Daily risk assessment on COVID-19, 27 February 2020

Risk assessment

The risk associated with COVID-19 infection for people in the EU/EEA and UK is currently considered to be low to moderate

This assessment is based on the following factors:

  • With the exception of a number of cases reported in several regions in Italy, most cases reported in the EU/EEA and UK so far have clearly established epidemiological links; contact tracing measures have been in place to contain further spread. Extraordinary public health measures have been implemented in northern Italy, and strong efforts are being made to identify, isolate and test contacts in order to contain the outbreak. The probability of further transmission in the EU/EEA and the UK is considered to be  high, but  with a high level of uncertainties with several unpredictable factors and a situation that is still evolving.
  • The possibility of new introductions from other countries outside China into the EU/EEA appears to be increasing as the number of countries reporting cases keeps going up. A comprehensive list of countries reporting cases worldwide can be found here. This also increases the possibility of cases being introduced by travellers from other countries outside China to the EU/EEA and UK.
  • The impact of sustained transmission in the EU/EEA would be moderate to high, especially for elderly populations with comorbidities, given that the reported case severity is high among these groups.

The risk of the occurrence of similar clusters, similar to the ones in Italy, associated with COVID-19 in other countries in the EU/EEA and the UK is currently considered to be moderate to high

This assessment is based on the following factors:

  • The current event in Italy indicates that local transmission may have resulted in several clusters for which an epidemiological link to areas where ongoing transmission is presumed, was not apparent. The accumulated evidence from clusters reported in the EU/EEA and the UK indicates that once imported, the virus causing COVID-19 can transmit rapidly. It is plausible that a proportion of transmissions occur from cases with mild symptoms that do not provoke healthcare-seeking behaviour. The increases in cases and the number of countries outside China reporting those cases increases the potential routes of importation of the infection into the EU/EEA and the UK.
  • The impact of such clusters in the EU/EEA would behigh, especially if hospitals were affected and a large number of healthcare workers had to be isolated. The impact on vulnerable groups within affected hospitals or healthcare facilities is considered to be severe, in particular for the elderly.
  • The rigorous public health measures that were implemented immediately after identifying the Italian COVID-19 cases will reduce the probability of further spread.

The risk for people from the EU/EEA and the UK travelling/resident in areas with presumed community transmission is currently high

This assessment is based on the following factors:

  • The overall number of reported cases in areas with community transmission is high or increasing. However, there are significant uncertainties regarding transmissibility and under-detection, particularly among mild or asymptomatic cases.
  • For travellers/residents, the impact of one or more infections is considered high, especially for elderly populations with comorbidities, because the reported case severity is high in these groups. The impact will also depend on the capacity and availability of healthcare during the epidemic.

The risk for healthcare systems capacity in the EU/EEA and the UK during the peak of the influenza season is low to moderate

This assessment is based on the following factors:

  • As the number of reported COVID-19 cases in the EU/EEA and the UK remains low, the probability of widespread infection remains low during the peak of the 2019–2020 influenza season. The majority of countries reported widespread influenza activity for week 7/2020, but the proportion of specimens tested positive in sentinel surveillance is slightly decreasing; some EU/EEA countries might have already moved past the peak period of high influenza circulation. For the latest influenza update see the joint ECDC-WHO/Europe weekly influenza update.
  • If a significant increase in COVID-19 cases were to coincide with a high level of influenza activity, the potential impact on healthcare systems would be moderate to high. The increased number of cases would require additional resources for testing, case management, surveillance, and contact tracing. Increased transmission could result in further pressure on healthcare systems. This situation would be exacerbated should a substantial number of healthcare workers become infected.

Previous risk assessments

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Threat assessment brief: Outbreak of novel coronavirus disease 2019 (COVID-19): Situation in Italy

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Risk assessment: Outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): increased transmission beyond China – fourth update

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Risk assessment: Outbreak of acute respiratory syndrome associated with a novel coronavirus, China: first local transmission in the EU/EEA − third update

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Risk assessment: outbreak of acute respiratory syndrome associated with a novel coronavirus, China; First cases imported in the EU/EEA; second update

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Risk assessment: Outbreak of acute respiratory syndrome associated with a novel coronavirus, Wuhan, China; first update

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Sources of updated information on COVID-19 in the EU/EEA and the UK

Case definition for EU surveillance of COVID-19, as of 25 February 2020

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