Severity: Informational Alert

Health: Several countries in Southeast Asia report COVID-19 cases since January 2020. Local transmission in some areas. Use basic precautions.

The locations affected by this alert are:

  • Bangladesh
  • Bhutan
  • India
  • Nepal
  • Sri Lanka
  • Thailand
  • Maldives
  • Indonesia

This alert began 13 Mar 2020 23:40 GMT and is scheduled to expire 30 Apr 2020 23:59 GMT.

  • Incident: Imported cases of coronavirus disease (COVID-19), local transmission
  • Location(s): Southeast Asia (map)
  • Period: January-March 2020

Summary
Several countries in Southeast Asia have identified imported cases of coronavirus disease (COVID-19) from mainland China and, in some instances, limited human-to-human transmission from those imported cases. As of March 13, the following countries have identified confirmed COVID-19 cases:

Countries reporting community transmission:

  • India: 74 cases, primarily in Haryana, Kerala, Maharashtra, and Uttar Pradesh
  • Thailand: 75 cases (41 imported, 28 locally transmitted) in Bangkok and the provinces of Chon Buri and Nakhon Si Thammarat
  • Indonesia: 34 cases in Central and West Java
  • Maldives: 8 cases
  • Bangladesh: 3 cases


Countries where community transmission has not been determined:

  • Nepal: One imported case in Kathmandu
  • Sri Lanka: 5 cases
  • Bhutan: Single imported case in Paro District


The US CDC maintains an "Alert-Level 2" travel health notice for the global COVID-19 outbreak. This indicates older individuals and people of any age with chronic medical conditions or otherwise compromised immunity should consider postponing nonessential travel and take special precautions to avoid becoming ill, especially where sustained community transmission of COVID-19 has been identified. All individuals should monitor their health and limit interactions with others for 14 days after returning from travel.

Background and Analysis
Additional cases and locations may be added to this list at any time as disease surveillance and testing continues. Older individuals, infants, and those with chronic illness are more susceptible to infection and are at increased risk for severe complications. Human-to-human transmission can occur, though it remains unclear how easily the virus spreads between people.

On March 11, the WHO declared the ongoing coronavirus outbreak a pandemic. This shift in posture from an earlier briefing indicating the WHO would no longer use the term "pandemic" to describe disease transmission is reflective of the current COVID-19 global impact. The March 11 statement specifically noted that "Describing the situation as pandemic does not change WHO's assessment of the threat posed by this virus. It does not change what WHO is doing, and it does not change what countries should do."

COVID-19 is a viral respiratory disease caused by infection with the SARS-CoV-2 virus (previously known as 2019-nCoV). Symptoms occur 1-14 days following exposure (average of 3-7 days). These symptoms include fever, fatigue, cough, difficulty breathing, sometimes worsening to pneumonia and kidney failure - especially in those with underlying medical conditions.

Advice
Emphasize basic health precautions, especially frequent handwashing with soap and water, or an alcohol-based hand sanitizer if soap and water are unavailable. Avoid close contact with animals (dead or alive), especially at wet markets. Practice good coughing/sneezing etiquette (i.e., covering coughs and sneezes with a disposable tissue, maintaining distance from others, and washing hands). There is no evidence that the influenza vaccine, antibiotics, or antiviral medications will prevent this disease, highlighting the importance of diligent basic health precautions.

Resources
WHO advice for international travel

WHO coronavirus knowledge base

US CDC Global COVID-19 Travel Health Notice

WHO: Getting your workplace ready for COVID-19

US CDC: Interim Guidance for Businesses and Employers