Severity: Warning Alert

Health: Widespread COVID-19 continues in Western Europe since Jan. 2020. Local transmission in most areas; maintain strict basic health precautions.

The locations affected by this alert are:

  • Albania
  • Andorra
  • Austria
  • Belgium
  • Bosnia and Herzegovina
  • Bulgaria
  • Croatia
  • Cyprus
  • Czech Republic
  • Denmark
  • Estonia
  • Faroe Islands
  • Finland
  • France
  • Germany
  • Gibraltar
  • Greece
  • Iceland
  • Vatican City
  • Hungary
  • Italy
  • Latvia
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • North Macedonia
  • Malta
  • Monaco
  • Netherlands
  • Norway
  • Poland
  • Portugal
  • Romania
  • San Marino
  • Serbia
  • Slovakia
  • Slovenia
  • Spain
  • Sweden
  • Switzerland
  • Kosovo
  • Ireland
  • United Kingdom
  • Montenegro
  • San Marino
  • Guernsey

This alert began 07 Apr 2020 04:20 GMT and is scheduled to expire 13 Apr 2020 23:59 GMT.

  • Incident: Coronavirus disease (COVID-19): imported cases, local transmission
  • Affected Area(s): Western Europe (map)
  • Period: January-April 2020

Summary
Several countries and territories in western Europe have identified imported cases of coronavirus disease (COVID-19) and human-to-human transmission from those imported cases. Some countries provide more detailed location information than others. US CDC maintains a "Warning-Level 3" travel health notice, the highest of three levels that indicates authorities recommend avoiding nonessential travel due to the global COVID-19 pandemic. According to data through April 6 from the WHO, the following countries and territories in Western Europe have identified confirmed COVID-19 cases:

Community disease transmission

  • Spain: 130,759 cases reported nationwide. Most cases have occurred in Madrid, Catalonia, and Castilla la Mancha. Imported cases in Mallorca and the Canary Islands.
  • Italy: 128,948 cases reported nationwide. Most local transmission reported in Lombardy, Emilia Romagna, and Veneto regions.
  • Germany: 95,391 cases reported nationwide. The most affected states are Bavaria, North Rhine-Westphalia, and Baden-Wurttemberg.
  • France: 69,607 cases reported throughout the country. Localized outbreaks reported in Paris, Lyon, Haut-Savoie, Oise, Haut-Rhin, and Morbihan departments.
  • UK: 51,608 cases reported throughout the country, including Northern Ireland and Scotland. Most cases have occurred in Birmingham, Hampshire, Surrey, Sheffield, Hertfordshire, and Essex. Authorities have identified 1,158 cases in Northern Ireland and 3,961 cases in Scotland.
  • Switzerland: 21,065 cases reported among the following cantons: Aargau, Appenzell Ausserrhoden, Baselland, Basel-Stadt, Bern, Freiburg, Geneva, Glarus, Graubunden, Jura, Lucerne, Neuchatel, Nidwalden, Obwalden, Schaffhausen, Schwyz, Solothurn, St. Gallen, Ticino, Thurgau, Vaud, Valais, Zug, and Zurich.
  • Belgium: 19,961 cases
  • Netherlands: 17,851 cases
  • Austria: 11,983 cases, primarily in the states of Tyrol, Upper Austria, Vienna, and Lower Austria.
  • Portugal: 11,278 cases
  • Sweden: 6,830 cases
  • Norway: 5,640 cases among Viken, Vestland, Agder, Oslo, Toms of Finnmark, Rogaland, Nordland, Innlandet, Bergen, More of Romsdal, Telemark of Vestfold, and Trondelag.
  • Ireland: 5,111 cases
  • Czech Republic: 4,587 cases
  • Denmark: 4,369 cases
  • Poland: 4,102 cases
  • Romania: 3,864 cases
  • Luxembourg: 2,804 cases
  • Finland: 1,927 cases
  • Serbia: 1,908 cases
  • Greece: 1,735 cases
  • Iceland: 1,486 cases
  • Croatia: 1,182 cases
  • Estonia: 1,097 cases
  • Slovenia: 997 cases
  • Lithuania: 811 cases
  • Hungary: 744 cases
  • Bosnia and Herzegovina: 662 cases
  • North Macedonia: 555 cases
  • Latvia: 533 cases
  • Bulgaria: 531 cases
  • Andorra: 523 cases
  • Slovakia: 485 cases
  • Cyprus: 446 cases
  • Albania: 377 cases
  • San Marino: 266 cases
  • Malta: 234 cases
  • Montenegro: 203 cases
  • Monaco: 37 cases
  • Faroe Islands: 181 cases
  • Kosovo: 145 cases
  • Gibraltar: 103 cases
  • Jersey: 155 cases
  • Isle of Man: 127 cases
  • Guernsey: 154 cases


Imported cases only

  • Liechtenstein: 78 cases
  • Vatican City: 7 cases



Background and Analysis
Additional cases and locations may be added to this list at any time as disease surveillance and testing continues. The US CDC maintains a "Warning-Level 3" travel health notice for the global COVID-19 pandemic. This is the highest of three levels and indicates US authorities recommend avoiding all nonessential travel. Furthermore, older individuals and people of any age with chronic medical conditions or otherwise compromised immunity should consider postponing nonessential travel, including domestic 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.

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.

Coronavirus disease 2019 (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. 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 coronavirus knowledge base: www.who.int/emergencies/diseases/novel-coronavirus-2019

US CDC: Guidance for Businesses and Employers: www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response

US CDC: Preventing COVID-19 Spread in Communities: www.cdc.gov/coronavirus/2019-ncov/community

Mental Health Considerations during COVID-19 Outbreak: www.who.int/docs/default-source/coronaviruse/mental-health-considerations

US CDC: Manage Anxiety and Stress: www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety

US CDC Global COVID-19 Travel Health Notice: wwwnc.cdc.gov/travel/notices/warning/coronavirus-global

WHO: Getting your workplace ready for COVID-19: www.who.int/docs/default-source/coronaviruse/getting-workplace-ready-for-covid-19

WHO advice for international travel: www.who.int/news-room/articles-detail/updated-who-recommendations-for-international-traffic-in-relation-to-covid-19-outbreak