* All figures, numbers and situations are current as of the date of this publication.
Following our initial summary from Dr. Peter Jüni‘s presentation on COVID-19 on March 5, 2020(here), we are providing an update on the ongoing epidemic around the world.
Where the Epidemic Seems to Have Stabilized
Although China’s confirmed cases have continued to rise (now at 81,048), they have plateaued with the number of new confirmed cases decreasing significantly – this is attributable to the country’s quarantine and lockdown measures (including that of the Hubei province and several major cities). While the Chinese government’s decision was extreme, it does, nevertheless, seem to have worked with government officials and international experts, announcing/agreeing that the peak of the epidemic seems to have passed. Following a March 10, 2020 visit by the Chinese President in Wuhan, the city at the centre of the epidemic, various cities in the province of Hubei, where Wuhan is located, began lifting some of the lockdown measures (on March 13). Although yet to be fully lifted, the Hubei lockdown seems to have lasted, at least, ~49 days (January 23 to March 13) serving as a guide of the quarantine length that we can expect from other countries.
Another example of a country that employed far-reaching, albeit different, measures to control the spread of COVID-19 is South Korea. To control the spread of the disease, it deployed massive free testing to identify (and isolate) any new cases – it is estimated there have been ~210,000 people tested in South Korea versus, for example, just ~10-14k people in the U.S.
South Korea’s approach seems to have worked thus far with confirmed cases starting to plateau (at 8,162) and new confirmed cases decreasing, although cumulative fatalities are still increasing (at 75 as of March 15). As discussed in our previous COVID-19 note, South Korea has previously experienced another coronavirus outbreak with MERS in 2015 that was followed by legislation (and experience) to help contain similar outbreaks.
Where the Epidemic Continues to Spread
The epicentre of COVID-19 has moved from China to Europe (according to the World Health Organization) where many countries have introduced border controls (or closed them) and imposed severe mandatory lockdowns including in Italy, Spain, Czech Republic, Netherlands, etc.
As of March 15, the most impacted European country is Italy with 21,157 confirmed cases, followed by Spain (5,753), France (4,469) and Germany (3,795). Overall, there have been 45,061 confirmed cases in Europe with 1,738 fatalities – the only European country without confirmed cases is Montenegro.
In Canada, confirmed cases continue to increase with Ontario the most affected province with 142 cases, followed by British Columbia with 73 and Alberta and Quebec with 39 each – there have been a total of 304 cases country-wide. As the majority of the cases, so far, seem to be travel-related rather than in-country transmissions, the federal government is considering diverting some international flights to certain airports and have urged Canadians abroad to return home while commercial options are still available. While closing of airports to domestic flights is not currently being considered in Canada, it might not necessarily be off the table in the U.S. where President Trump said it would be considered should specific geographies see a spike in cases. In a March 15 update, Prime Minister Trudeau said he would not rule out closing Canada’s borders or placing other travel restrictions, similar to those adopted by the U.S. for E.U. and China travelers. Additionally, the Canadian federal government announced a $1 billion package to combat the pandemic with funds allocated to research (such as vaccines), medical supplies, communication and public education efforts, enhanced surveillance and testing, etc.
At the provincial level, several provinces including Ontario, Québec, New Brunswick and Manitoba are closing schools for several weeks while Alberta’s schools have been closed indefinitely. In Québec, the provincial government has imposed closures on all non-essential services included public venues such bars, gyms, libraries, etc.
Similar to Canada, the U.S. is still in the early stages of dealing with the epidemic and currently has 1,678 confirmed cases with the majority of these in Washington, New York, California, Massachusetts and Colorado.
The U.S. has announced several measures to mitigate the spread of the virus, including temporary bans on travellers originating from the E.U. and China, declaration of a national emergency, allocation of US$8.3 bln (and up to US$50 bln in low-interest loans to affected businesses) to help combat the epidemic as well as free testing services regardless of insurance status. The latter is particularly important as the U.S. has had a low testing penetration rate, which was initially due to various administrative reasons including unavailability of test kits, but was exacerbated by non-insured or under-insured people not testing due to the costs involved. It has been estimated that just ~10-14k people have been tested in the U.S. versus, ~33k in the UK, ~15k in Canada and, as discussed, ~210k in South Korea.
At the state level, there have been various degrees of lockdowns with schools closed in 32 states as well as in Los Angeles and New York City while several states, including Illinois, Ohio, Massachusetts, Washington, etc., temporarily closing or reducing the capacity of restaurants, bars, cafes, etc.
It appears that the containment methods utilized by China (severe quarantine) and South Korea (mass testing and treatment) have been the most successful ones so far, and we would not be surprised to see them employed, ideally in combination, in other countries. Using China’s Hubei quarantine of at least 49 days as a guide, it appears that Italy’s March 9, 2020 lockdown could be in place until April 27, 2020. We would not be surprised to see quarantines in Italy (and other countries) extend well into May 2020 to ensure that seasonality (and warmer weather) help subside infections.
The financial and economic implications of these quarantines, or even the closing of public space in North America, will have an impact that will, likely, extend beyond Spring 2020 after considering that 1) not all employees will be compensated (particularly non-salaried ones) for their forced time off, and 2) some salaried employees will likely be required to use vacation time, likely impacting their travel plans and spend later in the year.