A cluster of respiratory illness, originating in the Chinese province of Hubei in December, has health officials on high alert around the world. In January, the causative agent of the disease was found to be a novel coronavirus, dubbed SARS-CoV-2. It has now infected more than 85,000 people and claimed over 2,900 lives, with signs of a slowdown in China, but outbreaks of the disease taking hold in Italy, South Korea and Japan. Saturday, Feb. 29, brought news of the first confirmed death in the US, a man in the Seattle area, according to the Washington State Department of Health.
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The number of cases and deaths seems to be slowing in mainland China, with only 439 new cases and 29 reported deaths coming on Feb. 27. However, the spread of the virus appears to be gaining momentum outside of China. At least 56 countries have confirmed infections. Cases in Italy jumped to over 1,000 on Feb. 29, while South Korea is reporting over 3,000 infections.
The CDC has warned people in the US to prepare for an outbreak, suggesting the virus is likely to spread through the community. “We are asking the American public to work with us to prepare for the expectation that this is going to be bad,” said Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases.
In a press conference Feb. 26, President Donald Trump reiterated the risk to Americans remains low. “The No. 1 priority from our standpoint is the health and safety of the American people,” he said. He noted of the original 15 US cases, one remains in hospital and is “pretty sick,” with 14 others either fully recovered or in recovery. He also announced Vice President Mike Pence will coordinate the response to the virus.
The situation continues to evolve as more information becomes available. We’ve collated everything we know about the novel virus, what’s next for researchers and some of the steps you can take to reduce your risk.
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What is a coronavirus?
Coronaviruses belong to a family known as Coronaviridae, and under an electron microscope they look like spiked rings. They’re named for these spikes, which form a halo or “crown” (corona is Latin for crown) around their viral envelope.
Coronaviruses contain a single strand of RNA (as opposed to DNA, which is double-stranded) within the envelope and, as a virus, can’t reproduce without getting inside living cells and hijacking their machinery. The spikes on the viral envelope help coronaviruses bind to cells, which gives them a way in, like blasting a door open with C4. Once inside, they turn the cell into a virus factory — the RNA and some enzymes use the cell’s molecular machinery to produce more viruses, which are then shipped out of the cell to infect other cells. Thus, the cycle starts anew.
Typically, these types of viruses are found in animals ranging from livestock and household pets to wildlife such as bats. Some are responsible for disease, like the common cold. When they make the jump to humans, they can cause fever, respiratory illness and inflammation in the lungs. In immunocompromised individuals, such as the elderly or those with HIV-AIDS, such viruses can cause severe respiratory illness, resulting in pneumonia and even death.
Extremely pathogenic coronaviruses were behind the diseases SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome) in the last two decades. These viruses were easily transmitted from human to human but were suspected to have passed through different animal intermediaries: SARS was traced to civet cats and MERS to dromedary camels. SARS, which showed up in the early 2000s, infected more than 8,000 people and resulted in nearly 800 deaths. MERS, which appeared in the early 2010s, infected almost 2,500 people and led to more than 850 deaths.
On Feb. 11, the WHO named the new disease COVID-19. “Having a name matters to prevent the use of other names that can be inaccurate or stigmatizing,” Tedros Adhanom Ghebreyesus, director-general of the WHO, said during a briefing. “It also gives us a standard format to use for any future coronavirus outbreaks.”
The Coronavirus Study Group, part of the International Committee on Taxonomy of Viruses, was responsible for naming the novel coronavirus itself. According to a preprint paper uploaded to bioRxiv on Feb. 11, the virus will be known as SARS-CoV-2. The group “formally recognizes this virus as a sister to severe acute respiratory syndrome coronaviruses (SARS-CoVs),” the species responsible for the SARS outbreak in 2002-2003. The virus itself was originally given a placeholder name of “2019-nCoV.”
To avoid confusion:
The novel coronavirus is officially named SARS-CoV-2.
The disease caused by SARS-CoV-2 is officially named COVID-19.
Where did the virus come from?
The virus appears to have originated in Wuhan, a Chinese city about 650 miles south of Beijing that has a population of more than 11 million people. The Huanan Seafood Wholesale Market, which sells fish, as well as a panoply of meat from other animals, including bats, snakes and pangolins, was implicated in the spread in early January.
Prestigious medical journal The Lancet published an extensive summary of the clinical features of patients infected with the disease stretching back to Dec. 1, 2019. The very first patient identified had not been exposed to the market, suggesting the virus may have originated elsewhere and been transported to the market, where it was able to thrive or jump from human to animal and back again. Chinese authorities shut down the seafood market on Jan. 1.
Markets have been implicated in the origin and spread of viral diseases in past epidemics, including SARS and MERS. A large majority of the people so far confirmed to have come down with the new coronavirus had been to the Huanan Seafood marketplace in recent weeks. The market seems like an integral piece of the puzzle, but researchers continue to test and research the original cause.
An early report, published in the Journal of Medical Virology on Jan. 22, suggested snakes were the most probable wildlife animal reservoir for SARS-CoV-2, but the work was soundly refuted by two further studies just a day later, on Jan. 23.
Here’s a study refuting the evidence for the snake as a #coronavirus reservoir. Suggests that the closest coronavirus relatives are found in bats (bats were also considered the reservoir for SARS in 2003)https://t.co/gRHWIdwMFX
“We haven’t seen evidence ample enough to suggest a snake reservoir for Wuhan coronavirus,” said Peter Daszak, president of nonprofit EcoHealth Alliance, which researches the links between human and animal health.
“This work is really interesting, but when we compare the genetic sequence of this new virus with all other known coronaviruses, all of its closest relatives have origins in mammals, specifically bats. Therefore, without further details on testing of animals in the markets, it looks like we are no closer to knowing this virus’ natural reservoir.”
Another group of Chinese scientists uploaded a paper to preprint website biorXiv, having studied the viral genetic code and compared it to the previous SARS coronavirus and other bat coronaviruses. They discovered the genetic similarities run deep: The virus shares 80% of its genes with the previous SARS virus and 96% of its genes with bat coronaviruses. Importantly, the study also demonstrated the virus can get into and hijack cells the same way SARS did.
The ant-eating pangolin, a small, scaled mammal, has also been implicated in the spread of SARS-CoV-2. According to the New York Times, it may be one of the most trafficked animals in the world and it was sold at the Huanan Seafood Market. The virus likely originated in bats but may have been able to hide out in the pangolin, before spreading from that animal to humans.
All good science builds off previous discoveries — and there is still more to learn about the basic biology of SARS-CoV-2 before we have a good grasp of exactly which animal vector is responsible for transmission — but early indications are the virus is similar to those seen in bats and likely originated from them.
How many confirmed cases have been reported?
Authorities have confirmed more than 85,000 cases as of Feb. 29.
On Feb. 12, Chinese health authorities reported a jump in the amount of cases and deaths in Hubei, the epicenter of the outbreak. Over 13,300 new cases were recorded in Hubei alone, an increase of 700% over the previous day. Chinese authorities had adopted a new clinical method for confirming cases, which sees them add “clinically diagnosed cases” to the count, potentially helping patients receive treatment sooner, according to CNN.
In the US, 60 cases have been confirmed. President Trump spoke on Feb. 26 and said of the original 15 infected individuals, eight are recovering at home while one remains in hospital and is “pretty sick.” The remaining individuals are recovering or have already recovered. On Feb. 26, The Washington Post reported the first US case of unknown origin in Northern California. The infected individual did not return from a foreign country and did not have contact with a confirmed case, the Post said.
The number of discharged patients has climbed to over 39,000.
A breakdown of the top 10 countries, as of Feb. 29, is below:
You can track the spread of the virus across the globe with this handy online tool, which is collating data from a number of sources including the CDC, the WHO and Chinese health professionals.
On Feb. 7, Li Wenliang, the 34-year-old Chinese doctor who spoke out about the rising cases of pneumonia in an online chat room during the early days of the outbreak, died as a result of COVID-19. A day later, the first known American death from the illness was announced: a US citizen in Wuhan, and on Feb. 29, the first death was confirmed inside US borders.
Iran has currently reported 43 deaths, the most outside of mainland China. South Korea has reported 16 deaths and a cluster of illnesses in northern Italy has caused 29.
The death toll surpassed that of the SARS epidemic (severe acute respiratory syndrome) on Feb. 8. That outbreak killed 774 people. On Feb. 9, the death toll surpassed 900, overtaking the death toll of MERS (Middle East respiratory syndrome), a similar coronavirus that has killed 858 people since 2012.
Those two viruses have a higher death rate, with SARS-CoV killing about 10% of those infected and MERS-CoV killing about 34%, whereas this virus, SARS-CoV-2, hovers at around 2% to 3%.
The death toll still pales in comparison to that of influenza — the flu — which, through the first four weeks of 2020, had killed 1,210 in the US alone, according to the CDC.
A pedestrian in the city of Wuhan, China. The virus appears to have originated in Wuhan’s Huanan Seafood Wholesale Market.
Getty Images
How do we know it’s a new coronavirus?
The Chinese Center for Disease Control and Prevention dispatched a team of scientists to Wuhan to gather information about the new disease and perform testing in patients, hoping to isolate the virus. Their work, published in the New England Journal of Medicine on Jan. 24, examined samples from three patients. Using an electron microscope, which can resolve images of cells and their internal mechanics, and studying the genetic code, the team were able to visualize and genetically identify the novel coronavirus.
Understanding the genetic code helps researchers in two ways: It allows them to create tests that can identify the virus from patient samples, and it gives them potential insight into creating treatments or vaccines.
Additionally, the Peter Doherty Institute in Melbourne, Australia, was able to identify and grow the virus in a lab from a patient sample. They announced their discovery on Jan. 28. This is seen as one of the major breakthroughs in developing a vaccine and provides laboratories with the capability to both assess and provide expert information to health authorities and detect the virus in patients suspected of harboring the disease.
How does the coronavirus spread?
This is one of the major questions researchers are still working hard to answer. The first infections were potentially the result of animal-to-human transmission, but confirmation that human-to-human transmission was obtained in late January.
The University of Minnesota’s Center for Infectious Disease Research and Policy reported that health workers in China had been infected with the virus in late January. During the SARS epidemic, this was a notable turning point, as health workers moving between countries were able to help spread the disease.
“The major concern is hospital outbreaks, which were seen with SARS and MERS coronaviruses,” said C. Raina MacIntyre, a professor of global biosecurity at the University of New South Wales. “Meticulous triage and infection control is needed to prevent these outbreaks and protect health workers.”
A handful of viruses, including MERS, can survive for periods in the air after being sneezed or coughed from an infected individual. Although recent reports suggest the novel coronavirus may be transmitted in this way, the Chinese Center for Diseases Control and Prevention have reiterated there is no evidence for this. Writing in The Conversation on Feb. 14, virologists Ian Mackay and Katherine Arden explain “no infectious virus has been recovered from captured air samples.”
Hong Kong closed many public facilities on Jan. 28 and has prevented traveling between mainland China. The US announced sweeping border control measures at 20 ports of entry. Esports tournaments have been postponed, Shanghai and Hong Kong Disneyland has closed, Olympic women’s soccer tournaments have been moved entirely, and McDonald’s has shuttered thousands of locations across China where the virus is spreading.
International airlines have suspended flights to and from mainland China, and cruise ships have also been denying passengers who hold China, Hong Kong and Macau passports, regardless of residency, and barring those who have traveled to China, Hong Kong or Macau in the 15 days prior to boarding; and anyone who has come within six feet of someone from China, Hong Kong or Macau 15 days prior; and anyone with fever or low blood oximetry.
Speaking to the media on Feb. 17, Shigeru Omi, the chief director of the Japan Community Health Care Organization, suggested the Olympics could be disrupted or even cancelled, depending on how the virus continues to spread and evolve over the next few months.
“Whether the virus is under control by the time of the Olympics is anyone’s guess,” he said.
An electron microscopy image of the coronavirus that causes SARS.
Getty Images
How infectious is coronavirus?
A widely shared Twitter thread by Eric Feigl-Ding, a Harvard University epidemiologist, suggests the new coronavirus is “thermonuclear pandemic level bad” based on a metric known as the “r nought” (R0) value. This metric helps determine the basic reproduction number of an infectious disease. In the simplest terms, the value relates to how many people can be infected by one person carrying the disease. It was widely criticized before being deleted.
Infectious diseases such as measles have an R0 of 12 to 18, which is remarkably high. The SARS epidemic of 2002-2003 had an R0 of around 3. A handful of studies modeling the COVID-19 outbreak have given a similar value with a range between 1.4 and 3.8. However, there is large variation between studies and models attempting to predict the R0 of novel coronavirus due to the constantly changing number of cases.
In the early stages of understanding the disease and its spread, it should be stressed these studies are informative, but they aren’t definitive. They give an indication of the potential for the disease to move from person-to-person, but we still don’t have enough information about how the new virus spreads.
“Some experts are saying it is the most infectious virus ever seen — that is not correct,” MacIntyre said. “If it was highly infectious (more infectious than influenza as suggested by some) we should have seen hundreds, if not thousands of cases outside of China by now, given Wuhan is a major travel hub.”
China has suggested the virus can spread before symptoms present. Writing in The Conversation on Jan. 28, MacIntyre noted there was no evidence for these claims so far but does suggest children and young people could be infectious without displaying any symptoms. This also makes airport screening less impactful, because harboring the disease but showing no signs could allow it insidiously spread further.
As the virus has continued to spread, it’s easy to get caught up in the fear and alarmism rampantly escalating through social media. There is misinformation and disinformation swirling about the effects of the disease, where it’s spreading and how. Experts still caution the virus appears to be mild, especially in comparison to infections by other viruses, like influenza or measles, and markedly lower death rates than previous coronavirus outbreaks.
On Jan. 30, the World Health Organization declared a public health emergency of international concern over the coronavirus outbreak. Tedros Adhanom Ghebreyesus, the director-general of the WHO, said the organization is working with national and international public health partners to get the outbreak under control.
The WHO also issued recommendations to prevent the spread of the virus and ensure a “measured and evidence-based response.”
“To the people of #China & to all of those around the ?who have been affected by this outbreak, we want you to know that the ? stands with you”-@DrTedros#2019nCoV
The new coronavirus causes symptoms similar to those of previously identified disease-causing coronaviruses. In currently identified patients, there seems to be a spectrum of illness: A large number experience mild pneumonia-like symptoms, while others have a much more severe response.
As the disease progresses, patients also come down with pneumonia, which inflames the lungs and causes them to fill with fluid. This can be detected by an X-ray.
Is there a treatment for coronavirus?
Coronaviruses are hardy organisms. They’re effective at hiding from the human immune system, and we haven’t developed any reliable treatments or vaccines to eradicate them. In most cases, health officials attempt to deal with the symptoms.
“There is no recognized therapeutic against coronaviruses,” Mike Ryan, executive director of the WHO Health Emergencies Programme, said during the Emergency Committee press conference on Jan. 29. “The primary objective in an outbreak related to a coronavirus is to give adequate support of care to patients, particularly in terms of respiratory support and multi-organ support.”
That doesn’t mean vaccines are an impossibility, however. Chinese scientists were able to sequence the virus’ genetic code incredibly quickly, giving scientists a chance to study it and look for ways to combat the disease. According to CNN, researchers at the US National Institutes of Health are already working on a vaccine, though it could be a year or more away from release.
Notably, SARS, which infected around 8,000 people and killed around 800, seemed to run its course and then mostly disappear. It wasn’t a vaccine that turned the tide on the disease but rather effective communication between nations and a range of tools that helped track the disease and its spread.
“We learnt that epidemics can be controlled without drugs or vaccines, using enhanced surveillance, case isolation, contact tracking, PPE and infection control measures,” MacIntyre said.
A handful of organizations and research institutes have started work on vaccines, according to Global Times.
In addition, China is running clinical trials on the experimental antiviral drug remdesivir, which was originally developed to treat Ebola. Remdesivir was also given to a US patient in Washington state whose symptoms worsened. In that case, doctors made a “compassionate use” request to the Food and Drug Administration. Those allow people to try experimental drugs outside of clinical trials, usually in emergency situations.
Developing new drugs requires time and resources, so “while you’re waiting for the new miracle drug, it’s worthwhile looking for existing drugs that could be repurposed” to treat new viruses, Stephen Morse, a professor at Columbia University’s Mailman School of Public Health, told Live Science.
Scientists are racing to develop a vaccine against the new #coronavirus. China’s CDC, Shanghai-based Stemirna Therapeutics Co., US’ Johnson & Johnson, Moderna Therapeutics, and Inovio Pharmaceuticals are all working quickly to develop a vaccine. pic.twitter.com/bwiUPvSWJ0
With confirmed cases now seen across the globe, it’s possible that SARS-CoV-2 may spread much further afield than China. The WHO recommends a range of measures to protect yourself from contracting the disease, based on good hand hygiene and good respiratory hygiene — in much the same way you’d reduce the risk of contracting the flu. The novel coronavirus does spread and infect humans slightly differently to the flu, but because it predominantly affects the respiratory tract, the protection measures are quite similar.
Meanwhile, the US State Department on Jan. 30 issued a travel advisory with a blunt message: “Do not travel to China.” An earlier warning from the CDC advised people to “avoid nonessential travel.”
A Twitter thread, developed by the WHO, is below.
You may also be considering buying a face mask to protect yourself from contracting the virus. You’re not alone — stocks of face masks have been selling out across the world, with Amazon and Walmart.com experiencing shortages. Reporting from Sydney in January, I found lines at the pharmacy extending down the street.
The risk of contracting the virus outside of China remains low, but if you’re considering buying a mask, you’ll want to know exactly which face mask you should be looking for. Disposable masks can protect any large droplets from entering the mouth or nasal passage but a respirator mask is far more effective. CNET’s Wellness team has put together a comprehensive guide to which masks you should buy.
Originally published in January and updated frequently with new developments.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
