The Center for Disease Control and Prevention (CDC) is providing health officials around the world with situational updates and guidance on the outbreak of the novel coronavirus, which was first identified in the Chinese city of Wuhan on New Year’s Eve.
Coronaviruses were first described in the 1960s and derive their name for their characteristic appearance under electron microscopes, where they resemble a royal crown or solar corona. Coronaviruses cause diseases in mammals and birds, with symptoms of diarrhea in farm animals such as pigs and cows and respiratory symptoms in birds. The lethal infection of humans has been rare historically.
Since the 2019 novel coronavirus (2019-nCoV) first emerged at the end of December, there have been 570 cases of people developing a pneumonia-like respiratory illness. There have been 553 confirmed illnesses and 17 fatalities reported in mainland China—a three percent fatality rate. Cases have now been confirmed in Thailand, Japan, South Korea, Taiwan, Vietnam, Singapore, Saudi Arabia and the United States. Possible cases are being investigated in Canada, Australia and the United Kingdom.
Though scientists had thought that the virus could spread only from animal to person, evidence has emerged that person-to-person infection is occurring, though authorities still surmise that such infections are limited. The World Health Organization (WHO) has delayed declaring an international emergency, though it is reconsidering the matter again today.
Dr. Didier Houssin, the chair of an emergency committee convened by WHO, told a press conference yesterday that it was “too early to consider that this event is a public health emergency of international concern.” WHO Director General Tedros Adhanom Ghebreyesus told reporters in Geneva: “Our team is on the ground in China as we speak, working with local experts and officials to investigate the outbreak and get more information.”
Chinese authorities moved this week to effectively lock down and isolate Wuhan, a city of more than 11 million people and the seventh most populous Chinese city. They have canceled planes and trains leaving the city and suspended local transportations such as buses and subways. The news of these measures has inundated Chinese social media.
The virus has emerged on the eve of the Chinese New Year, which falls on January 25. Hundreds of millions of people travel to visit families across China and abroad. According to Xinhuanet, “there will be three billion trips during the travel rush from January 10 to February 18 for family reunions and travel.” Such a mass movement could make the outbreak an international pandemic.
Concerns about the virus’s potential to mutate and become more infective and virulent have senior Chinese health officials extremely uneasy, leading to the drastic measures before the holiday commences. The experiences of 2003 remain fresh, when the Severe Acute Respiratory Syndrome (SARS) virus, also known as the Asian Avian Flu, spread across 32 countries, with over 8,000 cases and 800 deaths reported. SARS was the first occurrence of a coronavirus where human-to-human transmission was documented.
Additionally, in September 2012, the Middle East Respiratory Syndrome (MERS) epidemic germinated in Saudi Arabia and spread to 27 countries. The epidemiologic investigation led to two slaughterhouses where camels were slaughtered. Saudi Arabia imports thousands of camels from African nations, which were found infected with MERS. The virus was found on meat destined for supermarkets.
Human-to-human transmission of MERS was first reported in May 2013 in France. However, researchers noted that the virus spread slowly among humans, suggesting a regression in its virulence. By the end of October of 2013, Saudi Arabia had reported 124 cases, with a high fatality rate of 52 deaths. The disease itself has since entrenched itself in human communities. As of December 2019, WHO has confirmed 2,468 cases of MERS infection, with 851 fatalities.
According to WHO China, the outbreak of the new SARS-related 2019-nCoV virus was first recognized on December 31, 2019, when it was informed of cases of pneumonia-like illness of an unknown vector in Wuhan. By January 3, 44 cases had been identified. On January 11, the National Health Commission China confirmed that the epicenter of the disease had been traced to a seafood market in the city. In less than three weeks, the virus has spread across China and internationally.
The first confirmed fatality was a 61-year-old man, a regular shopper at the seafood market where vendors sold processed meats and live animals such as donkeys, sheep, camels, fox, badgers, hedgehogs and snakes. Authorities believe that the narrow corridors of the market and tight stalls provided the ideal opportunity for this outbreak. Incidentally, researchers had discovered that SARS came from a population of bats endemic in China’s Yunnan province. However, experts have yet to identify the animal species that enabled the Wuhan coronavirus to spread.
Wuhan is a major travel hub in China, with more than 30,000 people flying out on an average day. Nearly 6,000 foreign-invested enterprises from at least 80 countries are operating in city. Its major industries include optoelectronic, automobile manufacturing, iron and steel manufacturing, pharmaceutical and biologic engineering. With the suspension of transportation and the ban on gathering, tens of thousands of workers could be laid off.
The epidemic crisis has exacerbated existing social tensions. Many residents of Wuhan had heard of the outbreaks in Hong Kong before they were informed of the developments in their city. Through social media, people are asking family living abroad of news of events. On the Chinese microblogging website, one user wrote: “If the government wants us to trust them, they should be trustworthy, first. If we have lost confidence in them, the government needs to reflect on itself instead of shutting people up.”
Chinese authorities have extended the lockdown in Wuhan to several nearby cities. In Beijing, major Chinese New Year festivities that attract large crowds have been cancelled. Such a level of containment is unprecedented in modern history and questions have been raised as to the real effectiveness of such draconian measures.
James G. Hodge Jr., the director of the Center for Public Health Law and Policy at Arizona State University, told the New York Times yesterday that quarantines are effective when they isolate those infected or suspected of infection. Instead, he commented, “the Chinese authorities have drawn a line around the city and said, ‘No-one in and no-one out.’ That type of thing is obviously an excessive response.”
The Chinese government, however, is taking such extreme measures primarily to calm corporate investors, as concerns are being raised in financial markets about the implications of the epidemic for China’s economic growth.