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What Lessons from the Coronavirus?

by John Brian Shannon

It has been reported by Johns Hopkins Medical Center that more than 100,000 people have died worldwide as a result of the COVID-19 Coronavirus.

Thus it follows that in the post-Coronavirus economy some things might need to change, as it’s doubtful that things will return to what we once considered ‘normal’ — but if we do return to that normal we might set ourselves up for another Coronavirus event that will play havoc with the economy and needlessly harm millions of people.


ONE: Let’s Be Prepared Next Time

It seems obvious that there will be another SARS or MERS health crisis. In fact, the Novel Coronavirus is itself a SARS-type virus named SARS-CoV-2 which journalists have (thankfully) named COVID-19, and it is simply the latest version of a long line of SARS or MERS type viruses that mutate at irregular intervals.

Let’s hope we never face the prospect of two highly infectious viruses at the same time, say, one mutated SARS virus (COVID-20, or COVID-21) and another mutated virus of the MERS family, because healthcare systems would reach full capacity within 7-days and millions of people worldwide would die before ever seeing the inside of a Hospital.

With that prospect in mind, let’s ensure that our politicians work on preparations for the next killer pandemic to the point that we could be in a strong enough position to take on, not one, but two killer pathogens at the same time, because given enough time, that will occur. Eventually.

But for now, let’s just be ready for the next SARS or MERS virus and we can do that by consolidating our best knowledge and practices into official government policy by passing an Emergency Infectious Disease Protocol bill in the House of Commons, soon.

How to Do That?

  1. The UK government should mail a package of 5-individually-wrapped surgical masks to every UK household to hang in the pantry/utility room/in the RV, or wherever appropriate.
    I fully realize that surgical masks provide little protection, but in the case of unwitting carriers of an infectious respiratory virus, etc., they help to protect others from being contaminated by that person’s breath. But even more importantly is that ‘perception’ is everything. When people see other people out and about and wearing surgical masks, it will automatically cause people to remember to maintain proper social distancing!
  2. The UK government mailout that I propose, should include an 8″x10″ plastic laminated card with a pre-punched hole so that every household can use a thumbtack to hang the infectious disease info card (and the package of masks) from a thumbtack or nail in their pantry or utility room. This card should show each type of respiratory protection (surgical, N95, and medical respirator) and the reasons for wearing each type of mask, and when to switch from one type of mask to another:
    A pictogram, followed by an explanation such as; “Surgical Mask; Wear this kind of mask if you’re walking in the park or uncrowded shopping mall.” and “N95 Surgical Mask: Wear this kind of mask if you work in a crowded environment where you can’t maintain proper social distancing OR if you’re a healthcare worker OR if you work in a Senior Citizens long-term care facility.” and “Medical Respirator: Wear this kind of protection if you’re a surgeon, or other operating theatre staff, OR if you work as a pathogen researcher.”
  3. The “8×10” card should show pictograms of each type of mask and the legitimate reasons for wearing each type of mask — and should CLEARLY summarize typical respiratory symptoms and what to do about them, such as: “If you experience any combination of fever, malaise, dry cough or uncontrollable coughing, or weakness/tiredness (or whatever symptoms you feel are appropriate for such an info card) call this toll-free number for instructions and ensure your front door is unlocked in case you can’t make it to the door.” Or words to that effect.
  4. A list of websites where people can re-order any of those respiratory protections online (along with the part number or model number) and have them delivered to their home, to ensure they can maintain (a minimum of 5 masks, for example) in their home, which would be helpful for most people. If the government provides such a headstart for people now and in the future, I believe that for the duration of this COVID-19 crisis and any mutated (say, COVID-20 or COVID-21, or MERS mutation) virus which may be more infectious, or more deadly (or both) UK citizens and residents will be better prepared, better educated, and better able to survive this event and the (almost certainly more dangerous) next mutation.

TWO: ‘Social Distancing’ is Now a Thing

Many people were/are completely asymptomatic — meaning, they had no symptoms at all, or may have felt a bit ‘off’ for a few days — in regards to the COVID-19 virus, however, those people may unwittingly carry on with their normal schedule and interact with dozens of people daily, thereby passing the virus on to everyone they come into close contact with.

If you have “B” type blood, you already know that you don’t catch as many colds or flu as your friends and co-workers. Which is handy for you, but you could pass infectious respiratory disease to everyone you interact with. Please use caution. Your ‘off day’ could become someone else’s major healthcare crisis simply because they don’t have the same built-in defences you have. Thank your parents and be considerate to others. Please.

While in public, we’ll be urged to maintain social distancing, which is difficult to get used to until you do get used to it, and then you’ll never go back to the old informal distancing rules.

Every year, I expect that a call will go out via the media telling people there’s a novel coronavirus or MERS-type virus making the rounds and to take appropriate precautions. And we all know that the best way to avoid such a virus is to lock yourself in your house until the crisis is over — which isn’t a lot of fun. But the second-best way to avoid contracting such an infection is to maintain proper social distancing, which isn’t that difficult. In addition to social distancing, wearing a surgical mask or an N95 mask will help, and even better, if you have the virus, you won’t be passing it along to everyone you come into close contact with. Unless you take it off, of course.

The UK government should create legislation that requires transportation operators to reconfigure their seating arrangements to allow for proper social distancing. In trains and buses, this could take the form of perimeter seating around the entire train car or bus, while in airlines, seating that faces each other might be the way to go. “Look ma, I’m flying backwards!” Seriously though, perimeter seating in airlines, with opposing seats in the centre of the aircraft would maximize passenger safety and still allow a large number of passengers and permit two aisles. On ferries, similar seating arrangements could be made and onboard restaurants and cafeterias should be able to reconfigure their seating area to opposing (and easy clean fabric) seating to maintain social distancing rules. Remember, when you’re eating your prime rib or vegan tortellini you can’t wear a mask, so the seating plan in those areas must consider passenger safety more seriously.

Some sidewalks in the UK are barely wide enough for one person let alone the busyness of the tourist season, therefore, cities and towns across the UK need a complete rethink of their pedestrian areas. In many cities around the world we’re seeing typical four-lane city streets turned into two-lane cobblestone streets that are only open to buses or trams. Allowing taxicabs and limos seems appropriate too, but not passenger cars or motorcycles. By converting a four-lane road into a two-lane road, it allows wider sidewalks for people to maintain the recommended social distancing rules. This can look very attractive and many cities have succeeded in this in recent years.

Working from home four days per week could become the new normal for many office workers and others who can work from home. Imagine a worker assembling 250 car mirrors per day (or 250 car tail lights per day) at a factory; Now, imagine that worker doing the same in their (formerly) two-car garage. It’s the same thing except for the location. The worker gets paid a standard price for each piece they assemble instead of payment by the hour, yet all other employee benefits for that worker would remain the same. FedEx or the automobile manufacturer’s own delivery vans could pick up and deliver the parts from the home worker. Final assembly, of course, would be done at a large factory designed exclusively for ‘just-in-time-delivery’ of the necessary parts.

Shopping online is one way to limit exposure to potentially infected persons, it also frees-up the roadways for transport trucks and delivery vans and ends the daily gridlock that spews billions of tons of pollutants into the air which, as we now find out, breathing those toxins for a few hours every day further weakens our immune system response to infectious disease. Seems obvious in retrospect, doesn’t it?


THREE: Government Policy Must Allow the NHS to ‘Hit the Ground Running’

Boris Johnson’s government has handled this healthcare crisis about as well as any government on the planet.

However, when the next SARS or MERS-type virus hits, the NHS should be fully stocked with every PPE they need, they should have standing arrangements with every available airport hangar or unoccupied office tower or movie theatre, etc., they should have millions of test kits which should be used on each person who enters a Hospital (with or without symptoms) and test kits should be used to test every passenger arriving in the country — before they debark the aircraft, ferry, cruise ship or pleasure craft — and they could be notified via SMS if their test proved positive, allowing them to self-isolate or see a Doctor, as appropriate. This would give the infected person a jump start on their treatment and provide the NHS with almost realtime tracking of infected persons arriving in the UK.

Finally, the NHS needs an entire fleet of state-of-the-art Hospitals that are built to suit the modern NHS. Yesterday’s hospitals, built in the 18th, 19th and 20th-centuries, just aren’t up to scratch. Some of them cost more than £1 million per month to heat let alone pay the lighting bill. Many aren’t fit for purpose, or are located in the worst possible place now that entire cities have sprung up around them over the past 10 or 20 decades. Some NHS facilities are simply too small to serve regular needs let alone having enough capacity to handle a major epidemic. Ten new Hospitals need to be built every year until the NHS reaches 130% capacity so that it can then offer so-called medical tourism and thereby earn valuable foreign cash from its foreign patients. Each new Hospital should be much smaller than the 1950’s era monster-sized facilities. Modern Hospitals need a smaller footprint, they need to be easily accessible, and the UK needs many more locations — more + smaller + energy efficient Hospitals, instead of few + large + energy inefficient + barely fit for purpose Hospitals.

MORE, SMALLER, ENERGY EFFICIENT HOSPITALS are the future.


Captain Tom Moore Raises Millions for the NHS

And to end on a positive note, let’s give a warm shoutout to the UK’s 99-year-old Captain Tom Moore who has raised over £18 million since April 10th for NHS Charities Together, by walking laps in his back yard. Thank you again, Captain Moore. He is 2020’s best example of the spirit of the United Kingdom. Hats off!

You can still donate HERE or SEE HOW MUCH HE’S RAISED SO FAR, if you like!

There’s a petition that already has more than 500,000 names on it to award this great military warrior and NHS hero the George Cross, please consider signing it HERE.

The End of Bricks and Mortar Stores is Nigh as Online Shopping Enters a New Era in The Coronavirus Economy

by John Brian Shannon

Those who fail to change with the times become obsolete. Just ask the dinosaurs.

Some dinosaur groups morphed into new species that allowed them to continue to live and procreate in a changed environment and we see examples of them today in our world; Today’s birds are descended from Pterodactyls, today’s crocodiles from Stegosaurus, and today’s kimono lizards are descended from Squamata (Megachirella wachtleri) which is the father of all lizards and snakes on the planet today.

The species that didn’t adapt quickly to the then-changing conditions on the Earth, died. And the ones that did change, changed slowly, consequently they exist on the Earth in smallish populations unlike their ancestors which had until then, enjoyed total dominance on this world.

If science isn’t your thing, you might look to anthropology (the study of human societies and cultures and their development) for some examples of this rule and you’ll see those that couldn’t adapt got left behind.

One example of this is the Indus Valley civilization which flourished from 7000 to 1900 BC. Although we see traces of their existence in archaeological sites, they are no more. Another example would be the Mongol civilization (1206 to 1294 AD) Seen any lately? More recently, we witnessed the end of the German Nazi Party circa 1945.


Prediction: Businesses that Don’t Learn to Sell Online (Successfully) Will Fail within 24-Months – Everywhere on Earth

Any retail store — including grocery stores — that don’t evolve quickly enough to meet the demands of the new ‘Coronavirus economy’ are sure to fail. And I have no sympathy for them. None whatsoever. ‘Change with the times or die’ is the nature of all commerce.

There’s no excuse good enough to not have a robust internet e-commerce site and multiple redundant delivery systems for your business, as every business owner knows about the internet, everyone knows how e-commerce websites work, and they’re not that expensive to create.

Indeed, you may have purchased something online, whether it was a hat, golf balls, or enough furnishings to equip your new office tower. (The link points to STAPLES.UK which has a sophisticated website that makes it easy to order any business related product or service quickly and efficiently. With STAPLES.UK shipping is free on orders over £36 and in most cases you receive your order within a couple of days of ordering) That’s the kind of commitment required to meet customer expectations in the new Coronavirus economy thereby allowing those businesses to thrive and prosper well into the 21st-century.

It isn’t difficult to create and maintain an online e-commerce presence. Yes, it takes a little work, but nothing too onerous. And yes, it does cost a little money to set up and operate, but again, those costs should be considered as part of the normal cost of doing business in the 21st-century.

It’s nothing but utter laziness if your company isn’t selling at least fifty per cent of its goods or services online in the 21st-century. It’s so easy to do. But it needs true leadership — which isn’t about nice-sounding speeches in shareholder meetings or at the company Christmas Party — it’s about the kind of leadership that gets it done by the end of the year, not by the end of the company, if you take my meaning.

If you think things haven’t changed profoundly, you’re not looking hard enough.

Many businesses want to get you into their store so you’ll be tempted to purchase so-called ‘impulse buy’ items — things you wouldn’t normally buy, but because you walked past an appealing display you were tempted to purchase. If your business model depends on that you’re already halfway to insolvency, because whether you like it or not, the old ways of doing business are already gone. Not next month, not next year, but now.

The old days of people milling around at the weekend and walking into your store by chance and buying things are over. The Coronavirus economy is here, and it isn’t going away. Ever.

Many people will catch the Coronavirus bug over the coming months and the ones that don’t die of it will become immune to that strain of the virus. We’re presently at COVID-19 (SARS Coronavirus 2019 variant) and there will no doubt be a COVID-20 (Coronavirus 2020 variant) and a COVID-21, and a COVID-22, etc., until the end of time.

“There are three to five emerging diseases every year, and only by luck and the grace of God that they don’t turn into pandemics each time.”William Karesh, Executive Vice President for Health and Policy at EcoHealth Alliance

At the moment, COVID-19 is killing one to two per cent of those who contract the virus. But that’s a temporary situation until the virus mutates (and all viruses mutate) whereupon it will become more deadly — and those who’ve contracted COVID-19 may, I repeat may, have some immunity to a newer version of the virus. Fifty per cent immunity is typical among SARS virus survivors when a new version comes along, but you still get ill, and you still ‘go down’ for a few days, and you can still pass the new variant to others who breathe the same air as you. And the same holds true among MERS survivors.

In fact, I suggest that perhaps later this year, there will be people who haven’t yet caught the COVID-19 variant (and therefore have no immunity to subsequent COVID versions) and may contract a (likely more serious) COVID-20 version (which has yet to appear) and die within days or hours of contracting that new and more robust virus.

There will be people who contract both COVID versions at the same time, sorry to say.

There will be people who haven’t caught either variant and they will be ‘sitting ducks’ by simply walking into a store or subway landing with hundreds of other people, and thereby catch one or both viruses in the same week. And there will be people who catch the normal flu and while their immune system is barely coping with that, they’ll catch one or more SARS or MERS respiratory illnesses. They won’t last long and they’ll know it from Day One.

And that’s why most people will choose to dramatically and permanently alter their shopping habits, gravitating towards online shopping — instead of them playing Russian Roulette with their life every time they walk into a store or onto a train platform. Once people comprehend the enormity of the Coronavirus economy and the implications thereof, the ‘bricks & mortar store’ model will be dead.

Now, if you’re a serious fly fisherman or fly fisherwoman (for example) you’ll need to visit a bricks & mortar store at some point to do a few casts with a selection of rods and reels before you decide which one to purchase. Other situations may apply, as not everything can be easily purchased online.

In the near-future, well-managed stores will sell MORE goods and services online than they do now from all sources combined — and their staff will deal elusively with the Fed Ex driver and perhaps one in-store customer per day who needs to try out that rod and reel combination, or who needs to try-on that dress before purchasing.

Some stores will prosper as never before — and the ones that don’t accept a new business model will fail. Just as it should be.


Lead, Follow, Or Get Out of the Way!

If you’re a business owner presently without a robust online e-commerce site, it’s time to pick up that phone today and get a new e-commerce website built. Otherwise, you’re gone by the end of the year, IMHO.

The retail world is about to change more profoundly than at any time since the first electrical grids appeared, when grid-powered heat and light in stores suddenly allowed workers the opportunity to shop at the end of their workday.

Some of you already and clearly see this new paradigm, some will realize it in the coming weeks, and some will cling to their horse and buggy thinking until the day they reach the Pearly Gates.

Regardless of when you see it, or whether you like it or not, change is coming to the retail world. Better get ready, as it’s going to get rough for businesses that don’t evolve to meet the demands of the new Coronavirus economy.


Related Articles:

  • World Health Organization Coronavirus Situation Reports webpage (WHO)
  • World Health Organization Situation report 25 March 2020 available here

Why ‘Herd Immunity’ Isn’t the Answer to Solve a Serious Pandemic

by John Brian Shannon

As I write this blog post (Saturday, March 14, 2020) there are 142,539 cases of the Novel Coronavirus variant 2019 (COVID-19) in the world and in some countries the total number of new cases continues to grow at a slow rate, yet in other countries the number of new cases is growing at a steady geometric rate, while in other countries new COVID-19 cases are growing at an exponential rate.

In places where COVID-19 is growing slowly, most countries have the capacity to deal with it and should see exactly as many cases treated as diagnosed. Where the virus is spreading at a geometric rate, only those healthcare systems with sufficient capacity will be able to handle that progressively larger daily number of cases, and where COVID-19 is growing at an exponential rate, about 2% of infected persons will die — because, so far, that’s the fatality rate for COVID-19 globally.

Centers for Disease Control COVID-19 Situation Summary (updated daily)

Also as of today, there have been 5,393 deaths verified as COVID-19 fatalities — although, especially in developing countries — thousands of people die every day from all sorts of things and there isn’t the capability to test the cause of each and every death. Indeed, some 29,000 people die every day from hunger alone and if they can’t solve the hunger issue in their country, trying to find funding for millions of COVID-19 test kits must surely rank farther down their priority list.

Thus far, 135 countries have reported COVID-19 cases and a report out of China says that serious illness occurs in only 16% of cases. That kind of information helps to keep the illness rate for this virus in the proper perspective.


World Coronavirus cases, March 14, 2020

Global Coronavirus case countries, March 14, 2020. Image courtesy of Centers for Disease Control and Prevention.


Europe is Now the Epicentre of COVID-19 Cases Due to their ‘Herd Immunity’ Health Paradigm

Much of Europe operates their healthcare systems by purposely not treating such conditions as influenza (the flu) and other contagions, which they think is the best way to facilitate their much-vaunted ‘Herd Immunity’ goals.

And in previous decades where the vast majority of contagious diseases had low fatality rates the ‘Herd Immunity’ option was worthwhile, as everyone who subsequently caught the virus and then later recovered were thereby and automatically permanently immunized by the (terrible) experience of becoming ill and recovering courtesy of the human body’s own immune system response. Healthcare systems liked it because it was and remains the cheapest way to ‘immunize’ the public against a mild virus.

But That Was Then, And This Is Now…

During the peak Baby Boomer years, most people were young, healthy, lived in a healthier environment, and often spent considerable time outdoors which can be beneficial for human health.

In 2020, a larger proportion of people are older, less healthy, and live in a less healthy environment — although, due to advanced healthcare in most countries, people also tend to live longer lives. And for that, you can thank modern healthcare.


Global Population Pyramid 1960 & 2020

Global population pyramid 1960-2020 comparisons


In 2020, We’re Living On Borrowed Time

Millions of people return from visiting abroad every year in 2020, therefore, our species is exposed to countless more contagions — and chief among them are respiratory diseases such as influenza, SARS and MERS viruses and more recently, the latest Novel Coronavirus (which itself is a SARS-type virus) and others such as the Zika virus that made headlines a few years ago after travelling from Egypt to the United States for the first time in recorded history.

All these viruses mutate over time, and it can happen that they mutate several times in a decade. Which doesn’t bode well for the future as we’re in a permanent state of being one mutation away from extinction or something approaching that. And the leaders of healthcare systems don’t want to admit it to themselves, nor do they want to be accused of spreading panic among the general population.

So, carry on blissfully, because one day a mutated SARS or MERS virus or some other mutated and highly contagious respiratory virus may spread across the globe in a matter of days and we’ll all die horribly! Won’t that be fun? 😉

If I had told you a month ago that a Novel Coronavirus was going to spread across the globe and that the United States was going to close its airspace to European aircraft and (after tomorrow night) stop those Americans stuck in Europe from returning and simultaneously close its border with Mexico, you would’ve laughed.

After all it has never happened in recorded history, although during the Spanish Influenza pandemic in 1918, had there been millions of people flying around on passenger aircraft every day, the United States and other developed countries may have ceased to exist as we know them.

“The 1918 influenza pandemic was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. Although there is not universal consensus regarding where the virus originated, it spread worldwide during 1918-1919.
In the United States, it was first identified in military personnel in spring 1918.
It is estimated that about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States.” — Centers for Disease Control and Prevention

Now that particular H1N1 virus variant still exists and it continues to appear from time to time in human populations. You know it as ‘the flu’ which many people are resistant to on account of their ancestors catching H1N1-1918 and their immune systems creating antibodies to combat the disease which (the antibodies to H1N1-1918) are passed to their children via Mother’s milk which is loaded with antibodies for their infants.

But not everyone is resistant, nor has everyone the same amount of immunity. In 2020, the H1N1-1918 strain no longer kills millions of people per year. That’s a benefit of so-called ‘Herd Immunity’ — whomever doesn’t get killed by it develops some amount of immunity and can pass along the antibodies to their infant children.

It’s great when it works, although the fatality numbers can get high. But ‘Herd Immunity’ was as good a method as any in 1918 to prevent further outbreaks, because medical knowledge about viruses was low and the level of medical technology was even lower.


What if COVID-19 Fatality Rates Were the Same as Ebola or Other Viral Killers?

All Europeans would be dead by now, is the short answer and North Americans would be barely hanging on.

And there are two reasons for that; One, politicians were initially slow to get the message that a major healthcare crisis was on the way (and there’s a reason for that which we’ll discuss in a moment) and Two, Europeans prefer to ignore viruses because (although small numbers of deaths occur) it helps to build a ‘Herd Immunity’ within a given country (which only works where everyone doesn’t die or are permanently maimed by the virus)

Healthcare Systems are Permanently One-Week Behind Viral Transmission

It’s nobody’s fault that the world’s healthcare systems are at a supreme disadvantage when it comes to tracking viral outbreaks.

For example, it can take a week or even longer for a person to show any symptoms at all, while some people may remain asymptomatic (without symptoms) while still passing the virus on to others wherever they go.

Not only that, but once the first case is diagnosed (patient zero) it may be days or weeks before a similar case shows up on the system.

And further, those subsequent cases may be hundreds or even thousands of miles away from the original viral case which makes it difficult to associate those cases together as one virus or disease, in one database.

Consequently, once healthcare systems sufficiently ramp-up to handle the epidemic (‘pandemic’ once it crosses international boundaries) the virus will still hide from Doctors and Nurses for a week or more, and in some patients, months.

Which is why it can take time to nail down a rapidly-spreading virus, especially when it’s enabled by millions of people flying from country to country carrying the virus, and in some cases, showing no symptoms while still passing-on the contagion.


What Healthcare Systems Don’t Need is Politicians Adding Another Week or Two of Dither and Delay to the Equation

If leaders of countries refuse to make timely decisions about banning flights from affected countries, it stands to reason that their country will receive evermore carriers and spreaders of the virus, thereby creating more victims in their own country. Which gets costly for healthcare systems once it gets into the thousands or millions of patients.

But that’s only if those healthcare systems choose to treat those infected patients, or (as in the European Union) where they let it run its course through the general population in hopes that fatalities will be low and large numbers of people will gain immunity after plenty of suffering by infected persons.

It’s a dangerous way to proceed, IMHO, and it isn’t for the faint of heart; Hoping that it doesn’t mutate enroute from one city to another, and hoping that not too many people die as it hits the elderly and the infirm much harder than the typical healthy person.

As I said above, it could be argued that countries once had the moral right to follow a ‘Herd Immunity’ philosophy back when there were no real alternatives, but now, in this interconnected world where millions of people fly to and from everywhere on the planet every day of the year and viruses continue to mutate completely unaware of our views on the topic, and when a virus is identified and politicians then add one or two weeks to the equation before finally making the right decision (or at least, some of the right decisions) it’s like playing Russian Roulette with the global population.

We’re only one random genetic mutation from viral annihilation! (Probably unlikely in the short term, but we almost certainly will take a major hit by 2050) Still, we can lower fatalities and huge amounts of suffering now by not employing the “Herd Immunity’ philosophy during global pandemics.

Therefore, the so-called ‘Herd Immunity’ philosophy must end where novel viruses are concerned, and the weeks of political delay prior to taking practical steps to prevent massive spreading of infected persons must end. Or we homo sapiens, will end. One day.

Remember, wash your hands often, maintain a social distance of about six feet, don’t shake hands, and don’t go on a cruise ship if you’re aged or infirm. Other than that, have a great week everyone!


Notes:

Visit the World Health Organization webpage that displays up-to-the-minute situation reports here: WHO Coronavirus Disease (COVID-2019) Situation Reports


Situation report – 54 Coronavirus disease 2019 (COVID-19) SitRep | Dated 14 March 2020
(This WHO link displays the most recent report as of March 14, 2020)