LONDON – The EU launched a “Corona” response team, bringing together oversight of all the separate strands put in place to control the virus, as the infection spread to 18 of 27 member states, with 2,100 confirmed cases and 31 deaths.

The first cases were reported from Ireland and Portugal, prompting an increase in the threat level in Europe, from moderate to “moderate to high” on March 2.

“We have a situation that is very complex and it requires on one side very swift action, and on the other side a strong coordination on all levels and different sectors,” said European Commission President Ursula von der Leyen, announcing the EU is stepping up control efforts.

The Corona team unites measures that have been in place since the start of the crisis, but also will involve new initiatives.

Von der Leyen, who is a medical doctor, was speaking from the EU Emergency Response Coordination Center in Brussels. She was accompanied by the five EU commissioners who will steer the Corona team. Their main areas of concern are public health measures and preparedness of member states’ health care systems; mobility and advice about travel and border restrictions; and softening the economic impact.

Although there will be a focus on research and development, and cooperation with the EMA to support and speed up development of vaccines, therapeutics and diagnostics, Mariya Gabriel, the commissioner with responsibility for research and innovation, including the Innovative Medicines Initiative partnership with the pharma industry, is not part of the Corona team.

“We are clearly faced with a rapidly changing situation,” said Stella Kyriakides, health commissioner. “Different member states face different challenges. Italy is in the worst position, but for all it is an evolving situation and we need to be ready for further developments.” Italy now has 1,128 confirmed cases and 29 deaths.

Kyriakides wrote to all national health ministers on Feb 28 to compare notes on case management, laboratory capacity for diagnoses and contact tracing, public health measures at ports of entry, and risk communication. She said she will talk to them by phone over the next two days, with all 27 ministers due to meet in Brussels on March 6.

With the number of confirmed infections and affected countries increasing, Janez Lenarčič, EU commissioner for crisis management, said the situation “is likely still to get worse.” The lesson learned from China is that every country “needs to get ready,” while at the same time, EU-level measures are needed across policy silos to ensure a coherent pan-European response, Lenarčič said.

The EU has pledged €230 million (US$257 million) to help with the response, of which €130 million has gone to support the World Health Organization’s effort, €90 million is for vaccines development and €10 million for therapies and diagnostics.

This is not a pandemic

In his latest briefing, WHO Director General Tedros Adhanom Ghebreyesus continued to stress the need for every country to be prepared for the spread of COVID-19, holding up the declining infection rates in China as a demonstration the novel coronavirus can be controlled.

On March 1, China reported 206 cases of COVID-19 to WHO, the lowest since Jan. 22, with only eight cases outside Hubei province, the epicenter of the epidemic.

Outside China, a total of 8,739 cases of COVID-19 were reported to WHO from 61 countries, with 127 deaths.

That means over the weekend there were almost nine times more cases reported outside China than inside.

Ghebreyesus said the epidemics in South Korea, Italy, Iran and Japan “are our greatest concern.” International sanctions have made it difficult to get access to Iran, but a WHO team arrived there on March 2 with supplies of diagnostic tests and protective clothing and to support the government in the response. A WHO staff member in the Iran country office has tested positive for COVID-19.

Korea has now reported more than 4,200 cases and 22 deaths, meaning it has more than half of all cases outside China. However, the cases appear to be coming mostly from five known clusters, rather than the community.

“That’s important because it indicates that surveillance measures are working and Korea’s epidemic can still be contained,” Ghebreyesus said. “Knowing and understanding your epidemic is the first step to defeating it.”

It also highlights unique features of COVID-19. “We have never before seen a respiratory pathogen that is capable of community transmission, but which can also be contained with the right measures,” said Ghebreyesus. “If this was an influenza epidemic, we would have expected to see widespread community transmission across the globe by now, and efforts to slow it down or contain it would not be feasible.”

The debate goes on over whether COVID-19 is now a pandemic. Ghebreyesus repeated previous commitments to keep monitoring the situation. “I have said it before and I’ll say it again: WHO will not hesitate to describe this as a pandemic if that’s what the evidence suggests.”

But, he said, “We need to see this in perspective.” Of the 88,913 cases reported globally so far, 90% are in China, mostly in one province.

Meanwhile, of the 8,739 cases reported outside China, 81% are from four countries. Of the other 57 affected countries, 38 have reported 10 cases or fewer, 19 have reported only one case, and a good number of countries have contained the virus and not had any new cases to report in the last two weeks. More than 130 countries have not detected any cases yet.

Seven-day doubling time

To date, the U.S. has reported 62 cases to WHO. But the latest analysis of the genome sequences of virus samples from patients indicates that is likely to be an underestimate.

Trevor Bedford, computational biologist at Fred Hutchinson Cancer Research Center, Seattle, who has been using genomes sequences taken from patient samples to track the spread of the virus since Jan. 11., posted details of a comparison of the viral DNA sequence taken from a patient in Shohomish County, Washington, last week, with that of the first case of COVID-19 in the U.S., diagnosed on Jan. 19. The two are genetically almost alike, implying local spread.

It could be a coincidence and those are two separate introductions, related to travel, but this is “highly unlikely,” Bedford said. “Additionally, the two cases are geographically proximal,” he wrote on Twitter.

The implication is that there is an already “substantial outbreak” in Washington state that was not detected until now due to narrow case definition, requiring direct travel to China. Bedford said based on the rate at which the virus mutates, there are probably a few hundred current infections.

Bedford estimates the epidemic doubling time is seven days. “If U.S. cases more than double in the next week, it’s not because the virus is moving any faster. It’s just because we’ll finally be catching up to it,” he said.

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