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 2021COVID-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 TwentyCOVID-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 journalCOVID-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-2COVID-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 CaixinCOVID-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 PressCOVID-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 MedicineCOVID-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 EVIDENCECOVID-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 LancetCOVID-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-2COVID-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.
NatureCOVID-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 BBCCOVID-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 BloombergCOVID-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 ChinaCOVID-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 CollegeCOVID-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 FrontlineCOVID-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 NatureANNOUNCEMENT
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 EVIDENCECOVID-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 EVIDENCECOVID-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 DiseasesCOVID-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 PNASCOVID-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 EVIDENCECOVID-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.
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