COVID-19: U.S. Officials Issue New Guidelines to Slow Spread / WHO Emphasizes Isolation for 2 Weeks After Symptoms Stop

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

President Donald Trump on Monday announced new guidelines for Americans to follow over the next 15 days to slow the spread of novel coronavirus disease (COVID-19). In particular, he urged Americans to avoid groups of more than 10 people, including in homes, and to avoid restaurants and bars. He also called for avoiding discretionary travel, as well as schooling at home when possible.

Elsewhere, WHO Director-General Dr. Tedros Adhanom Ghebreyesus called on countries to "test, test, test" all suspected cases of COVID-19 — and to isolate all those infected, including those with mild disease, until at least 2 weeks after symptoms resolve. WHO officials also noted that while COVID-19 continues to be relatively mild in children, pediatric deaths have occurred.

In other COVID-19 developments:

• In the Annals of Internal Medicine, a bit of good news on protective equipment: Some 41 healthcare workers in Singapore were exposed to aerosol-generating procedures on a single patient who tested positive for SARS-COV-2, the virus that causes COVID-19. Roughly 85% were exposed while wearing a surgical mask and the rest while wearing N95 masks. None became infected.

• As of Monday, over 181,000 cases of COVID-19 were reported worldwide. The U.S. reported some 4300 cases and at least 74 deaths.

• Separately in Annals, researchers suggest that the outbreak in Iran may be much larger than reported. Their analysis was based on data on known COVID-19 cases exported from Iran, plus air travel between Iran and other countries.

• In a modeling study in Science, researchers report that undocumented infections with SARS-COV-2 accounted for the majority of COVID-19 transmissions in China in January. They note that many of these undocumented infections "were likely not severely symptomatic." They conclude, "These findings explain the rapid geographic spread of [SARS-CoV-2] and indicate containment of this virus will be particularly challenging."