INTELLIGENCE UPDATE Coronavirus Outbreak – March 17, 2020
TABLE OF CONTENTS CURRENT SITUATION │3 Travel and Health Advisory │3 Infections and Deaths by Territory and Country │4 U.S. Government Measures │7 Work Cancellations│8 Medical Services│8 Travel Restrictions│8 National/State of Emergency│9
Global Measures │9 Travel Restrictions│9
Virus Factsheet │9
BUSINESS RISKS │10 Business Continuity│10 Security Response Benchmarking │10
RECOMMENDATIONS FOR TRAVELERS │11 RECOMMENDATIONS FOR BUSINESSES │12 EMERGENCY CONTACTS │13
Disclaimer: This report was prepared for the exclusive use of the recipient. It may contain proprietary, confidential information of either the recipient or G4S Corporate Risk Services (CRS) and is not intended for public disclosure. Any dissemination or reproduction of the report is governed by the applicable contract or letter of agreement between the recipient and CRS. Any disclosures outside of the contract terms must be authorized in writing by CRS. The findings in this report are based on information provided by the recipient and information to which CRS was provided access. CRS does not assume any responsibility or liability for the failure to detect, identify or make known any additional hazards, threats or areas of risk beyond what is identified in the report. Additionally, CRS makes no representations or warranties with respect to the recipient’s use of the report nor to any third party relating to information contained in this report.
2 | Intelligence Update
G4S Corporate Risk Services
CURRENT SITUATION As of March 17, 2020, the COVID-19 outbreak continues to show signs of slowing in mainland China, but infections are rapidly escalating in several other countries, including Italy, Iran, Spain, Germany, France and others. On March 15, for the first time the global number of confirmed infections in the rest of the world overtook those in mainland China. On Wednesday, March 11, the World Health Organization (WHO) declared that the COVID-19 outbreak is officially a “pandemic.” The WHO has called on the international community to increase the frequency of testing for the virus. In the United States, there are now 4,661 confirmed cases, with every state except for West Virginia recording infections. The CDC has warned that sustained person-to-person infections are likely to continue across the United States. Highlights: ▪
As of 9 a.m. ET on Tuesday, March 17, there were 185,067 confirmed global cases and 7,330 deaths. Italy (27,980), Iran (14,991) and Spain (11,279) have experienced a surge in infections. As one of the most severely affected counties, between March 15-16 Italy reported more than 3,000 new coronavirus cases and 349 deaths.
▪
154 countries, areas or territories have confirmed cases of infection. Some of the most recent have included Cuba, Guyana, Reunion and Saint Vincent and the Grenadines.
▪
In the past week, there has been a rapid escalation in governments around the world introducing social distancing measures, including the banning of large public gatherings, the suspension of schools and cancelation of sporting events. An increasing number of countries are asking all citizens to stay at home and self-isolate.
▪
International travel restrictions are multiplying, with an increasing number of countries barring visitors from Europe and the worst-affected countries in Asia, as well as mandating quarantines for returning citizens and residents.
Travel and Health Advisory U.S. government agencies maintain strict travel advisories for high-risk countries. ▪
The U.S. Department of State advisory remains at Level 4, Do Not Travel, for all of China. On Feb. 26, the Department of State also issued a Level 4, Do Not Travel, advisory for Iran. It advises that those currently in either country attempt to depart using commercial means, if possible. For those who stay, it advises following CDC guidelines and stocking up on food to limit movement outside the home. The CDC has issued a Level 3 alert, recommending the avoidance of all non-essential travel to China, Iran, South Korea and most countries in Europe, including the United Kingdom and Ireland.
▪
On March 15, the U.S. Department of State announced a global Level 3, Reconsider Travel, advisory covering all international countries and territories.
▪
From March 13, the United States introduced a 30-day ban on travelers from Europe, except for returning U.S. citizens, lawful permanent residents, spouses of U.S. citizens or lawful permanent residents, diplomatic and official travelers, air and sea crew members, members of the U.S. Armed Forces and their spouses and children, and certain other categories of travelers. On March 16, the ban was extended to cover the United Kingdom and Ireland.
▪
A rapidly increasing number of state parties have implemented restrictions on foreign nationals with travel history in Europe, Asia or altogether. Many airlines have limited or suspended services to and from these countries.
3 | Intelligence Update
G4S Corporate Risk Services
The WHO risk assessment in Situation Report 56 published March 16 is as follows: China: Very High; Regionally: Very High; Globally: Very High.
Infections and Deaths by Territory and Country The table below shows the latest number of confirmed cases of infection and death tied to the coronavirus by country, area and territory. Figure – Table of Infections and Deaths by Country, Area and Territory Coronavirus Outbreak Infection Numbers – 9 a.m. March 17 ET Total Confirmed Infections: 185,067 Deaths: 7,330 Recovered: 80,236 Total Countries, Areas and Territories with Confirmed Infections: 154 Country/Area/Territory
Infected/Deaths
Country/Area/Territory
Infected/Deaths
China
81,058; 3,230 dead
Uruguay
29; 0 dead
Italy
27,980; 2,158 dead
Moldova
29; 0 dead
Iran
14,991; 853 dead
Sri Lanka
29; 0 dead
Spain
11,279; 499 dead
Azerbaijan
28; 1 dead
South Korea
8,320; 81 dead
Kazakhstan
27; 0 dead
Germany
7,689; 20 dead
North Macedonia
26; 0 dead
France
6,664; 148 dead
Senegal
26; 0 dead
United States
4,661; 85 dead
Bosnia and Herzegovina
25; 0 dead
Switzerland
2,330; 21dead
Cambodia
24; 0 dead
United Kingdom
1,553; 56 dead
Oman
24; 0 dead
Norway
1,419; 3 dead
Tunisia
24; 0 dead
Netherlands
1,416; 24 dead
Afghanistan
22; 0 dead
Sweden
1,140; 7 dead
Dominican Republic
21; 1 dead
Austria
1,132; 3 dead
Lithuania
18; 0 dead
Belgium
1,058; 10 dead
Guadeloupe
18; 0 dead
Denmark
1,007; 4 dead
Martinique
16; 1 dead
Japan
833; 28 dead
Burkina Faso
15; 0 dead
Malaysia
566; 2 dead
Andorra
14; 0 dead
Canada
439; 4 dead
Maldives
13; 0 dead
Qatar
439; 0 dead
New Zealand
12; 0 dead
4 | Intelligence Update
G4S Corporate Risk Services
Australia
426; 5 dead
Jamaica
12; 0 dead
Czech Republic
383; 0 dead
Bolivia
11; 0 dead
Greece
352; 4 dead
French Guiana
11; 0 dead
Portugal
331; 1 dead
Bangladesh
10; 0 dead
Finland
321; 0 dead
Uzbekistan
10; 0 dead
Israel
304; 0 dead
Reunion
9; 0 dead
Slovenia
253; 1 dead
Paraguay
9; 0 dead
Singapore
243; 0 dead
Honduras
8; 0 dead
Brazil
234; 0 dead
Monaco
7; 0 dead
Bahrain
228; 1 dead
Rwanda
7; 0 dead
Estonia
225; 0 dead
Ukraine
7; 1 dead
Ireland
223; 2 dead
Liechtenstein
7; 0 dead
Poland
205; 5 dead
Guyana
7; 1 dead
Pakistan
194; 0 dead
Guatemala
6; 1 dead
Philippines
187; 12 dead
Ghana
6; 0 dead
Romania
184; 0 dead
Ethiopia
5; 0 dead
Iceland
180; 0 dead
Cameroon
5; 0 dead
Thailand
177; 1 dead
Cote d’Ivoire
5; 0 dead
Indonesia
172; 5 dead
Mongolia
4; 0 dead
Egypt
166; 4 dead
Cuba
4; 0 dead
Chile
156; 0 dead
Seychelles
4; 0 dead
Saudi Arabia
133; 0 dead
Trinidad and Tobago
4; 0 dead
Iraq
133; 10 dead
Aruba
3; 0 dead
Kuwait
130; 0 dead
Guam
3; 0 dead
India
129; 3 dead
Kenya
3; 0 dead
Lebanon
120; 3 dead
Nigeria
3; 0 dead
San Marino
109; 7 dead
Puerto Rico
3; 0 dead
United Arab Emirates
98; 0 dead
Congo (Kinshasa)
3; 0 dead
Luxembourg
94; 1 dead
Jersey
2; 0 dead
5 | Intelligence Update
G4S Corporate Risk Services
Russia
93; 0 dead
Saint Lucia
2; 0 dead
Peru
86; 0 dead
Namibia
2; 0 dead
Mexico
82; 0 dead
Kosovo
2; 0 dead
Taiwan
77; 1 dead
Guinea
1; 0 dead
Slovakia
72; 0 dead
Liberia
1; 0 dead
Panama
69; 1 dead
Tanzania
1; 0 dead
Bulgaria
67; 2 dead
Gabon
1; 0 dead
Argentina
65; 7 dead
Greenland
1; 0 dead
Serbia
65; 0 dead
Congo (Brazzaville)
1; 0 dead
Croatia
65; 0 dead
Saint Vincent and the Grenadines
1; 0 dead
South Africa
62; 0 dead
Somalia
1; 0 dead
Vietnam
61; 0 dead
Benin
1; 0 dead
Algeria
60; 4 dead
Republic of Congo
1; 0 dead
Ecuador
58; 2 dead
Togo
1; 0 dead
Colombia
57; 0 dead
Central African Republic
1; 0 dead
Brunei
54; 0 dead
The Bahamas
1; 0 dead
Armenia
52; 0 dead
Guernsey
1; 0 dead
Albania
51; 1 dead
Antigua and Barbuda
1; 0 dead
Hungary
50; 1 dead
Eswatini
1; 0 dead
Latvia
49; 0 dead
Bhutan
1; 0 dead
Turkey
47; 0 dead
Sudan
1; 1 dead
Cyprus
46; 0 dead
Nepal
1; 0 dead
Costa Rica
41; 0 dead
Suriname
1; 0 dead
Morocco
37; 1 dead
Holy See
1; 0 dead
Belarus
36; 0 dead
Mauritania
1; 0 dead
Georgia
34; 0 dead
Mayotte
1; 0 dead
Jordan
34; 0 dead
Equatorial Guinea
1; 0 dead
Venezuela
33; 0 dead
Malta
30; 0 dead
6 | Intelligence Update
G4S Corporate Risk Services
The map and chart below show the location of confirmed cases of infection and death tied to the coronavirus. Figure – Map and Chart of Confirmed Global Cases of COVID-19
Source: Johns Hopkins Center for Systems Science and Engineering (CSSE)
U.S. Government Measures On March 6, the U.S. government announced the allocation of $8.3 billion to combat the epidemic and preventive measures are continuing to escalate. Most state and local health departments are in the mitigation phase of responding to the outbreak, which includes conducting investigations into possible infections, establishing isolation orders and trying to disrupt chains of transmission. In the past week, there has been a rapid escalation in social distancing measures encouraged in several states, although such
7 | Intelligence Update
G4S Corporate Risk Services
mitigation strategies have been introduced unevenly across the country. In general, the state of epidemic response varies greatly from state to state. Clients are advised to research their own areas of operation and residence to ascertain the most accurate and up-to-date information. Work Cancellations ▪
Adjustments and cancellations to normal school schedules are growing throughout the United States. Many schools and colleges have announced that the remainder of the semester will be taught online.
▪
As of the week of March 16, most restaurants, movie theaters, bars, gyms and other public venues have been instructed to close in several states, including California, Ohio, Illinois, Massachusetts and Washington.
▪
The CDC has recommended an eight-week suspension of public gatherings of more than 50 people, but does not apply to schools or businesses. As with other epidemic countermeasures, these may vary significantly from place to place, and clients are advised to research their own locations.
▪
A growing number of employers have introduced work-from-home arrangements, including Microsoft, Google, Facebook, Amazon and Twitter, among others.
Medical Services ▪
Most medical services are currently operating normally with no signs of strained capacity, except for some isolated cases in badly hit Kings County, Washington.
▪
Many hospitals are starting to adjust their epidemic preparedness and response plans to take into account a potential heightened need for specialized equipment and the possibility of outsourcing patient services to off-site facilities, among other measures.
Travel Restrictions ▪
The U.S. Department of State advisory remains at Level 4, Do Not Travel, for all of China. On Feb. 26, the Department of State also issued a Level 4, Do Not Travel, advisory for Iran. It advises that those currently in either country attempt to depart using commercial means, if possible. For those who stay, it advises following CDC guidelines and stocking up on food to limit movement outside the home. The CDC has issued a Level 3 alert, recommending the avoidance of all non-essential travel to China, Iran, South Korea and most countries in Europe, including the United Kingdom and Ireland.
▪
On March 15, the U.S. Department of State announced a global Level 3, Reconsider Travel, advisory covering all international countries and territories.
▪
From March 13, the United States introduced a 30-day ban on travelers from Europe, except for returning U.S. citizens, lawful permanent residents, spouses of U.S. citizens or lawful permanent residents, diplomatic and official travelers, air and sea crew members, members of the U.S. Armed Forces and their spouses and children, and certain other categories of travelers. On March 16, the ban was extended to cover the United Kingdom and Ireland.
▪
From midnight March 16, all residents in San Francisco and five other Bay Area counties have been ordered to stay at home in an effort to halt the spread of the virus. Similar to lockdown measures taken in China, Italy and Spain, this is the first restriction on the free movement of people to have been introduced within the United States.
8 | Intelligence Update
G4S Corporate Risk Services
▪
A growing number of U.S. companies have cancelled all international business travel for their employees.
National/State of Emergency ▪
On March 13, the president of the United States declared a national emergency. As of the evening of March 16, close to 40 states have declared a state of emergency. The National Guard has been activated in at least 18 states, and 19 states have placed restrictions on state employees traveling.
Global Measures Preventive measures taken by the international community also continue to escalate. Travel Restrictions ▪
Airports across the world have introduced enhanced screening measures to prevent the further international spread of the disease. A rapidly increasing number of state parties have implemented restrictions on foreign nationals with travel history in Europe, Asia or altogether. Many airlines have limited or suspended international services. Although specific regulations may vary, foreign nationals are typically barred entry if they have been to these countries within the past 14 days upon arrival at customs. At least 43 airlines around the world have suspended flights to China, Italy, Iran, South Korea and/or Japan. The WHO is working on recommendations for resuming flights.
▪
On March 9, Italy extended travel restrictions from the northern region to encompass the entire country, limiting the free movement of approximately 60 million people. Police are enforcing quarantine restrictions and imposing fines on anyone who attempts to violate or evade the measures. Residents are required to have special passes if they wish to travel internally within the country.
▪
On March 14, Spain declared a state of emergency and enforced a similar lockdown to that enforced in Italy. Residents have been ordered to stay at home and non-essential shops, entertainment venues, bars and restaurants have been closed. Residents are only allowed out to travel to work, buy groceries and medicine, and take care of dependents and elderly family members.
▪
An increasing number of countries and cities are introducing travel and public transit restrictions of various degrees. If traveling, clients are advised to research their route and destination to ascertain up-to-date information.
Virus Factsheet Key aspects of the Wuhan coronavirus, or “2019nCoV,” are still relatively poorly understood. The following information is derived from WHO Situation Reports and other sources: ▪
Incubation Period: 1-14 days, but generally 3-7 days. Recent research by a Chinese team found that the incubation period could be as long as 24 days. The Hubei government has said the incubation period could be as long as 27 days, based on data from one case. According to the WHO, the median incubation period has been further refined to 5-6 days.
▪
Severity: Most people display relatively mild symptoms. Current estimates suggest that about 15% progress to severe disease with 3% becoming critical, including pneumonia and respiratory failure. The mortality rate for confirmed infections is about 2%, with some experts expecting this number to fall as milder cases are found. However, these preliminary estimations should be treated with caution. The mortality rate of seasonal flu is below 0.1%. According to a WHO statement on March 9, more than 70% of coronavirus cases in China have recovered.
9 | Intelligence Update
G4S Corporate Risk Services
▪
Transmissibility: The virus is human transmissible. Recent research by Chinese scientists supports asymptomatic spread and concludes that the virus behaves similarly to the flu, suggesting that it may spread more easily than previously thought. Chinese researchers have documented the case of a woman who spread the virus to five family members without showing symptoms herself. In Chengdu, a recovered patient was readmitted to hospital after once again testing positive for the virus (an earlier test may have been a false negative). On Feb. 22, Wuhan subsequently mandated a 14 day quarantine for all patients cured of the virus. The reproduction number of the virus, expressed as “R0” (R-naught), which indicates how many additional infections will result from each infection, remains uncertain. In a disease with a value R-naught = 1 each infection would be expected to cause one additional infection; the WHO published an estimated R-naught of 1.4 to 2.5, although some teams have placed this number higher. o
▪
Routes of transmission are believed to include respiratory droplets and close physical contact. It is also likely that the disease is transmissible via contact with contaminated surfaces, where the virus may survive for some time. There is little evidence of transmission via the fecal-oral route. There has been some misinformation that the virus may be able to spread long distances through the air. This is false.
Treatment: The only proven available treatment for the disease is standard supportive care. There is anecdotal evidence that anti-viral and AIDS drugs may be useful in treating patients, but these treatments have not yet been validated.
BUSINESS RISKS Business Continuity The coronavirus outbreak presents a heightened business risk environment for multinational corporations operating across the globe. The widespread introduction of quarantine measures and travel restrictions present a significant business continuity challenge for businesses dependent on person-to-person services and transactions, such as those operating in the tourism, hospitality, retail, retail-based financial services and banking sectors, among others. In addition, the closure of production facilities and travel bans are creating supply-chain challenges and logistical problems for the transfer of goods, equipment and the ability for employees to reach their places of work. Clients are advised to remain up to date with national and local regulations related to the crisis, and to note that measures adopted by national and local governments may not be uniform. On a broader level, the coronavirus outbreak continues to take a toll on global markets. Amid market jitters caused by the outbreak, on March 16 the Dow experienced its biggest ever points loss. There are mounting fears of a global recession despite recent efforts taken by various central banks to prop up the market and reassure investor confidence. Whether planning to mitigate the heightened medical or business risk environment, companies — especially, but not limited to, those with a footprint in the worst-hit countries — should prepare for the crisis and its potential negative effects to be felt for months rather than weeks.
Security Response Benchmarking Multinational firms have begun adopting various policies in response to the outbreak, including the following: ▪
Restricting all non-essential international travel to China, Europe and other badly affected countries, or altogether.
▪
Allowing flexible working arrangements, including working from home.
10 | Intelligence Update
G4S Corporate Risk Services
▪
For employees returning from China, Europe and other badly affected countries, mandatory work from home for a set period, for example 14 days, to mitigate the risk of passing infection to other employees.
▪
Mandating that employees presenting flu-like symptoms obtain a diagnosis before returning to work.
▪
Some companies in badly affected European and Asian countries have introduced controls at work, including carrying out fever checks on employees at entrances and restricting guest access to company premises.
▪
A large number of major multinational corporations and retailers (see a list here) have closed their offices, stores or suspended operations in countries experiencing a rapid uptick in infections, including the United States, Canada and Western Europe. These measures follows similar actions taken in badly hit Asian countries, such as mainland China and Hong Kong, some of which are gradually resuming operations.
RECOMMENDATIONS FOR TRAVELERS According to the CDC, travelers should avoid all non-essential travel to China, Iran, South Korea and most countries in Europe, including the United Kingdom and Ireland. If traveling to any of these countries, you are recommended to: ▪
Avoid contact with sick people.
▪
Discuss travel to with your health care provider. Older adults and travelers with underlying health issues may be at risk for more severe disease.
▪
Avoid animals (alive or dead), animal markets and products that come from animals (such as uncooked meat).
▪
Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.
Those who have become ill during a 14-day period following travel to these countries should: ▪
Seek medical care right away. Before you go to a doctor’s office or emergency room, call ahead and tell them about your recent travel and your symptoms.
▪
Avoid contact with others.
▪
Do not travel while sick.
▪
Cover your mouth and nose while sneezing with a sleeve or tissue, not with the hands.
▪
Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.
11 | Intelligence Update
G4S Corporate Risk Services
RECOMMENDATIONS FOR BUSINESSES According to the CDC, businesses are recommended to: Actively encourage sick employees to stay home ▪
Employees who have symptoms of acute respiratory illness should be recommended to stay home and not come to work until they are free of fever (100.4° F [37.8° C] or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines (e.g. cough suppressants). Employees should notify their supervisor and stay home if they are sick.
▪
Ensure that company sick leave policies are flexible and consistent with public health guidance and that employees are aware of these policies.
▪
If your company uses vendors/businesses who provide contract or temporary employees, talk with them about the importance of sick employees staying home and encourage them to develop nonpunitive leave policies.
▪
Do not require a healthcare provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work, as healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way.
▪
Employers should maintain flexible policies that permit employees to stay home to care for a sick family member. Employers should be aware that more employees may need to stay at home to care for sick children or other sick family members than is usual.
Separate sick employees ▪
Employees who appear to have acute respiratory illness symptoms (i.e. cough, shortness of breath) upon arrival to work or become sick during the day should be separated from other employees and be sent home immediately. Sick employees should be instructed to cover their noses and mouths with a tissue when coughing or sneezing (or an elbow or shoulder if no tissue is available).
Emphasize staying home when sick, respiratory etiquette and hand hygiene by all employees ▪
Place posters that encourage staying home when sick, cough and sneeze etiquette, and hand hygiene at the entrance to your workplace and in other workplace areas where they are likely to be seen.
▪
Provide tissues and no-touch disposal receptacles for use by employees.
▪
Instruct employees to clean their hands often with an alcohol-based hand sanitizer that contains at least 60-95% alcohol, or wash their hands with soap and water for at least 20 seconds. Soap and water should be used preferentially if hands are visibly dirty.
▪
Provide soap and water and alcohol-based hand rubs in the workplace. Ensure that adequate supplies are maintained. Place hand rubs in multiple locations or in conference rooms to encourage hand hygiene.
Perform routine environmental cleaning ▪
Routinely clean all frequently touched surfaces in the workplace, such as workstations, countertops and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label.
12 | Intelligence Update
G4S Corporate Risk Services
▪
No additional disinfection beyond routine cleaning is recommended at this time.
▪
Provide disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls and desks) can be wiped down by employees before each use.
Advise employees before traveling to take certain steps ▪
Check the CDC’s Traveler’s Health Notices for the latest guidance and recommendations for each country to which you will travel. Specific travel information for travelers going to and returning from China, and information for aircrew, can be found on the CDC website.
▪
Advise employees to check themselves for symptoms of acute respiratory illness before starting travel and notify their supervisor and stay home if they are sick.
▪
Ensure employees who become sick while traveling or on temporary assignment understand that they should notify their supervisor and should promptly call a healthcare provider for advice if needed.
▪
If outside the United States, sick employees should follow your company’s policy for obtaining medical care or contact a healthcare provider or overseas medical assistance company to assist them with finding an appropriate healthcare provider in that country. A U.S. consular officer can help locate healthcare services. However, U.S. embassies, consulates and military facilities do not have the legal authority, capability and resources to evacuate or give medicines, vaccines or medical care to private U.S. citizens overseas.
Additional measures in response to currently occurring sporadic importations of COVID-19 ▪
Employees who are well but who have a sick family member at home with COVID-19 should notify their supervisor and refer to CDC guidance for how to conduct a risk assessment of their potential exposure.
▪
If an employee is confirmed to have COVID-19, employers should inform fellow employees of their possible exposure to COVID-19 in the workplace but maintain confidentiality as required by the Americans with Disabilities Act (ADA). Employees exposed to a co-worker with confirmed COVID19 should refer to CDC guidance for how to conduct a risk assessment of their potential exposure.
In addition to these recommendations, the CDC advises businesses to create an Infectious Disease Outbreak Response Plan. Guidance and considerations for creating a plan can be found here.
EMERGENCY CONTACTS G4S Risk Operations Center For questions regarding this report or for immediate assistance, please call: ▪
G4S Risk Operations Center: (866) 604-1226
▪
Alternate Phone: (866) 943-8892
13 | Intelligence Update
G4S Corporate Risk Services