Data as reported by national authorities by 10AM CET 06 March 2020
Coronavirus disease 2019 (COVID-19)
Situation Report – 46
SITUATION IN NUMBERS
total and new cases in last 24
hours
Globally
98 192 confirmed (2873 new)
China
80 711 confirmed (146 new)
3045 deaths (30 new)
Outside of China
17 481 confirmed (2727 new)
335 deaths (69 new)
88 Countries/territories/
areas (4 new)
WHO RISK ASSESSMENT
China
Regional Level
Global Level
HIGHLIGHTS
• 4 new countries/territories/areas (Bhutan, Cameroon, Serbia, and South
Africa) have reported cases of COVID-19 in the past 24 hours.
• As the COVID-19 outbreak continues to evolve, comparisons have been drawn
to influenza. WHO has provided a Q&A regarding the similarities and
differences between the two diseases. Please see the Situation in Focus below
for more information.
Figure 1. Countries, territories or areas with reported confirmed cases of COVID-19, 06 March 2020
SUBJECT IN FOCUS: Q&A: Similarities and differences – COVID-19 and influenza
As the COVID-19 outbreak continues to evolve, comparisons have been drawn to influenza. Both cause respiratory
disease, yet there are important differences between the two viruses and how they spread. This has important
implications for the public health measures that can be implemented to respond to each virus.
Q. How are COVID-19 and influenza viruses similar?
Firstly, COVID-19 and influenza viruses have a similar disease presentation. That is, they both cause respiratory
disease, which presents as a wide range of illness from asymptomatic or mild through to severe disease and death.
Secondly, both viruses are transmitted by contact, droplets and fomites. As a result, the same public health
measures, such as hand hygiene and good respiratory etiquette (coughing into your elbow or into a tissue and
immediately disposing of the tissue), are important actions all can take to prevent infection.
Q. How are COVID-19 and influenza viruses different?
The speed of transmission is an important point of difference between the two viruses. Influenza has a shorter
median incubation period (the time from infection to appearance of symptoms) and a shorter serial interval (the
time between successive cases) than COVID-19 virus. The serial interval for COVID-19 virus is estimated to be 5-6
days, while for influenza virus, the serial interval is 3 days. This means that influenza can spread faster than COVID-
19.
Further, transmission in the first 3-5 days of illness, or potentially pre-symptomatic transmission –transmission of the
virus before the appearance of symptoms – is a major driver of transmission for influenza. In contrast, while we are
learning that there are people who can shed COVID-19 virus 24-48 hours prior to symptom onset, at present, this
does not appear to be a major driver of transmission.
The reproductive number – the number of secondary infections generated from one infected individual – is
understood to be between 2 and 2.5 for COVID-19 virus, higher than for influenza. However, estimates for both
COVID-19 and influenza viruses are very context and time-specific, making direct comparisons more difficult.
Children are important drivers of influenza virus transmission in the community. For COVID-19 virus, initial data
indicates that children are less affected than adults and that clinical attack rates in the 0-19 age group are low.
Further preliminary data from household transmission studies in China suggest that children are infected from
adults, rather than vice versa.
While the range of symptoms for the two viruses is similar, the fraction with severe disease appears to be different.
For COVID-19, data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe infection,
requiring oxygen and 5% are critical infections, requiring ventilation. These fractions of severe and critical infection
would be higher than what is observed for influenza infection.
Those most at risk for severe influenza infection are children, pregnant women, elderly, those with underlying
chronic medical conditions and those who are immunosuppressed. For COVID-19, our current understanding is that
older age and underlying conditions increase the risk for severe infection.
Mortality for COVID-19 appears higher than for influenza, especially seasonal influenza. While the true mortality of
COVID-19 will take some time to fully understand, the data we have so far indicate that the crude mortality ratio (the
number of reported deaths divided by the reported cases) is between 3-4%, the infection mortality rate (the number
of reported deaths divided by the number of infections) will be lower. For seasonal influenza, mortality is usually
well below 0.1%. However, mortality is to a large extent determined by access to and quality of health care.
Q. What medical interventions are available for COVID-19 and influenza viruses?
While there are a number of therapeutics currently in clinical trials in China and more than 20 vaccines in
development for COVID-19, there are currently no licensed vaccines or therapeutics for COVID-19. In contrast,
antivirals and vaccines available for influenza. While the influenza vaccine is not effective against COVID-19 virus, it is
highly recommended to get vaccinated each year to prevent influenza infection.
SURVEILLANCE
Table 1. Confirmed and suspected cases of COVID-19 acute respiratory disease reported by provinces, regions and
cities in China, Data as of 06 March 2020
Province/
Region/
City
Population
(10,000s)
In last 24 hours
Cumulative
Confirmed
cases
Suspected
cases
Deaths
Confirmed
cases
Deaths
Hubei
5917
126
43
29
67592
2931
Guangdong
11346
1
0
0
1351
7
Henan
9605
0
0
0
1272
22
Zhejiang
5737
0
1
0
1215
1
Hunan
6899
0
0
0
1018
4
Anhui
6324
0
0
0
990
6
Jiangxi
4648
0
0
0
935
1
Shandong
10047
0
0
0
758
6
Jiangsu
8051
0
0
0
631
0
Chongqing
3102
0
2
0
576
6
Sichuan
8341
0
2
0
539
3
Heilongjiang
3773
0
0
0
481
13
Beijing
2154
4
3
0
422
8
Shanghai
2424
1
22
0
339
3
Hebei
7556
0
0
0
318
6
Fujian
3941
0
0
0
296
1
Guangxi
4926
0
0
0
252
2
Shaanxi
3864
0
0
0
245
1
Yunnan
4830
0
2
0
174
2
Hainan
934
0
0
1
168
6
Guizhou
3600
0
2
0
146
2
Tianjin
1560
0
9
0
136
3
Shanxi
3718
0
0
0
133
0
Liaoning
4359
0
13
0
125
1
Hong Kong SAR
745
0
0
0
104
2
Gansu
2637
11
0
0
102
2
Jilin
2704
0
3
0
93
1
Xinjiang
2487
0
0
0
76
3
Inner Mongolia
2534
0
0
0
75
1
Ningxia
688
0
0
0
75
0
Taipei and environs
2359
3
0
0
45
1
Qinghai
603
0
0
0
18
0
Macao SAR
66
0
0
0
10
0
Xizang
344
0
0
0
1
0
Total
142823
146
102
30
80711
3045
Table 2. Countries, territories or areas outside China with reported laboratory-confirmed COVID-19 cases and
deaths. Data as of 06 March 2020
*
Reporting Country/
Territory/Area
†
Total
confirmed
‡
cases
Total
confirmed
new cases
Total
deaths
Total
new
deaths
Transmission
classification
§
Days since
last reported
case
Western Pacific Region
Republic of Korea
6284
518
42
7
Local transmission
0
Japan
349
32
6
0
Local transmission
0
Singapore
117
7
0
0
Local transmission
0
Australia
57
0
2
0
Local transmission
1
Malaysia
55
5
0
0
Local transmission
0
Viet Nam
16
0
0
0
Local transmission
22
Philippines
5
2
1
0
Local transmission
0
New Zealand
4
2
0
0
Local transmission
0
Cambodia
1
0
0
0
Imported cases only
38
European Region
Italy
3858
769
148
41
Local transmission
0
Germany
534
272
0
0
Local transmission
0
France
420
138
6
2
Local transmission
0
Spain
257
59
3
2
Local transmission
0
The United Kingdom
118
29
0
0
Local transmission
0
Norway
86
30
0
0
Local transmission
0
Switzerland
86
30
1
1
Local transmission
0
Netherlands
82
44
0
0
Local transmission
0
Sweden
61
26
0
0
Local transmission
0
Belgium
50
27
0
0
Local transmission
1
Austria
47
10
0
0
Imported cases only
0
Greece
32
23
0
0
Local transmission
1
Iceland
26
0
0
0
Imported cases only
1
San Marino
21
5
0
0
Local transmission
0
Denmark
18
8
0
0
Local transmission
1
Israel
15
0
0
0
Local transmission
1
Ireland
14
12
0
0
Local transmission
0
Czechia
12
7
0
0
Local transmission
0
Finland
12
5
0
0
Local transmission
0
Croatia
10
1
0
0
Local transmission
0
Georgia
9
6
0
0
Imported cases only
0
Portugal
9
0
0
0
Local transmission
1
Belarus
6
0
0
0
Local transmission
1
Romania
6
2
0
0
Local transmission
0
Slovenia
6
5
0
0
Local transmission
0
Russian Federation
4
1
0
0
Imported cases only
0
Azerbaijan
3
0
0
0
Imported cases only
5
Estonia
3
1
0
0
Imported cases only
0
Bosnia and
Herzegovina
2
0
0
0
Local transmission
1
Hungary
2
0
0
0
Imported cases only
1
Andorra
1
0
0
0
Imported cases only
3
Armenia
1
0
0
0
Imported cases only
4
Latvia
1
0
0
0
Imported cases only
3
Liechtenstein
1
0
0
0
Imported cases only
0
Lithuania
1
0
0
0
Imported cases only
7
Luxembourg
1
0
0
0
Imported cases only
4
Monaco
1
0
0
0
Under investigation
5
North Macedonia
1
0
0
0
Imported cases only
8
Poland
1
0
0
0
Imported cases only
2
Serbia
1
1
0
0
Under investigation
0
Ukraine
1
0
0
0
Imported cases only
2
Territories
**
Gibraltar
1
0
0
0
Under investigation
2
South-East Asia Region
Thailand
47
0
1
0
Local transmission
1
India
30
1
0
0
Local transmission
0
Indonesia
2
0
0
0
Local transmission
4
Bhutan
1
1
0
0
Imported cases only
0
Nepal
1
0
0
0
Imported cases only
42
Sri Lanka
1
0
0
0
Imported cases only
39
Eastern Mediterranean Region
Iran (Islamic
Republic of)
3513
591
107
15
Local transmission
0
Kuwait
58
0
0
0
Imported cases only
1
Bahrain
49
0
0
0
Imported cases only
3
Iraq
36
0
2
0
Imported cases only
1
United Arab
Emirates
27
0
0
0
Local transmission
2
Lebanon
16
3
0
0
Local transmission
0
Oman
16
1
0
0
Imported cases only
0
Qatar
8
0
0
0
Imported cases only
2
Saudi Arabia
8
6
0
0
Imported cases only
0
Pakistan
5
0
0
0
Imported cases only
3
Egypt
3
1
0
0
Imported cases only
0
Morocco
2
0
0
0
Imported cases only
1
Afghanistan
1
0
0
0
Imported cases only
11
Jordan
1
0
0
0
Imported cases only
3
Tunisia
1
0
0
0
Imported cases only
3
Territories
**
Occupied
Palestinian Territory
7
0
0
0
Imported cases only
1
Region of the Americas
United States of
America
148
19
10
1
Local transmission
0
Canada
45
15
0
0
Local transmission
0
Ecuador
13
6
0
0
Local transmission
0
Brazil
7
4
0
0
Imported cases only
0
Mexico
5
0
0
0
Imported cases only
4
Argentina
1
0
0
0
Imported cases only
2
Chile
1
0
0
0
Imported cases only
2
Dominican Republic
1
0
0
0
Imported cases only
4
Territories
**
Saint Martin
2
0
0
0
Under investigation
3
Saint Barthélemy
1
0
0
0
Under investigation
3
African Region
Algeria
12
0
0
0
Local transmission
1
Senegal
4
0
0
0
Imported cases only
1
Cameroon
1
1
0
0
Imported cases only
0
Nigeria
1
0
0
0
Imported cases only
7
South Africa
1
1
0
0
Imported cases only
0
Subtotal for all
regions
16785
2727
329
69
International
conveyance
(Diamond Princess)
696
0
6
0
Local transmission
0
Grand total
17481
2727
335
69
*
Numbers include both domestic and repatriated cases
†
The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on
the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its
frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.
‡
Case classifications are based on WHO case definitions for COVID-19.
§
Transmission classification is based on WHO analysis of available official data and may be subject to reclassification as additional data become
available. Countries/territories/areas experiencing multiple types of transmission are classified in the highest category for which there is
evidence; they may be removed from a given category if interruption of transmission can be demonstrated. It should be noted that even within
categories, different countries/territories/areas may have differing degrees of transmission as indicated by the differing numbers of cases and
other factors. Not all locations within a given country/territory/area are equally affected.
Terms:
- Community transmission is evidenced by the inability to relate confirmed cases through chains of transmission for a large number of cases, or by
increasing positive tests through sentinel samples (routine systematic testing of respiratory samples from established laboratories).
- Local transmission indicates locations where the source of infection is within the reporting location.
- Imported cases only indicates locations where all cases have been acquired outside the location of reporting.
- Under investigation indicates locations where type of transmission has not been determined for any cases.
- Interrupted transmission indicates locations where interruption of transmission has been demonstrated (details to be determined)
** “Territories” include territories, areas, overseas dependencies and other jurisdictions of similar status
Figure 2. Epidemic curve of confirmed COVID-19 cases reported outside of China, by date of report and WHO
region through 06 March 2020
STRATEGIC OBJECTIVES
WHO’s strategic objectives for this response are to:
• Interrupt human-to-human transmission including reducing secondary infections among close contacts
and health care workers, preventing transmission amplification events, and preventing further
international spread*;
• Identify, isolate and care for patients early, including providing optimized care for infected patients;
• Identify and reduce transmission from the animal source;
• Address crucial unknowns regarding clinical severity, extent of transmission and infection, treatment
options, and accelerate the development of diagnostics, therapeutics and vaccines;
• Communicate critical risk and event information to all communities and counter misinformation;
• Minimize social and economic impact through multisectoral partnerships.
*This can be achieved through a combination of public health measures, such as rapid identification, diagnosis
and management of the cases, identification and follow up of the contacts, infection prevention and control in
health care settings, implementation of health measures for travelers, awareness-raising in the population and
risk communication.
PREPAREDNESS AND RESPONSE
• To view all technical guidance documents regarding COVID-19, please go to this webpage.
• WHO is working closely with International Air Transport Association (IATA) and have jointly developed a
guidance document to provide advice to cabin crew and airport workers, based on country queries. The
guidance can be found on the IATA webpage.
• WHO has been in regular and direct contact with Member States where cases have been reported. WHO is also
informing other countries about the situation and providing support as requested.
• WHO has developed interim guidance for laboratory diagnosis, advice on the use of masks during home care and
in health care settings in the context of the novel coronavirus (2019-nCoV) outbreak, clinical management,
infection prevention and control in health care settings, home care for patients with suspected novel
coronavirus, risk communication and community engagement and Global Surveillance for human infection with
novel coronavirus (2019-nCoV).
• WHO is working with its networks of researchers and other experts to coordinate global work on surveillance,
epidemiology, mathematical modelling, diagnostics and virology, clinical care and treatment, infection
prevention and control, and risk communication. WHO has issued interim guidance for countries, which are
updated regularly.
• WHO has prepared a disease commodity package that includes an essential list of biomedical equipment,
medicines and supplies necessary to care for patients with 2019-nCoV.
• WHO has provided recommendations to reduce risk of transmission from animals to humans.
• WHO has published an updated advice for international traffic in relation to the outbreak of the novel
coronavirus 2019-nCoV.
• WHO has activated the R&D blueprint to accelerate diagnostics, vaccines, and therapeutics.
• WHO has developed online courses on the following topics: A general introduction to emerging respiratory
viruses, including novel coronaviruses (available in Arabic, English, French, Chinese, Spanish, Portuguese, and
Russian); Critical Care of Severe Acute Respiratory Infections; and Health and safety briefing for respiratory
diseases - ePROTECT (available in English and French); Infection Prevention and Control for Novel Coronavirus
(COVID-19) (available in English and Russian); Critical Care Severe Acute Respiratory Infection (available in
English and French); and COVID-19 Operational Planning Guidelines and COVID-19 Partners Platform to support
country preparedness and response.
• WHO is providing guidance on early investigations, which are critical in an outbreak of a new virus. The data
collected from the protocols can be used to refine recommendations for surveillance and case definitions, to
characterize the key epidemiological transmission features of COVID-19, help understand spread, severity,
spectrum of disease, impact on the community and to inform operational models for implementation of
countermeasures such as case isolation, contact tracing and isolation. Several protocols are available here. One
such protocol is for the investigation of early COVID-19 cases and contacts (the “First Few X (FFX) Cases and
contact investigation protocol for 2019-novel coronavirus (2019-nCoV) infection”). The protocol is designed to
gain an early understanding of the key clinical, epidemiological and virological characteristics of the first cases of
COVID-19 infection detected in any individual country, to inform the development and updating of public health
guidance to manage cases and reduce the potential spread and impact of infection.
RECOMMENDATIONS AND ADVICE FOR THE PUBLIC
If you are not in an area where COVID-19 is spreading or have not travelled from an area where COVID-19 is
spreading or have not been in contact with an infected patient, your risk of infection is low. It is understandable that
you may feel anxious about the outbreak. Get the facts from reliable sources to help you accurately determine your
risks so that you can take reasonable precautions (see Frequently Asked Questions). Seek guidance from WHO, your
healthcare provider, your national public health authority or your employer for accurate information on COVID-19
and whether COVID-19 is circulating where you live. It is important to be informed of the situation and take
appropriate measures to protect yourself and your family (see Protection measures for everyone).
If you are in an area where there are cases of COVID-19 you need to take the risk of infection seriously. Follow the
advice of WHO and guidance issued by national and local health authorities. For most people, COVID-19 infection
will cause mild illness however, it can make some people very ill and, in some people, it can be fatal. Older people,
and those with pre-existing medical conditions (such as cardiovascular disease, chronic respiratory disease or
diabetes) are at risk for severe disease (See Protection measures for persons who are in or have recently visited (past
14 days) areas where COVID-19 is spreading).
CASE DEFINITIONS
WHO periodically updates the Global Surveillance for human infection with coronavirus disease (COVID-19)
document which includes case definitions.
For easy reference, case definitions are included below.
Suspect case
A. A patient with acute respiratory illness (fever and at least one sign/symptom of respiratory disease (e.g.,
cough, shortness of breath), AND with no other etiology that fully explains the clinical presentation AND a
history of travel to or residence in a country/area or territory reporting local transmission (See situation
report) of COVID-19 disease during the 14 days prior to symptom onset.
OR
B. A patient with any acute respiratory illness AND having been in contact with a confirmed or probable COVID-
19 case (see definition of contact) in the last 14 days prior to onset of symptoms;
OR
C. A patient with severe acute respiratory infection (fever and at least one sign/symptom of respiratory disease
(e.g., cough, shortness breath) AND requiring hospitalization AND with no other etiology that fully explains
the clinical presentation.
Probable case
A suspect case for whom testing for COVID-19 is inconclusive.
• Inconclusive being the result of the test reported by the laboratory
Confirmed case
A person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms.
• Information regarding laboratory guidance can be found here.