVIDENCE virus was present in the environment, not in animals Joint WHO-China mission Published: 31 Jul 2020 Of 336 samples collected from animals at Huanan Seafood Market, none was positive by polymerase chain reaction (PCR) for SARS-CoV-2. 69 out of 842 environmental samples were positive by PCR for SARS- CoV-2. Three genetic sequences of SARS-CoV-2 from environmental samples at Huanan Seafood Market eventually were published on the Global Initiative on Sharing All Influenza Data. WHO-Convened Global Study of the Origins of SARS-CoV-2
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 11 of 48 04 Jan – 11:22 CST/04:22 CET 13:27 CST/06:27 CET 04 Jan – 19:13 CET PUBLICATION REQUEST ANNOUNCEMENT 05 Jan – 02:13 CST ANNOUNCEMENT WHO reports 44 cases in Disease WHO WPRO requests more WHO WPRO tweets China has Outbreak News information; advises IHR state reported a cluster of PUO cases WHO HQ tweets China has INTERNATIONAL WHO parties will be notified WHO WPRO reported a cluster of pneumonia WHO WPRO cases Based on Chinese data, WHO “#China has reported to WHO WHO HQ reports the 44 cases identified WHO WPRO IHR Focal Point regarding a cluster of pneumonia by 3 Jan. in Disease Outbreak acknowledges the information cases in Wuhan, Hubei Province. “#China has reported to WHO News, and states that there is “no received under Article 10 of IHR The Govt has also met with our a cluster of #pneumonia cases evidence of significant human-to- and requests more information country office, and updated @ —with no deaths— in Wuhan, human transmission”. from the Chinese National Focal WHO on the situation. Govt actions Hubei Province. Investigations are WHO Disease Outbreak News Point. WHO WPRO advises that to control the incident have been underway to identify the cause of IHR state parties will be notified. instituted and investigations into this illness.” The Focal Point replies one hour the cause are ongoing.” WHO Twitter later. WHO WPRO Twitter WHO internal documents COUNTRY ANNOUNCEMENT Wuhan issues third public bulletin confirming 59 PUO cases Wuhan Municipal Health Commission 17:00 CST/10:00 CET Published: 5 Jan 2020 CASES Wuhan Municipal Health Commission issues a third bulletin, Wuhan issues second public REAL-TIME EVIDENCE bulletin confirming 44 PUO cases reporting 59 cases, seven in serious condition, no deaths. The Wuhan Municipal Health Commission bulletin reports that preliminary Wuhan Municipal Health studies have not shown any sign Commission issues second public of h-to-h transmission, and that bulletin, confirming 44 PUO cases, no health care workers have been of which 11 are severely ill and 33 infected. are in stable condition. Wuhan Municipal Health Commission, WHO Center for Infectious Disease Research and Policy 03 Jan, cont. 04 Jan 05 Jan RETROSPECTIVE EVIDENCE 01 Jan-09 Jan 2020 SCIENCE Re estimated at 3.54 in China Hao X, Chen S, et al. Published: 16 Jul 2020 Re estimated at 3.54 (3.4-3.67) in China for the period 1 Jan.-9 Jan., suggesting rapid spread. Nature
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 12 of 48 ALERT NEWS BRIEFING WHO alerts Member States via WHO briefs UN journalists IHR WHO INTERNATIONAL WHO WHO participates in a regular UN WHO shares information about Geneva press briefing to give an the cluster of cases through the update on the cluster of cases. IHR Event Information System WHO internal documents accessible to all WHO Members States and advises countries to take precautions to reduce the risk of acute respiratory infections. WHO Timeline, IHR Review Committee Report COUNTRY SCIENCE China CDC isolates the virus REAL-TIME EVIDENCE China CDC The National Institute for Viral Disease Control and Prevention of the China CDC succeeds in isolating the first novel coronavirus strain. Interview: Dr. George Gao 25 Nov. 20, State Council Information Office of the People’s Republic of China 05 Jan, cont. 06 Jan 07 Jan SCIENCE Shanghai group submit genome RETROSPECTIVE EVIDENCE SCIENCE to GenBank NEWS REPORT NEWS REPORT Wuhan Institute of Virology Zhang YZ, Wu F et al. isolates virus Published: 11 Jan 2020 China CDC raised emergency WHO was concerned that not level enough data was shared NEWS REPORT Wuhan Institute of Virology A consortium of researchers from Chinese top leaders discussed Published: 29 Jan 2020 the Shanghai Public Health Center Published: 02 Jun 2020 Published: 02 Jun 2020 the outbreak The Wuhan Institute of Virology sequenced the novel coronavirus China CDC raised emergency level “We’re currently at the stage and uploaded the sequence to to second highest. Staff isolated where they’re giving it to us 15 Published: 09 Jun 2020 confirmed the isolation of the novel coronavirus with GenBank on 5 Jan. The submitted the virus, drafted lab testing minutes before it appears on Chinese top leaders, including the immunofluroscence and sequence was subsequently guidelines, and designed test kits. CCTV (China Central Television),” President, discussed the outbreak quantitative PCR assays. published on 11 Jan. and updated The agency has no authority to said WHO Representative to at a meeting of the Politburo Interview and correspondence with Dr. on 14 Jan. and 17 Jan. issue public warnings. China. Standing Committee. Zhengli Shi, Wuhan Institute of Virology GenBank submission, Nature Associated Press Associated Press BBC
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 13 of 48 REQUEST 09–12 Jan 2020 ANNOUNCEMENT PUBLICATION INTERIM GUIDANCE WHO requests detailed case WHO announces China has Risk for introduction to the EU information from China WHO issues a series of guidance identified new coronavirus considered low tools INTERNATIONAL WHO WHO China ECDC WHO HQ Published: 9 Jan 2020 WHO writes to the China IHR Published: 9 Jan 2020 ”Chinese authorities have made National Focal Point and requests a preliminary determination of Three EU airports have direct urgent confirmation of the WHO issues a series of guidance a novel (or new) coronavirus, flights to Wuhan. As there is no discovery of the novel coronavirus, tools related to national capacities identified in a hospitalized person indication of h-to-h transmission and detailed information on its (9 Jan.), disease commodities (9 with pneumonia in Wuhan.” and no cases detected outside etiology, clinical presentation, Jan.), infection prevention and Wuhan, the European Centre for WHO Statement, IHR Review Committee additional laboratory findings, control (10 Jan.), laboratory testing Report Disease Prevention and Control including sequencing, and the (10 Jan.), risk communication and (ECDC) considers the likelihood containment measures put in community engagement (10 Jan.), of introduction to the European place. surveillance case definitions (11 Union (EU) to be low, but it can’t be Jan.), and clinical management (12 excluded. WHO internal documents Jan.). ECDC WHO guidance COUNTRY NEWS REPORT Chinese scientists identify new coronavirus REAL-TIME EVIDENCE Published: 08 Jan 2020 Ahead of anyone, the Wall Street Journal reports that Chinese scientists investigating a mystery illness that has sickened dozens in central China have discovered a new strain of coronavirus. Wall Street Journal 07 Jan, cont. 08 Jan 09 Jan CASES CASES RETROSPECTIVE EVIDENCE First death occurs NEWS REPORT Unobserved cases due to h-to-h Wuhan Municipal Health Commission transmission in China estimated Published: 11 Jan 2020 Mayor of Wuhan reported to the to be 52,381 People’s Congress of Wuhan The first pandemic-related death Mizumoto K, Kagaya K, and Chowell G. occurred on 9 Jan. — a 61-year- Published: 01 Feb 2020, updated 7 Feb 2020 Published: 2 Jun 2020 old male with liver disease who In his address to the People’s Unobserved cases due to human- frequented the Huanan Seafood Congress of Wuhan, the Mayor to-human transmission were Market. The immediate cause of Wuhan focused on new estimated to be 52,381 from 8 Dec. of death was respiratory and infrastructure, didn’t mention the 2019 to 9 Jan. 2020. R0 estimated circulatory failure. outbreak. to 2.37. Wuhan Municipal Health Commission, NY Times International Journal of Infectious Disease Bloomberg
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 14 of 48 MEETING REQUEST MEETING ADVICE MEETING WHO convenes global experts WHO requests PCR primer and First meeting of the STAG-IH WHO recommends no specific GCM for R&D Preparedness WHO genome sequence WHO STAG-IH health measures for travellers and Scientific Advisory Group of the R&D Blueprint hold first INTERNATIONAL WHO begins convening expert The Executive Director of the WHO WHO Strategic and Technical WHO HQ teleconference Health Emergencies Programme Published: 10 Jan 2020 panels including clinicians and Advisory Group for Infectious writes to China’s National IHR WHO publishes advice for WHO experts on diagnostics and Hazards (STAG-IH) discusses the laboratory guidance. Focal Point requesting China share situation in Wuhan and provides a international travel and trade, The Global Coordination WHO internal documents, WHO Timeline the diagnostic PCR primer and full risk analysis. WHO convenes R&D recommends caution while Mechanism for R&D Preparedness genome sequence. experts as well. traveling in or from Wuhan. and the Scientific Advisory Group IHR Review Committee Report WHO STAG-IH Advises against travel or trade of the R&D Blueprint hold their first restrictions on China based on teleconferences on the novel currently available information. coronavirus. WHO HQ GCM teleconference meeting minutes, BORDER MEASURES WHO timeline Areas impose international travel screening and/or controls Various countries COUNTRY By 10 Jan., Hong Kong SAR (China), Japan, Macao SAR (China), Taiwan (China), Singapore, Turkmenistan, Viet Nam, Malaysia, and the Philippines all implement some border measures. Our World in Data, Viet Nam, Malaysia, Philippines REAL-TIME EVIDENCE 09 Jan, cont. 10 Jan SCIENCE PCR diagnostic reagent RETROSPECTIVE EVIDENCE developed and tested SCIENCE China CDC Published: 29 Jan 2020 R0 initially estimated at 2.2 in China PCR diagnostic reagent was developed and tested in China, Li Q, Guan X, et al. Published: 29 Jan 2020 allowing for accurate identification and diagnosis of SARS-CoV-2 Initial estimates of transmission infection. Reagent was distributed dynamics in Wuhan indicated R0 to Wuhan the next day. to be 2.2 (1.4-3.9) and a doubling New England Journal of Medicine, State time of 7.4 days. Council Information Office of the People’s New England Journal of Medicine Republic of China
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 15 of 48 MEETING PUBLICATION ACTION Second technical briefing WHO reports 41 cases and one Scientists publish first protocol between China and WHO death for RT-PCR test INTERNATIONAL WHO WHO WHO Published: 12 Jan 2020 Published: 13 Jan 2020 Second of three technical briefings between WHO China Country WHO issues a Disease Outbreak WHO publishes the first protocol Office and the Chinese National News update, based on for a reverse transcription Health Commission. The list of information from China’s National polymerase chain reaction (RT- cases shared confirm there are Health Commission. It reads “WHO PCR) assay for detection of the cases not linked to the Huanan is reassured of the quality of the novel coronavirus, developed by Seafood Market. ongoing investigations and the partner laboratories. WHO internal documents response measures implemented Charité Virology in Wuhan..” WHO Disease Outbreak News COUNTRY CASES Wuhan reports 41 cases using updated case definition and the first death Wuhan Municipal Health Commission SCIENCE The Wuhan Municipal Health Research consortium publishes Commission publishes its fourth draft genome bulletin coinciding with the second Chinese researchers technical briefing between China CASES and WHO. The total number of A consortium of researchers led Thailand: First reported case cases is revised down to 41, based by Professor Yong-Zhen Zhang REAL-TIME EVIDENCE on a new case definition. The first from the Shanghai Public Health First reported case in Thailand, death is reported. The bulletin Clinical Center publishes a draft imported from Wuhan (see also states that no new cases have genome of the newly discovered retrospective entry on 12 Jan.). been reported since 3 Jan., and coronavirus suspected of causing WHO Dashboard and Situation Reports “no clear evidence of human-to- the outbreak on GenBank. human transmission” has been The genome was submitted found. to GenBank on 5 Jan. (see retrospective entry on 5 Jan.). Wuhan Municipal Health Commission, WHO internal documents Science Magazine, Post by Edward Holmes, Caixin, Twitter 11 Jan 12 Jan 13 Jan CASES First case outside China detected RETROSPECTIVE EVIDENCE in Thailand Okada P, Buathong R, et al. NEWS REPORT Published: 27 Feb 2020 Crowds gather at Wuhan events Air traveler who arrived from Wuhan on 8 Jan. was Published: 01 Feb 2020 identified through airport CASES Holiday shopping fairs and other thermosurveillance and was events continued. Without clear China: 1,723 estimated cases diagnosed in hospital on 12 Jan. government warnings, people Virus was genetically identical to Estimated cases of COVID-19 were kept travelling within and beyond 30 Dec. strains in Wuhan. 1,723 based on data looking at China. Euro Surveillance, IHR Review Committee probability of exportation. Washington Post Report Imperial College
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 16 of 48 MEETING ANNOUNCEMENT ACTION WHO teleconference on WHO seemingly gives conflicting WHO reaches agreement with diagnostics strategy information on h-to-h China to visit Wuhan transmission INTERNATIONAL WHO WHO WHO HQ WHO holds a teleconference with WHO China Country Office the diagnostics and laboratories WHO scientist in press briefing: reaches agreement with China to global expert network to discuss “From the information that we visit Wuhan. The visit takes place a diagnostics strategy. The have it is possible that there from 20-21 Jan. teleconference includes members is limited human-to-human WHO internal documents from WHO Global Laboratories transmission”. WHO tweet: Alliance for the Diagnosis of High “Preliminary investigations Threat Pathogens. conducted by the Chinese WHO internal documents authorities have no clear evidence of human-to-human transmission of the novel coronavirus (2019- nCoV) identified in Wuhan, China”. WHO Twitter, Reuters, IHR Review Committee Report COUNTRY SCIENCE NEWS REPORT Travel data predict cities most CASES Japan and Thailand report connected to Wuhan Japan: First reported case coronavirus cases Bogoch II, Watts A, et al. Published: 15 Jan 2020, updated 21 Jan 2020 REAL-TIME EVIDENCE Published: 14 Jan 2020 First reported case in Japan, imported from Wuhan. Japan’s Health Ministry says Travel data is used to produce a patient had not visited any WHO Dashboard and Situation Reports list of top 20 passenger destination seafood market in China. “It is cities from Wuhan, with the possible that the patient had close majority being in Asia. Infectious contact with an unknown patient Disease Vulnerability Index (IDVI) with lung inflammation while in scores are calculated for each China.” destination. NY Times Journal of Travel Medicine 13 Jan, cont. 14 Jan 15 Jan RETROSPECTIVE EVIDENCE NEWS REPORT China’s top health official ordered the country to prepare for a pandemic China CDC Published: 02 Jun 2020 In a confidential teleconference, China’s top health official ordered the country to prepare for a pandemic. China CDC internally declared level one emergency. Chinese officials still said that the chance of sustained h-to-h transmission was low. Associated Press, PBS Frontline
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 17 of 48 ALERT MEETING ANNOUNCEMENT PAHO issues Epidemiological Third technical briefing between WHO WPRO: no clear evidence of Alert WHO and China h-to-h transmission INTERNATIONAL PAHO WHO WHO WPRO Published: 16 Jan 2020 The Pan American Health The third in-person technical Organization (PAHO) issues an briefing between WHO China WHO WPRO tweets that Epidemiological Alert about the Country Office and Chinese health “According to the latest info we novel coronavirus recommending authorities occurs. China National have, there is no clear evidence Member States ensure health Health Commission provides the of sustained human-to-human workers have access to first “line list” of cases. transmission and there are no information, are familiar with WHO internal documents infections reported among health principles and procedures, and care workers.” trained to ask about patient travel WHO WPRO Twitter history. Screening at entry points and restrictions on travel and trade are not recommended. PAHO COUNTRY CASES First US COVID-19 patient seeks care REAL-TIME EVIDENCE US CDC Published: 21 Jan 2020 A man from Seattle seeking care for illness is later confirmed on 21 Jan. as the first US COVID-19 case. US Centers for Disease Control and Prevention 15 Jan, cont. mid Jan 16 Jan RETROSPECTIVE EVIDENCE CASES Virus potentially circulated in Italy SCIENCE 10 Jan–22 Jan 2020 Alteri C, Cento V, et al. Rt estimated at 2.35 in China SCIENCE Published: 19 Jan 2021 Kucharski AJ, Russel TW, et al. Analysis of early Italy cases Published: 11 Mar 2020 Re estimated at 3.32 in China suggests the virus was already Rt estimated at 2.35 in China one Hao X, Chen S, et al. circulating in the community prior week before travel restrictions Published: 16 Jul 2020 to first confirmed case, as early as were put in place on 23 Jan. It fell Re estimated at 3.32 (3.19-3.44) in mid-January. to 1.05 one week later. China for the period 10 Jan.-22 Jan. Nature The Lancet Infectious Diseases Nature
ANNOUNCEMENT COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 18 of 48 WHO WPRO tweets: Evidence of MEETING limited h-to-h transmission MEETING 20 Jan–21 Jan 2020 WHO WPRO ACTION First meeting of analysis and Published: 19 Jan 2020 Second meeting of the STAG-IH modelling group WHO STAG-IH WHO China Country Office visits “According to the latest info Wuhan INTERNATIONAL WHO received and WHO analysis, there STAG-IH experts discuss the WHO China Country Office WHO holds the first meeting of the is evidence of limited human-to- epidemiological situation, clinical analysis and modelling working human transmission... While there features, the development of WHO China Country Office has group for the novel coronavirus. is currently no clear evidence a technical package (interim its first mission to Wuhan since WHO internal documents, WHO timeline of sustained human-to-human guidance), research and the outbreak. The team visits the transmission, we do not have development (R&D) Blueprint Wuhan Tianhe Airport, Zhongnan enough evidence to evaluate the landscape analyses (diagnostics, hospital and the Hubei provincial full extent of human-to-human vaccines, and therapeutics). The CDC, including the Biosafety Level transmission.” R&D Blueprint Scientific Advisory 3 laboratory handling coronavirus Group and Global Coordination specimens. 18 Jan–19 Jan 2020 WHO WPRO Twitter Mechanisms also meet that day. WHO staff interview, WHO Timeline, IHR ACTION NEWS REPORT Review Committee Report WHO STAG-IH Prof. Nanshan Zhong leads China announces intention mission to Wuhan to step up efforts to contain NEWS REPORT The Chinese National Health outbreak NEWS BRIEFING President Xi Jinping says China COUNTRY Commission sends a mission to Ahead of the Lunar New China medical expert confirms will curb outbreak Wuhan, led by Prof. Nanshan Year, China’s National Health h-to-h transmission “People’s lives and health should Zhong. Commission says it will step up Prof. Nanshan Zhong be given top priority and the National Health Commission prevention and control measures. National Health Commission spread of the outbreak should be Wuhan’s deputy mayor says he will delegation led by Prof. Nanshan resolutely curbed,” state media strengthen oversight of big events Zhong announces on state quote President Xi Jinping. and reduce public gatherings. TV cases involving h-to-h Reuters Reuters transmission, that medical staff NEWS REPORT CASES CASES have been infected, and that US reports it will screen there are two cases in Guangdong Republic of Korea: First reported passengers on Wuhan flights China reaches 198 reported cases cases REAL-TIME EVIDENCE Province. The delegation suggests The US will begin screening Wuhan Municipal Health people don’t travel in and out of First reported cases in the efforts at three US airports to Commission announces 198 cases Wuhan. Republic of Korea, imported from detect travelers from Wuhan who of nCoV-2019 and four deaths, National Health Commission, Reuters, Wuhan. might have symptoms of a new as of 19 Jan. In Wuhan Jinyintan Chinese Ministry of Education, IHR Review WHO Dashboard and Situation Reports respiratory virus. Many countries Hospital, a doctor reports 150 Committee Report follow suit in the days to come. cases based on a clinical case Reuters definition. Wuhan Municipal Health Commission, Report: Prof. Nanshan Zhong 10 Nov 2020 17 Jan 18 Jan 19 Jan 20 Jan RETROSPECTIVE EVIDENCE
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 19 of 48 ANNOUNCEMENT Clear evidence of h-to-h transmission according to WHO WPRO tweet INTERNATIONAL WHO WPRO Published: 21 Jan 2020 “It is now very clear from the latest information that there is at least some human-to-human transmission of #nCoV2019. Infections among health care workers strengthen the evidence for this.” CONTACT TRACING SCHOOL CLOSURES WHO WPRO Tweet Singapore implements China closes schools comprehensive contact tracing Ministry of Education Government of Singapore China begins school closures. COUNTRY Singapore is the first country EdSurge other than China in the Western Pacific Region (WPR) to implement comprehensive contact tracing. Our World in Data NEWS REPORT NEWS REPORT CASES CASES Risk to UK very low WHO expects further spread China: Cases spread to 14 Multiple medical staff in Wuhan provinces infected REAL-TIME EVIDENCE “Based on the available evidence, “More cases should be expected in the current risk to the UK is very other parts of China and possibly 309 cases are reported in China, Wuhan Municipal Health Commission low,” says Dr. Nick Phin, deputy other countries in the coming spread across 14 provinces/ Wuhan Municipal Health director of the National Infection days,” says WHO spokesman Tarik municipalities. Commission reports 15 medical Service (NIS). “We are... keeping Jasarevic. WHO Situation Report staff confirmed as cases of the situation under constant Reuters pneumonia caused by new review.” coronavirus infection in Wuhan. Reuters China Daily 20 Jan, cont. 21 Jan RETROSPECTIVE EVIDENCE
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 20 of 48 22 Jan–23 Jan 2020 22 Jan–23 Jan 2020 MEETING MEETING WHO’s IHR Emergency WHO’s IHR Emergency Committee starts first meeting Committee ends meeting. INTERNATIONAL WHO No PHEIC declared WHO WHO’s IHR Emergency Committee starts its first COVID-19-related The IHR Emergency Committee meeting. On this day, WHO does not recommend the outbreak reports 314 cases, with 310 cases a Public Health Emergency of in 14 provinces and municipalities International Concern (PHEIC), but within China, and four confirmed urges countries to be prepared for cases in three countries outside additional spread. The Committee China, all with direct connections agrees to meet again within 10 CONTACT TRACING CONTACT TRACING MASK USAGE to Wuhan. days. By this day, cases have Germany implements Costa Rica introduces France recommends mask IHR Committe Statement, WHO Situation increased to 581, with 571 cases in comprehensive contact tracing comprehensive contact tracing wearing Report 24 provinces and municipalities within China, and 10 cases in Government of Germany Government of Costa Rica Government of France four countries outside China, all COUNTRY Germany is the first country in the Contact tracing for all COVID-19 France recommends mask connected to Wuhan. WHO European Region (EUR) to cases is introduced in Costa wearing, the first country in EUR IHR Committe Statement, WHO Situation implement comprehensive contact Rica, the first country in the WHO to do so. Report tracing. Region of the Americas (AMR) to Our World in Data Our World in Data do so. Our World in Data LOCKDOWN/ NEWS REPORT STAY-AT-HOME MEASURES China reports 15 samples from First lockdown in Wuhan Huanan Seafood Market contain Chinese Centre for Disease Control and virus Prevention Published: 22 Jan 2020 Lockdown initiated in Wuhan. REAL-TIME EVIDENCE It is unclear whether the virus China CDC is shed by humans or animals. Cases per million Chinese scientists publish the China: 0.45 genetic sequence from some samples, but the information CASES provides no clues to the virus’ Singapore: First reported case origins. China CDC, NY Times First reported case in Singapore. WHO Statement 22 Jan 23 Jan RETROSPECTIVE EVIDENCE CASES China: 18,700 estimated cases, R0 at 5.7 Sanche S, Lin Y, et al. Published: July 2020 18,700 estimated cases in China. Transmission dynamics of early Wuhan spread were possibly as high as R0 5.7, with a doubling time of 2.3-3.3 days. Emerging Infectious Diseases
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 21 of 48 PUBLICATION ADVICE MEETING Molecular assays to diagnose WHO recommends no restrictions Informal consultation on COVID-19 on international traffic therapeutics INTERNATIONAL WHO HQ WHO WHO HQ Published: 24 Jan 2020 Published: 24 Jan 2020 Published: 24 Jan 2020 WHO publishes an overview WHO updates advice WHO R&D Blueprint initiates of assays that have applied to for international traffic, an informal consultation on Foundation for Innovative New recommending against prioritization of candidate Diagnostics for participation in its restrictions, but supporting airport therapeutic agents for use in novel assay assessment work. exit screening and suggesting coronavirus 2019 infection. WHO HQ possible entry screening. WHO HQ WHO BORDER MEASURES CONTACT TRACING 21 countries/areas have Nepal introduces comprehensive international screening in place contact tracing National governments Government of Nepal COUNTRY Officials across the globe from Contact tracing for all cases of Africa to South America begin COVID-19 introduced in Nepal, the containment measures. first country in SEAR to do so. Our World in Data Our World in Data Jan 24: Key scientific articles published in the Lancet SCIENCE SCIENCE Clinical characteristics, severity, Family cluster suggests h-to-h and mortality published transmission and asymptomatic Huang C, Wang Y, et al. infection Chan JF-W, Yuan S, et al. Common symptoms: cough, fever, short breath, and myalgias. Study describes a family cluster Approximately 17-42% developed where h-to-h transmission REAL-TIME EVIDENCE acute respiratory distress and asymptomatic infection is syndrome, 23-32% admitted to documented. intensive care units, and 11-15% The Lancet died. Of the 41 first laboratory- confirmed patients 27/41(66%) were found to be exposed to Huanan Seafood Market. The Lancet 23 Jan, cont. 24 Jan “Because of the pandemic potential RETROSPECTIVE EVIDENCE of 2019-nCoV, careful surveillance CASES CASES is essential to monitor its future host adaption, viral evolution, infectivity, Vast majority of early infections Travel restrictions in China transmissibility, and pathogenicity.” in China undetected significantly reduced spread Li R, Pei S, et al. Wells CR, Sah P, et al. Published: 16 Mar 2020 Published: 13 Mar 2020 Researchers estimate that 86% Researchers estimate that travel of all infections were undetected restrictions enacted in China after prior to the lockdown of Wuhan on 23 Jan. reduced the average daily 23 Jan., leading to rapid spread. rate of case exportations by 81.3%. Science PNAS
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 22 of 48 ACTION WHO grades outbreak as level three emergency INTERNATIONAL The SARS-CoV-2 outbreak is elevated to the highest level of emergency. WHO HQ takes over emergency management from the regional office. WHO internal documents MASK USAGE First mask mandates in Guangdong, China The Guangdong Provincial Headquarters Office for the Prevention and Control of Pneumonia Infected by the Novel COUNTRY Coronavirus Mask wearing in public places made mandatory in Guangdong province. Xinhuanet Cases per million NEWS REPORT China: 1.44 Trump: The US appreciates CASES CASES CASES CASES China’s efforts and transparency France and Viet Nam: First Australia: First reported cases Index case disembarks Diamond China nears 2,000 cases, spread “China has been working very reported cases Princess in Hong Kong to 10 countries REAL-TIME EVIDENCE hard to contain the Coronavirus. First cases reported in Australia. The United States greatly France and Viet Nam WHO Dashboard and Situation Reports, Government of Hong Kong 2,014 cases globally, of which Published: 01 Feb 2020 1,985 are from China. There are 29 appreciates their efforts and First reported cases in Viet Nam Australian Department of Health transparency. It will all work out and France. The two Vietnamese An 80 year old man disembarks cases in 10 other countries. well. In particular, on behalf of the cases involve a father who the Diamond Princess in Hong WHO Situation Report American People, I want to thank travelled to China, who met his son Kong with a cough. On 1 Feb. he President Xi!” Trump writes in a in Viet Nam. tests positive for COVID-19. tweet. WHO Dashboard and Situation Reports, Government of Hong Kong, Journal of Reuters NEJM, franceinfo Travel Medicine 24 Jan, cont. 25 Jan 26 Jan RETROSPECTIVE EVIDENCE
COVID-19: The Authoritative Chronology, December 2019–March 2020, Background paper 2a, The Independent Panel for Pandemic Preparedness and Response, May 2021 — Page 23 of 48 ACTION PUBLICATION 27 Jan–28 Jan 2020 MEETING R&D Blueprint: Open call to Publication of trial designs for researchers experimental therapeutics WHO DG meets President Xi INTERNATIONAL WHO HQ WHO WHO DG Evaluating cross-reactivity WHO publishes outline of WHO Director-General (DG): of nCoV with SARS to identify trial designs for experimental “We appreciate the seriousness possible designs for experimental therapeutics. with which China is taking vaccines and therapeutics. WHO this outbreak, especially the WHO STAG-IH commitment from top leadership, and the transparency they have demonstrated, including sharing data and genetic sequence of the virus.” WHO News Release BORDER CONTROL MEASURES Viet Nam implements border BORDER CONTROL MEASURES controls Singapore expands border Prime Minister controls COUNTRY Government announces plans to Health Ministry ban travel from China. Travel ban from Hubei Government News Report, Think Global implemented, later expanded to Health include China. Cases per million Viet Nam: 0.02 Straits Times Cases per million Singapore: 1.20 REAL-TIME EVIDENCE late Jan 27 Jan 28 Jan RETROSPECTIVE EVIDENCE CASES Possible community circulation of 23 Jan-01 Feb 2020 SARS-CoV-2 in Washington state SCIENCE Bedford T, Greninger A, et al. Published: 10 Sep 2020 Dramatic Re reduction to 1.18 in Phylogenetic analysis suggests China SARS-CoV-2 were circulating in Hao X, Chen S, et al. community in Washington state as Published: 16 Jul 2020 early as late Jan., prior to active Re estimated at 1.18 (1.11-1.25) in community surveillance. China for the period 23 Jan.-1 Feb. Science Nature
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