World Health Organization warns of global risk from coronavirus outbreak

Over the weekend, the fatalities attributed to the novel coronavirus outbreak—now named Covid-19 by the World Health Organization—surpassed the 774 that succumbed during the SARS epidemic in 2002–2003.

Though the number of new reported cases appears to have reached its apogee on February 4 and has been gradually declining, with 2,478 new confirmed cases on Tuesday morning, the number of people who have died continues to climb. A least 108 fatalities were reported yesterday.

People wearing masks, walk in a subway station, in Hong Kong [Credit: AP Photo/Kin Cheung]

The total number of confirmed cases globally currently stands at 44,789, with 1,112 attributable deaths—of which the vast majority have taken place in China’s Hubei province where the virus first emerged in the city of Wuhan.

Hubei has suffered the lion’s share of the misery and suffering. Some 11 million people in Wuhan and 60 million across the province have been living under conditions of a virtual lockdown since January 22, in a belated attempt by the Chinese authorities to contain the spread of the virus. Some 80 cities in 20 provinces, including Beijing and Shanghai, have travel restrictions and bans on public assemblies in place.

Though the unprecedented measures appear to have slowed the number of new cases in China, the WHO has cautioned against unguarded optimism. WHO Director-General Tedros Adhanom Ghebreyesus, having been unconcerned three weeks ago, made starkly ominous comments on Tuesday. “The virus is more powerful in bringing serious consequences than any terrorist attack,” he stated. “It’s not just the health issues; it’s a matter of economic, political and social upheavals…time is of the essence.” He indicated that the opportunity to limit the global spread of the virus was fading.

A WHO team of international experts arrived in Beijing on Monday to assist efforts to contain the epidemic. Dr. Bruce Aylward, a Canadian epidemiologist and emergency expert, is leading the group and its attempts to gain a better understanding of both the virus and China’s public health response. Specific questions include identifying the origin of the virus and appreciating its true severity. Dr. Aylward was involved in WHO’s response to the Ebola outbreak in West Africa.

Chinese authorities have sprung into action to shore up their credibility in the wake of public outrage over the death of Wuhan’s Doctor Li Wenliang, who was threatened for raising concerns about the virus in late December. Anger has also been fueled by delays in healthcare delivery and shortages of medical supplies. It is believed that as many as 1,000 medical workers have been infected due to both the delay in official warnings that a new virus had emerged and a lack of protective equipment.

Beijing has sent Chen Yixin, President Xi Jinping’s protégé and secretary-general of the Central Political and Legal Affairs Commission, the Communist Party’s top law enforcement body, to the epicenter of the coronavirus outbreak. Accompanying him was Wang Hejun, National Health Commission deputy director.

Wuhan University law professor Gin Qianhong commented: “The fight against the outbreak now requires more coordination with the military and police force, and Chen’s background might be useful. He used to be Wuhan’s party chief. Social stability consideration is also obvious. Resentment among patients, their family, and people’s lives affected by the virus and the city’s lockdown status is building.”

A special task force that is reviewing prevention efforts has summoned Wuhan deputy mayor Chen Xiexing and two district chiefs, Lin Wenshu and Yu Song, for questioning over their “negligence” in containing the outbreak as well as efforts to care for the afflicted. Local officials will most likely be scapegoated in order to divert from any role the national government played in blocking early public health warnings.

Nevertheless, Chinese President Xi is making rare admissions of political failings. After made a visit to a neighborhood near the Forbidden City, wearing a blue surgical mask, he somewhat candidly stated: “The outbreak of the coronavirus is a major test of the national disease control and prevention centers of all levels in the country. It has shown both the strength and many shortcomings of the system.”

The long-term economic impact will be enormous. Many corporations have chosen not to resume operations, due to the ongoing restrictions in many provinces and cities. Morgan Stanley wrote to its investors: “It’s uncertain whether factories could resume production this week amid local quarantine efforts and traffic control. Indeed, many authorities and enterprises at local levels are targeting February 17 or later to restart businesses, and the resumption is likely to be a phased approach.”

The delay in the resumption of work is expected to lead to part shortages and a domino effect in manufacturing industries around the globe that are interdependent with Chinese-based production. US Federal Reserve chairman, Jerome H. Powell, testified at the House Financial Services Committee on Tuesday: “We are closely monitoring the emergence of the coronavirus, which could lead to disruptions in China that spill over to the rest of the global economy.”

As to the question of how long the epidemic might persist, Dr. Ian Lipkin, Columbia University Professor of epidemiology, noted: “If we have an early spring, this should make a dramatic difference in the rate of acquisition of new infections. So, the dates to think about are the end of February and whenever the temperature begins to climb.” Viruses do not tolerate high heat and humidity, preferring cooler and drier conditions of winter and spring.

Beyond mainland China, the number of new cases remains low. However, concerns have been voiced in Hong Kong, Singapore and Thailand that the epidemic may spread widely, as cases among people who have never had contact with infected patients from China have now been diagnosed.

Dr. Amesh Adalja, an infectious disease specialist at the Johns Hopkins Center for Health Security, commented on the potential impact of the global spread of the virus. She noted: “The first wave will be particularly bad because we have an immunologically naïve population.”

The epidemic has a case fatality of around 2 percent at present, while demonstrating it is very contagious. To comprehend the implication of this figure, the 2009 H1N1 swine flu that originated in Mexico went on to infect over one billion people on the planet. Of these, at least 200,000 died, according to a WHO-sponsored study, with a case fatality of approximately 0.02 percent—100 times less than Covid-19.

In other words, should Covid-19 spread extensively beyond mainland China, the human cost, especially in countries whose populations have limited access to advanced healthcare, could be horrific.