Coronavirus More Infectious Than Suspected; China Expands Quarantine

Some 50 million people in China were under quarantine as infections by the novel coronavirus first discovered in Wuhan accelerated rapidly, and new research suggested that it was far more infectious than previously thought.

China’s Minister of the National Health Commission acknowledged that “the epidemic had entered a grave and complex period,” as the country reported 2858 cases of the 2019-nCoV virus on Monday – three times that of Friday – along with 81 deaths.

World Health Organization Director General Dr Tedros Adhanom Ghebreyesus meanwhile rushed to Beijing to confer with authorities on their outbreak control efforts, and the Chinese sent top government officials to Wuhan – the epicentre of the outbreak.

Li Keqiang, Premier of the State Council of China, visited Wuhan on Monday to inspect and guide the outbreak control work.

A dozen countries outside of China had also confirmed cases of the novel coronavirus 2019-nCoV, including new confirmed cases in France, Canada and Australia, as well as in Nepal and Malaysia. Singapore, Japan, Taiwan and Thailand had already reported cases last week. As of Monday, more than 5000 suspected cases await clarification around the world, including 2 suspected cases in Zurich, Switzerland.

On Friday, a team of UK and US researchers published a preliminary research paper estimating that the real number of cases in Wuhan, a city of 10 million people at the epicentre of the outbreak, could be as high as 11,341 as of 21 January – in contrast to the official number of 440 on 23 January.

The paper, which has not yet undergone peer review, appeared on a health sciences preprint server, Medrxiv. Since last Tuesday, the number of diagnosed coronavirus patients in Wuhan has virtually doubled.

Their model further forecast that within 14 days, those infected could exceed 190,000 in Wuhan alone.

The model estimates that the virus’s reproduction number – e.g. the number of people one person can infect before being contained– relatively high at 3.6-4, is comparable to the infectious potential of the 2002-03 SARS coronavirus, which was 2-5. However, SARS was also deadlier with a case-fatality rate around 9%, while the current virus has a mortality rate of around 2%.

Other recent estimates have been more conservative. A team of  Harvard researchers estimated the viral reproductive number at 2-3.3 in a preliminary assessment also published over the weekend, while WHO officials had on Thursday estimated it at 1.4- 2.5.

However, there was broad scientific agreement that a much larger reservoir of people were becoming infected, and rapidly transmitting the virus, without necessarily showing symptoms themselves, as per another study published in The Lancet by a Chinese research team. The team, which examined data from the first 41 patients that had been admitted to hospitals in Wuhan, estimated that the virus incubation period is only 3-6 days and it can cause serious pneumonia-like symptoms even in healthy people, and not just older individuals with underlying health issues. A number of the

Chinese officials acknowledge grave concerns

The researcher’s concerns were echoed by the Chinese Minister of the National Health Commission, Ma Xiaowei, who spoke Sunday at a press conference captured by the government-owned CCTV network.

“According to recent clinical data, the novel coronavirus seems to be more infectious,” Xiaowei said. “Currently the transmission of the epidemic is rather speedy which has posed some challenges and pressures on the prevention work. Experts have predicted that the epidemic has entered a rather grave and complex period.”

Ma further added that the epidemic was still in an “early and sporadic phase.” Therefore, given the increased pace of the outbreak, he predicted “it may last for some time.”

“It is likely that there will be a rise of the number of cases in the coming period,” warned Ma.

However, as stringent outbreak control measures implemented in the area around Wuhan and “top-level” public health emergency responses take effect throughout the country, “the epidemic intensity of the outbreak will go down.”

Such outbreak control measures include the expansion of travel restrictions to more cities over the weekend, with over 50 million Chinese citizens now under lockdown. By Monday, three military medical teams composed of some 450 doctors and nurses from Shanghai, Chongqing, and Xi’an had been deployed to Wuhan to help hospitals manage the overwhelming influx of patients.

Meanwhile, medical equipment companies ramped up production as demand for medical devices surged. Workers in over 30 factories around China worked through the annual Lunar New Year celebration to produce face masks, thermometers, and other tools for the outbreak response.

The national Chinese government increased funding for the outbreak response to approximately US $1.2 billion, according to a statement from the National Health Commission.

Coronavirus Outbreak in the Legacy of SARS:

As case numbers seem to double every day, a mixture of fear, solidarity, and hope permeate the lives of Chinese citizens over what is normally a celebratory holiday season.

One Wuhan resident currently abroad told HPW that the state of emergency imposed by this new coronavirus is giving citizens chilling flashbacks to life during the 2002-2003 SARS epidemic.

“My mom was isolated during the SARS period in 2003 for a month and a half. She didn’t have the virus, just some similar symptoms,” the person said. “I don’t have much memory of it since I was only 6, but my family keeps telling me how terrifying it was back then.”

“My parents are staying safely at home, mainly because they are the most vulnerable people that have the highest possibility to be infected. My dad currently has diabetes and high-blood pressure, and all the obesity-related diseases you can think of. Thus, it’s really dangerous for him in the current environment.

Added the person, “The most worried case is my aunt’s family, who are isolated at home because my aunt’s mother recently passed away from swine flu. It’s really terrifying given how close the timeframe is, so that’s why they chose to isolate themselves spontaneously in that way. My family was not aware of how bad the situation was when the government released the first news.”

Just this morning, the source said, a person in their aunt’s apartment complex was suspected of being sick with the coronavirus. Neighborhood committee members visited the person fully equipped in protective gear, but ultimately chose to isolate the person in their home rather than send them to the hospital.

“They did not sanitize the public area in the apartment complex at all,” the source protested.

Still, most people in Wuhan are “really behaving” and complying with the quarantine, and Chinese around the world have come together to participate in the emergency response.

Videos of whole apartment complexes singing “Wuhan, add oil!” – a common Chinese encouragement – in unison are trending on Weibo, China’s Twitter equivalent. Volunteer groups both in the country and abroad are banding together to send emotional and material support to the besieged city.

Said another Chinese citizen currently abroad who has participated in one of the many donation drives, “We just teamed up and fight for this, united all the resources we have, and donate them to Wuhan.”

Image Credits: China Government Network.