INTELLIGENCE UPDATE Coronavirus Pandemic – April 27, 2020
TABLE OF CONTENTS CURRENT SITUATION │3 Travel and Health Advisory │4 Infections and Deaths by Territory and Country │4 U.S. Government Measures │7 Work Cancellations│8 Medical Services│8 Travel Restrictions and Stay at Home Orders│9 National/State of Emergency│10
Global Measures │10 Argentina│10 Barbados│10 Brazil│10 Canada│11 Chile│11 Colombia│11 Costa Rica│11 Ecuador│12 El Salvador│12 Guatemala│12 Mexico│12 Nicaragua│12 Paraguay│13 Peru│13 Puerto Rico│13 Saint Lucia│13 Trinidad and Tobago│14 Uruguay│14
Virus Factsheet │14
BUSINESS RISKS │15 Business Continuity│15 Security Response Benchmarking │15
RECOMMENDATIONS FOR TRAVELERS │16 RECOMMENDATIONS FOR BUSINESSES │16 EMERGENCY CONTACTS │18 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.
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CURRENT SITUATION As of April 27, 2020, the COVID-19 pandemic continues to escalate. As confirmed global cases near 3 million, the United States remains the global epicenter of the coronavirus pandemic, with 965,933 confirmed cases compared to 759,786 on April 20, a 27% increase in cases for the week. The United States currently has the highest number of new cases globally and accounts for more than one-third of daily deaths worldwide. This past week, confirmed coronavirus-related deaths in the United States surpassed 50,000. While national numbers of infections and hospitalizations are showing signs of plateauing, each state is at different points in their epidemic. Social distancing measures are showing early signs that they are working. However, owing to a lack of testing and other factors an accurate picture of the geographic spread and prevalence of infection remains difficult to determine. Some states have either started or made plans to ease lockdown restrictions. Despite a recent rise in infections and deaths, on April 23 Georgia became the first state to begin easing social-distancing measures and allowing a range of non-essential businesses to reopen. Governor Brian Kemp’s move to reopen the state has generated criticism as several leading government and health authorities have expressed concern that this move could result in an exponential growth in new infections and lead to a lockdown for a second time. To varying degrees, others states such as Alaska, Colorado, Mississippi, Montana, Oklahoma, Tennessee and South Carolina are set to lift restrictions in the coming weeks or have in recent days already started to do so. The World Health Organization and senior U.S. government experts have cautioned that a “second wave” of infections could be sparked if national and local governments prematurely lift stay-at-home restrictions. The CDC has advised that states should only lift restrictions once state hospitalization rates have recorded a decline for 14 days in a row. Recently published CDC forecasting models have shown that a reduction in social distancing measures could result in a more rapid rise in deaths over the next four weeks compared to models based on maintaining existing social-distancing orders. On April 21, CDC Director Robert Redfield warned of the possibility that a new wave of COVID-19 infections next winter could be worse than the first wave we are currently experiencing. This is largely because a second wave, if not halted by mitigation measures or a vaccine, could coincide with the start of the winter flu season and overwhelm health systems. Highlights: ▪
As of 8 a.m. ET on Monday, April 27, there were 2,994,690 confirmed global cases and 207,270 associated deaths. This is up from 2,416,135 cases and 165,939 deaths reported on April 20. Infections have been recorded in 185 countries and territories.
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In the United States, New York (288,045) remains the worst-affected state, but a continuing decline in recorded hospitalizations is tentatively encouraging. According to preliminary results from a recent anti-body study, state officials estimate that up to 2.7 million New York residents could have been infected — more than 10 times the number of officially recorded cases at the time.
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According to a WHO statement this week, there is no evidence that those who have recovered from COVID-19 and have antibodies are protected from reinfection. This finding contradicts international and U.S. reopening strategies based on the premise of immunity post recovery.
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Worker activist groups at several major U.S. retail chains, including Amazon, Whole Foods and Target have announced plans to hold “sickout” protests on May 1 — International Workers’ Day — in response to alleged workplace safety concerns.
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Anti-lockdown protests have occurred in at least 12 states, with more planned over the coming weeks. Thus far, the protests have ranged in size from dozens of protesters to a few thousand. While most have primarily involved ordinary citizens, in some locations there have been reports of the involvement of armed far-right groups.
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Travel and Health Advisory U.S. government agencies maintain strict travel advisories. ▪
On March 19, the U.S. Department of State announced a global Level 4, Do Not Travel, advisory for all international countries and territories. It advises that those currently overseas attempt to depart using commercial means, if possible. For those who stay, it advises following CDC guidelines and limiting movement outside the home.
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The CDC has issued a Level 3 alert, recommending the avoidance of non-essential travel to all global destinations. Carefully considering the risk of travel within the United States, especially to areas with high rates of infection, has also been advised.
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On March 28, the CDC issued its first domestic travel advisory for New York, New Jersey and Connecticut. Residents of these states have been advised to avoid non-essential domestic travel for 14 days. Exceptions have been made for employees of critical infrastructure industries (see advisory list of critical infrastructure employees here).
The WHO risk assessment in Situation Report 97 published April 26 is as follows: Global: Very High. To prevent transmission of the virus, the CDC has advised all Americans to wear cloth masks when outside of the home in public settings where social distancing measures are hard to maintain. If cloth masks are not available, the CDC has recommended the use of improvised DIY face coverings using household items or made from common materials (see guidance here).
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 Infection Numbers – 8 a.m. April 27 ET Total Confirmed Infections: 2,994,690 Deaths: 207,270 Recovered: 881,635 Total Countries, Areas and Territories with Confirmed Infections: 185 Country/Area/Territory
Infected/Deaths
Country/Area/Territory
Infected/Deaths
United States
965,933; 54,877 dead
Niger
696; 29 dead
Spain
236,199; 23,521 dead
Costa Rica
695; 6 dead
Italy
197,675; 26,644 dead
Kyrgyzstan
695; 8 dead
France
162,220; 22,890 dead
Senegal
671; 9 dead
Germany
157,781; 5,976 dead
Honduras
661; 61 dead
United Kingdom
154,037; 20,795 dead
Burkina Faso
632; 42 dead
Turkey
110,130; 2,805 dead
Uruguay
606; 15 dead
Iran
91,472; 5,806 dead
Sri Lanka
567; 7 dead
Russia
87,147; 794 dead
San Marino
538; 41 dead
China
83,912; 4,637 dead
Kosovo
510; 12 dead
Brazil
63,100; 4,286 dead
Guatemala
500; 15 dead
Canada
47,147; 2,663 dead
Georgia
496; 6 dead
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Belgium
46,687; 7,207 dead
Congo (Kinshasa)
459; 28 dead
Netherlands
38,040; 4,491 dead
Malta
450; 4 dead
Switzerland
29,061; 1,640 dead
Jordan
447; 7 dead
India
27,977; 884 dead
Somalia
436; 23 dead
Peru
27,517; 728 dead
Taiwan*
429; 6 dead
Portugal
23,864; 903 dead
Mali
389; 23 dead
Ecuador
22,719; 576 dead
Kenya
363; 14 dead
Ireland
19,262; 1,087 dead
Jamaica
350; 7 dead
Sweden
18,640; 2,194 dead
West Bank and Gaza
342; 2 dead
Saudi Arabia
17,522; 139 dead
Mauritius
332; 9 dead
Israel
15,466; 202 dead
Venezuela
325; 10 dead
Austria
15,274; 549 dead
El Salvador
323; 8 dead
Mexico
14,677; 1,351 dead
Montenegro
321; 7 dead
Singapore
14,423; 12 dead
Tanzania
299; 10 dead
Japan
13,441; 372 dead
Vietnam
270; 0 dead
Chile
13,331; 189 dead
Equatorial Guinea
258; 1 dead
Pakistan
13,328; 281 dead
Sudan
237; 21 dead
Poland
11,761; 539 dead
Paraguay
228; 9 dead
Romania
11,339; 631 dead
Maldives
214; 0 dead
Belarus
11,289; 75 dead
Congo (Brazzaville)
200; 6 dead
Qatar
11,244; 10 dead
Rwanda
191; 0 dead
Korea, South
10,738; 243 dead
Gabon
176; 3 dead
United Arab Emirates
10,349; 76 dead
Burma
146; 5 dead
Indonesia
9,096; 765 dead
Brunei
138; 1 dead
Ukraine
9,009; 220 dead
Ethiopia
124; 3 dead
Denmark
8,896; 422 dead
Liberia
124; 12 dead
Philippines
7,777; 511 dead
Madagascar
124; 0 dead
Norway
7,527; 202 dead
Cambodia
122; 0 dead
Czech Republic
7,408; 221 dead
Trinidad and Tobago
116; 8 dead
Australia
6,714; 83 dead
Cabo Verde
106; 1 dead
Serbia
6,630; 125 dead
Togo
98; 6 dead
Dominican Republic
6,135; 278 dead
Monaco
94; 4 dead
Bangladesh
5,913; 152 dead
Sierra Leone
93; 4 dead
Malaysia
5,820; 99 dead
Zambia
88; 3 dead
Panama
5,779; 165 dead
Liechtenstein
82; 1 dead
Colombia
5,379; 244 dead
Bahamas
80; 11 dead
Finland
4,695; 190 dead
Barbados
79; 6 dead
South Africa
4,546; 87 dead
Uganda
79; 0 dead
Egypt
4,534; 317 dead
Mozambique
76; 0 dead
Morocco
4,115; 161 dead
Guyana
74; 8 dead
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Argentina
3,892; 192 dead
Haiti
74; 6 dead
Luxembourg
3,723; 88 dead
Benin
64; 1 dead
Moldova
3,408; 101 dead
Libya
61; 2 dead
Algeria
3,382; 425 dead
Eswatini
59; 1 dead
Kuwait
3,288; 22 dead
Guinea-Bissau
53; 1 dead
Thailand
2,931; 52 dead
Nepal
52; 0 dead
Kazakhstan
2,791; 25 dead
Chad
46; 0 dead
Bahrain
2,647; 8 dead
Syria
43; 3 dead
Hungary
2,583; 280 dead
Eritrea
39; 0 dead
Greece
2,517; 134 dead
Mongolia
38; 0 dead
Oman
2,049; 10 dead
Malawi
34; 3 dead
Croatia
2,030; 55 dead
Zimbabwe
31; 4 dead
Uzbekistan
1,887; 8 dead
Angola
26; 2 dead
Iraq
1,820; 87 dead
Antigua and Barbuda
24; 3 dead
Armenia
1,808; 29 dead
Timor-Leste
24; 0 dead
Iceland
1,792; 10 dead
Botswana
22; 1 dead
Afghanistan
1,703; 57 dead
Central African Republic
19; 0 dead
Estonia
1,647; 50 dead
Laos
19; 0 dead
Azerbaijan
1,645; 21 dead
Belize
18; 2 dead
Cameroon
1,621; 56 dead
Fiji
18; 0 dead
Ghana
1,550; 11 dead
Grenada
18; 0 dead
Bosnia and Herzegovina
1,516; 59 dead
Dominica
16; 0 dead
New Zealand
1,469; 19 dead
Namibia
16; 0 dead
Lithuania
1,449; 41 dead
Saint Kitts and Nevis
15; 0 dead
Slovenia
1,402; 83 dead
Saint Lucia
15; 0 dead
North Macedonia
1,386; 61 dead
Saint Vincent and the Grenadines
14; 0 dead
Slovakia
1,381; 18 dead
Nicaragua
13; 3 dead
Cuba
1,369; 54 dead
Burundi
11; 1 dead
Bulgaria
1,348; 56 dead
Seychelles
11; 0 dead
Nigeria
1,273; 40 dead
Gambia
10; 1 dead
Cote d'Ivoire
1,150; 14 dead
Suriname
10; 1 dead
Djibouti
1,023; 2 dead
Holy See
9; 0 dead
Guinea
996; 7 dead
Papua New Guinea
8; 0 dead
Bolivia
950; 50 dead
Bhutan
7; 0 dead
Tunisia
949; 38 dead
Mauritania
7; 1 dead
Latvia
818; 13 dead
South Sudan
6; 0 dead
Cyprus
817; 14 dead
Western Sahara
6; 0 dead
Andorra
738; 40 dead
Sao Tome and Principe
4; 0 dead
Albania
726; 28 dead
Yemen
1; 0 dead
Lebanon
710; 24 dead
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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 Confirmed cases of infection have been recorded across all 50 states, Puerto Rico, Guam, the U.S. Virgin Islands and Washington, D.C. 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. A $2.2 trillion rescue package, intended to provide support to U.S. workers, businesses, the healthcare system and state and local governments, was approved by the U.S. government on March 27. On April 24, the U.S. government
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approved a $484 billion relief package primarily to provide emergency financial aid to small businesses and hospitals. On April 16, the U.S. President unveiled a three-phase-program for state and local officials to implement to lift lockdown restrictions in areas with a downward trajectory of infection cases and strong testing. It is likely that efforts to lift restrictions will vary on a state-by-state basis and at differing speeds, with several governors announcing that they will only gradually ease restrictions after having increased rates of testing. Social distancing measures remain in place in most states, although such mitigation strategies have been introduced unevenly across the country. In general, the state of epidemic response varies from state to state and county to county. 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 widespread throughout the United States. Many schools and colleges have announced that the remainder of the semester will be taught online.
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As of the week of April 27, most restaurants, movie theaters, bars, gyms and other public venues remain closed in most states. Most businesses have been advised to remain shut until at least the end of April.
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Some states have either started or made plans to ease lockdown restrictions. Despite a recent rise in infections and deaths, on April 23 Georgia became the first state to begin easing socialdistancing measures and allowing a range of businesses to reopen. To varying degrees, others states such as Alaska, Colorado, Mississippi, Montana, Oklahoma, Tennessee and South Carolina, are set to lift restrictions in the coming weeks or have in recent days already started to do so.
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Most state and county authorities are continuing to encourage or order businesses, institutions and organizations to let “non-essential” employees work remotely from home. As with other COVID-19 countermeasures these orders may vary significantly from place to place and clients are advised to research their own locations.
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In some states, stay-at-home-orders that were due to expire by the end of the month have been extended, in some cases with modifications that to a greater or lesser extent ease some restrictions currently in place. For example, Illinois Governor J.B. Pritzker has extended a modified version of the state’s stay-at-home order until May 30. Among other stipulations, the modifications include a requirement to wear masks in public settings where social distancing cannot be maintained, a phased reopening of state parks, and allowing certain non-essential retail stores to reopen to service phone and online orders for pick-up and delivery.
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Most employers are maintaining work-from-home arrangements for “non-essential staff.”
Medical Services ▪
Most medical services across the country are currently operating normally with few signs of strained capacity. In some badly affected states, such as New York, some previously overwhelmed hospitals have reported that while the volume of patients is high, it is manageable. Many states are continuing to step up efforts to acquire ventilators and other vital medical equipment amid fears of a shortage to deal with expected demand.
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Many hospitals have adjusted 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.
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Several states have been, or are, setting up drive-thru testing sites offering screening services.
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In badly affected New York City, five emergency field hospitals are being constructed in Manhattan, Brooklyn, Queens, Staten Island and the Bronx, with a combined capacity of more than 4,000 beds. The USNS Comfort, a Navy hospital ship equipped with 1,000 beds and 12 operating rooms, arrived in New York on March 30. Another Navy hospital ship, the USNS Mercy, arrived in Los Angeles on March 27 to provide emergency services.
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Government authorities from several states reported low supplies of diagnostic testing kits, critical medical equipment, ventilators and personal protective equipment (PPE).
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Federal authorities are continuing to ramp up efforts to secure medical equipment and Personal Protective Equipment (PPE). On April 8, the first contract for the production of ventilators under the Defense Production Act (DPA) was agreed with General Motors, as announced by the Department of Health and Human Services (HHS). The contract stipulates that by August, 30,000 ventilators will be delivered to the Strategic National Stockpile, of which 6,132 may be delivered by June 1. A second contract under the DPA was announced with Philips for the delivery of 2,500 ventilators by the end of May and 43,000 by the end of December. On April 8, HHS also announced it had reached an agreement with DuPont to deliver 450,000 TYVEK® protective suits for healthcare workers within the week, 2.25 million suits within the next five weeks and an option for additional deliveries in the future. Several other contracts have since been announced. In total, there are contracts in place to secure 41,000 ventilators by the end of May and more than 187,000 by year’s end.
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On April 10, HHS announced the initial delivery of $30 billion in relief funds to hospitals and healthcare providers to assist with coronavirus-related expenses and to fund patient testing and treatment.
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On April 16, the FDA announced that it has approved the production of a new type of nasal swab to speed up coronavirus testing.
Travel Restrictions and Stay at Home Orders ▪
On March 19, the U.S. Department of State announced a global Level 4, Do Not Travel, advisory for all international countries and territories. It advises that those currently overseas attempt to depart using commercial means, if possible. For those who stay, it advises following CDC guidelines and limiting movement outside the home.
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The CDC has issued a Level 3 alert, recommending the avoidance of non-essential travel to all global destinations. Carefully considering the risk of travel within the United States, especially to areas with high rates of infection, has also been advised.
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On March 28, the CDC issued its first domestic travel advisory for New York, New Jersey and Connecticut. Residents of these states have been advised to avoid non-essential domestic travel for 14 days. Exceptions have been made for employees of critical infrastructure industries (see advisory list of critical infrastructure employees here).
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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.
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All non-essential travel across the U.S.-Mexico and U.S.-Canada borders has been temporarily banned. On April 18, the U.S. and Canada announced that non-essential travel across the U.S.Canada border will be extended to May 21. Trade, commerce, medical and education related travel will be permitted to continue across the border. U.S. citizens, permanent residents and those with work permits will be exempt from the ban.
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At least 45 states have ordered residents to stay home, shelter in place, or some variation thereof (see a list here). Cities and counties in several other states have announced similar orders, which generally place restrictions on the free movement of people outside of the home. There are exceptions for those working essential jobs and for collecting critical supplies, such as groceries and medicine.
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States are introducing measures at airports and state borders to screen travelers from badly affected states, such as New York. In addition, at least 19 states have mandated that out of state and returning travelers from badly affected states are required to self-isolate for 14 days.
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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. All U.S. states, territories and the District of Columbia have declared a state of emergency. The National Guard has deployed more than 33,000 troops across the nation.
Global Measures Preventive measures taken by the international community also continue to escalate. Argentina Current situation: 3,892 confirmed cases and 192 deaths have been reported. A nationwide mandatory quarantine will be in effect until May 10. Infection locations: Most confirmed cases have been recorded in Buenos Aires, although all regions have been affected. Travel restrictions: Borders will remain closed for foreign nationals and non-residents. All commercial flights have been suspended until September 1. Barbados Current situation: 79 confirmed cases and six deaths have been reported. A public health emergency was declared on March 26. A nationwide curfew from 6 p.m. to 6 a.m. daily is in effect until further notice. Infection locations: Cases have been confirmed in the capital of Bridgetown. Travel restrictions: Barbados’ airspace will be closed to international commercial passenger flights through May 3. All persons arriving in Barbados will undergo a 14-day quarantine at a government administered facility. Brazil Current situation: 63,100 confirmed cases and 4,286 deaths have been reported. No national quarantine is in effect in Brazil; however, several states have implemented their own restrictions. Statewide quarantine and social distancing measures in Sao Paulo are in effect until May 10. Infection locations: The southeastern and northeastern parts of the country have the most confirmed cases of infection, with Sao Paulo being the most-affected state.
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Travel restrictions: As of March 30, all foreign travelers are barred entry into Brazil for the next 30 days. There are few exceptions. Brazil's land borders are closed to non-essential traffic. Canada Current situation: 47,147 confirmed cases and 2,663 have been reported. Provincial governments have introduced a number of restrictive measures, including a ban on social gatherings. Authorities are urging the public to stay at home and many businesses are closed. Infection locations: Cases have been confirmed in all of Canada’s provinces and territories, except for Nunavut. Ontario and Quebec are among the worst-affected provinces. Travel restrictions: Canada will require all air travelers to wear face masks beginning April 20. As of April 8, most foreign nationals are prohibited from entering Canada, with certain exceptions. As of March 30, individuals showing symptoms of COVID-19 must be refused boarding on domestic flights and some intercity train services. Canada announced an Emergency Order under the Quarantine Act on March 26, which requires any person entering the country by air, sea, or land to self-isolate for 14 days whether or not they have symptoms of coronavirus. In addition, all of Canada’s provinces/territories have declared a state of emergency, which can permit restrictions or denial of entry to domestic travel. As of April 27, several provinces have various local border restrictions in place, including News Brunswick, the Northwest Territories, Nunavut, Prince Edward Island, and Quebec. The land border between Canada and the U.S. will remained closed to non-essential traffic until May 21. The closure permits border crossings for cargo, trade and healthcare workers. Chile Current situation: 13,331 confirmed cases and 189 deaths have been reported. Stay-at-home measures are in effect in northern Santiago and Nunoa, western Puente Alto, northeastern San Bernardo, and El Bosque in Santiago Metropolitan Region, as well as in Arica, Temuco, Osorno and Punta Arenas, until April 30. Similar measures have been imposed in the Independencia, Quinta Normal and Pedro Aguirre Cerda regions of Santiago. Infection locations: The overwhelming majority of cases have occurred in the Santiago metropolitan area, but all regions have been affected. Travel restrictions: All borders are closed until at least April 29. Nationals and residents arriving from China, South Korea, Japan, Iran, Italy, Spain, Germany, France, Argentina, Bolivia or Peru are subject to a 14-day quarantine. Colombia Current situation: 5,379 confirmed cases and 244 deaths have been reported. The Colombian government implemented a nationwide quarantine that will remain in place until May 11 but will allow some sectors of the economy, such as construction and manufacturing, to reopen. Infection locations: Most confirmed cases have occurred in Bogota, Valle del Cauca and Antioquia departments. Travel restrictions: All international travelers will be prohibited from entering the country until May 30. Colombia implemented an entry ban on all foreign travelers from abroad on March 16. Travelers entering the country from abroad are subject to a 14-day quarantine. Costa Rica Current situation: 695 confirmed cases and six deaths have been reported.
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Infection locations: Positive cases have been confirmed in all seven of Costa Rica’s provinces, with San Jose being most affected. Travel restrictions: Restrictions on the use of private vehicles continue through April 30, with the closure of all air, land and maritime borders being extended to May 15. Costa Rican citizens and residents are subject to a 14-day quarantine upon entry. Ecuador Current situation: 22,719 confirmed cases and 576 deaths have been reported. A nationwide curfew remains in effect from 2 p.m. to 5 a.m. daily. Infection locations: Positive cases have been confirmed in all regions, with Guayaquil being the most affected. Travel restrictions: All international arrivals to Ecuador by air have been suspended. Land borders have also been closed. In addition, there are restrictions in place for travel within Ecuador. Reports indicate that those attempting inter-provincial domestic travel must obtain a safe-passage document from authorities. El Salvador Current situation: 323 confirmed cases and eight deaths have been reported. A mandatory 24/7 nationwide quarantine is in effect until May 6. Infection locations: Confirmed or suspected cases have been recorded in the San Salvador area. Travel restrictions: Borders are closed to non-residents and non-diplomats. All citizens/residents arriving in El Salvador must remain in quarantine for 30 days. Guatemala Current situation: 500 confirmed cases and 15 deaths have been reported. A nationwide curfew is currently in effect until at least May 3. All movement is restricted between 6 p.m. and 4 a.m. Infection locations: Confirmed cases have been reported mostly in Guatemala City. Travel restrictions: All domestic and international flight operations are suspended until April 30. Mexico Current situation: 14,677 confirmed cases and 1,351 deaths have been reported. A suspension on all non-essential activities in the public and private sector is in effect until May 30. Infection locations: Mexico City, the State of Mexico, and Baja California are among the most-affected areas. Travel restrictions: The land border between the U.S. and Mexico closed on March 21 to all non-essential traffic. This closure was extended on April 20 for an additional 30 days. It applies primarily to tourism and recreational travel. Cargo, trade, and healthcare workers will still be able to cross the border. Nicaragua Current situation: 13 confirmed cases and three deaths have been reported. As of April 27, few restrictions have been implemented in the country.
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Infection locations: Confirmed or suspected cases have been reported in the country’s capital of Managua. Travel restrictions: Reports indicate that the Nicaraguan government has closed its borders. All international flights have been effectively suspended. All international travelers with suspected cases of infection are subject to a 10-day quarantine. Paraguay Current situation: 228 confirmed cases and nine deaths have been reported. Nationwide quarantine measures will remain in effect until May 3, after which officials will gradually ease restrictions, implementing “Smart Quarantine” measures. Infection locations: Confirmed cases have been reported in all departments, with Asuncion being the hardest hit. Travel restrictions: Borders are closed for non-residents. All international commercial and air travel is banned until further notice. All travelers must undergo a 14-day quarantine. Peru Current situation: 27,517 confirmed cases and 728 deaths have been reported. A nationwide quarantine, including restrictions on inter-city travel and overnight curfews, has been extended until at least May 10. Certain economic activities are scheduled to resume beginning May 4. Infection locations: Confirmed or suspected cases have been recorded all of Peru’s departments. More than half of all cases have been confirmed in Lima. Travel restrictions: All international borders are closed at this time. Domestic travel by air is banned due to a state of emergency. Puerto Rico Current situation: 1,371 confirmed cases and 84 deaths have been reported. A state of emergency was declared on the island on March 12. An island-wide lockdown has been extended until at least May 3, with a curfew in effect from 9 p.m. to 5 a.m. Infection locations: Confirmed cases have been recorded in all regions, with metro San Juan being most affected. Travel restrictions: All ports, ferries and cruise services have been suspended. There is an entry ban for nearly all foreign nationals who have been in China, Iran and certain European countries, including the UK and Ireland, at any point within 14 days of their scheduled travel to the U.S. Saint Lucia Current situation: 15 confirmed cases and 0 deaths have been reported. The Government of Saint Lucia declared a national state of emergency, effective March 23. A 10-hour curfew from 7 p.m. to 5 a.m. will remain in place until May 31. Infection locations: Confirmed or suspected cases have been reported in several quarters. Travel restrictions: The government of Saint Lucia has closed all air, sea and land borders to international arrivals. Cruise ships are not permitted to dock in Saint Lucia. Cargo operations are exempted.
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Trinidad and Tobago Current situation: 116 confirmed cases and eight deaths have been reported. A stay-at-home home order for all non-essential workers is in effect until May 15. Infection locations: Confirmed or suspected cases have been reported in multiple regions and municipalities. Travel restrictions: The country’s borders remain closed until further notice and internal restrictions are in place. Uruguay Current situation: 606 confirmed cases and 15 deaths have been reported. Officials have urged people to stay at home and maintain social distancing. Infection locations: Confirmed cases have been reported in Salto, Colonia, Soriano, Flores, Rio Negro, Paysandu, Artigas, Montevideo, Canelones, Lavalleja, Maldonado, Rocha, San Jose and Durazno departments. Montevideo is the most affected. Travel restrictions: An entry ban for foreign travelers is currently in effect, with few exceptions. In addition, passengers arriving from WHO declared risk or symptomatic countries, and those who have had contact with a coronavirus infected person, are subject to a mandatory 14-day quarantine. Direct flights to and from Europe and the U.S. have been suspended. The border with Argentina has been closed.
Virus Factsheet Key aspects of the novel 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 published by the CDC suggests a median incubation period of 4.2 days.
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Severity: Most people display relatively mild symptoms. Current estimates suggest that about 15% progress to severe disease with 4% becoming critical, including pneumonia and respiratory failure. The crude mortality ratio (number of reported deaths divided by reported cases) is between 3-4%, with the infection mortality rate (number of reported deaths divided by number of infections) expected to be lower. 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. According to a recently published CDC report covering the week ending April 18, the overall cumulative hospitalization rate in the U.S. is 29.2 per 100,000 people, with the highest rates observed in people over the age of 65 year (95.5 per 100,000) and those between the ages of 50-64 (47.2 per 100,000).
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Transmissibility: The virus is human transmissible. Recent research supports asymptomatic and pre-symptomatic spread (i.e. those infected can transmit the virus before they have developed symptoms), and that the virus behaves similarly to the flu, although it spreads more efficiently. Preliminary data suggests that those infected are most contagious around the time that symptoms first appear rather than later stages of the disease. 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 2 to 2.5, although some teams have placed this number higher.
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Routes of transmission are believed to include respiratory droplets and close physical contact. There is also evidence 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.
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According to the WHO, there is no evidence that those who have recovered from COVID19 and have antibodies are protected from reinfection.
Treatment: More than 100 drugs are being tested for their effectiveness, but there has been no clear breakthrough in finding a treatment for the disease. This past week, the WHO has launched a new global fundraising initiative for vaccine research, treatment and tests. The only proven available treatment for the disease is standard supportive care.
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 pandemic continues to take a toll on global markets. 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. In the United States, a $2.2 trillion rescue package was approved by the government on March 27. Other stimulus packages have been introduced or are currently under consideration in several other countries in an effort to assist hard-hit workers, businesses and healthcare systems. However, the economic impact of the virus is continuing to make its negative mark around the world. According to recently released statistics, in the first quarter of 2020 China recorded a 6.8% drop in GDP, the country’s first contraction since the mid-1970s and a sign of the global economic challenges ahead. The IMF has predicted that the COVID-19 pandemic will result in the worst economic downturn since the Great Depression and a recession “far worse” than the 2008 financial crisis. Among other downside risks, it has warned that the economic fallout could result in renewed social unrest in some countries, especially those where government policies to mitigate the spread of COVID-19 are considered to be insufficient, unfair or when such policies are withdrawn. Whether planning to mitigate the heightened medical or business risk environment, companies — especially 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 are adopting various policies in response to the outbreak, including the following: ▪
Restricting all non-essential international travel.
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Allowing flexible working arrangements, including working from home.
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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.
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Mandating that employees presenting flu-like symptoms obtain a diagnosis before returning to work.
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Some companies in badly affected countries have introduced controls at work, including carrying out fever checks on employees at entrances and restricting guest access to company premises.
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A large number of major multinational corporations and retailers 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 non-essential travel to all global destinations. Carefully considering the risk of travel within the United States, especially to areas with high rates of infection, has also been advised. If traveling, you are recommended to: ▪
Avoid contact with sick people.
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Discuss travel to with your health care provider. Older adults and travelers with underlying health issues may be at risk for more severe disease.
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Avoid animals (alive or dead), animal markets and products that come from animals (such as uncooked meat).
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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 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.
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Avoid contact with others.
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Do not travel while sick.
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Cover your mouth and nose while sneezing with a sleeve or tissue, not with the hands.
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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.
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
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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.
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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.
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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.
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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 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.
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Provide tissues and no-touch disposal receptacles for use by employees.
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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.
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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.
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No additional disinfection beyond routine cleaning is recommended at this time.
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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.
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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.
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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.
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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.
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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.
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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
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Alternate Phone: (866) 943-8892
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