explainer

70,000 prisoners released in Iran and Italy in lockdown: The current state of COVID-19.

This article was originally published on February 28 and has been regularly updated as new information comes to hand.

Feature image: Woman protests outside Italian prison/Getty.

The entire country of Italy has been placed into coronavirus lockdown after the death toll jumped by 97 in one day.

“Restrictions will include banning all public gatherings and preventing all movement other than for work and emergencies,” Italian Prime Minister Guiseppe Conte said, describing the situation as a “national emergency”.

“The restrictions will take effect on Tuesday and like those in northern Italy will last until April 3,” he said.

The new orders increase the 16 million people under quarantine in the north of Italy to 60 million people.

Italy Bans Public Gatherings Nationwide Over COVID-19 Worries
Relatives of prisoners clash with Italian Police outside the Rebibbia prison, in Rome, Italy. Image: Antonio Masiello/Getty Images.

Cinemas, theatres and museums have been ordered to close in Italy, with sporting events cancelled and shops and restaurants informed to have diners sitting at least one metre apart, and close at dusk.

Even events like weddings and funerals are affected by the lockdowns, and the country's "nightlife" is no longer permitted.

Six prisoners have died in a COVID-19 protest in Modena, while in Foggia some inmates have escaped as they rage about containment measures.

The inmates broke into the infirmary of their prison and overdosed on methadone as more than two dozen riots broke out across Italian lockups.

On Monday, inmates climbed onto the roof of the San Vittore prison in Milan and held up a painted sheet reading "Indulto", Italian for "pardon".

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Family visits have been banned to prevent transmissions in the country's prison system, with the country recording 366 deaths and 7375 cases.

Coronavirus: Death toll in Iran climbs to 54
Death rates continue to rise in Iran as 70,000 prisoners are released. Image: Fatemeh Bahrami/Anadolu Agency via Getty.

Iran has reported 595 new infections of COVID-19 within 24 hours and has freed 70,000 prisoners to help combat the spread as the disease totals rise above 7000.

The country has emerged in recent weeks as a major coronavirus hotspot with 237 deaths so far recorded.

Judiciary Chief Ebrahim Raisi announced the temporary release of prisoners as Iranian authorities seek to counter one of the worst national outbreaks outside China, where the new virus originated, and one of the highest death rates from the illness.

Raisi said the release of prisoners would continue "to the point where it doesn't create insecurity in society", according to the Mizan news site of the judiciary.

He did not give further details or specify when those released would have to return to jail.

Stock market plummets.

Stocks have fallen by nearly eight percent on Wall Street overnight, and it's triggered the first automatic halt in trading in over two decades.

European markets had had their worst day since the GFC and the Dow Jones has closed down 2,014 points, which is the worst single day drop ever on record.

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Missy Higgin's father diagnosed.

A Victorian doctor who tested positive for COVID-19 is the father of Australian singer-songwriter Missy Higgins, it was revealed on Saturday.

Dr Chris Higgins, who is in his 70s, treated more than 70 patients while ill, prompting concern for his patients at The Toorak Clinic in Melbourne.

"I'm absolutely flabbergasted that a doctor who has experienced flu-like symptoms has presented to work," Victoria Health Minister Jenny Mikakos said on Saturday.

coronavirus update
Image: Facebook.

"I understand it was very mild symptoms - perhaps he didn't make the potential link - but we've now got 70 patients that have been contacted, so it is incredibly important that all healthcare workers take this matter very seriously."

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Here's exactly how to protect yourself from COVID-19. Post continues below.

However, Dr Higgins has responded to Mikakos' remarks in a reply to a Facebook post by the Minister, saying he was "upset"  about the "inaccuracies and unfairness of your comments".

"This is not the story that I told the DHSS whose job it is to relay information to you," he wrote.

"I had a mild cold when I returned from the USA last Saturday morning, which had almost resolved itself by Monday morning, hence my decision to return to work."

He continued: "I hesitated to do a swab because I did not fulfill your criteria for testing but did one anyway on Thursday evening for sake of completeness, not imagining for one moment it would turn out to be positive.

"I believe you have taken a cheap opportunity for political grandstanding and would appreciate an apology,” he wrote.

Dr Chris Higgins, who works at the clinic, is in isolation and his patients, along with staff, are required to self-isolate.

With the rise in coronavirus cases worldwide, the World Health Organisation has urged countries to "act with speed, scale and clear-minded determination" to stop the spread of COVID-19.

Speaking at a press conference on Thursday night, WHO Director-General Dr Tedros Adhanom Ghebreyesus said that, while the organisation is concerned about the rise in diagnoses outside origin-country China, the epidemic could still be "pushed back" with a collective, coordinated response from governments.

"This is not a drill. This is not the time to give up. This is not a time for excuses. This is a time for pulling out all the stops," WHO Director-General Dr Tedros Adhanom Ghebreyesus said.

"Countries have been planning for scenarios like this for decades. Now is the time to act on those plans.

"If countries act aggressively to find, isolate and treat cases, and to trace every contact, they can change the trajectory of this epidemic."

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So just how serious is the situation? Should Australians be worried? And what's being done to stop the spread?

Here's a look at the current state of COVID-19 in Australia and around the world.

COVID-19 is now in all continents except Antarctica.

COVID-19 is now in 104 countries and territories. As of March 8, there have been more than 110,000 confirmed cases and 3,800 deaths worldwide. Eighty-four per cent of these have occurred in China, although, the number of new foreign cases is now climbing at a much higher rate.

South Korea, Italy and Iran are emerging as other COVID-19 epicentres, with 43 new deaths in Iran in just 24 hours.

Egypt reported its first death on Sunday, while Bangladesh, Bulgaria, Colombia and Moldova reported their first cases.

Still, the WHO Director-General on Thursday said there are "encouraging signs" from Korea: "The number of newly-reported cases appears to be declining, and the cases that are being reported are being identified primarily from known clusters".

He added: "Although a few countries are reporting large numbers of cases, 115 countries have not reported any cases; 21 countries have reported only one case; and five countries that had reported cases have not reported new cases in the past 14 days".

Listen: An infectious disease specialist answers your most pressing questions about COVID-19.

On Friday, health officials also have confirmed 21 people on a cruise ship barred from docking in San Francisco have tested positive for coronavirus. Four Australians are among those on board.

Vice President Mike Pence, who is running the White House's response to the outbreak, said 19 crew members and two passengers had the virus out of 46 people tested so far. He said the vessel with about 3,400 passengers and crew would be taken to a non-commercial port where everyone on board would be tested.

COVID-19 in Australia.

In Australia, there have been 92 COVID-19 cases, a small minority of which have been contracted locally, including an eight-month-old baby. The South Australian infant's mother had also been diagnosed with the virus following a recent trip to Iran.

So far, Australia has recorded three deaths, while 22 of the 92 have recovered.

The first — travel agent James Kwan, 78 — died in the early hours of March 1 at Perth’s Sir Charles Gairdner Hospital, after being evacuated from the Diamond Princess cruise ship following an onboard outbreak.

The second was a 95-year-old female resident of Dorothy Henderson Lodge nursing home at Macquarie Park in Sydney's west. Her death on Tuesday came after a 50-year-old worker at the facility was diagnosed with the virus earlier this week. Age and underlying health conditions were a significant factor in both deaths.

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On Sunday morning, a third death was confirmed. The man, aged in his 80s, died in a Sydney hospital.

Three students from two Sydney highschools are among Australia's latest coronavirus cases, with NSW preparing to shut schools for a day if any staff or students test positive.

Two year 10 students from St Patrick's Marist College in Dundas, and a year 7 pupil from Willoughby Girls High Schools were confirmed to have COVID-19.

The Dundas students' fathers have tested positive as has the Willoughby girl's mother.

The Australian Defence Force confirmed a third member had tested positive on Monday night after they caught it off someone outside the defence.

NSW authorities are now investigating a coronavirus cluster in northern Sydney that seems to be centred around Ryde hospital, the Defence Force and the Dorothy Henderson Lodge aged care facility.

COVID-19 in China.

COVID-19 was first identified in the central Chinese travel hub of Wuhan in late December. As of March 8, there has been 80,652 cases, with 55,524 of those patients having now made a full recovery. There has been 3,070 deaths in China alone.

China's central province of Hubei, excluding its capital Wuhan, reported no new cases over 24 hours for the first time during the outbreak, heath chiefs said on Friday.

On Saturday, state media reported that a five-storey hotel being used for coronavirus quarantine collapsed in the southeast Chinese port city of Quanzhou trapping about 70 people.

The hotel collapsed about 7:30 p.m. local time and 34 people were rescued in the following two hours, the Quanzhou municipality said on its website.

"I was at a petrol station and heard a loud noise. I looked up and the whole building collapsed. Dust was everywhere, and glass fragments were flying around," a witness said in a video posted on the Miaopai streaming app.

"I was so terrified that my hands and legs were shivering."

A woman named only by her surname, Chen, told the Beijing News website that relatives including her sister had been under quarantine at the hotel as prescribed by local regulations after returning from Hubei province, where the coronavirus emerged.

Panic is harmful.

There is already evidence of the damage COVID-19 panic can do. Australians have been stockpiling goods, including food and toilet paper.

On Saturday morning, NSW Police had to be called to a western Sydney supermarket after a fight broke out among customers over toilet paper.

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Police said they were called to a Woolworths store at Chullora about 9:30 a.m. after reports a 49-year-old woman had been assaulted, however, no arrests were made.

A video of the incident went viral on social media and showed a group of women pushing, yelling and fighting over a packet of toilet paper.

Experts have stressed that panic buying is not necessary. Most simply advise that you have adequate supplies of your usual required medication, just in case of possible future delays in the supply chain or the slim chance you are required to self-isolate.

As for travel, Dr Keith Suter of public policy think tank, The Australia Institute, said there's no reason for people to cancel holidays, unless the Australian Government has advised against it.

Currently, travellers are urged not to travel to China and Iran, and to "exercise a high degree of caution" when travelling to countries including South Korea, Japan and Italy (visit smarttraveller.gov.au for up-to-date information).

"Many other countries are still safe to visit," Dr Suter told Mamamia's daily news podcast, The Quicky.

"You might run into insurance problems if you do start cancelling, because it may be that your travel insurance won't cover the cost of your losing the airline ticket. So hold off for the moment.

"If you have a medical condition, are pregnant or have a small baby, consult with your doctor before heading overseas and check with your travel insurance company to see if you're covered if things should change."

COVID-19 is not a pandemic - yet.

It's up to the World Health Organisation to declare an outbreak to be a 'global pandemic'. It defines that as “an outbreak of a new pathogen that spreads easily from person to person across the globe”.

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The WHO has already declared COVID-19 to be a "Public Health Emergency of International Concern", which is its highest level of alarm (You can read about what that means in our previous story). But it has so far resisted calling it a pandemic.

Speaking to the media last week, WHO Director-General, Dr Tedros Adhanom Ghebreyesus, said while COVID-19 does have the potential to become a pandemic, the WHO hadn't yet observed "sustained and intensive" community transmission of the virus, nor "large-scale severe disease or death" to justify the label.

“Using the word pandemic carelessly has no tangible benefit, but it does have a significant risk in terms of amplifying unnecessary and unjustified fear and stigma, and paralysing systems," he said.

“It may also signal that we can no longer contain the virus, which is not true. We are in a fight that can be won if we do the right things.”

The vast majority of cases are mild.

There have been several headlines heralding the prediction by Harvard University epidemiologist Marc Lipsitch that between 40 to 70 per cent of the world's population will contract COVID-19 in the coming year.

But speaking to The Atlantic, he stressed that, "It’s likely that many will have mild disease, or may be asymptomatic".

Indeed, the Chinese Centre for Disease Control and Prevention last week released a report that found 81 per cent of COVID-19 cases are mild. Meaning, the patient had symptoms no more severe than mild pneumonia. (Most report cold and flu-like illness including coughing, fever and sore throat.)

The fatality rate is low.

According to current data from the WHO, the case fatality rate of COVID-19 is approximately 3.4 per cent globally. In other words, 3.4 per cent of the people diagnosed have died as a result of the disease.

In countries outside China, it's even less: 1.8 per cent.

That's far lower than previous, similar epidemics such as the SARS outbreak of 2002-3, which had a fatality rate of 9.6 per cent, and the ongoing MERS crisis (34.4 per cent).

So, while COVID-19 may be spreading further and resulting in more cases overall than recent epidemics, patients are far more likely to make a full recovery.

In fact, according to the CCDCP report, which looked at 72,000 recorded Chinese cases, for those aged under 50, the fatality rate is just 0.2-0.4 per cent.

Image: Mamamia.
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Scientists are still working to understand how COVID-19 behaves.

It's not entirely understood how COVID-19 behaves.

Based on understanding of other coronaviruses (SARS, for example), it's believed that it's transmitted via respiratory droplets through coughing and sneezing, and via contaminated surfaces. There is also evidence that it can be present in faeces, though that's not believed to be a significant source of infection.

Chinese authorities have recorded rare examples (less than one per cent) of 'asymptomatic' cases — that is, a person being diagnosed with the virus despite not appearing unwell. However, the World Health Organisation said that in most of these cases, symptoms presented within the following two days.

According to the WHO, the time between contracting the virus and showing symptoms can be anywhere between 1-14 days, though is typically around five.

Meanwhile, the government in Hong Kong announced that a pet dog belonging to a COVID-19-infected patient had returned a "weak positive" when tested for the virus.

There is currently no evidence that pet animals can be infected with COVID-19, or be a source of infection for humans.

But the dog, which has no relevant symptoms, has been placed in quarantine for further testing.

"The Department will conduct close monitoring of the above dog and collect further samples for testing to confirm if the dog has really been infected with the virus or this is a result of environmental contamination of the dog's mouth and nose," the statement read.

Governments are responding to the outbreak.

Thousands of scientists around the world are dedicating their skills and resources to the effort to understand the virus and develop a vaccine, but the Coalition of Epidemic Preparedness Innovations says a vaccine is still a good year away.

The Australian government has put $2 million towards a local fund to develop a vaccine and has so car pledged less than $5 million to CEPI.

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CEPI chair Jane Halton, a former federal health department head, says about $3 billion is needed so multiple versions of potential vaccines can be developed.

At the moment, national governments are largely free to respond to the COVID-19 outbreak as they see fit. Although, the WHO has strong guidelines on what measures they ought to take.

Some countries are being more cautious than others. Australia, the US and New Zealand are among those to have enforced a ban on foreign travellers who've come from/via COVID-19 epicentres including China and Iran. Several governments in Asia have also put body-temperature screening in place at airports to detect travellers with fever.

Major events in countries from Italy to Saudi Arabia have been cancelled or dramatically scaled back. And Japanese and Italian authorities have announced that all schools will be closed until mid-March.

As for Australian travel...

On Thursday, the Australian Government widened its travel ban to include foreigners entering Australia within 14 days of leaving South Korea. Australian citizens and residents who'd been to the country, meanwhile, are now required to self-isolate for 14 days after returning home.

A similar ban was already in place for those coming from/via China and Iran.

Prime Minister Scott Morrison also announced additional screenings of passengers travelling to Australia from Italy, including temperature checks and health questioning.

The Government also has an 'emergency response plan' in place. The scope of the roll-out will happen in tandem with the spread of the disease.

For now, it's focused on preparations such as ensuring adequate stockpiles of medical equipment. But otherwise, it's business-as-usual — especially for ordinary Australians.

"You can still go to the football, you can still go to the cricket. You can still go and play with your friends down the street. You can go after the concert and you can go out for a Chinese meal," Prime Minister Morrison said last week.

"You can do all of these things because Australia has acted quickly."

If the virus begins to spread further locally, however, the response will be escalated. At its most extreme, that could mean: large gatherings are cancelled, people are directed to work from home, aged care homes are locked down and childcare centres are closed, and more.

— With AAP. 


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